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Cognitive & Behavioral Indices

 Cognitive  Behavior and Early Dementia Research Team



    Prof. Yea-Ing Lotus Shyu

     Research Expertise: Gerontological nursing, Qualitative research, Family nursing, Long-term care



Prof. Yea-Ing Lotus Shyu, Prof. Tzu-Ting Huang, Assoc. Prof. Yi-Chen Chiu, Dr. Yu-Cheng Pei, Dr. Yi-Ping Chao, Assoc. Prof. Chung-Chih Lin and Dr. Wen-Chuin Hsu.



Cognitive and behavioral indices are important indicators of mental and physical health during the aging process. Cognitive decline and related behavioral changes constitute a severe health problem for the elderly. Not only do they seriously impact a person's quality of life, but for many of them it leads to dementia. Studies have shown that the differentiation of the changes in cognitive function and behavior caused by a disease resulting from normal aging can help health care professionals make a more accurate assessment and diagnosis. This in turn allows health care professionals to arrange for appropriate interventions to delay the onset or progress of dementia and decrease the resulting financial burden on society. The main focus of this group project is the “cognitive and behavioral indices of aging”. Cognitive decline associated with a progressive neurological condition (e.g., Alzheimer’s disease), major trauma (e.g. hip fracture), or cognitive improvement as a result of an intervention (music, case management, or cognitive training) are of great interests to health care providers.


Research Purpose

The main focus of this group project is to develop cognitive and behavioral indicators to determine the mental and physical condition of the elderly and the intervention required if any. Therefore, the purpose of this group project is to:

1.     Develop cognitive and behavioral indices for the assessment, detection and diagnosis of cognitive decline in elderly patients

2.     Explore the influences of aging and disease/disability on these cognitive and behavioral indices

3.     Develop dementia management, cognitive training and care models and determine the effects of any change in the cognitive and behavioral indices as well as the quality of life for patients with dementia




Description of the Subprojects

The subprojects include: (1) The development and validate of measures for the cognitive and behavioral indices which include self-report and performance-based assessment instruments for cognitive functioning, a fun-cube screening system for cognitive dysfunction, and magnetic resonance imaging biomarker; (2) Investigate the influences of age and disease/disability (dementia, mild cognitive impairment and hip fracture) on cognitive and behavioral indices; and (3) Develop and Determine the effects of interventions, including music therapy, patient-centered case management, interdisciplinary care, Fun Cube, exercises, end of life care for patients with cognitive impairment and mild to moderate dementia, and patients after hip fracture surgery and their family caregivers.





Prior Accomplishment and Resources

The PIs of our sub-projects are all well-established researchers. Dr. Yea-Ing Lotus Shyu has been collaborating with Dr. Liang from the University of Michigan in conducting clinical trials to improve the recovery for older patients following hip fracture. This project has been funded by the National Health Research Institute from 1996 until now. She has also been collaborating with Prof. Stewart from the Oregon Health Sciences University and Prof. Archbold from the John A. Hartford foundation on studies related to family care giving and the management of behavioral problems regarding older persons with dementia. Collaborations with Dr. Heather Wilkinson at University of Edinburgh and Dr. Amit Dias at Goa Medical College, on cross-nation research of dementia care have been initiated since 2013. Dr. Ho-Ling Liu has been conducting studies on functional MRI and has been collaborating with Chicago University and NIH. Dr. Yu-Cheng Pei is collaborating with Prof. Rothwell at the British Neurology Institute and with Prof. Ugawa at Tokyo University. Dr. Tzu-Ting Huang’s research focus is on the promotion of health and functional independence for the elderly, and she has worked with Dr. Acton at the Institute of Gerontology of The University of Texas at Austin. Dr.Yi-Chen Chiu established a cognition recovery lab to study behavioral problems of older persons with dementia and has collaborated with Dr. Algase and Dr. Liang from the University of Michigan. The research team of Dr. Chung-Chih Lin has substantial experience in developing a health information system for the elderly. They conducted projects on health care services for the elderly, supported by the Ministry of Economic Affairs and they established a remote monitoring and communication technology to facilitate health care services in the Chang Gung Health and Culture Village. Dr. Wen-Chuin Hsu established and is in charge of the Chang Gung Dementia Care Center and conducts studies on patients with dementia. Currently they are conducting an imaging study and are completing a clinical guidance study on patients with AD, DLB, and FTD. Their international research projects include several studies on the g-secretase inhibitor. They established the Taiwan ADNI and recently published 2 articles on ApoE4, ApoCI, and Lrrk2. These past accomplishments are a good foundation for our future studies.

In addition, the Chang Gung Memorial hospital (Linkou and Taoyuan Branch), the Chang Gung Health and the Culture Village and its dementia center will serve as the study sites and provide resources for this group project. In addition, the PIs of our projects have a long-term collaborative relationship with an internationally-known gerontological researcher, Dr. Jersey Liang, from the Institute of Gerontology at the University of Michigan.


Expected Outcomes and International Collaboration

In addition to achieving the research purposes of our research project, in collaboration with Dr. Liang we will analyze longitudinal data of the cognitive and behavioral functions of the elderly. We will also explore collaboration with the dementia research group at the University of Edinburgh.

Students that participate in any of these group projects will learn how to diagnose and assess cognitive function, and how to intervene with those elderly that suffer from cognitive decline or from dementia. Graduate students will learn how to analyze longitudinal data, use an intelligent information system, and how to conduct a cross-national comparative analysis. We can also develop contents for courses to advance the role of health care workers by teaching them how to assess and take care of elderly patients with cognitive impairment.


1.    Liu, H.-Y., Yang, C.-T., Wang, Y.-N., Hsu, W.-C., Huang, T.-H., Lin, Y.-E, Liu C.-Y., & Shyu, Y.-I. L.* (in press). Balancing competing needs mediates the association of caregiving demand with caregiver role strain and depressive symptoms of dementia caregivers: A cross-sectional stud. Journal of Advanced Nursing. (SCI, SSCI)

2.    Huang, H. L., Weng, L. C., Hu, W. Y., Shyu, Y. L., Yu, W. P., & Chen, K. H. (in press). End-of-life care discussion for residents with dementia in long-term care facilities. Journal of Nursing Research. (SCI, SSCI)

3.    Liu, H.-Y., Yang, C.-T., Tseng, M.-Y., Chen, C.-Y., Wu, C.-C., Cheng, H.-S., Lin, Y.-E, & Shyu, Y.-I. L. (in press). Trajectories in postoperative recovery of elderly hip-fracture patients at risk for depression: A follow-up study. Rehabilitation Psychology. (SSCI)

4.    Kuo, L.-M., Huang, H.-L., Liang, J., Kwok, Y.-T., Hsu, W.-C., Liu, J.-Y., & Shyu, Y.-I. L.* (2017). Trajectories of health-related quality of life among family caregivers of individuals with dementia: A home-based caregiver-training program matters. Geriatric Nursing, 38(2), 124-132. (SCI, SSCI)

5.   Yeh, H.-F., Shao, J.-H., Li, C.-L., Wu, C.-C., & Shyu, Y.-I.* (2017). Predictors of postoperative falls in the first and second postoperative years among elderly hip fracture patients. Journal of Clinical Nursing. Advance online publication. doi: 10.1111/jocn.13743 (SCI, SSCI)

6.   Chang, H.-Y., Shyu, Y.-I. L., Wong, M.-K., Chu, T.-L., Lo, Y.-Y., & Teng, C.-I.* (2017). How does burnout impact the three components of nursing professional commitment? Scandinavian Journal of Caring Sciences. Advance online publication. doi: 10.1111/scs.12425 (SSCI)

7.   Wang, C.-L., Shyu, Y.-I. L.,* Wang, J.-Y., & Lu, C.-H. (2017). Progressive compensatory symbiosis: Spouse caregiver experiences of caring for persons with dementia in Taiwan. Aging & Mental Health, 21(3), 241-252. (SCI, SSCI)

8.   Kuo, L.-M., Huang, H.-L., Liang, J., Kwok, Y.-T., Hsu, W.-C., Su P.-L., & Shyu, Y.-I. L.* (2017). A randomised controlled trial of a home-based training programme to decrease depression in family caregivers of persons with dementia. Journal of Advanced Nursing, 73, 585-598. (SCI, SSCI)

9.   Wang, H.-P., Liang, J., Kuo, L.-M., & Shyu, Y.-I. L.* (2017). Trajectories of nutritional status and cognitive impairment among older Taiwanese with hip fracture. Journal of Nutrition Health & Aging, 21(1), 38-45. (SCI)

10.  Huang, Y.-F., Liang, J., & Shyu, Y.-I. L.* (2016). Number of comorbidities negatively influence psychological outcomes of the elderly following hip fracture in Taiwan. Journal of Aging & Health, 28, 1343-1361. (SSCI)

11.  Wang, H.-H., Shyu, Y.-I. L., Chang, H.-Y., Bai, Y.-B., Stanaway, F., Lin, J.-D., & Li, C.-L.* (2016). Prevalence, characteristics, and acute care utilization of disabled older adults with an absence of help for activities of daily living: Findings from a nationally representative survey. Archives of Gerontology and Geriatrics, 67, 28-33. (SCI)

12.  Tseng, M.-Y., Shyu, Y.-I. L., Liang, J.,* & Tsai, W. C. (2016). Interdisciplinary intervention reduced the risk of being persistently depressive among older patients with hip fracture. Geriatrics & Gerontology International, 16, 1145-1152. Equal contribution (SCI, SSCI)

13.  Hsu, P.-C., Chuang, Y.-F., Chung, M.-Y., Shyu, Y.-I. L., Huang, H.-L.,* Cheng, S.-M. (2016). 失智症友善社區評估:以台北市中正區崁頂次分區為例[Dementia friendly community assessment: An example of assessment in Kanding Subzone, Zhongzheng District Taipei City]. 長庚護理, 27, 467-475.

14.  Kuo, L.-M., Huang, H.-L., Hsu, W.-C., Wang, Y.-T., & Shyu, Y.-I. L.* (2016). Home-based caregiver training: Benefits differ by care receivers' dementia diagnosis. Geriatric Nursing, 37, 376-384. (SCI, SSCI)

15.  Chen, K. H.,* Liu, C. Y., Shyu, Y. I. L., & Yeh, S. L. (2016). Living with chronic obstructive pulmonary disease: The process of self-managing chronic obstructive pulmonary disease. The Journal of Nursing Research, 24(3), 262-271. (SCI, SSCI)

16.  Shyu, Y.-I. L.,* Liang, J., Tseng, M.-Y., Li, H.-J., Wu, C.-C., Cheng, H.-S., Chou, S.-W., Chen, C.-Y., & Yang, C.-T. (2016). Enhanced interdisciplinary care improves self-care ability and decreases emergency department visits for older Taiwanese patients over 2 years after hip-fracture surgery: A randomised controlled trial. International Journal of Nursing Studies, 56, 54-62. (SCI, SSCI)

17.  Chen, S.-H., Shyu, Y.-I. L., Ko, Y. S., Kung, H. L., & Shao, J.-H.* (2016). Perceptions about eating experiences of low-literate older adults with heart disease: A qualitative study. Journal of Advanced Nursing, 72, 802-812. (SCI, SSCI)

18.  Kuo, W., Shyu, Y.-I. L.,* Wang, J.-S., Chen, M.-C., Wu, C.-C., & Huang, Y.-F. (2016). The impact of sleep duration on recovery post-hip fracture among older diabetic adults in Taiwan. Geriatric Nursing, 37(2), 137-144. (SCI, SSCI)

19.  Tseng, M.-Y., Liang, J., Shyu, Y.-I. L.,* Wu, C.-C., Cheng, H.-S., Chen, C.-Y., & Yang, S.-F. (2016). Effects of interventions on trajectories of health-related quality of life among older patients with hip fracture: A prospective randomized controlled trial. BMC Musculoskeletal Disorders, 17(1), 114. (SCI)

20.  Huang, H.-L., Shyu, Y.-I. L.,* Hsu, W.-C., & Huang, T.-H. (2015). 以能力為基礎的失智症衛教師訓練課程模式[A competency-based train-the-trainer curriculum for dementia educator]. 長庚科技學刊, 23, 23-34.

21.  Chang, H.-Y., Shyu, Y.-I. L., Wong, M. K., Friesner, D., Chu, T.-L., & Teng, C.-I.* (2015). Which aspects of professional commitment can effectively retain nurses in the nursing profession? Journal of Nursing Scholarship, 47, 468-476. (SCI, SSCI)

22.  Liu, H.-Y., Yang, C.-T., Cheng, H.-S., Wu, C.-C., Chen, C.-Y., & Shyu, Y.-I. L.* (2015). Family caregivers' mental health is associated with postoperative recovery of elderly patients with hip fracture: A sample in Taiwan. Journal of Psychosomatic Research, 78, 452-458. (SCI, SSCI)

23.  Huang, H.-L., Shyu, Y.-I. L.,* Chen, M.-C., Huang, C.-C., Kuo, H.-C., Chen, S.-T., & Hsu, W.-C. (2015). Family caregivers’ role implementation at different stages of dementia. Clinical Interventions in Aging, 2015(10), 135-146. (SCI)

24.  Kuo, L.-M., Huang, H.-L., Hsu, W.-C., & Shyu, Y.-I. L.* (2014). Health-related quality of life and self-efficacy of managing behavior problems for family caregivers of vascular dementia and Alzheimer‘s disease patients. Dementia and Geriatric Cognitive Disorders, 38, 310-320. (SCI)

25.  Liu, H.-Y., Wang, Y.-N., Huang, H.-L., Hsu, W.-C., Lin, Y.-E, Huang, T.-H., & Shyu, Y.-I. L.* (2014). Psychometric properties of the finding a balance scale for family caregivers of elders with dementia in Taiwan. Research in Nursing & Health, 37, 336-346. (SCI & SSCI)

26.  Wang, H.-H., Sheu, J.-T., Shyu, Y.-I. L., Chang, H.-Y., & Li, C.-L.* (2014). Geriatric conditions as predictors of increased number of hospital admissions and hospital bed days over one year: Findings of a nationwide cohort of older adults from Taiwan. Archives of Gerontology & Geriatrics, 59(1), 169-174. (SCI)

27.  Liu, H.-Y., Tseng, M.-Y., Li, H.-J., Wu, C.-C., Cheng, H.-S., Yang, C.-T., Chou, S.-W., Chen, C.-Y., & Shyu, Y.-I. L.* (2014). Comprehensive care improves physical recovery of hip-fractured elderly Taiwanese patients with poor nutritional status. Journal of the American Medical Directors Association, 15, 416-422. (SCI)

28.  Yang, C.-T., Liu, H.-Y., & Shyu, Y.-I. L.* (2014). Dyadic relational resources and role strain in family caregivers of persons living with dementia at home: A cross-sectional survey. International Journal of Nursing Studies, 51, 593-602. (SCI, SSCI)

29.  Huang, Y.-F., Liang, J., & Shyu, Y.-I. L.* (2014). Ageism perceived by the elderly in Taiwan following hip fracture. Archives of Gerontology & Geriatrics, 58(1), 30-36. (SCI)


1. 裴育晟:Memory consolidation enhancement device記憶固化提昇裝置


2. 裴育晟:Multi-digit tactile motion stimulator觸覺運動刺激裝置


中國發明專利2012 I0380518.3 (2014/07/09)

3. 林仲志:互動提問回答遊戲編輯系統及方法


4. 林仲志:腦力開發或訓練之多面向感應裝置



1. 徐亞瑛:老年髖關節骨折保健:認知功能缺損老人家庭照顧

2. 徐亞瑛:及早認識失智症的高危險因子:輕度認知障礙


                                                       Contact:  Ms. Jin-Ying Liu