People with dementia: Exploring
the relationship between
function & sensory processing
Sue Southam
image courtesy of royalvoluntaryservice.org
image courtesy of culinaryschools.org
Why do this research?
• Dementia impacts on the person, their carers,
society and the economy. (Department of Health
[DoH] 2009)
• Number of people living with dementia to rise
to 1.4 million in next 30 years; costs to over
£50 billion. (DoH 2009)
• NIHR MRes studentship
• Improve practice
Image courtesy of AAP
What is Sensory Processing?
Behavioural response
Neurological threshold
Low
High
Passive
Low registration (LR)
Needs intense stimuli for
recognition
May miss stimuli others
notice
Adapts easily to changes in
environments
Sensory sensitivity (SSY)
Responds easily
Notices stimuli others do
not recognise
Distractible
Active
Sensation seeking (SSK)
Enjoys intense stimuli
Creates additional stimuli
Seeks sensory rich environments
Sensation avoiding (SA)
Overwhelmed by stimuli
Intentionally uses strategies to
minimise or eliminate stimuli
Summarised from Adolescent / Adult Sensory Profile, Brown & Dunn, 2002.
What is the evidence?
Neurological
studies
Multisensory
environments
?
Developmental/
sensory
integration
Sensory
processing and
adults
Sensory
processing and
older people
The research question…
Is there a relationship between scores on the
Adolescent/Adult Sensory profile (AASP) and the functional
ability of people with mild / moderate dementia when
measured by the Assessment of Motor & Process Skills
(AMPS)?
People with
atypical scores on
AASP will perform
less competently
when measured
using AMPS
Relationships exist
between AMPS
performance and
AASP scores, with
and without
atypical sensory
processing
Data collection
Identified via Memory Assessment Service & CMHT
Information given, consent to contact
Signed consent sought at home visit
AMPS explained, 2 tasks completed
AASP completed and scored
Basic information on quadrant with most effect on behaviour
given
Researcher leaves
Demographic and clinical characteristics
 Age (years): m = 78.47 (6.0) 64-89
 Gender: male = 13 female = 4
 Diagnosis: Alzheimer’s 12, Vascular 1, Mixed 4
 AMPS motor score: m = 2.08 (0.30) 1.60-2.60
 AMPS process scores: m = 0.92 (0.23) 0.60-1.50
Results: Is there a difference between
typical/atypical AASP scores and AMPS scores?
Motor Skills
Process Skills
Typical group:
Mean logit = 2.00, SD =.14
Atypical group:
Mean logit = 2.10, SD =.33
Typical group:
Mean logit = 1.07, SD =.35
Atypical group:
Mean logit = .88, SD =.17
Mean difference (-.11) ns.
(t = -.61 (15); p=.55)
95% confidence interval
-.48 to .26
Mean difference (.20) ns.
(t = 1.60 (15); p=.13)
95% confidence interval
-.07 to .46
Results: Is there a relationship between scores on the
AASP and scores on the AMPS?
Correlations between the AASP quadrants and AMPS scores.
AMPS
Low
Sensation
registration seeking
Sensory
sensitivity
Sensation
avoiding
Motor
score
-.13 (.62)
-.02 (.95)
-.32 (.21)
-.28 (.27)
Process
score
-.14 (.58)
-.13 (.61)
-.09 (.72)
-.24 (.36)
Results: do people with atypical scores on AASP
perform less well on AMPS?
Motor skills
x2(1, N = 17) = .56, p = .44, Fisher’s Exact test
6 out of 7 under 2 logits = atypical processing
Process skills
x2(1, n = 17) = .49, p = .44, Fisher’s Exact test
9 out of 11 under 1 logit = atypical processing
Discussion…
• Scores for Low Registration similar to findings of Pohl et
al (2003)
• High scores for ‘Low Registration’ = low AMPS scores for
‘organises’, ‘restores’ and ‘notices and responds’
• 13 of the 17 people had atypical sensory processing
patterns
• Scores for AASP sensory categories were different to
normal population (Brown and Dunn 2002):
Much less/more than most
Normal
2%
Study
35%
Similar to most
Normal
48%
Study
24%
Less/more than most
Normal
14%
Study
41%
Why does this matter?
 Compensatory strategies developed based on sensory need
 Environments adapted to reduce or increase stimulation,
reducing challenging behaviours and use of medication
 Skills & routines maintained, reducing burden on carers
 Knowledge is empowering for service user & carer
 People remain engaged within the community and society
Summary…
 First study to explore this relationship
 Sensory processing affects function
 Managing sensory demand may facilitate higher cognitive
functioning
 Increased effectiveness of interventions
 Community living for longer
With thanks to:
Dr Lesley Collier: mentor
Dr Sean Ewings: statistical advice
Thank You
Please e-mail for full reference list
[email protected]
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