Feasibility study of the integrated circuit tag monitoring system for dementia residents in Japan.
ABSTRACT Videotaping, direct observation, and biomechanical devices have been used to measure the wandering behavior of institutionalized people with dementia and to identify patterns of movement. Owing to technical limitations, the variability in movement patterns or the distance traveled could not be examined. The present study examined the feasibility of an integrated circuit tag monitoring system to monitor the movement patterns of Japanese dementia residents. This system generated the following data: the frequency of detection by each receiver, the duration of stay in each location, the cumulative distance walked per day, and the graphic display of the movement pattern. This new system offers objective measurements of ambulation in time and space, which can be used to characterize demented patients and to evaluate the effects of treatment and care.
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ABSTRACT: Pharmacological and non-pharmacological approaches are commonly used to treat patients' institutionalised for nighttime wandering. Actigraphy and other scales have been used to evaluate the efficacy of these treatments. However, in clinical settings, nursing records are often the sole source of daily observation of nighttime wandering. Thus, physicians rely on nursing records to evaluate pharmacological and non-pharmacological treatments. This study examined nighttime movements of patients with dementia, comparing the results of integrated circuit tag monitoring with hourly nighttime nursing records. We tested which factors were associated with agreement rates between the two data sources. The study hospital was a general hospital in Osaka, Japan. Monitoring was conducted in a closed 60-bed dementia care unit. An integrated circuit tag monitoring system was used to monitor the movement of institutionalised dementia patients for over half a year. The distance moved per hour by subjects was measured using the monitoring system, and the data were compared with hourly nighttime nursing records. Agreement rates were calculated between the two data sources. Thirty-five patients were monitored. Between 10-30% of subjects moved at any given hour during the night. The overall agreement rate between sources of movement data was 39%. Agreement rates were significantly correlated with the interquartile of the distance moved, changes in medication, physical conditions, and behavioural and psychological symptoms of dementia measured during the day. Although the agreement rate was low, staff appeared to pay more attention to patients associated with notable events during the day and patients exhibiting variability in distance moved.Psychogeriatrics 03/2012; 12(1):18-26. · 1.26 Impact Factor
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ABSTRACT: Little is known about the side effects of sedative-hypnotic agents in elderly dementia patients with sleep disorders. The present study describes activity pattern changes after a single dose of brotizolam in elderly patients with dementia. We conducted retrospective analysis of prospectively collected data from a case series at Asakayama Hospital (Osaka, Japan) between September 2008 and September 2009. Around-the-clock movements of dementia patients who were administered a single dose of brotizolam were recorded by the integrated circuit tag monitoring system during a 4-week baseline and 7-day peri-administration period. Diurnal and nocturnal activity levels and the onset times of the least-active and most-active phases were then measured. Seven patients (four men, three women; age range 59-85 years) were analyzed. All seven patients had disturbed activity patterns during the peri-administration period. Compared with the pre-administration period, the incidence of reversed rest-activity pattern increased significantly in the post-administration period, as measured by the distance moved per hour (P < 0.000). Patients with advanced stages of dementia had prolonged and delayed activity responses. Findings showed changes in activity levels and reversed active/resting phases after a single dose of brotizolam in elderly patients with dementia. Use of brotizolam in elderly patients with dementia, especially in advanced stages, calls for closer attention and longer observation periods.Psychogeriatrics 06/2012; 12(2):99-105. · 1.26 Impact Factor
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ABSTRACT: In Japan, where older people already make up more than 23% of the population and the proportion is still growing, the burden on those caring for people with dementia is an increasing problem. This burden is magnified by wandering behavior, a peripheral symptom. Thus, there is a need for an objective measure of wandering behavior to determine what constitutes effective care. In this study, we translated the Algase Wandering Scale - Version 2 into Japanese, and examined its reliability and validity. Ambulatory residents with dementia were selected from two nursing homes and two wards specializing in dementia care in hospitals in Japan. Nurses and care workers taking care of these residents answered questionnaires regarding the residents. From the results, the Algase Wandering Scale - Version 2, Japanese version, was examined for inter-rater reliability, stability, internal consistency, and concurrent validity. The results of the analysis in the present study demonstrated that the Algase Wandering Scale - Version 2, Japanese version, has reliability and validity, and that it can measure the presence or absence of wandering and its severity. Surveys of residents with various wandering patterns in many facilities and verification of construct validity are warranted in the future.Nursing and Health Sciences 06/2013; · 0.71 Impact Factor