{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T22:01:15Z","timestamp":1785016875299,"version":"3.55.0"},"reference-count":47,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,4,9]],"date-time":"2017-04-09T00:00:00Z","timestamp":1491696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Older People Nursing"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Behavioural and psychological symptoms of dementia (<jats:styled-content style=\"fixed-case\">BPSD<\/jats:styled-content>) are very common among older people, and previous studies showed that<jats:styled-content style=\"fixed-case\">BPSD<\/jats:styled-content>affects eating behaviour negatively, possibly resulting in undernutrition. In a previous study, we constructed a set of 11 items based on direct observations of older people with dementia during mealtime and named them \u2018<jats:styled-content style=\"fixed-case\">SSADE<\/jats:styled-content>: signs and symptoms accompanying dementia while eating\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study aimed to conduct a factor analysis to clarify the structure of the set of 11<jats:styled-content style=\"fixed-case\">SSADE<\/jats:styled-content>items and to analyse the relationship of the<jats:styled-content style=\"fixed-case\">SSADE<\/jats:styled-content>with nutritional status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We sampled 259 older people from 14 institutional facilities in Japan. To assess the status of the<jats:styled-content style=\"fixed-case\">SSADE<\/jats:styled-content>, we quantified each item according to its frequency and severity, using a 5\u2010point scale. We also collected information regarding characteristics and nutritional status (body mass index [<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>], dietary intakes, body weight change, serum albumin level). We performed an exploratory factor analysis on the<jats:styled-content style=\"fixed-case\">SSADE<\/jats:styled-content>. In addition, associations between grouped factor scores and nutritional status were analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Exploratory factor analysis indicated four factors. \u2018Hypoactivity\u2019 including \u2018dietary agnosia\u2019 and \u2018drowsiness\u2019 correlated negatively with<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>and serum albumin levels. \u2018Hyperactivity\u2019 including \u2018agitation\u2019, \u2018delusion\u2019, \u2018wandering\u2019 and \u2018eating too rapidly\u2019 correlated negatively with<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>. \u2018Obsessiveness\u2019 including \u2018food refusal\u2019 and \u2018fad eating\u2019 correlated negatively with<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>, dietary intake and body weight change. \u2018Aberrant behaviours\u2019 including \u2018eating apraxia\u2019, \u2018pica\u2019 and \u2018stealing food\u2019 correlated positively with dietary intake.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The identified factors of the<jats:styled-content style=\"fixed-case\">SSADE<\/jats:styled-content>were related to nutritional status, which may suggest acceptable factorial validity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Implications for practice<\/jats:title><jats:p>We expected the<jats:styled-content style=\"fixed-case\">SSADE<\/jats:styled-content>to contribute to the prevention and improvement of undernutrition, through the development of a concrete strategy for nutritional care planning by professional teams including dietitians in long\u2010term care facilities.<\/jats:p><\/jats:sec>","DOI":"10.1111\/opn.12149","type":"journal-article","created":{"date-parts":[[2017,4,10]],"date-time":"2017-04-10T04:02:43Z","timestamp":1491796963000},"source":"Crossref","is-referenced-by-count":11,"title":["Grouped factors of the \u2018<scp>SSADE<\/scp>: signs and symptoms accompanying dementia while eating\u2019 and nutritional status\u2014An analysis of older people receiving nutritional care in long\u2010term care facilities in Japan"],"prefix":"10.1111","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6232-8659","authenticated-orcid":false,"given":"Kento","family":"Takada","sequence":"first","affiliation":[{"name":"Aomori University of Health and Welfare Graduate School of Health Sciences Aomori Japan"},{"name":"Kanagawa University of Human Services Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazumi","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Yamato City Hall Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihoko","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Yamato City Hall Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiko","family":"Sugiyama","sequence":"additional","affiliation":[{"name":"Kanagawa University of Human Services Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuo","family":"Yoshiike","sequence":"additional","affiliation":[{"name":"Aomori University of Health and Welfare Graduate School of Health Sciences Aomori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,4,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2015.01.029"},{"key":"e_1_2_10_3_1","first-page":"825","article-title":"Study on the reliability of the Japanese version of the BEHAVE\u2010AD","volume":"10","author":"Asada T.","year":"1999","journal-title":"Japanese Journal of Geriatric Psychiatry"},{"key":"e_1_2_10_4_1","unstructured":"Asada T. 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