Factors associated with social behaviour for people with Alzheimer's dementia: a video observation study

Background: People with Alzheimer’s dementia (AD) often experience changes in their social behaviour, which is distressing for them and their caregivers. However, little is understood about whether this is affected by the support provided by or familiarity with their conversation partners. Objective: This study aimed to quantitatively explore the influence of support provided by, and familiarity with, conversation partners on the social behaviour of people with mild AD during conversation. Method: Three independent researchers double-rated recordings of conversations between 19 participants with mild AD and a friend or family member (familiar conversation partner), and an unfamiliar researcher. We assessed the support provided by conversation partners using the Measure of Support in Conversation-Dementia (MSC-D), and the social behaviour of participants with AD using two measures of social behaviour: the Measure of Participation in Conversation-Dementia (MPC-D) and Social Observation Inventory (SOI). We used multilevel modelling to explore adjusted associations of support and familiarity with social behaviour. Results: Greater support in conversation was associated with more participation in social conversation of participants with AD. In fully adjusted models, every 1-point increase in MSC-D score was associated with a 0.29 (95% CI: 0.14 to 0.44) increase in MPC-D score and a 1.59 (95% CI: 0.87 to 2.32) increase in SOI score. Familiarity with the conversation partner was not associated with social behaviour of participants with AD. Conclusions: More support from conversation partners facilitated social behaviour for people with AD, suggesting that interventions to improve conversational support from friends and families of people with dementia may be helpful and should be developed and tested in future research.