TY - JOUR
T1 - Circadian aspects of mobility‐related behavior in patients with dementia
T2 - An exploratory analysis in acute geriatric psychiatry
AU - Trumpf, Rieke
AU - Haussermann, Peter
AU - Zijlstra, Wiebren
AU - Fleiner, Tim
PY - 2023/6/19
Y1 - 2023/6/19
N2 -
Background
Analyzing patients' mobility-related behavior may improve the assessment of motor behavior in dementia, however, few studies addressed circadian aspects of mobility. This cross-sectional explorative study analyzed the timing of peak mobility-related behavior, the prevalence of mobility-related sundowning and nocturnal mobility-related behavior and associated clinical characteristics in acute geriatric psychiatry.
Methods
Mobility-related behavior of 73 patients (M: 81 years) was measured over 48 h using lower-back worn hybrid motion sensors. We derived the start of the 30-min period with peak gait activity (highest number of steps) for each day and the number of nocturnal steps taken from 10PM to 7AM. Professional caregiver ratings of the patients' motor behavior were conducted within the Neuropsychiatric Inventory (NPI).
Results
The mean start time of peak gait activity was 2:37PM, but large variations in timing were found (range: 3:25AM–9:30PM). Twenty-five patients (34%) were identified as “sundowners”. Nocturnal mobility-related behavior was measured in 35 patients (53%), whereas professional caregivers assessed night-time disorders in only 19 patients (26%). Clinical characteristics of “sundowners” were not significantly different from other patients, except for lower doses of antipsychotics as compared to non-sundowners (M:1.6 mg/day; p = 0.015). The number of nocturnal steps was significantly associated to corresponding NPI ratings (Spearman's rho = 0.4; p < 0.001).
Conclusion
Analyzing the timing of peak gait activity and nocturnal step-count seem to provide clinical applicable information on the circadian aspects of mobility-related behavior in acute geriatric psychiatry. Even though the clinical validity needs to be evaluated, objective information on the individual circadian aspects of mobility-related behavior could help to personalize treatment with benefits for patients and caregivers.
AB -
Background
Analyzing patients' mobility-related behavior may improve the assessment of motor behavior in dementia, however, few studies addressed circadian aspects of mobility. This cross-sectional explorative study analyzed the timing of peak mobility-related behavior, the prevalence of mobility-related sundowning and nocturnal mobility-related behavior and associated clinical characteristics in acute geriatric psychiatry.
Methods
Mobility-related behavior of 73 patients (M: 81 years) was measured over 48 h using lower-back worn hybrid motion sensors. We derived the start of the 30-min period with peak gait activity (highest number of steps) for each day and the number of nocturnal steps taken from 10PM to 7AM. Professional caregiver ratings of the patients' motor behavior were conducted within the Neuropsychiatric Inventory (NPI).
Results
The mean start time of peak gait activity was 2:37PM, but large variations in timing were found (range: 3:25AM–9:30PM). Twenty-five patients (34%) were identified as “sundowners”. Nocturnal mobility-related behavior was measured in 35 patients (53%), whereas professional caregivers assessed night-time disorders in only 19 patients (26%). Clinical characteristics of “sundowners” were not significantly different from other patients, except for lower doses of antipsychotics as compared to non-sundowners (M:1.6 mg/day; p = 0.015). The number of nocturnal steps was significantly associated to corresponding NPI ratings (Spearman's rho = 0.4; p < 0.001).
Conclusion
Analyzing the timing of peak gait activity and nocturnal step-count seem to provide clinical applicable information on the circadian aspects of mobility-related behavior in acute geriatric psychiatry. Even though the clinical validity needs to be evaluated, objective information on the individual circadian aspects of mobility-related behavior could help to personalize treatment with benefits for patients and caregivers.
UR - https://www.scopus.com/pages/publications/85162660130
U2 - 10.1002/gps.5957
DO - 10.1002/gps.5957
M3 - Journal articles
SN - 0885-6230
VL - 2023
JO - International journal of geriatric psychiatry
JF - International journal of geriatric psychiatry
M1 - e5957
ER -