Quantity of Movement as a Measure of Engagement for Dementia: The Influence of Motivational Disorders

Engagement in activities is crucial to improve quality of life in dementia. Yet, its measurement relies exclusively on behavior observation and the influence that behavioral and psychological symptoms of dementia (BPSD) have on it is overlooked. This study investigated whether quantity of movement, gauged with a wrist-worn accelerometer, could be a sound measure of engagement and whether apathy and depression negatively affected engagement. Fourteen participants with dementia took part in 6 sessions of activities: 3 of cognitive games (eg, jigsaw puzzles) and 3 of robot play (Pleo). Results highlighted significant correlations between quantity of movement and observational scales of engagement and a strong negative influence of apathy and depression on engagement. Overall, these findings suggest that quantity of movement could be used as an ancillary measure of engagement and underline the need to profile people with dementia according to their concurrent BPSD to better understand their engagement in activities.

[1]  Allan Wigfield,et al.  Handbook of motivation at school , 2009 .

[2]  Ian Goodwin-Smith,et al.  Increasing constructive engagement and positive affect for residents with severe and very severe dementia through group‐based activities , 2014, Australasian journal on ageing.

[3]  D. Lamping,et al.  Quality of life in dementia: more than just cognition. An analysis of associations with quality of life in dementia , 2006, Journal of Neurology, Neurosurgery & Psychiatry.

[4]  M. Amore,et al.  Depression and apathy in dementia: same syndrome or different constructs? A critical review. , 2009, Archives of gerontology and geriatrics.

[5]  G. Arbanas.  Diagnostic and Statistical Manual of Mental Disorders (DSM-5) , 2015 .

[6]  Jiska Cohen-Mansfield,et al.  Engagement in persons with dementia: the concept and its measurement. , 2009, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[7]  Wendy Moyle,et al.  Assessing engagement in people with dementia: a new approach to assessment using video analysis. , 2015, Archives of psychiatric nursing.

[8]  W. Moyle,et al.  Exploring the effect of companion robots on emotional expression in older adults with dementia: a pilot randomized controlled trial. , 2013, Journal of gerontological nursing.

[9]  J. Cohen-Mansfield,et al.  The comprehensive process model of engagement. , 2011, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[10]  Zengqiang Zhang,et al.  Cognitive stimulation therapy in the treatment of neuropsychiatric symptoms in Alzheimer’s disease: a randomized controlled trial , 2010, Clinical rehabilitation.

[11]  M P Lawton,et al.  Observed affect in nursing home residents with Alzheimer's disease. , 1996, The journals of gerontology. Series B, Psychological sciences and social sciences.

[12]  D. Brooker,et al.  Enriching opportunities for people living with dementia in nursing homes: An evaluation of a multi-level activity-based model of care , 2007, Aging & mental health.

[13]  Robert Howard,et al.  Effect of enhanced psychosocial care on antipsychotic use in nursing home residents with severe dementia: cluster randomised trial , 2006, BMJ : British Medical Journal.

[14]  R. Mizrahi,et al.  On the overlap between apathy and depression in dementia , 2005, Journal of Neurology, Neurosurgery & Psychiatry.

[15]  M. Mega,et al.  The Neuropsychiatric Inventory , 1994, Neurology.

[16]  M. Csíkszentmihályi,et al.  Validity and Reliability of the Experience‐Sampling Method , 1987, The Journal of nervous and mental disease.

[17]  Marcia S. Marx,et al.  The impact of past and present preferences on stimulus engagement in nursing home residents with dementia , 2010, Aging & mental health.

[18]  D. O'Connor,et al.  A randomized crossover trial to study the effect of personalized, one-to-one interaction using Montessori-based activities on agitation, affect, and engagement in nursing home residents with Dementia , 2012, International Psychogeriatrics.

[19]  Ya-Huei Wu,et al.  Designing robots for the elderly: appearance issue and beyond. , 2012, Archives of gerontology and geriatrics.

[20]  Magda Tsolaki,et al.  Grouping for behavioral and psychological symptoms in dementia: clinical and biological aspects. Consensus paper of the European Alzheimer disease consortium , 2005, European Psychiatry.

[21]  Helmut Hlavacs,et al.  A Revisit of the Measurements on Engagement in Videogames: A New Scale Development , 2016, ICEC.

[22]  Serge Thill,et al.  Engagement: A traceable motivational concept in human-robot interaction , 2015, 2015 International Conference on Affective Computing and Intelligent Interaction (ACII).

[23]  Frans Verhey,et al.  Prevalence and Predictors of Neuropsychiatric Symptoms in Cognitively Impaired Nursing Home Patients , 2006, Journal of geriatric psychiatry and neurology.

[24]  B. Reisberg,et al.  The Global Deterioration Scale for assessment of primary degenerative dementia. , 1982, The American journal of psychiatry.

[25]  Rosalind W. Picard,et al.  Empatica E3 — A wearable wireless multi-sensor device for real-time computerized biofeedback and data acquisition , 2014, 2014 4th International Conference on Wireless Mobile Communication and Healthcare - Transforming Healthcare Through Innovations in Mobile and Wireless Technologies (MOBIHEALTH).

[26]  Nadia Bianchi-Berthouze,et al.  Understanding the Role of Body Movement in Player Engagement , 2012, Hum. Comput. Interact..

[27]  L. Gitlin,et al.  The Tailored Activity Program to reduce behavioral symptoms in individuals with dementia: feasibility, acceptability, and replication potential. , 2009, The Gerontologist.

[28]  Ellen A. Skinner,et al.  Engagement and disaffection as organizational constructs in the dynamics of motivational development. , 2009 .

[29]  R. Marin,et al.  Apathy: a neuropsychiatric syndrome. , 1991, The Journal of neuropsychiatry and clinical neurosciences.

[30]  V. Roos,et al.  The role of context and the interpersonal experience of loneliness among older people in a residential care facility , 2012, Global health action.

[31]  Candace L. Sidner,et al.  Explorations in engagement for humans and robots , 2005, Artif. Intell..

[32]  U. Müller,et al.  Actigraphic Daytime Activity is Reduced in Patients With Cognitive Impairment and Apathy , 2011, European Psychiatry.

[33]  Candace L. Sidner,et al.  Recognizing engagement in human-robot interaction , 2010, 2010 5th ACM/IEEE International Conference on Human-Robot Interaction (HRI).

[34]  C. Camp,et al.  Resident-Assisted Montessori Programming (RAMP™): Use of a Small Group Reading Activity Run by Persons With Dementia in Adult Day Health Care and Long-Term Care Settings , 2007, American journal of Alzheimer's disease and other dementias.

[35]  Jan Passchier,et al.  Motor activity and autonomic cardiac functioning in major depressive disorder. , 2003, Journal of affective disorders.

[36]  Masatoshi Takeda,et al.  [Behavioral and psychological symptoms of dementia]. , 2011, Nihon rinsho. Japanese journal of clinical medicine.

[37]  Emmanuel Mulin,et al.  Decreased daytime motor activity associated with apathy in Alzheimer disease: an actigraphic study. , 2012, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[38]  C. Hatton,et al.  Emotional and behavioural responses to music in people with dementia: an observational study , 2004, Aging & mental health.

[39]  M. Litaker,et al.  Factors that relate to activity engagement in nursing home residents , 2006, American journal of Alzheimer's disease and other dementias.

[40]  Karolien Poels,et al.  Characterising and measuring user experiences in digital games , 2007 .

[41]  L. Burgio,et al.  Studying disruptive vocalization and contextual factors in the nursing home using computer-assisted real-time observation. , 1994, Journal of gerontology.

[42]  Jamie M. Zeitzer,et al.  Ambulatory actigraphy correlates with apathy in mild Alzheimer’s disease , 2010 .

[43]  M. Carter,et al.  Revision and validation of the Individual Child Engagement Record: A practitioner‐friendly measure of learning opportunities for children with disabilities in early childhood settings , 2008, Journal of intellectual & developmental disability.

[44]  Emmanuel Mulin,et al.  REVIEW: Apathy Diagnosis, Assessment, and Treatment in Alzheimer's Disease , 2010, CNS neuroscience & therapeutics.