title: The Association Between Characteristics of Care Environments and Apathy in Residents With Dementia in Long-term Care Facilities.
abstract: OBJECTIVE
  Apathy is highly prevalent in dementia but often overlooked. Environment-based interventions have demonstrated positive impact on apathy, yet, influential environmental components are largely understudied. This study examined the relationship between care environments and apathy in long-term care residents with dementia.
  
  
  METHODS
  This study was exploratory and employed a descriptive and repeated observation design. A sample of 40 was selected from a parent study with 185 participants from 28 facilities. Three videos from each participant were coded to measure apathy and environmental stimulation. Data on ambiance, crowding, staff familiarity, light, and sounds were extracted from the parent study. Generalized linear mixed models were used for analysis.
  
  
  RESULTS
  The clarity and strength of environmental stimulation were significantly associated with a lower apathy level. An increase of 1 point on stimulation clarity and strength corresponded to a decrease of 1.3 and 1.9 points on apathy score, respectively (p < .0001). Other environmental factors did not show significant effect on apathy.
  
  
  CONCLUSIONS
  This study explored influential environmental features on apathy in dementia. Findings suggest that care environments that contain clear and sufficient environmental stimulation are significantly associated with lower resident apathy levels. Findings will guide environmental design and interventions for dementia care.
authors.affiliation: College of Nursing, The Pennsylvania State University, University Park, Pennsylvania. College of Nursing, The University of Iowa Iowa City, Iowa. yuj15@psu.edu.
authors.forename: Ying-Ling
authors.initials: YL
authors.lastname: Jao
authors.affiliation: School of Nursing, University of Michigan, Ann Arbor Michigan.
authors.forename: Donna L
authors.initials: DL
authors.lastname: Algase
authors.affiliation: College of Nursing, The University of Iowa Iowa City, Iowa. John A. Hartford Center for Geriatric Nursing Excellence, Iowa City, Iowa.
authors.forename: Janet K
authors.initials: JK
authors.lastname: Specht
authors.affiliation: College of Nursing, The University of Iowa Iowa City, Iowa. John A. Hartford Center for Geriatric Nursing Excellence, Iowa City, Iowa.
authors.forename: Kristine
authors.initials: K
authors.lastname: Williams
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057565:Apathy; D040561:Assisted Living Facilities; D003704:Dementia / Q000451:nursing*; D004777:Environment; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D011788:Quality of Life
keywords: Alzheimer’s disease; Assisted living; Neuropsychiatric symptoms; Nursing homes,