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The Influence of Behavioral and Psychological Symptoms of Dementia on the Autonomic Nervous System

Dementia is a broad category of brain diseases that cause a long-term and often gradual decrease in the ability to think and remember that is great enough to affect a person’s daily functioning. Memory loss is one typical example. In fact, many dementias are progressive, meaning symptoms start out slowly and gradually get worse. Various factors can cause behavioral and psychological symptoms of dementia (BPSD). And stress is one of the most potent of many factors that can cause expression of behavioral and psychological symptoms of dementia (BPSD). If a patient with dementia is coping with stress, the autonomic nervous system becomes dominated by sympathetic nervous-adrenal medullary (SAM) activity. This study aimed to clarify the causal relationship between BPSD and autonomic nervous system activity by making a theoretical model in which BPSD influencing autonomic nervous system activity, analyzing the model using SEM, and examining the standardization coefficient.

In this study, the authors recruited 35 participants diagnosed with dementia from nearby geriatric health service facilities. The Neuropsychiatric Inventory was used for the evaluation of BPSD, and a TAS 9 VIEW (manufactured by YKC) was used for the heart rate variability analysis to measure autonomic nervous system activity. They also constructed a model in which the autonomic nervous system comprised a category and performed a structural equation modeling analysis to calculate the standardization coefficient and correlation coefficient for each factor. And the authors assessed the data from the model for fitness with the goodness of fit index (GFI), adjusted goodness of fit index (AGFI), and root-mean-square error of approximation (RMSEA). Analyses were performed using the Statistical Package for the Social Sciences (SPSS), version 25 (SPSS, Inc., Chicago, IL, USA) and SEM was performed using SPSS Amos 19.0 (SPSS, Inc.). Kaiser-Meyer-Olkin (KMO) and Bartlett’s tests were performed to determine whether the factor analysis using 10 variables was suitable. The level of significance was set at a p-value of less than 5%.

The results showed that the influence of BPSD suppressed sympathetic nervous system activity and enhanced parasympathetic nervous system activity. In addition, this study shows that it is necessary to pay attention to not only sympathetic nervous system activity, but also parasympathetic nervous activity when measuring autonomic nervous system activity for stress in dementia.

Article by Daisuke Kimura, et al, from Japan.

Full access: http://mrw.so/1EIEbe

Image by Kim Noce, from Flickr-cc.

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