- Email: [email protected]
Patient and caregiver's characteristics related with neuropsychiatric symptoms in Alzheimer's disease
Poster Presentations P2 was associated with support service need, worse psychologial well-being, and patient’s neuropsychiatric symptoms. Time spent caring was related to patient’s functional status. There was no relationship between the patient’s cognitive functioning/depression and burden. Conclusions: Caregivers of individuals with MCI report greater burden in caring for their loved ones and this level of burden appears to be related to the patient’s neurobehavioral and functional status. Early identification of MCI patients with psychiatric issues may be particularly important for predicting caregiver burden. P2-061
DEMENTIA AND COMMUNICATION
Johannes Schro¨der, Maren Knebel, University of Heidelberg, Heidelberg, Germany. Contact e-mail: [email protected] Background: Dementia is a growing phenomenon in our society. As there still is no effective therapy to stop this disease, much research is done to find ways to ameliorate the carer’s and the patients’ quality of life. One of the arising issues in the attempt to meet the needs of people suffering from dementia is based on their decreasing abilities to communicate. Especially the verbal and more cognitive communication abilities can be reduced in the early stages of dementia while the nonverbal and more emotional abilities can still be functional. Preliminary results show that it is possible to measure and to differentiate between verbal and nonverbal capacity. Methods: In our study we observed the communication abilities of 85 elderly persons suffering from dementia (aged 95-98 years; M ¼ 83,18; s ¼ 7,81). Results: General linear model with repeated measures shows nonverbal communication abilities differ from verbal communication abilities in the proposed way nonverbal communication abilities persist longer than verbal communication abilities with proceeding cognitive decline. Further more in the group with severe dementia (MMSE < 10; N ¼ 19) there is a significant relationship between nonverbal communication abilities and total score of 5 NPI subscales (r ¼ -.636, p < .05; depression, agitation/aggression, anxiety, irritation/lability, aberrant motor behaviour) but not with cognitive status or activities of daily living. No clear relationship between communication abilities and relative’s report of patient’s quality of life was found. Interestingly relatives rated the patient’s quality of life lower when they reported a higher burden according to the 5 NPI subscales in the MMSE 17-25 group (r ¼ -.419, p < .05). In our sample a significant relationship for nonverbal communication abilities and quality of life is found when the partial correlation is controlled for cognitive abilities measured by the Global Deterioration Scale (r ¼ .310, p < .05). Conclusions: The proposed difference between verbal and nonverbal communication abilities is demonstrated. The relationship between communication skills and other capacities and their importance for the quality of life of dementia patients is complex and needs further investigation but already gives implications for praxis. P2-062
DEMENTIA AND HEARING IMPAIRMENT: DIFERENTIAL DIAGNOSIS
Amanda L. Costa, Juliana S. Varela, Luciane M. F. Restelatto, Karine Bombardelli, Rodolfo S. Silva, Alan Palmero, Pedro Abrahim, Rodrigo A. Ribeiro, Elisa Rosin, Carisi A. Polanczyk, Marcia L. Chaves, Universidade Federal do Rio Grande do Sul/Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil. Contact e-mail: [email protected] Background: Hearing loss in the elderly is an important factor of social disaggregation. Of all of the sensory deprivations, hearing impairment is the one that produces the most devastating effect on the communication process. In Brazil, the prevalence of hearing loss among the elderly varies between 20-85% and has been associated with negative psychosocial impact, inability to perform domestic activities and increase in occupational accidents. Dementia is one of the most common mental disorders of the elderly and affects 15-20% of individuals aged more than 60 years. The objective of this study was to observe the relation between these two frequent pathological conditions among the elderly. Methods: 130 subjects aged more than 50 years from the Coronary Artery Disease Clinics of a university hospital were evaluated by tests for cognitive screening (MMSE - Mini-Mental State
S331
Examination, Geriatric Depression Scale- GDS and Head Computed Tomography). A score of 24 or less in the MMSE was considered as cognitive impairment, and in case the patient had 4 years or less of education, the cut off point was 17. The cut off point considered for the presence of depressive symptoms in the GDS was 6 points. Results: 13 subjects had a positive screening for cognitive impairment and their mean age was 65 years. Of these subjects, 4 (30,7%) showed hearing loss and because of that, could not be adequately evaluated for the cognitive status. So, before going on with the neurologic cognitive evaluation, they were referred to an audiological evaluation. Conclusions: Other studies are necessary to evaluate those common disorders in the elderly and the real physical and emotional impact that hearing loss may have in the cognition. In the cognitive evaluation of the elderly a hearing evaluation is not included and it is important to remember that hearing loss can influence in the correct establishment of the diagnosis of cognitive decline. P2-063
ORAL HEALTH STATUS IN COGNITIVE IMPAIRMENT PATIENTS (CIP) EVALUATED IN THE COGNITION AND BEHAVIOUR UNIT (BCU) OF CLINICO SAN CARLOS HOSPITAL (HCSC), MADRID, SPAIN
Sagrario Manzano Palomo1, Beatriz Santiago Perez2, Jose Rosado Olaran2, Angel Miguel Gonzalez Sanz2, Jorge Matias Guiu Guia3, 1Behaviour and Cognition Unit, Universitary Clinico San Carlos Hospital, Madrid, Spain; 2Stomatology, Anatomy and Human Embriology Department. Rey Juan Carlos University, Madrid, Spain; 3Neuroscience Institute, Behaviour and Cognition Unit, Universitary Clinico San Carlos Hospital, Madrid, Spain. Contact e-mail: [email protected] Background: Cognitive impairment is a prevalent public health problem in general population. Oral problems become more prevalent with increasing age. From a socio-economic point of view, all considerations are necessary in order to implement preventive and therapeutic strategies. Methods: A cross-sectional epidemiological study was carried out to assess the oral health status in CIP. We recruited 127 patients in BCU of HCSC from June 2009 to January 2010. We selected Alzheimer disease (AD) (NINCSADRDA criteria), mild cognitive impairment (MCI) (Petersen criteria), mixed and other dementias. We analysed age, sex, MMSE, GDS, hygienic habits, oral mucosa pathology, prosthesis, periodontal and dental state. An informant consent was obtained. The study was approved by the Ethics Committee of HCSC. Results: The mean age was 77.39, (63% females). We evaluated 40.9% AD (GDS4: 42.5%%, GDS5: 32.5%, GDS6: 21.25%, GDS7: 3.75%); MCI: 27.6%, mixed: 20.5%, others: 9.4%. The mean of MMSE was in MCI:26.28, AD:18.32 and mixed:20.15. About periodontal state, in the first (64.3%, p:0.03) and second (55.6%, p:0.000) sextants there are more bleeding presence and excluded sextants between AD than others. There are 21.3% (71.4% females) of edentulism. About 40.9% of AD has caries [more caries ratio than the others (p > 0.05)]. About 55.9% of patients has some kind of prosthesis. Among AD patients, 86.5% make brushing teeth themselves (p: 0.001). The more severity of AD, the less brushing teeth frequency (p: 0.04). Conclusions: AD patients has more oral pathology. There are no differences among AD severity stages. The more severity of AD, the worst hygienic habits. Oral therapeutic and preventive strategies are necessary in order not to increase the socio-economic burden of dementia. P2-064
PATIENT AND CAREGIVER’S CHARACTERISTICS RELATED WITH NEUROPSYCHIATRIC SYMPTOMS IN ALZHEIMER’S DISEASE
Renata Kochhann, Ericksen Borba, Ana Luiza Camozzato, Claudia Godinho, Maria Otı´lia Cerveira, Ma´rcia L. Chaves, Hospital de Clı´nicas de Porto Alegre, Porto Alegre, Brazil. Contact e-mail: erick. [email protected] Background: Neuropsychiatric symptoms may reduce the quality of life of both patients and caregivers. They are associated with caregiver distress, pharmacological administration and increased institutionalization likelihood.
S332
Poster Presentations P2
This study aims to evaluate patient and caregiver’s characteristics related with neuropsychiatric symptoms. Methods: A cross-sectional study was conducted in a sample of 58 probable Alzheimer’s disease (AD) patients (NINCDS-ADRDA criteria). The neuropsychiatric symptoms were evaluated by the Brazilian version of the Neuropsychiatric Inventory (NPI). The dementia severity was assessed with the Clinical Dementia Rating (CDR), Brazilian version. The analyzed patient’s variables were sex, age, age of onset of AD symptoms and education. The analyzed caregiver’s variables were sex, type of relationship, age, education, time as caregiver, weekly time of care, residing with patient and type of job. Student’s t test and one-way Anova were performed for parametric variables. Spearman’s rho was used for correlations. Results: NPI intensity and distress were similar in both patient’s sex (p ¼ 0.742 and p ¼ 0.902, respectively) and in the three stages of severity of dementia (F ¼ 1.951, p ¼ 0.152; F ¼ 0.763, p ¼ 0.471, respectively). Patient’s education was inversely correlated with NPI frequency, intensity and distress (rho ¼ -0.283, rho ¼ -0.276, rho ¼ -0.262, p ¼ 0.05). NPI intensity and distress were similar in both caregiver’s sex (p ¼ 0.809 and p ¼ 0.743, respectively), relationship type (p > 0.5) and caregiver’s type of job (p > 0.5). However, a tendency for statistical difference was observed between caregivers who resided and those who not resided with patients (p ¼ 0.05), caregivers who resided with patients showed higher NPI intensity and NPI distress. Caregiver’s education was inversely correlated with NPI frequency, intensity and distress (rho ¼ -0.302, rho ¼ -0. 272, rho ¼ -0. 300, p ¼ 0.05). Caregiver’s age was inversely correlated with NPI severity (rho ¼ -0.270, p ¼ 0.05). Weekly time of care was correlated with NPI frequency (rho ¼ 0. 291, p ¼ 0.05). Conclusions: Some variables may interfere on neuropsychiatric symptoms evaluation by caregivers of AD patients, as age, education, weekly time of care and residing with patients. Some of them can be modified through different approaches improving quality of care. P2-065
BURDEN INTERVIEW VERSUS NEUROPSYCHIATRIC INVENTORY: EVALUATION OF BURDEN IN CAREGIVERS OF ALZHEIMER’S DISEASE PATIENTS
Andrea Heisler, Ericksen Borba, Renata Kochhann, Diego Onyszko, Iulek Gorczevski, Livia Gonc¸alves Rodrigues, Ana Luiza Camozzato, Claudia Godinho, Maria Otilia Cerveira, Leticia Forster, Ma´rcia L. Chaves, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil. Contact e-mail: [email protected] Background: Neuropsychiatric symptoms (NPS) are common in Alzheimer’s disease (AD) and may produce behavioral changes that reduce the quality of life of both patients and caregivers. The aim of this study is to correlate the burden level with frequency of NPS and their distress in caregivers of AD patients. Methods: NPS were evaluated with the Neuropsychiatric Inventory (NPI). The burden level was evaluated with the Burden Interview (BI) and the severity of dementia was assessed with the Clinical Dementia Rating (CDR) scale. The sample was composed of 26 AD patients and their caregivers. The correlation of BI and NPI scores was analyzed by Spearman’s correlation. Results: NPI total frequency X severity and BI showed strong correlation (Rho ¼ 0.571, p ¼ 0.002). NPI total distress and BI also showed strong correlation (Rho ¼ 0.675, p < 0.001). Conclusions: This preliminary data showed that the burden level was positively correlated with the frequency of neuropsychiatric symptoms and their distress. Burden increase may reduce the quality of life of caregivers. P2-066
EFFECTS OF LIGHT EXPOSURE ON RESTACTIVITY RHYTHM IN ELDERLY INSTITUTIONAL RESIDENTS WITH DEMENTIA OF THE ALZHEIMER TYPE
Fumiharu Togo1, Taiki Komatsu2, Takeshi Mitani3, Hayami Togashi4, Etsuko Satoh4, Maiko Ikegami3, Kyohei Ohta3, 1National Institute of Occupational Safety and Health, Kawasaki, Japan; 2Graduate School of Education, The University of Tokyo, Tokyo, Japan; 3Watanabe Hospital, Kamisu, Japan; 4Sion Yokohama, Yokohama, Japan. Contact e-mail: [email protected]
Background: The prevalence of Alzheimer’s disease (AD) is rapidly increasing among Japanese elderly. Sleep disturbances are a common behavioral symptoms associated with AD. It has been shown that dysregulation of the circadian timing system in AD, and this may play a role in the development of sleep disturbance. In this study, we examined the effects of bright light exposure on rest-activity rhythm in elderly institutional residents with AD. Methods: Subjects were 8 AD patients (mean [SD] age, 80.0 10.0] years) living in geriatric healthcare facilities. Rest-activity rhythm was measured continuously over 3 weeks using actigraphy worn around the dominant wrist. In the second week, subjects received either white (12000K) or orange (2400K) light about 2000 lux from light-emitting diodes, measured before the eyes in gaze direction, from 9:00 to 9:30 during occupational therapy. Differences of variables between weeks were assessed using ANOVA with multiple comparisons (P < 0.05). Results: Percent of wake time in each hour increased and decreased during day and night, respectively. During the second and third weeks in the white light session, the percent of wake time during night significantly decreased compared with the first week, and the onset of decreasing the percent of wake time significantly advanced compared with the first week. Conclusions: These results suggest that circadian timing system in AD might be changed and sleep disturbance in AD could be improved by bright white light exposure in the morning. P2-067
THE EVALUATION OF GROUP MUSIC THERAPY ON AGITATED BEHAVIOR IN ELDERS WITH DEMENTIA
Kuei-Ru Chou, Taipei Medical University, Taipei, Taiwan. Contact e-mail: [email protected] Background: In Taiwan, psychiatric medication and physical restraints continue to be the primary management strategy for agitated behavior in patients with dementia. There has been very little use of non-medicinal music therapy. In light of the scarcity of studies of patients with dementia at the target age of eighty two or more, both domestically and abroad, this study explored the effects of group music therapy on these patients. Methods: This was an experimental study using repeated measurements. The subjects were demented elderly persons in nursing facilities. Their average age was 82 and they were randomly assigned to the experimental and control groups. A total of 86 subjects completed this study, among these 42 were in the experimental group and 44 in the control group. The experimental group received a total of twelve group music therapy sessions, conducted twice a week for six consecutive weeks, while the control group participated in normal daily activities. In order to measure the effectiveness of the therapy sessions, assessments were conducted before the intervention, at the 6th and 12th group sessions, and at one-month follow-up. Generalized Estimating Equation (GEE) was used for inferential statistics. Results: After group music therapy intervention, the experimental group showed better performance at the 6th, 12th, and onemonth follow-up as agitated behavior in general was reduced and physically nonaggressive behavior, verbally nonaggressive behavior, and physically aggressive behavior were reduced while a reduction in verbally aggressive behavior was shown only at the 6th session. These values are not typically shown in an abstract. Conclusions: Group music therapy alleviated agitated behavior in elderly persons with dementia. We suggest that nursing facilities for demented elderly persons incorporate group music therapy in routine activities in order to enhance emotional relaxation, create interpersonal interaction, and reduce future agitated behavior. P2-068
EFFECTS OF LIGHT EXPOSURE ON BPSD SYMPTOMS IN INSTITUTIONAL ELDERLY PEOPLES WITH DEMENTIA OF THE ALZHEIMER TYPE AND CAREGIVER’S BURDEN
Taiki Komatsu1,2, Fumiharu Togo3, Takeshi Mitani4, Hayami Togashi5, Etsuko Satoh5, Maiko Ikegami4, Kyohei Ohta4, 1The University of Tokyo, Department of Physical and Health Education, Tokyo, Japan; 2Tokyo University of Technology, Tokyo, Japan; 3Department of Work Stress Control, National Institute of Occupational Safety and Health, Kawasaki, Japan; 4Watanabe Hospital, Kamisu, Ibaraki, Japan; 5Department of
DEMENTIA AND COMMUNICATION
Johannes Schro¨der, Maren Knebel, University of Heidelberg, Heidelberg, Germany. Contact e-mail: [email protected] Background: Dementia is a growing phenomenon in our society. As there still is no effective therapy to stop this disease, much research is done to find ways to ameliorate the carer’s and the patients’ quality of life. One of the arising issues in the attempt to meet the needs of people suffering from dementia is based on their decreasing abilities to communicate. Especially the verbal and more cognitive communication abilities can be reduced in the early stages of dementia while the nonverbal and more emotional abilities can still be functional. Preliminary results show that it is possible to measure and to differentiate between verbal and nonverbal capacity. Methods: In our study we observed the communication abilities of 85 elderly persons suffering from dementia (aged 95-98 years; M ¼ 83,18; s ¼ 7,81). Results: General linear model with repeated measures shows nonverbal communication abilities differ from verbal communication abilities in the proposed way nonverbal communication abilities persist longer than verbal communication abilities with proceeding cognitive decline. Further more in the group with severe dementia (MMSE < 10; N ¼ 19) there is a significant relationship between nonverbal communication abilities and total score of 5 NPI subscales (r ¼ -.636, p < .05; depression, agitation/aggression, anxiety, irritation/lability, aberrant motor behaviour) but not with cognitive status or activities of daily living. No clear relationship between communication abilities and relative’s report of patient’s quality of life was found. Interestingly relatives rated the patient’s quality of life lower when they reported a higher burden according to the 5 NPI subscales in the MMSE 17-25 group (r ¼ -.419, p < .05). In our sample a significant relationship for nonverbal communication abilities and quality of life is found when the partial correlation is controlled for cognitive abilities measured by the Global Deterioration Scale (r ¼ .310, p < .05). Conclusions: The proposed difference between verbal and nonverbal communication abilities is demonstrated. The relationship between communication skills and other capacities and their importance for the quality of life of dementia patients is complex and needs further investigation but already gives implications for praxis. P2-062
DEMENTIA AND HEARING IMPAIRMENT: DIFERENTIAL DIAGNOSIS
Amanda L. Costa, Juliana S. Varela, Luciane M. F. Restelatto, Karine Bombardelli, Rodolfo S. Silva, Alan Palmero, Pedro Abrahim, Rodrigo A. Ribeiro, Elisa Rosin, Carisi A. Polanczyk, Marcia L. Chaves, Universidade Federal do Rio Grande do Sul/Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil. Contact e-mail: [email protected] Background: Hearing loss in the elderly is an important factor of social disaggregation. Of all of the sensory deprivations, hearing impairment is the one that produces the most devastating effect on the communication process. In Brazil, the prevalence of hearing loss among the elderly varies between 20-85% and has been associated with negative psychosocial impact, inability to perform domestic activities and increase in occupational accidents. Dementia is one of the most common mental disorders of the elderly and affects 15-20% of individuals aged more than 60 years. The objective of this study was to observe the relation between these two frequent pathological conditions among the elderly. Methods: 130 subjects aged more than 50 years from the Coronary Artery Disease Clinics of a university hospital were evaluated by tests for cognitive screening (MMSE - Mini-Mental State
S331
Examination, Geriatric Depression Scale- GDS and Head Computed Tomography). A score of 24 or less in the MMSE was considered as cognitive impairment, and in case the patient had 4 years or less of education, the cut off point was 17. The cut off point considered for the presence of depressive symptoms in the GDS was 6 points. Results: 13 subjects had a positive screening for cognitive impairment and their mean age was 65 years. Of these subjects, 4 (30,7%) showed hearing loss and because of that, could not be adequately evaluated for the cognitive status. So, before going on with the neurologic cognitive evaluation, they were referred to an audiological evaluation. Conclusions: Other studies are necessary to evaluate those common disorders in the elderly and the real physical and emotional impact that hearing loss may have in the cognition. In the cognitive evaluation of the elderly a hearing evaluation is not included and it is important to remember that hearing loss can influence in the correct establishment of the diagnosis of cognitive decline. P2-063
ORAL HEALTH STATUS IN COGNITIVE IMPAIRMENT PATIENTS (CIP) EVALUATED IN THE COGNITION AND BEHAVIOUR UNIT (BCU) OF CLINICO SAN CARLOS HOSPITAL (HCSC), MADRID, SPAIN
Sagrario Manzano Palomo1, Beatriz Santiago Perez2, Jose Rosado Olaran2, Angel Miguel Gonzalez Sanz2, Jorge Matias Guiu Guia3, 1Behaviour and Cognition Unit, Universitary Clinico San Carlos Hospital, Madrid, Spain; 2Stomatology, Anatomy and Human Embriology Department. Rey Juan Carlos University, Madrid, Spain; 3Neuroscience Institute, Behaviour and Cognition Unit, Universitary Clinico San Carlos Hospital, Madrid, Spain. Contact e-mail: [email protected] Background: Cognitive impairment is a prevalent public health problem in general population. Oral problems become more prevalent with increasing age. From a socio-economic point of view, all considerations are necessary in order to implement preventive and therapeutic strategies. Methods: A cross-sectional epidemiological study was carried out to assess the oral health status in CIP. We recruited 127 patients in BCU of HCSC from June 2009 to January 2010. We selected Alzheimer disease (AD) (NINCSADRDA criteria), mild cognitive impairment (MCI) (Petersen criteria), mixed and other dementias. We analysed age, sex, MMSE, GDS, hygienic habits, oral mucosa pathology, prosthesis, periodontal and dental state. An informant consent was obtained. The study was approved by the Ethics Committee of HCSC. Results: The mean age was 77.39, (63% females). We evaluated 40.9% AD (GDS4: 42.5%%, GDS5: 32.5%, GDS6: 21.25%, GDS7: 3.75%); MCI: 27.6%, mixed: 20.5%, others: 9.4%. The mean of MMSE was in MCI:26.28, AD:18.32 and mixed:20.15. About periodontal state, in the first (64.3%, p:0.03) and second (55.6%, p:0.000) sextants there are more bleeding presence and excluded sextants between AD than others. There are 21.3% (71.4% females) of edentulism. About 40.9% of AD has caries [more caries ratio than the others (p > 0.05)]. About 55.9% of patients has some kind of prosthesis. Among AD patients, 86.5% make brushing teeth themselves (p: 0.001). The more severity of AD, the less brushing teeth frequency (p: 0.04). Conclusions: AD patients has more oral pathology. There are no differences among AD severity stages. The more severity of AD, the worst hygienic habits. Oral therapeutic and preventive strategies are necessary in order not to increase the socio-economic burden of dementia. P2-064
PATIENT AND CAREGIVER’S CHARACTERISTICS RELATED WITH NEUROPSYCHIATRIC SYMPTOMS IN ALZHEIMER’S DISEASE
Renata Kochhann, Ericksen Borba, Ana Luiza Camozzato, Claudia Godinho, Maria Otı´lia Cerveira, Ma´rcia L. Chaves, Hospital de Clı´nicas de Porto Alegre, Porto Alegre, Brazil. Contact e-mail: erick. [email protected] Background: Neuropsychiatric symptoms may reduce the quality of life of both patients and caregivers. They are associated with caregiver distress, pharmacological administration and increased institutionalization likelihood.
S332
Poster Presentations P2
This study aims to evaluate patient and caregiver’s characteristics related with neuropsychiatric symptoms. Methods: A cross-sectional study was conducted in a sample of 58 probable Alzheimer’s disease (AD) patients (NINCDS-ADRDA criteria). The neuropsychiatric symptoms were evaluated by the Brazilian version of the Neuropsychiatric Inventory (NPI). The dementia severity was assessed with the Clinical Dementia Rating (CDR), Brazilian version. The analyzed patient’s variables were sex, age, age of onset of AD symptoms and education. The analyzed caregiver’s variables were sex, type of relationship, age, education, time as caregiver, weekly time of care, residing with patient and type of job. Student’s t test and one-way Anova were performed for parametric variables. Spearman’s rho was used for correlations. Results: NPI intensity and distress were similar in both patient’s sex (p ¼ 0.742 and p ¼ 0.902, respectively) and in the three stages of severity of dementia (F ¼ 1.951, p ¼ 0.152; F ¼ 0.763, p ¼ 0.471, respectively). Patient’s education was inversely correlated with NPI frequency, intensity and distress (rho ¼ -0.283, rho ¼ -0.276, rho ¼ -0.262, p ¼ 0.05). NPI intensity and distress were similar in both caregiver’s sex (p ¼ 0.809 and p ¼ 0.743, respectively), relationship type (p > 0.5) and caregiver’s type of job (p > 0.5). However, a tendency for statistical difference was observed between caregivers who resided and those who not resided with patients (p ¼ 0.05), caregivers who resided with patients showed higher NPI intensity and NPI distress. Caregiver’s education was inversely correlated with NPI frequency, intensity and distress (rho ¼ -0.302, rho ¼ -0. 272, rho ¼ -0. 300, p ¼ 0.05). Caregiver’s age was inversely correlated with NPI severity (rho ¼ -0.270, p ¼ 0.05). Weekly time of care was correlated with NPI frequency (rho ¼ 0. 291, p ¼ 0.05). Conclusions: Some variables may interfere on neuropsychiatric symptoms evaluation by caregivers of AD patients, as age, education, weekly time of care and residing with patients. Some of them can be modified through different approaches improving quality of care. P2-065
BURDEN INTERVIEW VERSUS NEUROPSYCHIATRIC INVENTORY: EVALUATION OF BURDEN IN CAREGIVERS OF ALZHEIMER’S DISEASE PATIENTS
Andrea Heisler, Ericksen Borba, Renata Kochhann, Diego Onyszko, Iulek Gorczevski, Livia Gonc¸alves Rodrigues, Ana Luiza Camozzato, Claudia Godinho, Maria Otilia Cerveira, Leticia Forster, Ma´rcia L. Chaves, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil. Contact e-mail: [email protected] Background: Neuropsychiatric symptoms (NPS) are common in Alzheimer’s disease (AD) and may produce behavioral changes that reduce the quality of life of both patients and caregivers. The aim of this study is to correlate the burden level with frequency of NPS and their distress in caregivers of AD patients. Methods: NPS were evaluated with the Neuropsychiatric Inventory (NPI). The burden level was evaluated with the Burden Interview (BI) and the severity of dementia was assessed with the Clinical Dementia Rating (CDR) scale. The sample was composed of 26 AD patients and their caregivers. The correlation of BI and NPI scores was analyzed by Spearman’s correlation. Results: NPI total frequency X severity and BI showed strong correlation (Rho ¼ 0.571, p ¼ 0.002). NPI total distress and BI also showed strong correlation (Rho ¼ 0.675, p < 0.001). Conclusions: This preliminary data showed that the burden level was positively correlated with the frequency of neuropsychiatric symptoms and their distress. Burden increase may reduce the quality of life of caregivers. P2-066
EFFECTS OF LIGHT EXPOSURE ON RESTACTIVITY RHYTHM IN ELDERLY INSTITUTIONAL RESIDENTS WITH DEMENTIA OF THE ALZHEIMER TYPE
Fumiharu Togo1, Taiki Komatsu2, Takeshi Mitani3, Hayami Togashi4, Etsuko Satoh4, Maiko Ikegami3, Kyohei Ohta3, 1National Institute of Occupational Safety and Health, Kawasaki, Japan; 2Graduate School of Education, The University of Tokyo, Tokyo, Japan; 3Watanabe Hospital, Kamisu, Japan; 4Sion Yokohama, Yokohama, Japan. Contact e-mail: [email protected]
Background: The prevalence of Alzheimer’s disease (AD) is rapidly increasing among Japanese elderly. Sleep disturbances are a common behavioral symptoms associated with AD. It has been shown that dysregulation of the circadian timing system in AD, and this may play a role in the development of sleep disturbance. In this study, we examined the effects of bright light exposure on rest-activity rhythm in elderly institutional residents with AD. Methods: Subjects were 8 AD patients (mean [SD] age, 80.0 10.0] years) living in geriatric healthcare facilities. Rest-activity rhythm was measured continuously over 3 weeks using actigraphy worn around the dominant wrist. In the second week, subjects received either white (12000K) or orange (2400K) light about 2000 lux from light-emitting diodes, measured before the eyes in gaze direction, from 9:00 to 9:30 during occupational therapy. Differences of variables between weeks were assessed using ANOVA with multiple comparisons (P < 0.05). Results: Percent of wake time in each hour increased and decreased during day and night, respectively. During the second and third weeks in the white light session, the percent of wake time during night significantly decreased compared with the first week, and the onset of decreasing the percent of wake time significantly advanced compared with the first week. Conclusions: These results suggest that circadian timing system in AD might be changed and sleep disturbance in AD could be improved by bright white light exposure in the morning. P2-067
THE EVALUATION OF GROUP MUSIC THERAPY ON AGITATED BEHAVIOR IN ELDERS WITH DEMENTIA
Kuei-Ru Chou, Taipei Medical University, Taipei, Taiwan. Contact e-mail: [email protected] Background: In Taiwan, psychiatric medication and physical restraints continue to be the primary management strategy for agitated behavior in patients with dementia. There has been very little use of non-medicinal music therapy. In light of the scarcity of studies of patients with dementia at the target age of eighty two or more, both domestically and abroad, this study explored the effects of group music therapy on these patients. Methods: This was an experimental study using repeated measurements. The subjects were demented elderly persons in nursing facilities. Their average age was 82 and they were randomly assigned to the experimental and control groups. A total of 86 subjects completed this study, among these 42 were in the experimental group and 44 in the control group. The experimental group received a total of twelve group music therapy sessions, conducted twice a week for six consecutive weeks, while the control group participated in normal daily activities. In order to measure the effectiveness of the therapy sessions, assessments were conducted before the intervention, at the 6th and 12th group sessions, and at one-month follow-up. Generalized Estimating Equation (GEE) was used for inferential statistics. Results: After group music therapy intervention, the experimental group showed better performance at the 6th, 12th, and onemonth follow-up as agitated behavior in general was reduced and physically nonaggressive behavior, verbally nonaggressive behavior, and physically aggressive behavior were reduced while a reduction in verbally aggressive behavior was shown only at the 6th session. These values are not typically shown in an abstract. Conclusions: Group music therapy alleviated agitated behavior in elderly persons with dementia. We suggest that nursing facilities for demented elderly persons incorporate group music therapy in routine activities in order to enhance emotional relaxation, create interpersonal interaction, and reduce future agitated behavior. P2-068
EFFECTS OF LIGHT EXPOSURE ON BPSD SYMPTOMS IN INSTITUTIONAL ELDERLY PEOPLES WITH DEMENTIA OF THE ALZHEIMER TYPE AND CAREGIVER’S BURDEN
Taiki Komatsu1,2, Fumiharu Togo3, Takeshi Mitani4, Hayami Togashi5, Etsuko Satoh5, Maiko Ikegami4, Kyohei Ohta4, 1The University of Tokyo, Department of Physical and Health Education, Tokyo, Japan; 2Tokyo University of Technology, Tokyo, Japan; 3Department of Work Stress Control, National Institute of Occupational Safety and Health, Kawasaki, Japan; 4Watanabe Hospital, Kamisu, Ibaraki, Japan; 5Department of