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Misplacing objects in mild to moderate Alzheimer's disease: a descriptive analysis from the VISTA clinical trial
  1. Laura M Hamilton (laura.hamilton{at}cdha.nshealth.ca)
  1. Geriatric Medicine Research Unit, Capital District Health Authority & Dalhousie University, Canada
    1. Sherri Fay (fays{at}dal.ca)
    1. Geriatric Medicine Research Unit, Capital District Health Authority & Dalhousie University, Canada
      1. Kenneth Rockwood (kenneth.rockwood{at}dal.ca)
      1. Division of Geriatric Medicine, Capital District Health Authority & Dalhousie University, Canada

        Abstract

        Background: Misplacing objects is a commonly reported symptom of Alzheimer’s disease (AD), however it is little described systematically and conflicting characterizations (losing/forgetting the location of objects versus inappropriate placement) of this “warning sign” of dementia currently exist. We report on patient and carer descriptions of misplacing in clinical interviews.

        Methods: This is a secondary, qualitative analysis of video-recorded, open-ended and semi-structured, clinical interviews with 130 community-dwelling patients with mild-to-moderate AD (mean age = 77 ±7.7; 63% women; 67% mild AD) and their carers who participated in the Video-Imaging Synthesis of Treating Alzheimer’s Disease (VISTA) study: a 4-month, randomized, placebo-controlled trial of galantamine. Employing a framework analysis approach, we summarized descriptive accounts of misplacing with relevant proportions.

        Results: Recurrent incidents of misplacing were described for 96/130 (74%) study patients, 45 of whom established treatment goals to track this problem. For most (78/96, 81%), misplacing was the inability to recall where an item had been set down or put away. Fewer patients (25/96, including 18 with recall-misplacing) put objects in unusual or incorrect places. Patients were commonly aware of their misplacing (56/96, 58%) and were distressed by it (31/56). Patients who misplaced also displayed tendencies towards delusions/hallucinations (51/96, but only directly related to misplacing in 17 cases) and hiding items (15%).

        Conclusion: Misplacing is a common phenomenon in mild-to-moderate Alzheimer’s disease. Here, misplacing was usually described as an inability to recall where an item was set down, more so than the inappropriate placement of items.

        ISRCTN26167328

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