One-Year Evolution of Behavioral and Psychological Symptoms of Dementia in Patients Initially Hospitalized in Cognitive Behavioral Units: The EVITAL Prospective Cohort

Rouch, Isabelle; Pongan, Élodie; Trombert, Béatrice; Fabre, Florence; Auguste, Nicolas; Sellier, Claire; Freulon, Magalie; Jacqueline, Sophie; Fédérico, Denis; Mouchoux, Christelle; Martin-Gaujard, Géraldine; Krolak‐Salmon, Pierre; Laurent, Bernard; Dorey, Jean‐Michel

doi:10.3233/jad-161023

Cited by 15 publications

(13 citation statements)

References 21 publications

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“…We found that BPSD, and especially agitation, aberrant motor behavior, and sleep disturbance, was improved through treatment in the wards for patients with dementia. These findings are consistent with previous studies showing that treatment of older person with dementia at hospital improved BPSD, especially agitation (Bellelli et al, 1998; Colombo et al, 2007; Kitamura et al, 2013; Rouch et al, 2017; Sugiyama et al, 2013; Taniguchi et al, 2013). These results indicate that the treatment at hospital is effective in improvement of BPSD, especially agitation.…”

Section: Discussionsupporting

confidence: 93%

“…The sample size was relatively small and the information on caregivers was limited, especially for the family caregiver burden. Although the rate of re-hospitalized was relatively high in the previous study (Rouch et al, 2017), we did not investigate after discharge. Therefore, the results have to be interpreted with caution and a further study focused on the caregiver burden is needed.…”

Section: Discussionmentioning

confidence: 86%

“…The BPSD is often treated in the special units including ward for patients with dementia in Japan (Taniguchi et al, 2013), special care units in Italy (Bellelli et al, 1998; Colombo et al, 2007), and cognitive and behavioral units in France (Rouch et al, 2017). Treatment in the wards for patients with dementia in Japan is generally conducted by a multidisciplinary team including a psychiatrist, experienced nurses, an occupational therapist (OT), and a psychiatric social worker (PSW) or psychologist.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have shown the effectiveness of treatment of BPSD at hospital (Bellelli et al, 1998; Colombo et al, 2007; Kitamura, Kitamura, Hino, & Kurata, 2013; Rouch et al, 2017; Sugiyama et al, 2013; Taniguchi et al, 2013). However, there are some issues associated with the treatment in hospital.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of treatment in wards for patients with dementia and issues associated with this treatment: A prospective analysis

Taniguchi¹,

Matsuoka

Hikawa³

et al. 2017

Dementia

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In order to optimize the treatment in wards for patients with dementia, we investigated predictors of the length of stay in the ward for patients with dementia. A prospective analysis of 72 patients with dementia was conducted in two wards for patients with dementia. Severity of dementia was assessed by the Clinical Dementia Rating, basic activities of daily living were evaluated using the Physical Self-Maintenance Scale, and severity of behavioral and psychological symptoms of dementia and caregiver distress were determined with the Nursing Home version of the Neuropsychiatric Inventory. Stepwise regression analysis was used to identify predictors of the length of stay. Fewer patients were discharged to home compared to those discharged to institutions or transferred to a different hospital or ward. The mean length of stay was 92.0 days. Clinical Dementia Rating and total distress scale score on the Nursing Home version of the Neuropsychiatric Inventory were significant independent predictors of the length of stay. The total Nursing Home version of the Neuropsychiatric Inventory score and total distress scale score on the Nursing Home version of the Neuropsychiatric Inventory were significantly improved through treatment. Our results suggest that treatment in the wards for patients with dementia is effective for improvement of behavioral and psychological symptoms of dementia. However, some patients could not be discharged to their home despite improvement of behavioral and psychological symptoms of dementia, and this may be related to caregiver burden at admission.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effectiveness of treatment in wards for patients with dementia and issues associated with this treatment: A prospective analysis

Taniguchi¹,

Matsuoka

Hikawa³

et al. 2017

Dementia

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“…DAD, NPI, CDR, and MMSE have been used to evaluate ADL, BPSD, and cognitive function in various dementias, as well as in diseases that cause dementia symptoms, whereas DLB and FTLD are disease-specific evalu-ation scales. DAD, NPI, CDR, and MMSE are utilized frequently [20][21][22].…”

Section: Discussionmentioning

confidence: 99%

Concurrent Validity of the ABC Dementia Scale with Other Standard Scales: A New Comprehensive Instrument for Assessing Dementia in Japan

Shimoda

Murata²,

Nakatani³

et al. 2020

Dement Geriatr Cogn Disord

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Background/Aims: The ABC Dementia Scale (ABC-DS), a new tool for evaluating dementia, was developed in Japan. The ABC-DS is a comprehensive instrument that can simultaneously evaluate activities of daily living (ADLs), behavioral and psychological symptoms of dementia (BPSD), and cognitive function. The ABC-DS can be administered easily and quickly and can clarify the severity of dementia and its changes over time. While the ABC-DS has been reported to be useful in Alzheimer disease (AD)-type dementia, it has not yet been studied in other types of dementia. The purpose of this study was to reevaluate the standard validity of ABC-DS separately for various dementia types and severities. Methods: We evaluated the ABC-DS in outpatients at 1 hospital in Nagasaki Prefecture and patients who use the facility. Domain A, corresponding to ADLs, correlated with Disability Assessment for Dementia (DAD); domain B, corresponding to BPSD, correlated with the Neuropsychiatric Inventory (NPI); domain C, corresponding to cognitive functions, correlated with Mini-Mental State Examination (MMSE); and the total score of the ABC-DS correlated with the Clinical Dementia Rating (CDR). Results: 102 patients, comprising 38 males and 64 females with an average age of 80.7 ± 8.6 years, were enrolled. AD-type dementia was present in 38 cases, vascular dementia (VaD) in 23, mixed dementia in 23, dementia with Lewy bodies in 6, argyrophilic grain dementia in 9, and mild cognitive impairment in 3. A strong correlation was found between ABC-DS domain scores and their respective reference neuropsychological instruments (domain A and the DAD, domain B and the NPI, domain C and the MMSE, and total score and CDR). The correlation of each ABC-DS domain score with the corresponding standard scale depended on the type and severity of dementia, and we observed moderate or high correlations in AD and VaD patients with moderate and severe dementia. Discussion: Although the ABC-DS targets AD, it can be used in VaD based on the results of this study. In other types of dementia, the results differed depending on the domain; in some conditions, the ABC-DS may not show sufficient concurrent validity with other standard scales. Also, the ABC-DS is more beneficial for moderate-to-severe dementia, as reported in previous studies. It is highly useful in clinical practice in Japan since there more than half of all patients have moderate-to-severe dementia.

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Establishing an individualized model of conversion from normal cognition to Alzheimer's disease after 4 years, based on cognitive, brain morphology and neuropsychiatric characteristics

Lucas

Tien

Hanganu

2022

Int J Geriat Psychiatry

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Objectives The impact of neuropsychiatric symptoms (NPS) on cognitive performance has been reported, and this impact was better defined in the aging population. Yet the potential of using the impact of NPS on brain and cognitive performance in a longitudinal setting, as prediction of conversion – have remained questionable. This study proposes to establish a predictive model of conversion to Alzheimer's disease (AD) and mild cognitive impairment (MCI) based on current cognitive performance, NPS and their associations with brain morphology. Methods 156 participants with MCI from the Alzheimer's Disease Neuroimaging Initiative database cognitively stable after a 4‐year follow‐up were compared to 119 MCI participants who converted to AD. Each participant underwent a neuropsychological assessment evaluating verbal memory, language, executive and visuospatial functions, a neuropsychiatric inventory evaluation and a 3 Tesla MRI. The statistical analyses consisted of 1) baseline comparison between the groups; 2) analysis of covariance model (controlling demographic parameters including functional abilities) to specify the variables that distinguish the two subgroups and; 3) used the significant ANCOVA variables to construct a binary logistic regression model that generates a probability equation to convert to a lower cognitive performance state. Results Results showed that MCI who converted to AD in comparison to stable MCI, exhibited a higher NPS prevalence, a lower cognitive performance and a higher number of involved brain structures. Functional abilities, memory performance and the sizes of inferior temporal, hippocampal and amygdala sizes were significant predictors of MCI to AD conversion. We also report two models of conversion that can be implemented on an individual basis for calculating the percentage risk of conversion after 4 years. Conclusion These analytical methods might be a good way to anticipate cognitive and brain declines.

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One-Year Evolution of Behavioral and Psychological Symptoms of Dementia in Patients Initially Hospitalized in Cognitive Behavioral Units: The EVITAL Prospective Cohort

Abstract: The present study showed a decrease in the global NPI score and all its subscores during the year following the CBU hospitalization, regardless of the initial CDR score.

Cited by 15 publications

References 21 publications

Effectiveness of treatment in wards for patients with dementia and issues associated with this treatment: A prospective analysis

Effectiveness of treatment in wards for patients with dementia and issues associated with this treatment: A prospective analysis

Concurrent Validity of the ABC Dementia Scale with Other Standard Scales: A New Comprehensive Instrument for Assessing Dementia in Japan

Establishing an individualized model of conversion from normal cognition to Alzheimer's disease after 4 years, based on cognitive, brain morphology and neuropsychiatric characteristics

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