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New or Worsening Symptoms and Signs in Community-Dwelling Persons with Dementia: Incidence and Relation to Use of Acute Medical Services.

Publication ,  Journal Article
Sloane, PD; Schifeling, CH; Beeber, AS; Ward, KT; Reed, D; Gwyther, LP; Matchar, B; Zimmerman, S
Published in: J Am Geriatr Soc
April 2017

OBJECTIVES: To understand the range of symptoms that present to family caregivers of community-dwelling persons with Alzheimer's disease and related dementias (ADRD). DESIGN: Six-month longitudinal prospective study to identify the incidence of new or worsening symptoms and their association with acute care medical service use. SETTING: Community-based sample of volunteers from multiple states. PARTICIPANTS: A total of 136 patient-caregiver dyads with a range of dementia severity. MEASUREMENTS: Forty four symptoms and signs common in older persons and/or persons with dementia; frequency of emergency department visits, hospitalizations, and death; and associations between reported symptoms and acute medical care. RESULTS: During a mean of 5.7 months' follow-up, new or worsening organ-specific (90% of participants), nonspecific (89%), and behavioral (88%) symptoms were common, with the average caregiver reporting seven new or worsening symptoms. Most common were worsening confusion (74%), decreased activity (64%), agitation (57%), hallucinations/delusions (45%), voice and speaking problems (45%), not eating or drinking (44%), and stress/anxiety (41%). Hospitalization and emergency department use occurred respectively in 19% and 20% of participants, and were associated with organ-specific symptoms (OR 3.15, P = .02), less so with nonspecific symptoms (OR 2.27, P = .07), and very little with behavioral symptoms (OR 1.44, P = .38). Within each symptom category, certain symptoms were significantly associated with acute medical service use. CONCLUSION: Family caregivers of persons with ADRD must respond to a variety of medical, nonspecific, and behavioral symptoms. The high incidence of new or worsening symptoms and of acute medical care use suggests a need to better target symptom evaluation and management in caregiver education.

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Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

April 2017

Volume

65

Issue

4

Start / End Page

808 / 814

Location

United States

Related Subject Headings

  • Prospective Studies
  • Patient Acceptance of Health Care
  • Male
  • Longitudinal Studies
  • Independent Living
  • Incidence
  • Humans
  • Geriatrics
  • Female
  • Dementia
 

Citation

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ICMJE
MLA
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Sloane, P. D., Schifeling, C. H., Beeber, A. S., Ward, K. T., Reed, D., Gwyther, L. P., … Zimmerman, S. (2017). New or Worsening Symptoms and Signs in Community-Dwelling Persons with Dementia: Incidence and Relation to Use of Acute Medical Services. J Am Geriatr Soc, 65(4), 808–814. https://doi.org/10.1111/jgs.14672
Sloane, Philip D., Christopher H. Schifeling, Anna S. Beeber, Kimberly T. Ward, David Reed, Lisa P. Gwyther, Bobbi Matchar, and Sheryl Zimmerman. “New or Worsening Symptoms and Signs in Community-Dwelling Persons with Dementia: Incidence and Relation to Use of Acute Medical Services.J Am Geriatr Soc 65, no. 4 (April 2017): 808–14. https://doi.org/10.1111/jgs.14672.
Sloane PD, Schifeling CH, Beeber AS, Ward KT, Reed D, Gwyther LP, et al. New or Worsening Symptoms and Signs in Community-Dwelling Persons with Dementia: Incidence and Relation to Use of Acute Medical Services. J Am Geriatr Soc. 2017 Apr;65(4):808–14.
Sloane, Philip D., et al. “New or Worsening Symptoms and Signs in Community-Dwelling Persons with Dementia: Incidence and Relation to Use of Acute Medical Services.J Am Geriatr Soc, vol. 65, no. 4, Apr. 2017, pp. 808–14. Pubmed, doi:10.1111/jgs.14672.
Sloane PD, Schifeling CH, Beeber AS, Ward KT, Reed D, Gwyther LP, Matchar B, Zimmerman S. New or Worsening Symptoms and Signs in Community-Dwelling Persons with Dementia: Incidence and Relation to Use of Acute Medical Services. J Am Geriatr Soc. 2017 Apr;65(4):808–814.
Journal cover image

Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

April 2017

Volume

65

Issue

4

Start / End Page

808 / 814

Location

United States

Related Subject Headings

  • Prospective Studies
  • Patient Acceptance of Health Care
  • Male
  • Longitudinal Studies
  • Independent Living
  • Incidence
  • Humans
  • Geriatrics
  • Female
  • Dementia