title: Factors associated with problematic vocalizations in nursing home residents with dementia.
abstract: OBJECTIVE
  Problematic vocalizations (PVs) are the most frequent and persistent disruptive behaviors exhibited by nursing home residents with dementia. Understanding factors associated with these behaviors are important to prevent or reduce them. We used the Need-Driven Dementia-Compromised Behavior model to identify the characteristics of persons with dementia who are likely to display nonaggressive and aggressive PVs and the conditions under which these behaviors are likely to occur and persist.
  
  
  METHODS
  This multisite descriptive study included 138 residents of 17 nursing homes, and approximately half had a history of PVs. Background data were gathered through interviews, chart reviews, and administration of physical and neuropsychological assessments. Proximal data were obtained from observations and videotapes.
  
  
  RESULTS
  When the 2 subscales of the Verbal Behavior Scale were used as the dependent variables, agreeableness and conscientiousness, positive affect, and discomfort were associated with nonaggressive vocalizations, and general health state (GHS), age, and negative and positive affect were associated with aggressive vocalizations. When the verbally agitated (nonaggressive) section of the Cohen-Mansfield Agitation Inventory was the dependent variable, the background factors of gender, agreeableness, GHS, and age remained predictors, as did the proximal factors of affect and discomfort.
  
  
  CONCLUSIONS
  We identified 5 background factors and 3 proximal factors as risk factors for PVs in persons with dementia, with variation between nonaggressive or aggressive PVs. These data provide direction for caregiving for persons with dementia and design of interventions to prevent or reduce PVs.
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. beckcornelia@uams.edu
authors.forename: Cornelia
authors.initials: C
authors.lastname: Beck
authors.forename: Kathy
authors.initials: K
authors.lastname: Richards
authors.forename: Corinne
authors.initials: C
authors.lastname: Lambert
authors.forename: Rebecca
authors.initials: R
authors.lastname: Doan
authors.forename: Reid D
authors.initials: RD
authors.lastname: Landes
authors.forename: Ann
authors.initials: A
authors.lastname: Whall
authors.forename: Donna
authors.initials: D
authors.lastname: Algase
authors.forename: Ann
authors.initials: A
authors.lastname: Kolanowski
authors.forename: Zachary
authors.initials: Z
authors.lastname: Feldman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression / Q000523:psychology; D001131:Arkansas / Q000453:epidemiology; D003704:Dementia / Q000150:complications / Q000523:psychology*; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D007407:Interviews as Topic; D007802:Language; D008297:Male; D009483:Neuropsychological Tests; D009622:Noise; D009735:Nursing Homes; D011595:Psychomotor Agitation / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D012307:Risk Factors; D017678:Sex Distribution; D014705:Verbal Behavior; D014743:Videotape Recording