Introduction: Knowledge of how perceptions of personal control change over time may provide valuable insights into how people cope with having dementia. The present study aimed to examine change in locus of control over a 12-month period in persons with dementia. Method: The study included 52 participants with dementia. Locus of control was measured with the Locus of Control of Behavior Scale (LoCB), with higher scores indicating a more external locus of control, interpreted as perceiving less personal control. A ≥5% change on the LoCB was considered clinically meaningful. We recorded sociodemographic characteristics and assessed dementia severity, cognition, ability to function independently in daily activities and physical self-maintenance, depressive symptomatology, and number of prescribed medications. Analyses were performed to examine differences between those with increases (more external) or decreases (less external) in the LoCB score after 12 months and to examine associations between baseline variables and change in the LoCB score. Results: The mean LoCB score for the total sample did not change after 12 months (baseline mean 29.33 vs. follow-up mean 30.33, p = 0.553); however, 2 subgroups emerged. Using the ≥5% cutoff revealed that the LoCB score changed for 92.3% of the sample, becoming less external (lower LoCB) for 21 participants and more external (higher LoCB) for 27 participants. At baseline, the mean LoBC score was higher in the group that became less external (33.81 vs. 24.56), p = 0.006, while this was reverse at follow-up (23.57 vs. 34.41), p = 0.001. Dementia severity and dependence in physical self-maintenance increased during the 12 months in both groups. Among those becoming more external, we also found a decline in cognition (p = 0.002), an increase in dependence in daily activities (p = 0.003), an increase in the use of prescribed medication, and a decrease in depressive symptomatology (p = 0.003). The baseline LoCB score was the only variable associated with 12-month change in LoCB scores (p = 0.001). Conclusion: Most participants showed a clinically meaningful change in locus of control after 12 months. Those with more signs of dementia progression reported a decrease in personal control but also a decrease in depressive symptoms. These findings are interesting for our understanding of coping but must be replicated with a larger sample.
Dement Geriatr Cogn Disord Extra 2021;11:298–305

中文翻译：

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痴呆症患者控制点的一年变化

简介：了解个人控制的看法如何随时间变化，可以为人们如何应对痴呆症提供有价值的见解。本研究旨在检查痴呆症患者 12 个月内控制点的变化。方法：该研究包括 52 名患有痴呆症的参与者。控制点是用行为控制点量表（LoCB）测量的，分数越高表明控制点越多，被解释为感知到的个人控制越少。LoCB ≥5% 的变化被认为具有临床意义。我们记录了社会人口学特征并评估了痴呆症的严重程度、认知、在日常活动中独立运作的能力和身体自我维持、抑郁症状和处方药的数量。进行分析以检查 12 个月后 LoCB 评分增加（更多外部）或降低（更少外部）之间的差异，并检查基线变量与 LoCB 评分变化之间的关联。结果：12 个月后，总样本的平均 LoCB 评分没有变化（基线平均值 29.33 与随访平均值 30.33，p = 0.553）；然而，出现了 2 个亚组。使用≥5% 的临界值显示，92.3% 的样本的 LoCB 分数发生了变化，21 名参与者的外部性（较低的 LoCB）和 27 名参与者的外部性（较高的 LoCB）。在基线时，外部变得较少的组的平均 LoBC 得分较高（33.81 对 24.56），p = 0.006，而在随访时则相反（23.57 对 34.41），p = 0.001。在这 12 个月期间，两组的痴呆症严重程度和身体自我维持的依赖性均有所增加。在那些变得更加外在的人中，我们还发现认知能力下降（p= 0.002），对日常活动的依赖增加（p = 0.003），处方药的使用增加，抑郁症状减少（p = 0.003）。基线 LoCB 评分是与 LoCB 评分 12 个月变化相关的唯一变量（p = 0.001）。结论：大多数参与者在 12 个月后显示出具有临床意义的控制位点变化。那些有更多痴呆进展迹象的人报告说个人控制能力下降，但抑郁症状也有所减少。这些发现对我们理解应对很有趣，但必须用更大的样本来复制。
Dement Geriatr Cogn Disord Extra 2021；11:298–305