Objective Assessment of Behavioral Associations in Patients with Dementia

 描述（由申请人提供）： 摘要痴呆症患者的问题行为，如好斗、游荡和日落，是照顾者压力的主要来源，也是患者被机构化的常见原因。基于公认的概念，这些行为障碍源于躁动，我们提出了一种新的方法，使用皮肤电活动（EDA），以评估痴呆患者的躁动程度。其目标是，首先，在患者行为出现之前检测到越来越多的激动，其次，设计减少激动的方法，以防止出现异常行为。几乎没有人在痴呆症患者中使用EDA。文献表明，痴呆症患者的潜伏期和振幅与正常对照组相似，这意味着我们可以用标准的生物反馈技术来探测个体的反应。由于缺乏可用的数据，我们将首先开发一套标准的方法来研究痴呆患者的EDA和监测自发活动。我们的团队已经开发出一种可穿戴设备，可以测量EDA并使用蓝牙传输。我们将根据通常的参考方法（在指尖测量皮肤电导率）来验证该设备。一旦得到验证，我们就可以监测痴呆患者的长期自发EDA。这将使研究痴呆症患者的昼夜节律，这本身就很重要。这些长期研究将有助于识别可能先于激越的EDA活动。我们还将研究减少EDA的刺激，这是患者无法按照标准生物反馈技术的要求自行完成的，并且可能会阻止问题激动的进展。如果成功，这项工作可以减轻照顾者的负担，帮助痴呆症患者在家中呆得更久。

 DESCRIPTION (provided by applicant): Abstract Problem behaviors in demented patients, such as combativeness, wandering, and sundowning, are a major source of caregiver stress and a common reason for the institutionalization of the patient. Based on the well-accepted notion that these behavioral disturbances stem from agitation, we propose a novel approach of using electrodermal activity (EDA) to assess the degree of agitation in dementia patients. The goals are, first, to detect increasing agitation before it surfaces in the patient's behavior and, second, to devise methods of reducing the agitation to prevent the aberrant behavior from appearing. Almost no work has been done using EDA in dementia patients. The literature indicates that the latency and amplitude in dementia patients are similar to normal controls, implying that we can probe the individual's responses as with standard biofeedback techniques. Because of the paucity of data available, we will first develop a set of standard methods for studying EDA in dementia patients and monitoring spontaneous activity. Our group has developed a wearable device that will measure EDA and transmit it using Bluetooth. We will validate the device against the usual reference method, skin conductivity measured at the finger tips. Once validated, we can monitor long-term spontaneous EDA in dementia patients. This will allow the study of circadian rhythms in dementia patients, which is important in and of itself. These long term studies will aid in identifying EDA activity that may precede agitation. We will also study stimuli that decrease EDA, which the patient cannot do on his own as is required by standard biofeedback techniques and which may prevent the progression to problem agitation. If successful, this work could decrease caregiver burden and help dementia patients remain in their homes longer.