The proposed study is a competing continuation of the study ?Treatment Routes for Exploring Agitation? (TREA), a systematic approach to individualizing non-pharmacological interventions for persons with dementia. The study involved a controlled comparison of the efficacy of TREA interventions for agitated behaviors vs. placebo (i.e., usual care with a presentation to staff members on behavior problems and approaches to treatment) in nursing homes residents. Participants in the intervention group manifested significantly greater reduction in overall agitation and in physical agitation as compared to the control group. The same trend was evident for verbal agitation but did not reach statistical significance. However, the average percent of change for both physical and verbal behaviors in the intervention group was about 37% improvement, twofold the change exhibited in the control group.
The aim of the proposed research is to clarify the mechanisms of effective non-pharmacological interventions for agitation, as well as the factors that contribute to the success of such treatments in elderly persons with varying levels of cognitive functioning. It also aims to increase the size of the sample with persons with verbal agitation, and to elucidate process variables. It will test the following hypothesis: 1)The success of an intervention is affected by the responsiveness of the agitated person. Responsiveness is impacted by: a) ability to respond to stimuli, b) ability to communicate, and c) personality. 2)The success of an intervention is affected by external barriers to delivery. 3) Interventions will be more successful when the correct unmet need has been identified. The proposed research will involve a placebo-controlled intervention study in 12 nursing homes with comparable levels of care. This project is a necessary next step in studying the effectiveness of individualized non-pharmacological treatments for agitated residents with different levels of cognitive functioning. Successful non-pharmacological management of agitation will improve the quality of life of agitated nursing home residents by addressing the discomfort that triggered the agitation, decreasing the level of their agitation, enhancing their well-being, and thereby, providing benefits to their immediate caregivers. PHS 398 (Rev. 05/01) Page 2 Principal Investigator/Program Director (Last, first, middle): Cohen-Mansfield, Jiska

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG010172-14
Application #
7796677
Study Section
Adult Psychopathology and Disorders of Aging Study Section (APDA)
Program Officer
Ryan, Laurie M
Project Start
1992-08-18
Project End
2012-03-31
Budget Start
2010-04-01
Budget End
2012-03-31
Support Year
14
Fiscal Year
2010
Total Cost
$297,585
Indirect Cost
Name
Hebrew Home of Greater Washington
Department
Type
DUNS #
070914155
City
Rockville
State
MD
Country
United States
Zip Code
20852
Cohen-Mansfield, Jiska; Marx, Marcia S; Dakheel-Ali, Maha et al. (2015) The use and utility of specific nonpharmacological interventions for behavioral symptoms in dementia: an exploratory study. Am J Geriatr Psychiatry 23:160-70
Cohen-Mansfield, Jiska; Dakheel-Ali, Maha; Marx, Marcia S et al. (2015) Which unmet needs contribute to behavior problems in persons with advanced dementia? Psychiatry Res 228:59-64
Cohen-Mansfield, Jiska; Thein, Khin; Marx, Marcia S et al. (2015) Sources of Discomfort in Persons with Dementia: Scale and Initial Results. Behav Neurol 2015:732832
Cohen-Mansfield, Jiska; Thein, Khin; Marx, Marcia S (2014) Predictors of the impact of nonpharmacologic interventions for agitation in nursing home residents with advanced dementia. J Clin Psychiatry 75:e666-71
Cohen-Mansfield, Jiska; Marx, Marcia S; Thein, Khin (2014) What is discomfort in persons with dementia who are agitated?--reply. JAMA Intern Med 174:292-3
Cohen-Mansfield, Jiska; Thein, Khin; Marx, Marcia S et al. (2013) Sources of discomfort in persons with dementia. JAMA Intern Med 173:1378-9
Cohen-Mansfield, Jiska; Thein, Khin; Marx, Marcia S et al. (2012) Efficacy of nonpharmacologic interventions for agitation in advanced dementia: a randomized, placebo-controlled trial. J Clin Psychiatry 73:1255-61
Cohen-Mansfield, Jiska; Dakheel-Ali, Maha; Jensen, Barbara et al. (2012) An analysis of the relationships among engagement, agitated behavior, and affect in nursing home residents with dementia. Int Psychogeriatr 24:742-52
Cohen-Mansfield, Jiska; Thein, Khin; Marx, Marcia S et al. (2012) What are the barriers to performing nonpharmacological interventions for behavioral symptoms in the nursing home? J Am Med Dir Assoc 13:400-5
Cohen-Mansfield, Jiska (2008) Agitated behavior in persons with dementia: the relationship between type of behavior, its frequency, and its disruptiveness. J Psychiatr Res 43:64-9

Showing the most recent 10 out of 17 publications