Abstract
Purpose
The purpose of this study was to provide basic data about agitation in patients with dementia by surveying the literature.
Method
Key words used for search through hand-search and electronic database (CINHAL, Pubmed, Google scholar, Riss, Kiss, DBpia) included 'dementia', 'Alzheimer disease', ‘agitation’, ‘aggression or aggressive behavior’, ‘problem or disruptive behavior’, and ‘abnormal behavior.’ Seventeen studies met the inclusion criteria for the Meta-analysis and ‘R’ version 3.2.2 was used to analyze the correlated effect size.
Results
Study results showed that variables related to agitation were identified as the demographic (age, gender), dementia-related (cognition, medication uses), physical (Activity of Daily Living [ADL], pain), psychological (depression, psychotic symptom, caregiver burden) and environmental (psychosocial environment) factors. The effect size between the correlated variables and agitation were low to moderate (caregiver burden .36; ADL -.24; psychotic symptom and depression .21; pain .19; cognition -.15; medication uses .12; and psychosocial environment -.12).
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Figure 2.
Forest plots of the effects size of variables related to agitation in patients with dementia.
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Table 1.
Characteristics of Studies Included in Meta-Analysis
ADL=activity of daily living; BPC=behavioral problems checklist; DBS=disruptive behavior scale; CMAI=cohen-mansfield agitation inventory; RMBPC=revised memory and behavior problem checklist; BEHAVE-AD=behavioral pathology in Alzheimer's disease scale; NPI=neuropsychiatric inventory; PGDRS=psychogeriatric dependency rating scale; BSRS=behavior symptom rating scale; NPI-NH=neuropsychiatric inventory nursing home version; MDS=minimum data set.
Table 2.
Subgroup Analysis of Moderator Variables in Cognition
Variables | Categories | k | ES | -95% CI | +95% CI | I2 (%) | Qb (p) | R2 (%) |
---|---|---|---|---|---|---|---|---|
Setting | Community & outpatient clinic | 7 | -.17 | -.22 | -.11 | 0.0 | 0.07 | |
Nursing home & long-term facility | 8 | -.15 | -.24 | -.07 | 61.4 | (.789) | ||
Severity of dementia | Below & moderate | 8 | -.14 | -.20 | -.09 | 5.4 | 0.19 | |
Severe | 7 | -.16 | -.25 | -.07 | 68.6 | (.662) | ||
Cognition measurement | Type of score | 13 | -.17 | -.22 | -.12 | 18.3 | 11.10 | 80.7 |
Type of grade | 2 | -.05 | -.10 | -.01 | 0.0 | (<.001) | ||
Agitation measurement | CMAI | 6 | -.20 | -.25 | -.14 | 0.0 | 2.39 | |
Others | 9 | -.13 | -.19 | -.06 | 52.6 | (.122) |