Identification of pseudobulbar affect symptoms in the nursing home setting: Development and assessment of a screening tool

Document Type

Article

Publication Date

1-1-2018

Publication Title

Geriatric nursing (New York, N.Y.)

Abstract

Pseudobulbar Affect (PBA) is a neurologic condition characterized by involuntary outbursts of crying and/or laughing disproportionate to patient mood or social context. Although an estimated 9% of nursing home residents have symptoms suggestive of PBA, they are not routinely screened. Our goal was to develop an electronic screening tool based upon characteristics common to nursing home residents with PBA identified through medical record data. Nursing home residents with PBA treated with dextromethorphan hydrobromide/quinidine sulfate (n = 140) were compared to age-, gender-, and dementia-diagnosis-matched controls without PBA or treatment (n = 140). Comparative categories included diagnoses, medication use and symptom documentation. Using a multivariable regression and best decision rule analysis, we found PBA in nursing home residents was associated with chart documentation of uncontrollable crying, presence of a neurologic disorder (e.g., Parkinson's disease), or by the documented presence of at least 2 of the following: stroke, severe cognitive impairment, and schizophrenia. Based on these risk factors, an electronic screening tool was created.

Medical Subject Headings

Aged; Aged, 80 and over; Cross-Sectional Studies; Dextromethorphan; Drug Combinations; Emotions; Female; Humans; Male; Middle Aged; Nursing Homes; Pseudobulbar Palsy; Quinidine; Surveys and Questionnaires

PubMed ID

28807457

Volume

39

Issue

1

First Page

54

Last Page

59

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