Aomori University of Health and Welfare Graduate School of Health Sciences, Aomori, Japan.
Kanagawa University of Human Services, Kanagawa, Japan.
Int J Older People Nurs. 2017 Sep;12(3). doi: 10.1111/opn.12149. Epub 2017 Apr 9.
Behavioural and psychological symptoms of dementia (BPSD) are very common among older people, and previous studies showed that BPSD affects eating behaviour negatively, possibly resulting in undernutrition. In a previous study, we constructed a set of 11 items based on direct observations of older people with dementia during mealtime and named them 'SSADE: signs and symptoms accompanying dementia while eating'.
This study aimed to conduct a factor analysis to clarify the structure of the set of 11 SSADE items and to analyse the relationship of the SSADE with nutritional status.
We sampled 259 older people from 14 institutional facilities in Japan. To assess the status of the SSADE, we quantified each item according to its frequency and severity, using a 5-point scale. We also collected information regarding characteristics and nutritional status (body mass index [BMI], dietary intakes, body weight change, serum albumin level). We performed an exploratory factor analysis on the SSADE. In addition, associations between grouped factor scores and nutritional status were analysed.
Exploratory factor analysis indicated four factors. 'Hypoactivity' including 'dietary agnosia' and 'drowsiness' correlated negatively with BMI and serum albumin levels. 'Hyperactivity' including 'agitation', 'delusion', 'wandering' and 'eating too rapidly' correlated negatively with BMI. 'Obsessiveness' including 'food refusal' and 'fad eating' correlated negatively with BMI, dietary intake and body weight change. 'Aberrant behaviours' including 'eating apraxia', 'pica' and 'stealing food' correlated positively with dietary intake.
The identified factors of the SSADE were related to nutritional status, which may suggest acceptable factorial validity.
We expected the SSADE to contribute to the prevention and improvement of undernutrition, through the development of a concrete strategy for nutritional care planning by professional teams including dietitians in long-term care facilities.
行为和心理症状的痴呆症（BPSD）是非常常见的老年人，和以前的研究表明，BPSD 影响饮食行为呈负相关，可能导致营养不良。在以前的研究中，我们构建了一套 11 项基于直接观察的老年人痴呆症在吃饭时，他们的名字是“SSADE：与痴呆症有关的迹象和症状同时进食”。
本研究旨在进行因子分析，以明确一套 11 项 SSADE 的结构，并分析 SSADE 与营养状况的关系。
我们从日本的 14 个机构设施中抽取了 259 名老年人。为了评估 SSADE 的状况，我们根据频率和严重程度，用 5 分制对每个项目进行量化。我们还收集了有关特征和营养状况（体重指数[BMI]、饮食摄入、体重变化、血清白蛋白水平）的信息。我们对 SSADE 进行了探索性因子分析。此外，还分析了分组因子得分与营养状况之间的关系。
探索性因子分析表明有四个因素。“低活性”包括“饮食障碍”和“嗜睡”与 BMI 和血清白蛋白水平呈负相关。“高活性”包括“激动”、“妄想”、“徘徊”和“吃得太快”与 BMI 呈负相关。“强迫行为”包括“拒绝进食”和“异食癖”与 BMI、饮食摄入和体重变化呈负相关。“异常行为”包括“进食失用症”、“异食癖”和“偷食”与饮食摄入呈正相关。
SSADE 的鉴定因子与营养状况有关，这可能表明具有可接受的因子有效性。
我们希望 SSADE 通过包括营养师在内的专业团队制定具体的营养护理计划，为预防和改善营养不良做出贡献。
