Abstract
Objectives
To explore whether severity of cognitive impairment and agitation of older people
with dementia predict outcomes in engagement, mood states, and agitation after a 10-week
intervention with the robotic seal, PARO.
Design
Data from the PARO intervention-arm of a cluster-randomized controlled trial was used,
which involved individual, nonfacilitated, 15-minute sessions with PARO 3 afternoons
per week for 10 weeks.
Sample and participants
One hundred thirty-eight residents—aged ≥60 years, with dementia—from 9 long-term
care facilities.
Measures
A series of stepwise multiple linear regressions were conducted. Dependent variables
were participants’ levels of engagement, mood states, and agitation at week 10 [assessed
by video observation and Cohen Mansfield Agitation Inventory-Short Form (CMAI-SF)].
Predictor variables were baseline levels of cognitive impairment [assessed by Rowland
Universal Dementia Assessment Scale (RUDAS)] and agitation (CMAI-SF).
Results
Five models were produced. The strongest finding was that participants with more severe
agitation at baseline had higher levels of agitation at week 10 (R2 = .82, P < .001). Predictors of positive response were less significant. Low levels of agitation
at baseline predicted greater positive behavioral engagement with PARO (R2 = .054, P = .009) and fewer observed instances of agitation (R2 = .033, P = .045) at week 10, whereas greater visual engagement was predicted by both lower
levels of agitation and cognitive impairment (R2 = .082, P = .006). Less severe cognitive impairment predicted greater pleasure at week 10 (R2 = .067, P = .004).
Conclusions/Implications
Participants with severe agitation had poor response to PARO. Lower levels of agitation
and higher cognitive functioning were associated with better responses. In clinical
practice, we recommend PARO should be restricted to people with low-moderate severity
of agitation. Further research is needed to determine the optimal participant characteristics
for response to PARO.
Keywords
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Article info
Publication history
Published online: April 13, 2018
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
