DEMENTIA CARE: WHAT A DIFFERENCE A NURSE MAKES

EDITORIAL COMMENT
Few studies have been conducted on service provision for community dwelling dementia patients based in primary care settings. In a randomized controlled trial (RCT) of AD patients and their caregivers, usual care was compared with an intervention that included a nurse practitioner who acted as a care manager, and standardized care protocols to manage specific problems, such as a variety of neuropsychiatric symptoms (e.g. sleep, depression, psychosis). There was a significant reduction in neuropsychiatric symptoms associated with the intervention that rivalled results from many of the pure pharmacological trials. While the intervention was expensive, the authors argue it was probably cost-effective given the documented association between neuropsychiatric symptoms and increased cost of dementia care.

Effectiveness of collaborative care for older adults with Alzheimer disease in primary care: a randomized controlled trial
(JAMA 2006;295:2148-2157)

CHRISTOPHER M. CALLAHAN, MD,
MALAZ A. BOUSTANI, MD, MPH,
FREDERICK W. UNVERZAGT, PhD,
MARY G. AUSTROM, PhD,
ET AL,
indianapol is, in

 

INSIGHT AND NEUROPSYCHIATRIC SYMPTOMS

EDITORIAL COMMENT
Research on the relationship between insight and neuropsychiatric symptoms in dementia has previously focused on depression, anxiety and apathy. In a prospective study of dementia patients, Aalten et al (2006) examined insight (termed “awareness” by these authors) at baseline, and changes in neuropsychiatric symptoms over the course of one year. While baseline insight was negatively associated with psychosis, apathy and total neuropsychiatric symptom burden, at one year follow- up there was a positive association between insight and symptoms of depression and anxiety. As expected, the degree of insight in all patients declined significantly over the follow-up period.

Awareness and behavioral problems in dementia patients: a prospective study
(INT PSYCHOGERIATRICS 2006;18:3-17)

PAULINE AALTEN,
EVELIEN VAN VALEN,
MARJOLEIN E. DE VUGT,
RICHEL LOUSBERG,
ET AL,
maastricht, THE NETHERLANDS

 

 

 

 

 

 

 

 
 
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