Search

Objectives: Mild behavioral impairment (MBI) is a dementia risk indicator in older adults characterized by later‐life emergent and persistent neuropsychiatric symptoms. Quality of life (QoL) is a multi‐dimensional concept encompassing physical, spiritual, and emotional well‐being. QoL aims to measure and quantify perceptions of individual health, well‐being, standard of living, personal fulfillment, and satisfaction. As MBI symptoms may arise from early‐stage neurodegenerative disease, MBI may contribute to declining QoL before dementia onset. In this study, we investigated the relationship between symptoms of MBI and QoL in older adults. Methods: The sample comprised 1107 individuals aged ≥ 50 years from the Canadian Platform for Research Online to Investigate Health, Quality of Life, Cognition, Behavior, Function, and Caregiving in Aging (CAN‐PROTECT). Multivariable linear regressions were used to model the associations between MBI symptom severity (exposure), measured using the MBI Checklist (MBI‐C), and QoL (outcome) assessed by the EuroQol‐5D (EQ‐5D, higher score = poorer QoL) and the novel Quality of Life and Function Five Domain Scale (QFS‐5) (QFS‐5, lower score = poorer QoL). Covariates were age, sex, cognition, education, ethnocultural origin, marital status, employment status, high blood pressure, heart disease, and diabetes. Moderation analysis explored potential sex differences. A sensitivity analysis was performed removing anxiety/depression items from the EQ‐5D score. Results: Across the sample (mean age = 64.4 ± 7.2, 79.4% female) every 1‐point increase in MBI‐C score was associated with a 0.06‐point standard deviation (SD) increase in EQ‐5D score (95% confidence interval (CI): 0.05–0.06, p < 0.001) and 0.08 SD decrease in QFS‐5 score (95% CI: −0.09 to −0.08, p < 0.001). Neither association depended on sex (p = 0.59 and p = 0.41, respectively). The association remained significant after removing anxiety/depression items from the EQ‐5D score (β = 0.04, 95% CI: 0.03– 0.04, p < 0.001). Conclusions: The study shows that MBI is associated with poorer QoL, independent of sex, on two QoL scales. We addressed depression/anxiety items in the EQ‐5D as a potential confounder for the observed MBI‐QoL association by conducting a sensitivity analysis that excluded those items from the EQ‐5D total score and by employing a novel measure of QoL (QFS‐5) that excludes psychiatric symptoms from measurement of QoL. Associations of MBI with the novel QFS‐5 were similar to associations between MBI and the EQ‐5D. Finding interventions to reduce the burden of MBI symptoms might improve quality of life. [ABSTRACT FROM AUTHOR]

Physical inactivity in mid-life is a modifiable risk factor for dementia. Mild behavioral impairment (MBI) is a marker of potential neurodegenerative disease. We investigated the association between physical activity and MBI. Baseline data from the Canadian Platform for Research Online to Investigate Health, Quality of Life, Cognition, Behaviour, Function, and Caregiving in Aging (CAN-PROTECT) were used. Four categories of weekly physical activity (cardiovascular, mind-body, strength training, and physical labour) were derived from the Community Healthy Activities Model Program for Seniors questionnaire. MBI was measured using the MBI-Checklist. Multivariable negative binomial regressions modelled the association between the standardized physical activity duration and MBI severity, adjusted for age, sex, education, marital status, ethno cultural origin, occupation, hypertension, dyslipidemia, mobility, and body mass index. Every 1 SD increase in cardiovascular activity was associated with 8.42% lower MBI severity. In contrast, every 1 SD increase in physical labor duration was associated with 5.64% greater MBI severity. These associations were neither moderated by the frequency engaging in each physical activity nor by sex. Cardiovascular physical activity in older persons may reduce levels of non-cognitive dementia markers like MBI, comparable to effects seen in cognition, potentially modulating dementia risk. [ABSTRACT FROM AUTHOR]

Objective:The aims of the study were to report on the development and evaluation of a staff training intervention in dementia care designed for use in the general hospital setting: the ‘Getting to Know Me’ training programme. The study also aimed to undertake initial psychometric analysis on two new outcome scales designed to measure knowledge and confidence in dementia care.Methods:The study comprised two phases. The first phase comprised the design of two questionnaires which are shared within this paper: Confidence in Dementia (CODE) Scale and Knowledge in Dementia (KIDE) Scale. In phase two, staff undertook the ‘Getting to Know Me’ training programme (n= 71). The impact of the programme was evaluated using a pre–post design which explored: (1) changes in confidence in dementia; (2) changes in knowledge in dementia; and (3) changes in beliefs about challenging behaviour.Results:The psychometric properties of the CODE and KIDE scales are reported. Statistically significant change was identified pre–post training on all outcome measures. Clinically meaningful change was demonstrated on the CODE scale.Conclusions:The ‘Getting to Know Me’ programme was well received and had a significant impact on staff knowledge and confidence. Our findings add to a growing evidence base which will be strengthened by further robust studies, the exploration of the impact of staff training on direct patient outcomes, and further identification of ways in which to transfer principles of care from specialist dementia environments into general hospital settings. [ABSTRACT FROM PUBLISHER]