Measurement and estimation of lucidity prevalence in persons with dementia and neurological disorders

拟议的项目“痴呆症患者清醒患病率的测量和评估” 神经紊乱“是对RFA-AG-20-017”痴呆症的清醒(R21/R33)“的回应。我们的目标是 进一步发展矛盾清晰度的测量，并使用该测量来估计频率和 通过采访养老院工作人员与在居民中观察到的事件发生的相关性 在过去的一个月和六个月期间。此外，我们还将细化清晰度和 进一步发展一种案件裁决方法，以实现清晰的“诊断”。我们建议研究有关工作人员的报告 在R21阶段期间，一个长期护理设施的300名居民和12个设施的1500名居民 在R33阶段。疗养院的一线工作人员非常适合为研究提供自相矛盾的清晰信息， 研究不足的现象；可能是由于事件的暂时性和缺乏科学报道 频道。现存的文献主要集中在轶事证据和案例报告上。建议进行的研究 解决四个目标：1)制定一种方法来评估清醒的发生，2)分析 测量的心理测量学属性，3)制定协商一致的会议方法以确定 可能的、可能的和确定的病例，以及4)使用DIRECT进行基于人群的局部清醒研究 与养老院工作人员的访谈。这项研究将有助于弥补中国缺乏测量工具的问题 并提供了有关清醒现象的可靠的基本知识。拟议中的研究改进了 我们的病例发现方法用于疗养院先前的流行病学研究，以研究潜在的 潜在结构是早期研究的主题，需要明确定义。拟组建的团队 在测量和统计、老年学、神经科学、流行病学、老年医学和 精神病学(阿尔茨海默病)、心理学、定性方法和集体护理护理。目标是： 目标1-R21：开发一种方法来描述痴呆症患者的清醒时期， 神经疾病和其他疾病，并确定与事件有关的个人和事件特征； 目标2--R21：进一步制定报告事件的案例讨论程序，使用来自 300名工作人员报告的试点样本链接到300名具有和不具有清醒事件的独特居民，这些居民居住在 拥有750张床位的大型长期护理设施； 目标3-R33：对12个长期护理机构的清醒事件进行回顾性研究，以描述 与未发生事件的居民相比，他们的特征； 目标4-R33：按诊断类别确定事件的流行率和频率； 目标5-R33：检查清晰度及其亚型的预测因素。 调查结果可能导致制定一种病例报告方法，供前线工作人员使用，以确定 并对清醒事件进行表征，以便为未来的研究提供信息。

The proposed project, “Measurement and estimation of lucidity prevalence in persons with dementia and neurological disorders” is in response to RFA-AG-20-017 “Lucidity in Dementia (R21/R33)”. Our goals are to develop further a measure of paradoxical lucidity and to use this measure to estimate the frequency and correlates of occurrences by interviewing nursing home staff with respect to incidents observed in residents during the past one-month and six-month periods. In addition, we will refine the definition of lucidity and develop further a case-adjudication method for lucidity “diagnosis”. We propose to study staff reports related to 300 residents of one long-term care facility during the R21 phase and 1500 residents from 12 facilities during the R33 phase. Front line nursing home staff is ideally suited to inform research in paradoxical lucidity, an understudied phenomenon; likely due to the transience of the incidents and the lack of scientific reporting channels. The literature extant focuses on anecdotal evidence and case reports. The proposed study addresses four objectives: 1) develop a measure to assess the occurrence of lucidity, 2) analyze the psychometric properties of the measure, 3) develop a consensus conference methodology to determine possible, probable and definite cases, and 4) conduct a local, population-based study of lucidity using direct interviews with nursing home staff. This study will contribute to remediation of the lack of measurement tools in the field and provide robust basic knowledge about the phenomenon of lucidity. The proposed study refines our case finding methodology used in prior epidemiological research in nursing homes to study underlying latent constructs that are the subject of early-stage research and require definitional clarity. The proposed team has expertise in measurement and statistics, gerontology, neuroscience, epidemiology, geriatric medicine and psychiatry (Alzheimer’s disease), psychology, qualitative methods, and congregate care nursing. The aims are: Aim 1-R21: Develop a measure to describe episodes of lucidity among individuals with dementia, neurological and other illnesses and identify individual and episodic characteristics associated with events; Aim 2-R21: Develop further a procedure for case conferencing of reported events, using data from a pilot sample of 300 staff reports linked to 300 unique residents with and without lucidity events residing in a large 750-bed long term care facility; Aim 3-R33: Conduct a retrospective study of lucidity events in 12 long-term care facilities to describe their characteristics in comparison to residents without an event; Aim 4-R33: Determine the prevalence and frequency of events by diagnostic categories; Aim 5-R33: Examine the predictors of lucidity and its subtypes. Findings could result in the development of a case-reporting methodology for use by front-line staff to identify episodes of lucidity and to characterize lucidity events to inform future research.