Hostname: page-component-7c8c6479df-995ml Total loading time: 0 Render date: 2024-03-29T12:06:56.543Z Has data issue: false hasContentIssue false

Wandering and fecal smearing in people with dementia

Published online by Cambridge University Press:  22 February 2010

Toshie Ata
Affiliation:
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
Seishi Terada*
Affiliation:
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
Osamu Yokota
Affiliation:
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
Takeshi Ishihara
Affiliation:
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
Yoshikatsu Fujisawa
Affiliation:
Department of Psychiatry, Kinoko Espoir Hospital, Kasaoka, Japan
Ken Sasaki
Affiliation:
Department of Psychiatry, Kinoko Espoir Hospital, Kasaoka, Japan
Shigetoshi Kuroda
Affiliation:
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
*
Correspondence should be addressed to: Dr. Seishi Terada, Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. Phone: +81-86-235-7242, Fax: +81-86-235-7246. Email: terada@cc.okayama-u.ac.jp.

Abstract

Background: Wandering and fecal smearing (scatolia) are among the problematic behaviors in dementia, and many caregivers are troubled by these behaviors. The purpose of this study was to clarify the clinical characteristics of patients with these symptoms.

Methods: We performed a questionnaire survey. The questionnaire items were the age, sex, living environment, diagnosis, cognitive function, and activities of daily living. Other clinical characteristics were evaluated using the quality of life (QOL) questionnaire for dementia.

Results: A total of 246 patients with dementia were rated. Wandering was observed frequently in 23%, sometimes in 12%, rarely in 14%, and never in 51% of the patients; scatolia was observed frequently in 2%, sometimes in 8%, rarely in 15%, and never in 75%. Wanderers were more frequent among those with severe dementia. They displayed more restlessness, positive affect and attachment to others with respect to QOL. The patients with scatolia tended to get lower scores in tests of cognitive function and displayed more negative affect/actions with respect to QOL. Both wanderers and patients with scatolia suffered from insomnia more frequently.

Conclusions: These results suggest that both wandering and scatolia are behavioral symptoms intimately associated with cognitive dysfunction and insomnia.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Algase, D. L. (1992). Cognitive discriminants of wandering among nursing home residents. Nursing Research, 41, 7881.CrossRefGoogle ScholarPubMed
Algase, D. L. (1999). Wandering in dementia. Annual Review of Nursing Research, 17, 185217.CrossRefGoogle ScholarPubMed
Algase, D. L. and Struble, L. (1992). Wandering: what, why and how? In Buckwalter, K. (ed.), Geriatric Mental Health Nursing: Current and Future Challenges (pp. 6174) Thorofare, NJ: Slack.Google Scholar
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV). Washington, DC: American Psychiatric Association.Google Scholar
Ballard, C. G., Mohan, R. N., Bannister, C., Handy, S. and Patel, A. (1991). Wandering in dementia sufferers. International Journal of Geriatric Psychiatry, 6, 611614.CrossRefGoogle Scholar
Begg, A. H. and McDonald, C. (1989). Scatolia in elderly people with dementia. International Journal of Geriatric Psychiatry, 4, 5354.CrossRefGoogle Scholar
Burns, A., Jacoby, R. and Levy, R. (1990). Psychiatric phenomena in Alzheimer's disease. I: Disorders of thought content. British Journal of Psychiatry, 157, 7276.CrossRefGoogle ScholarPubMed
Coen, R. F., Swanwick, G. R., O'Boyle, C. A. and Coakley, D. (1997). Behaviour disturbance and other predictors of carer burden in Alzheimer's disease. International Journal of Geriatric Psychiatry, 12, 331336.3.0.CO;2-J>CrossRefGoogle ScholarPubMed
Cooper, J. K. and Mungas, D. (1993). Risk factor and behavioral differences between vascular and Alzheimer's dementias: the pathway to end-stage disease. Journal of Geriatric Psychiatry and Neurology, 6, 2933.CrossRefGoogle ScholarPubMed
Hope, R. A. and Fairburn, C. G. (1990). The nature of wandering in dementia: a community-based study. International Journal of Geriatric Psychiatry, 5, 239249.CrossRefGoogle Scholar
Hope, T., Keene, J., Gedling, K., Cooper, S., Fairburn, C. and Jacoby, R. (1997). Behaviour changes in dementia: 1. Point of entry data of a prospective study. International Journal of Geriatric Psychiatry, 12, 10621073.3.0.CO;2-N>CrossRefGoogle ScholarPubMed
Hwang, J. P., Yang, C. H., Tsai, S. J. and Liu, K. M. (1997). Behavioural disturbances in psychiatric inpatients with dementia of the Alzheimer's type in Taiwan. International Journal of Geriatric Psychiatry, 12, 902906.3.0.CO;2-Q>CrossRefGoogle ScholarPubMed
Karasawa, A., Kashara, H. and Kato, M. (1988). The role of psychiatric clinics for demented elderly patients. Japanese Journal of Psychiatric Treatment, 3, 949–853 (in Japanese).Google Scholar
Kiely, D. K., Morris, J. N. and Algase, D. L. (2000). Resident characteristics associated with wandering in nursing homes. International Journal of Geriatric Psychiatry, 15, 10131020.3.0.CO;2-X>CrossRefGoogle ScholarPubMed
Klein, D. A. et al. (1999). Wandering behaviour in community-residing persons with dementia. International Journal of Geriatric Psychiatry, 14, 272279.3.0.CO;2-P>CrossRefGoogle ScholarPubMed
Lai, C. K. and Arthur, D. G. (2003). Wandering behaviour in people with dementia. Journal of Advanced Nursing, 44, 173182.CrossRefGoogle ScholarPubMed
Logsdon, R. G., Teri, L., McCurry, S. M., Gibbons, L. E., Kukull, W. A. and Larson, E. B. (1998). Wandering: a significant problem among community-residing individuals with Alzheimer's disease. Journals of Gerontology. Series B: Psychological Sciences and Social Sciences, 53, 294299.CrossRefGoogle ScholarPubMed
Lyketsos, C. G., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J. and DeKosky, S. (2002). Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study. JAMA, 288, 14751483.CrossRefGoogle ScholarPubMed
Mason, T. (1996). Scatolia: psychosis to protest. Journal of Psychiatric and Mental Health Nursing, 3, 303311.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939944.CrossRefGoogle ScholarPubMed
Nagaratnam, N., Lim, W. and Hutyn, S. (2001). Some problematic behaviors in Alzheimer's dementia. Archives of Gerontology and Geriatrics, 32, 5765.CrossRefGoogle ScholarPubMed
Nishimura, T. et al. (1993). Scales for mental state and daily living activities for the elderly: clinical behavioral scales for assessing demented patients. International Psychogeriatrics, 5, 117134.CrossRefGoogle ScholarPubMed
O'Brien, J. A., Shomphe, L. A. and Caro, J. J. (2000). Behavioral and psychological symptoms in dementia in nursing home residents: the economic implications. International Psychogeriatrics, 12 (Suppl. 1), 5157.CrossRefGoogle Scholar
Rabins, P., Mace, M. and Lucas, M. (1982). The impact of dementia on the family. JAMA, 248, 333335.CrossRefGoogle ScholarPubMed
Rader, J., Doan, J. and Schwab, M. (1985). How to decrease problem wandering, a form of agenda behavior. Geriatric Nursing, 6, 196199.CrossRefGoogle Scholar
Reisberg, B., Auer, S. R., Monteiro, I., Boksay, I. and Sclan, S. G. (1996). Behavioral disturbances of dementia: an overview of phenomenology and methodologic concerns. International Psychogeriatrics, 8 (Suppl. 2), 169180.CrossRefGoogle ScholarPubMed
Riter, R. N. and Fries, B. E. (1992). Predictors of the placement of cognitively impaired residents on special care units. Gerontologist, 32, 184190.CrossRefGoogle ScholarPubMed
Román, G. C. et al. (1993). Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology, 43, 250260.CrossRefGoogle ScholarPubMed
Song, J. A., Lim, Y. M. and Hong, G. R. (2008). Wandering behaviour of persons with dementia in Korea: investigation of related factors. Aging and Mental Health, 12, 366373.CrossRefGoogle ScholarPubMed
Steele, C., Rovner, B., Chase, G. A. and Folstein, M. (1990). Psychiatric symptoms and nursing home placement of patients with Alzheimer's disease. American Journal of Psychiatry, 147, 10491051.Google ScholarPubMed
Terada, S. et al. (2002). Development and evaluation of a health-related quality of life questionnaire for the elderly with dementia in Japan. International Journal of Geriatric Psychiatry, 17, 851858.CrossRefGoogle ScholarPubMed
Terada, S. et al. (2005). Delusion of theft and phantom intruder delusion in demented elderly patients in Japan. Journal of Geriatric Psychiatry and Neurology, 18, 142148.CrossRefGoogle ScholarPubMed
Wancata, J., Windhaber, J., Krautgartner, M. and Alexandrowicz, R. (2003). The consequences of non-cognitive symptoms of dementia in medical hospital departments. International Journal of Psychiatry in Medicine, 33, 257271.CrossRefGoogle ScholarPubMed
Yang, C. H., Hwang, J. P., Tsai, S. J. and Liu, C. M. (1999). Wandering and associated factors in psychiatric inpatients with dementia of Alzheimer's type in Taiwan: clinical implications for management. Journal of Nervous and Mental Disease, 187, 695697.CrossRefGoogle ScholarPubMed