Behavioral syndromes in institutionalized elders

Abstract

Institutionalized elders often display behaviors that caretakers find disturbing and difficult to manage. These behaviors are not a single construct but include several syndromes with different etiologies. Using data from a NIA-funded longitudinal clinical trial, we previously identified, via factor analysis of the behavior subscale of the Psychogeriatric Dependency Rating Scale, two syndromes of J'behavior in a sample of 586 nursing home residents—agitated psychomotor behavior (APB) and verbally aggressive behavior (VAB). This secondary analysis used control group data (N=184) from that same clinical trial to determine if these syndromes were affected by residents' cognitive, functional and restraint status. Data were collected at three time points over a 12-month period. Results of logistic regression analyses indicated that the risk of APB was four times as great among those with severe cognitive impairment and that the more functionally impaired a resident, the less likelys/he was to engage in APB. Residents who were chemically restrained were three times as likely to engage in VAB, and those who were physically restrained were three times as likely to engage in APB as compared to unrestrained residents. The findings give direction for more extensive casual modeling of behaviors and suggest a need to develop resident-centered interventions for behavioral syndromes.