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Aim: To determine how the nighttime sleep patterns of older adults in a long‐term care facility vary according to cognitive function and participation in daytime activities. Methods: This observational study was conducted with older adults aged ≥65 years who are residents of a long‐term care facility. Nighttime sleep was monitored using a non‐wearable sleep monitor for 8 weeks. Based on the Mini‐Mental State Examination scores for assessment of cognitive function, participants were classified into non‐dementia, mild‐to‐moderate dementia, and severe dementia groups. The Mann–Whitney U test and Kruskal–Wallis test were used to analyze the data. Results: Twenty three older adults were included in this study. Sleep onset latency was significantly longer in the severe dementia group than in the non‐dementia (p =.027) and mild‐to‐moderate dementia (p =.041) groups. Sleep efficiency was significantly lower in the severe dementia group than in the mild‐to‐moderate dementia group (p =.003), whereas wakefulness after sleep onset was significantly longer in the severe dementia group than in the mild‐to‐moderate dementia group (p =.011). The number of days spent engaging in recreational activities was <50%, whereas those spent taking a nap was >60% in all older adults. Older adults with mild‐to‐moderate dementia had better sleep and participated in more daytime activities than those with severe or no dementia. Moreover, bathing in a bathtub improved sleep onset latency. Conclusions: This study demonstrates that participation in daytime activities and bathing in a bathtub affect nighttime sleep in older adults. [ABSTRACT FROM AUTHOR]

Background: It is imperative that a team consisting of a physician, pharmacist, and nursing professional provides pharmacotherapy support to achieve the optimal effect of pharmacotherapy for older adults with dementia. This study reviewed Japanese publications on the process of pharmacotherapy support practised by various professionals for home‐based older adults with dementia and investigated healthcare professionals' perceived importance and practice of pharmacotherapy support. Methods: This study aimed to shed light on basic pharmacotherapy support for behavioural and psychological symptoms among home‐based older adults with dementia using multidisciplinary collaboration, through a literature review of Japanese publications. Based on the literature review, 13 items pertaining to basic pharmacotherapy support for home‐based older adults with dementia were extracted. A mail‐based, self‐administered, anonymous questionnaire survey was conducted with professionals including physicians, pharmacists, and nursing professionals who provide pharmacotherapy support to home‐based older adults with dementia. Participants rated 13 items on their perceived importance and practice of basic pharmacotherapy support using a four‐point Likert scale. Results: The results indicated that participants recognised the importance of all 13 items. At least 80% of all professionals indicated that they practised seven out of 13 items. Less than 80% of all professionals indicated they practised the other six items that should be provided after the commencement of pharmacotherapy. A relatively high proportion of nursing professionals (70%) indicated they practised the remaining six items. The 13 items were indeed deemed important for characterising pharmacotherapy support. However, in Japan, suboptimal support is provided following the commencement of medication. This may be because appropriate modifications to dementia care are not made as the patient's condition progresses. Conclusions: It is suggested that multidisciplinary collaboration focusing on the progression of dementia and the process of pharmacotherapy, especially after the commencement of pharmacotherapy, may help provide effective, continuous pharmacotherapy. [ABSTRACT FROM AUTHOR]

Background: Older people with dementia who cannot perform daily activities independently due to cognitive impairment need support at home and in the community. This study identified aspects of activities of daily living (ADL) interventions that advanced dementia care practitioners recognise as challenging for informal caregivers to perform. Methods: We conducted a self‐administered cross‐sectional survey on advanced dementia care practitioners, including certified nurses, specialising in gerontological, community health, home care, and visiting nursing, nurses specialising in dementia certified by the Japanese Nursing Association, and dementia care leaders certified by prefectural governors. The participants rated a caregivers' extent of difficulty in aspects of ADL interventions on a four‐point Likert scale. Factor analysis was performed to determine ADL intervention aspects that are recognised by advanced dementia care practitioners as challenging for informal caregivers. Results: The highest loaded factors for mild, moderate, and severe cognitive impairment stages were 'right time to draw attention,' 'opportunities to perform ADL,' and 'communicating how to perform ADL without giving up,' respectively. Therefore, it is imperative to educate informal caregivers about the effects of cognitive impairment on ADL performance in people with dementia and enable them to provide concrete ADL interventions and tips to support the persons' autonomy and independence. The Cronbach's alpha values of the highest loaded factors for mild, moderate, and severe cognitive impairment stages were 0.851, 0.925, and 0.946, respectively. Moreover, the cumulative contribution ratios of each stage were 46.04%, 50.52%, and 47.36%, respectively. Conclusion: This study dealt with identifying informal caregivers' difficulties with ADL interventions across the stages of dementia. Informal caregivers should be supported on aspects of ADL interventions that are potentially difficult for them to perform. Useful educational content and approaches in training programs for informal caregivers should be developed to enable them to help people with Alzheimer's disease maintain ADL performance toward 'ageing in place' even as the disease progresses. [ABSTRACT FROM AUTHOR]

Geriatr Gerontol Int 2018; 18: 823–827. [ABSTRACT FROM AUTHOR]