Correlates among nocturnal agitation, sleep, and urinary incontinence in dementia

描述（由申请人提供）：70%到90%的阿尔茨海默病（AD）患者在家中接受护理。在美国，对于数百万的阿尔茨海默病患者的家庭照顾者来说，夜间躁动、睡眠障碍和尿失禁给这些已经负担沉重的照顾者增加了额外的负担。照护者经常报告说，这些干扰是为他们所爱的人寻求机构照护的“临界点”。虽然这些干扰在AD患者中都是独立的，但迄今为止还没有研究研究这些具有挑战性的行为在社区居民中的相互关系。一旦更好地了解这些关系，就可以开发和测试有效的干预措施。我们认为，这一领域研究有限的主要原因与使用传统方法（即直接观察）收集这些数据的资源密集性有关。无线身体传感器网络有望成为收集这些数据的创新、可靠和有效的手段。本研究将指导三个具体目标：(1)研究在社区居住的AD患者及其家庭照顾者中使用男孩传感器的可行性和可接受性；(2)描述社区AD患者夜间躁动、睡眠连续性和持续时间以及夜间尿失禁的模式；(3)探讨夜间躁动、睡眠连续性和持续时间与夜间尿失禁（时间、频率）的关系

DESCRIPTION (provided by applicant): Seventy to ninety percent of all persons with Alzheimer's Disease (AD) receive care in their homes. For the millions of family caregivers for persons with AD in the U.S., nighttime agitation, sleep disturbances, and urinary incontinence in their care recipients add additional burden to these already burdened caregivers. These disturbances are often reported by caregivers as being the "tipping point" for seeking institutional care for their loved ones. While each of these disturbances are recognized independently in persons with AD, no research, to date, has studied the interrelationships of these challenging behaviors in community-dwelling persons. Effective interventions can be developed and tested once these relationships are better understood. We believe that a primary reason for limited research in this area is related to the resource-intensiveness of collecting these data using conventional methods (i.e., direct observations). Wireless, body sensor networks hold promise as innovative, reliable, and valid means to collect these data. Three specific aims will guide this study: (1) examine the feasibility and acceptability of the use of boy sensors in community-dwelling persons with AD and in their family caregivers; (2) describe patterns of nocturnal agitation, sleep continuity and duration, and nighttime urinary incontinence in community-dwelling persons with AD; and (3) examine the relationships among nocturnal agitation, sleep continuity and duration, and nighttime urinary incontinence (timing, frequency) in persons with AD. We will use a single-group, descriptive design with AD participants and their caregivers (N = 50). Data collection will take place over 5 weeknights in participants' home environments. To measure the feasibility and acceptability of these body sensor systems, we will query family caregivers using a semi-structured interview and questionnaire regarding their satisfaction and ease of enactment with the study components (use of body sensors; alarming systems). This will allow for collection of data concerning the immediate experience of the caregiver, while providing the study team with valuable information upon which to make any needed adjustments prior to our conducting a larger scale study. Wireless, body sensor systems will be used with persons with AD in their natural home settings to collect objective data on nighttime agitation (restlessness, physical and verbal agitation), sleep (sleep onset latency, frequency of nighttime awakenings, wake after sleep onset, and total sleep time), and urinary incontinence (timing, frequency). Data analysis will examine the relationships in terms of timing and duration between incontinence and agitation and the subsequent effects on sleep. Results from this study will provide us with the necessary data to develop and test interventions to decrease or eliminate these problematic disturbances in persons with AD, and to influence positively the daily lives of family caregivers.