Methodologies for Clinical Outcomes of Dementia Gardens

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This grant examines new strategies to obtain objective, clinical data on persons with Alzheimer's disease or related dementias, matching this data against informant-based data (subjective measures being of questionable reliability in individuals with dementia). It also lays the foundation for studying an intervention (increased time outdoors) that can impact both the quality of life of individuals with dementia and their caregivers. The purpose of this R03 grant is to pilot test the methodologies needed to explore the relationship between spending increased time outdoors and sleep, agitation and activity patterns in individuals with dementia residing in lung-term care settings. There is excellent evidence of a broad range of positive impacts of nature and outdoor space on people who are stressed and our increased light exposure on sleep patterns, but virtually no empirical evidence of clinical outcomes of spending time outdoors for people with dementia. Existing studies on outdoor space and people with dementia either focus on the issue of autonomy/freedom to go outside, or on where people spend time when outdoors. Other researchers' projects with similar goals (to assess clinical outcomes of increased time outdoors for people with dementia. The issues to be examined include 1) encouraging residents to spend time outdoors without the activity confounding the results, 2) getting residents to wear the actigraphy technology to measure exposure to activity level and light and 3) determining whether the activity level readings from the Actiwatch provide discernable information about stress levels and agitation. Additionally, the pilot data will provide sufficient information about effect size for the power analyses to determine sample size needed for the subsequent R01 grant proposal.