“Friendship” Interactions and Expression of Agitation among Residents of a Dementia Care Unit

“Friendships” (ongoing interpersonal interactions) and agitated behavior were studied among 59 residents of a dementia special care unit; most residents had mild to moderate cognitive impairment. Behavior scan data were recorded by trained observers over six months. Three scans per hour were conducted, seven days a week, between 9 a.m. and 9 p.m., producing more than 17,000 observations. A marginal model for binary longitudinal data was developed to associate covariates with repeated observations of agitation, the dependent variable; generalized estimating equations were used to estimate regression parameters. Friendship behavior was significantly associated with (less) observed agitation in this group of dementia residents, controlling for additional variables expected to predict agitation. Opportunity for self-initiated interpersonal engagement may contribute significantly to the well-being of moderately impaired dementia residents. Repeated over-time assessments are important in understanding factors related to expression of problem behaviors in this population.