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Although help-seeking research is useful to improve the quality of dementia care and mental health of care staff, most studies have focused on family caregivers. The details of help-seeking behavior among care staff remain unclear. This study investigated the features of help-seeking behavior among staff working in long-term care facilities. Two online surveys were conducted, targeting individuals working in long-term care facilities in Kinki Region, as well as general citizens who are users of crowdsourcing services across all regions of Japan. Four hypothetical difficult caregiving situations were developed to examine staff help-seeking behavior, including older people’s going-home behavior, care resistance, apathy, and depression. When confronted with difficult situations, participants responded regarding whether they sought help from other staff, the timing of help-seeking when they chose to seek help from others, and the level of burden to deal with the situations. A total of 505 participants (273 care staff and 232 general citizens) were analyzed. Two-way analysis of variance (ANOVA) revealed that the burden in all situations experienced by general citizens was higher than that among care staff. Three-way ANOVA also showed that excessive help-seeking styles were associated with difficult care situations. Finally, care staff engaged in help-seeking behavior more quickly than general citizens. The current findings showed that, compared to general citizens, care staff exhibited more frequent help-seeking behavior, which would be helpful to support problem-solving or alleviate the burden of care. Additional research is necessary to clarify the functions of help-seeking behavior in dementia care. [ABSTRACT FROM AUTHOR]

Background: Cognitive assessment through communication has been the focus of recent studies because the conventional cognitive tests are often considered invasive for older people. Although the Conversational Assessment of Neurocognitive Dysfunction is designed to assess cognitive function non‐invasively, inter‐rater reliability remains unclear. The current study investigated the Conversational Assessment of Neurocognitive Dysfunction's reliability. Methods: The Conversational Assessment of Neurocognitive Dysfunction was used by four clinical psychologists, who evaluated 38 older people with and without cognitive dysfunction. One clinical psychologist evaluated the assessment based on face‐to‐face communication with participants, while the other clinical psychologists evaluated it according to the audio data in the digital voice recorder. All clinical psychologists were blind to the results of other conventional cognitive tests and details surrounding participants' daily living activities. Results: The univariate correlation scores of the Conversational Assessment of Neurocognitive Dysfunction among evaluators ranged from 0.61 to 0.79, all of which were significant (P < 0.001). The intraclass correlation coefficient was 0.64 (P < 0.001, 95% CI: 0.53–0.79 for agreement) and 0.67 (P < 0.001, 95% CI: 0.45–0.77 for consistency). The Conversational Assessment of Neurocognitive Dysfunction score of all evaluators was significantly associated with conventional cognitive tests like the Mini‐Mental State Examination (P < 0.001). Conclusions: The findings suggested that the Conversational Assessment of Neurocognitive Dysfunction has moderate to good inter‐rater reliability and high concurrent validity as a cognitive assessment tool, and it would be useful in clinical practice. [ABSTRACT FROM AUTHOR]

Leukoaraiosis, a common ischaemic lesion diagnosed using magnetic resonance imaging (MRI), can influence driving safety performance (DSP). Most older drivers with leukoaraiosis are unaware of their affliction. Japan is a super-aged country, where preventing accidents caused by older drivers is an urgent national issue. We investigated the subcortical and periventricular leukoaraiosis regions that were most involved in DSP decline. The driving skills of 101 drivers (49 men, 52 women; mean age, 77.88 ± 3.77 years) without dementia were assessed by official driving instructors, using actual vehicles on a closed-circuit course. Parietal and occipital (but not frontal or temporal) leukoaraiosis volumes were significantly correlated with decreased DSP scores regardless of age, especially when turning right at intersections, which needs more attention than turning left because left-side driving is legally enforced in Japan. Occipital leukoaraiosis was also involved via a decline in dynamic visual cognitive function. MRI-based assessment of leukoaraiosis volume and localisation may enable the identification of older drivers prone to DSP deterioration. Risk factors for leukoaraiosis include smoking and lifestyle-related diseases such as hypertension. Thus, brain healthcare in patients with MRI-diagnosed leukoaraiosis may be particularly useful for the risk management of traffic accidents caused by the elderly in Japan. [ABSTRACT FROM AUTHOR]

Background: Being diagnosed with dementia is a confronting experience for any individual and their caregiver. However, a diagnosis provides opportunity for future preparation for management of the condition. This study investigated attitudes toward dementia and preferences for diagnosis among a sample of health service consumers in Japan.Methods: Participants were patients or accompanying support persons (n = 217) who visited the specialty outpatient clinic of four hospital departments. The survey was conducted using an iPad with answers sent automatically to a secure server. The survey included items about the participants' most feared diseases and the reasons behind those fears, estimates of dementia prevalence in Japan, and preferences regarding a diagnosis of dementia and the reasons for their preference.Results: The most feared disease was cancer (43.8 %), followed by dementia (18 %). Those selecting dementia most commonly reported practical, emotional and social impacts as the reasons why they most feared this condition. Almost all participants preferred to know the diagnosis of dementia as soon as possible for themselves, with significantly fewer preferring their spouse to know as soon as possible if they had dementia (95.9 % for self vs. 67.5 % for partner/spouse, p < 0.001). On average, participants estimated that 18.1 % of Japanese people are diagnosed with dementia by age 65, while they thought that 43.7 % of Japanese people are diagnosed with dementia by age 85.Conclusions: The findings highlight a need for community education about the significant impacts of dementia on the lives of individuals and their caregivers. People were more reluctant for their spouse to receive a diagnosis as soon as possible if they had dementia. Physicians should sensitively disclose diagnosis and ensure they involve both the patient and their relatives in discussions about diagnosis disclosure. [ABSTRACT FROM AUTHOR]

Aim: The purpose of the present study was to investigate the effect of cognitive decline on household spending. Methods: The panel data covered the years 2007–2009 and were taken from the Japanese Study of Aging and Retirement, with data extracted for 253 participants aged 65 years and over. Sociodemographic characteristics, functional status, depressive symptoms, and monthly household spending excluding spending for shelter (e.g. mortgage) were used in the analysis. Cognitive function was evaluated by delayed recall and serial 7s and represented by the sum of both scores. Changes in spending and cognitive function scores were calculated by subtracting 2007 scores from 2009 scores. Participants were divided into two groups: cognitive decline and no cognitive decline. The effect of cognitive decline on changes in household spending was estimated. Results: Although the cognitive decline group had more severe depressive symptoms than the no cognitive decline group in 2009, cognitive decline was the only factor related to change in household spending. Conclusion: The results imply that cognitive decline may cause a decline in household spending in older people. Focusing on changes in household spending behaviour might help detect cognitive impairment in older people. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To examine the direct and indirect relationships between the characteristics of people with dementia and caregivers associated with caregivers' quality of life. Background: Complex relationships exist among the factors associated with caregivers' quality of life. Design: This study was a retrospective cross‐sectional design. Methods: The data were retrospectively extracted from participants who had visited the Center for Diagnosis of Dementia at Kyoto Prefectural University of Medicine from April 2013–March 2016. The data search was conducted on 21 April 2017. In total, 110 people with dementia and their caregivers participated. The characteristics of people with dementia were evaluated in terms of cognitive function, basic and instrumental activities of daily living and neuropsychiatric symptoms. We also evaluated caregivers' quality of life, depressive symptoms and care burden. Path analysis was used to investigate direct and indirect relationships. Results: The path analysis revealed that care burden and depressive symptoms directly affected caregivers' quality of life. Furthermore, declines in instrumental activities of daily living among people with dementia indirectly affected caregivers' quality of life, while declines in cognitive function of people with dementia also indirectly affected caregivers' care burden and depressive symptoms. Conclusion: Caregiver quality of life was directly and indirectly affected by the characteristics of caregivers and people with dementia. The present findings provided evidence that factors related to both people with dementia and caregivers should be considered when nursing interventions are conducted. [ABSTRACT FROM AUTHOR]

This large-scale study including 2548 healthy adults with no clinical attention-deficit/hyperactivity disorder (ADHD) diagnosis intended to clarify the complex relationships between cerebral grey matter volumes (GMVs), ADHD traits, and driving safety behaviours. Path analysis of magnetic resonance imaging (MRI) results and questionnaires about ADHD traits and traffic crashes over the past decade revealed significant correlations of ADHD traits with different brain regions relevant to different cognitive functions. The left precuneus responsible for visuospatial cognition was the sole region correlated with all ADHD trait categories, suggesting it plays an important role in understanding driving safety and traffic crashes. For the first time, a strong relationship was found among regional GMVs, ADHD traits, and real-life traffic crashes. These insights into the complex interplay may inform the development of an effective intervention with MRI examination to prevent traffic crashes. Large-scale brain volumetric data may further open social applications of behaviour science and neuroimaging. [ABSTRACT FROM AUTHOR]

This study examines the socio-economic factors influencing public awareness of the adult guardianship and civil trust systems in Japan. The results of this study show that financial literacy is the most influential factor affecting knowledge of the adult guardianship and civil trust systems. Gender, age, living alone, income, and assets are also found to be related to knowledge about these systems, but they are not consistent. We argue that policy makers should emphasize financial literacy and conduct targeted promotion campaigns to help those living with dementia to continue to participate in and benefit from economic activities. [ABSTRACT FROM AUTHOR]

Objectives: Loneliness is considered to be a crucial factor in mental health of elderly people. However, the effects of loneliness on behavioral and psychological symptoms of dementia (BPSD) have not been fully examined. The aim of this study was to investigate whether loneliness in patients with dementia is related to BPSD. Methods: A total of 152 patients with dementia were assessed using the Neuropsychiatric Inventory (NPI‐12) and the revised University of California at Los Angeles (UCLA) loneliness scale. Spearman correlation analysis and Mann–Whitney U‐tests were used to examine factors associated with the revised UCLA loneliness scale. Logistic regression analysis with a forced entry method was performed to identify risk factors for BPSD. Results: The revised UCLA loneliness scale score was not significantly associated with age, years of education, mini‐mental state examination (MMSE) score, gender, living status, visual impairment, hearing impairment, and marital status. However, this score was a significant predictor of NPI delusion and hallucination subscale scores and Geriatric Depression Scale‐15 score. The MMSE score was a significant predictor of NPI anxiety and apathy subscale scores. Conclusions: Loneliness is a risk factor for BPSD, especially for depressive symptoms and psychosis. Paying attention to loneliness in patients with dementia will help medical staff to intervene in psychiatric symptoms of these patients at an early stage. [ABSTRACT FROM AUTHOR]

We investigated the effectiveness of simulation-based education in Focused Assessment with Sonography for Trauma (FAST) to increase the number of Emergency Medical Technicians (EMTs) capable of performing ultrasound examinations in vehicles under the guidance of a physician. Twenty-eight paramedics watched a 14-min video on the features of the ultrasound system, its use, and the scanning method for each part of the body. Each participant performed four FAST examinations using a portable ultrasound device, and the task performance was rated using the Task Specific Checklist (TSC) and Global Rating Scale (GRS). The time required for visualizing each examination site and each FAST was assessed. The mean time required for the first and fourth FAST was 144.6 ± 52.4 s and 90.5 ± 31.0 s, respectively. The time required for each test significantly decreased with repeated testing (p < 0.001). The time to complete FAST was significantly shortened for the pericardial cavity (33.4 ± 23.1/15.3 ± 10.6 s, p < 0.01), right thoracic cavity (25.2 ± 11.8/12.1 ± 8.3 s, p < 0.01), Morrison fossa (19.1 ± 10.8/10.8 ± 6.3 s, p < 0.05), and left thoracic cavity (19.0 ± 8.3/15.6 ± 8.3 s, p < 0.05). TSC and GRS scores were elevated, and all EMTs could obtain valid images. The combination of a brief video lecture and hands-on training significantly reduced the time required for FAST performance. Moreover, repeated practice enabled the EMTs to efficiently obtain accurate and clinically useful images. [ABSTRACT FROM AUTHOR]