1
|
Cesana BM, Bergh S, Ciccone A, Cognat E, Fabbo A, Fascendini S, Frisoni GB, Froelich L, Handels R, Jori MC, Mecocci P, Merlo P, Peters O, Tsolaki M, Defanti CA. Predictors of Nursing Home Placement in a Cohort of European People with Alzheimer's Disease and Other Dementia Cases Enrolled in SCU-B or Non SCU-B Centers: The RECage Study. J Alzheimers Dis 2024; 98:1043-1052. [PMID: 38489173 DOI: 10.3233/jad-230878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
Background Nursing home placement (NHP) can be the final step of patients with Alzheimer's disease. Objective We aimed to identify NHP predictors among 508 people with dementia with a 3-year follow-up. Methods We analyzed data from the international observational RECage study, involving 508 people with especially Alzheimer's disease and comparing a cohort enrolled by five centers with a Special Care Unit for BPSD (behavioral and psychological symptoms of dementia) and another one enrolled by six centers lacking this facility. The tertiary objective of the study was to assess the possible role of the SCU-B in delaying NHP. We assessed the relationship of the baseline characteristics with NHP by means of univariate analysis followed by Cox's multivariate model. Results Patients' mean age was 78.1 years, 54.9% were women. Diagnosis mean age was 75.4 (±8.32) years; the main diagnosis was Alzheimer's disease (296; 58.4%). During follow-up, 96 (18.9%) patients died and 153 (30.1%) were institutionalized without a statistically significant difference between the two cohorts (p = 0.9626). The mean NHP time was 902 (95% CI: 870-934). The multivariable analysis without death as a competing risk retained four independent predictors of NHP: age increase (hazard ratio (HR) = 1.023, 95% CI: 1.000-1.046), patient education level increase (HR = 1.062, 95% CI: 1.024-1.101), Neuropsychiatric Inventory total increase (HR = 1.018; 95% CI: 1.011-1.026), and total Mini-Mental State Examination as a favorable factor (HR = 0.948, 95% CI: 0.925-0.971). Gender (females versus males: HR = 1.265, 95% CI: 0.899-1.781) was included in the final Cox's model for adjusting the estimates for. Conclusions Our data partially agree with the predictors of NHP in literature including the effect of high education level. No caregivers' factors were statistically significant. Clinical trial registration NCT03507504.
Collapse
Affiliation(s)
- Bruno Mario Cesana
- Department of Clinical Sciences and Community Health, Unit of Medical Statistics, Biometry and Bioinformatics "Giulio A. Maccacaro" Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | - Sverre Bergh
- Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway (SCU-B)
| | - Alfonso Ciccone
- Department of Neurology with Neurosurgical Activity "Carlo Poma" Hospital, ASST di Mantova, Mantua, Italy (non-SCU-B)
| | - Emmanuel Cognat
- Cognitive Neurology Centre, Lariboisière-Fernand Widal Hospital GHU AP-HP Nord, Université Paris-Diderot, Paris, France (non-SCU-B)
| | - Andrea Fabbo
- Department of Primary Care, Geriatric Service-Cognitive Disorders and Dementia, Local Health Authority of Modena (AUSL), Modena, Italy (SCU-B)
| | | | - Giovanni B Frisoni
- Division of Geriatrics and Rehabilitation, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland (SCU-B)
| | - Lutz Froelich
- Department of Geriatric Psychiatry, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany (SCU-B)
| | - Ron Handels
- Department of Psychiatry and Neuropsychology, Faculty of Health Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, the Netherlands
| | | | - Patrizia Mecocci
- Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
- NVS Department, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden (non-SCU-B)
| | - Paola Merlo
- Neurological Unit (PM), U.V.A. Centre, Humanitas Gavazzeni, Bergamo, Italy (non-SCUB)
| | - Oliver Peters
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany (non SCU-B)
| | - Magda Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece
- First Department of Neurology, School of Medicine, Aristotle University of Thessaloniki (AUTh), Thessaloniki, Greece
| | | |
Collapse
|
2
|
Hinkle JT, Pontone GM. Invited Perspective on "BPSD Patterns in Patients With Severe Neuropsychiatric Disturbances: Insight From the RECAGE Study" (Cognat et al. 2023): Roles for nosology and neurobiology in understanding the heterogeneity of BPSD. Am J Geriatr Psychiatry 2023; 31:640-642. [PMID: 37210250 DOI: 10.1016/j.jagp.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 04/19/2023] [Indexed: 05/22/2023]
Affiliation(s)
- Jared T Hinkle
- Medical Scientist Training Program (JTH), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry and Behavioral Sciences (JTH, GMP), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Gregory M Pontone
- Department of Psychiatry and Behavioral Sciences (JTH, GMP), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (GMP), Johns Hopkins University School of Medicine, Baltimore, MD.
| |
Collapse
|
3
|
Cognat E, Sabia S, Fayel A, Lilamand M, Handels R, Fascendini S, Bergh S, Frisoni GB, Fabbo A, Tsolaki M, Frölich L, Peters O, Merlo P, Ciccone A, Mecocci P, Dumurgier J, Defanti CA, Hugon J, Paquet C. BPSD Patterns in Patients With Severe Neuropsychiatric Disturbances: Insight From the RECAGE Study. Am J Geriatr Psychiatry 2023; 31:633-639. [PMID: 37183097 DOI: 10.1016/j.jagp.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/23/2023] [Accepted: 03/23/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVE Behavioral and psychological symptoms of dementia (BPSD) profiles vary depending on etiology in patients with mild-to-moderate BPSD. It is not known if similar differences exist in patients with severe BPSD. METHODS We analyzed data collected at baseline in 398 patients with severe BPSD (NPI ≥ 32) and defined diagnosis of dementia (Alzheimer's disease [AD] 297; frontotemporal dementia [FTD] 39; Lewy body disease/Parkinsonian dementia [LBD/PD] 31; and vascular dementia [VD] 31) included in the European multicenter cohort RECAGE. RESULTS Mean total NPI was 52.11 (18.55). LBD/PD patients demonstrated more hallucinations, more anxiety and more delusions than patients with other dementia. FTD patients had less delusions and more disinhibition than patients with other neurodegenerative disorders. These profiles overlapped partially with those reported in the literature in patients with less severe symptoms. CONCLUSION Patients with severe BPSD display different and specific profiles of neuropsychiatric symptoms depending on dementia etiology.
Collapse
Affiliation(s)
- Emmanuel Cognat
- Université Paris Cité (EC, ML, CP, SS, JD, JH), UMR-S 1144, INSERM, Paris, France; Cognitive Neurology Center (EC, AF, ML, JD, JH, CP), AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France.
| | - Séverine Sabia
- Université Paris Cité (EC, ML, CP, SS, JD, JH), UMR-S 1144, INSERM, Paris, France; Université Paris Cité (SS, JD), Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
| | - Alexandra Fayel
- Université Paris Cité (SS, JD), Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
| | - Matthieu Lilamand
- Université Paris Cité (EC, ML, CP, SS, JD, JH), UMR-S 1144, INSERM, Paris, France; Cognitive Neurology Center (EC, AF, ML, JD, JH, CP), AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France; Department of Geriatry (ML), AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France
| | - Ron Handels
- Alzheimer Centre Limburg (RH), School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Sara Fascendini
- Fondazione Europea di Ricerca Biomedica (FERB Onlus) (SF), Gazzaniga, Italy
| | - Sverre Bergh
- The Research Centre for Age-related Functional Decline and Disease (SB), Innlandet Hospital Trust, Ottestad, Norway; The Norwegian National Centre for Aging and Health (SB), Vestfold Hospital Trust, Tønsberg, Norway
| | - Giovanni B Frisoni
- Memory Clinic (GBF), Geneva University Hospitals, Geneva, Switzerland; Laboratory of Neuroimaging of Aging (LANVIE) (GBF), University of Geneva, Geneva, Switzerland
| | - Andrea Fabbo
- Geriatric Service-Cognitive Disorders and Dementia (AF), Department of Primary Care, Health Authority and Services of Modena, Modena, Italy
| | - Magdalina Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD) (MT), Thessaloniki, Hellas, Macedonia Greece; First Department of Neurology, School of Medicine (MT), Aristotle University of Thessaloniki (AUTh), Hellas, Macedonia Greece
| | - Lutz Frölich
- Department of Geriatric Psychiatry (LF), Central Institute of Mental Health; Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Oliver Peters
- Department of Psychiatry (OP), Charité Universitätsmedizin Berlin, Berlin, Germany; German Center for Neurodegenerative Diseases (DZNE) (OP), Berlin, Germany
| | - Paola Merlo
- Neurological Unit (PM), U.V.A. Centre, Humanitas Gavazzeni, Bergamo, Italy
| | - Alfonso Ciccone
- Department of Neurology with neurosurgical activity and stroke unit (AC), ASST di Mantova, Mantova, Italy
| | - Patrizia Mecocci
- Section of Gerontology and Geriatrics (PM), Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Clinical Geriatrics (PM), NVS Department, Karolinska Institutet, Stockholm, Sweden
| | - Julien Dumurgier
- Université Paris Cité (EC, ML, CP, SS, JD, JH), UMR-S 1144, INSERM, Paris, France; Cognitive Neurology Center (EC, AF, ML, JD, JH, CP), AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France; Université Paris Cité (SS, JD), Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
| | - Carlo A Defanti
- Fondazione Europea di Ricerca Biomedica (FERB Onlus) (SF), Gazzaniga, Italy
| | - Jacques Hugon
- Université Paris Cité (EC, ML, CP, SS, JD, JH), UMR-S 1144, INSERM, Paris, France; Cognitive Neurology Center (EC, AF, ML, JD, JH, CP), AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France
| | - Claire Paquet
- Université Paris Cité (EC, ML, CP, SS, JD, JH), UMR-S 1144, INSERM, Paris, France; Cognitive Neurology Center (EC, AF, ML, JD, JH, CP), AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France
| |
Collapse
|
4
|
Cesana BM, Poptsi E, Tsolaki M, Bergh S, Ciccone A, Cognat E, Fabbo A, Fascendini S, Frisoni GB, Frölich L, Jori MC, Mecocci P, Merlo P, Peters O, Defanti CA. A Confirmatory and an Exploratory Factor Analysis of the Cohen-Mansfield Agitation Inventory (CMAI) in a European Case Series of Patients with Dementia: Results from the RECage Study. Brain Sci 2023; 13:1025. [PMID: 37508955 PMCID: PMC10376951 DOI: 10.3390/brainsci13071025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND One of the most widely used instruments for assessing agitation in dementia patients is the Cohen-Mansfield Agitation Inventory (CMAI), nevertheless no global score has been proposed. The aim of this study is: (a) to conduct a confirmatory (CFA) and exploratory factor analysis (EFA) of CMAI on people with dementia and Psychological and Behavioral Symptoms (BPSD), and (b) to propose an alternative structure, based on clinical criteria including all CMAI items. METHODS Confirmatory and exploratory factor analyses were carried out on the CMAI 29 items administered at baseline to 505 patients with dementia (PwD) and BPSD enrolled in the international observational RECage study. RESULTS The three-factor structure has not been confirmed by the CFA, whilst the EFA was carried out respectively on 25 items disregarding 4 items with a prevalence ≤5% and then on 20 items disregarding 9 items with a prevalence ≤10%. The four-factor structure explaining 56% of the variance comprised Physically Aggressive behavior, Verbally Aggressive behavior, Physically non-aggressive behavior, and Physically and verbally aggressive behavior. CONCLUSIONS A new grouping of all items according to a clinical criterion is proposed, allowing for a more sensible evaluation of the symptoms leading to better differentiation.
Collapse
Affiliation(s)
- Bruno Mario Cesana
- Department of Clinical Sciences and Community Health, Unit of Medical Statistics, Biometry and Bioinformatics "Giulio A. Maccacaro" Faculty of Medicine and Surgery, University of Milan, 20122 Milan, Italy
| | - Eleni Poptsi
- Laboratory of Psychology, Section of Cognitive and Experimental Psychology, Faculty of Philosophy, School of Psychology, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), 54643 Thessaloniki, Greece
| | - Magda Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), 54643 Thessaloniki, Greece
- 1st Department of Neurology, School of Medicine, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece
| | - Sverre Bergh
- Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, 2313 Ottestad, Norway
- Norwegian National Centre for Aging and Health, Sykehuset i Vestfold, 3103 Tønsberg, Norway
| | - Alfonso Ciccone
- Department of Neurology with Neurosurgical Activity "Carlo Poma" Hospital, ASST di Mantova, 46100 Mantua, Italy
| | - Emmanuel Cognat
- Cognitive Neurology Centre, Lariboisière-Fernand Widal Hospital GHU AP-HP Nord, 75010 Paris, France
| | - Andrea Fabbo
- Geriatric Service-Cognitive Disorders and Dementia, Department of Primary Care, Local Health Authority of Modena (AUSL), 41124 Modena, Italy
| | | | - Giovanni B Frisoni
- Division of Geriatrics and Rehabilitation, University Hospitals of Geneva, 1205 Geneva, Switzerland
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany
| | | | - Patrizia Mecocci
- Institute of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
- Division of Clinical Geriatrics, NVS Department, Karolinska Institutet Stockholm, 17177 Stockholm, Sweden
| | - Paola Merlo
- Neurological Unit (PM), U.V.A. Centre, Humanitas Gavazzeni, 24125 Bergamo, Italy
| | - Oliver Peters
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, 12203 Berlin, Germany
| | | |
Collapse
|
5
|
Tsolaki M, Makri M, Tsatali M, Teichmann Β. European Projects for Patients with Dementia and Their Caregivers. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1425:609-618. [PMID: 37581834 DOI: 10.1007/978-3-031-31986-0_59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
As we all know there is no treatment that can stop or delay the progression of dementia. The treatment we use is only symptomatic. EFNS (European Federation of Neurological Societies) recommendations for dementia prevention by Sorbi et al. (2012) concluded that there is no treatment, no lifestyle, which could have an effect on prevention or delay of onset of different forms of dementia until today. The future studies in prevention must recruit younger people, larger sample, and for longer period. The last 10 years we have run, in collaboration with organizations in different European countries, many projects in order to support patients with neurodegenerative diseases, mainly patients with dementia and their caregivers. The first project was a 2-year prospective cohort study of antidementia drug non-persistency in mild-to-moderate Alzheimer's disease (AD) in Europe: predictors of discontinuation and switch in the ICTUS (Impact of Cholinergic Treatment USe) study, an FP5 project with 1380 patients. Five studies were published. The second project was DESCRIPA study, an FP5 project to DEvelopment of Screening guidelines and clinical CRIteria for Predementia Alzheimer's disease, with 881 patients with mild cognitive impairment (MCI). LLM (Long Lasting Memories) and VRADA (A virtual reality application for the exercise of dementia and Alzheimer patients) are two projects that include body and cognitive exercise for health for the elderly and patients with mild cognitive impairment. The next is the RECAGE (REspectful Caring for the AGitated Elderly) project (Horizon 2020), a prospective cohort study for coping with behavioral and psychological symptoms of dementia. With six European universities we finished a very interesting FP6 project, the AddNeuroMed one, which gives even now information about the progression of normal elderly MCI and AD patients, in collaboration with other consortia. A very interesting Innovative Medicines Initiative (IMI) project about digital biomarkers was entitled Remote Assessment of Disease and Relapse-Alzheimer's Disease (RADAR project). The main goal of this project was the development and validation of technology-enabled, quantitative and sensitive measures of functional decline in people with early-stage AD. A running project is an Erasmus+ one in the higher education field, "Genetic counseling in European universities: The case of neurodegenerative diseases" (GECONEU project). The target of this study is to develop an online course for university students focusing on genetic counseling, and support people and society to better understand the aims of genetic testing and the usefulness of genetic counseling by involving students in an innovative learning and teaching setting. AD-gaming, BRIDGE, iCONNECT (Intergenerational CONtact between studeNts and people with dEmentia through CreaTive education), E.L.So.M.C.I (English Lessons with the Use of Songs for People with Mild Cognitive Impairment), Games4CoSkills, and De-Sign are all Erasmus+ projects that aim to improve the quality of life of patients with MCI or dementia. Story2remember, Dementia right, ASPAD (Augmentation of the Support of Patients suffering from Alzheimer's Disease and their caregivers), INFOCARE (Supporting Informal Caregivers of People with Dementia), S.IN.CA.L.A (Supporting Informal Carers: A Whole-Family and Life course Approach), and PIA (Peer support workers as an Innovative force in Advocacy in dementia care) are all Erasmus+ projects for training and supporting caregivers of patients with dementia.
Collapse
Affiliation(s)
- M Tsolaki
- Alzheimer Hellas, Thessaloniki, Greece
- Laboratory of Neurodegenerative diseases, Center for Interdisciplinary Research and Innovation (CIRI-AUTh), Balkan Center, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - M Makri
- Alzheimer Hellas, Thessaloniki, Greece
- Laboratory of Neurodegenerative diseases, Center for Interdisciplinary Research and Innovation (CIRI-AUTh), Balkan Center, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - M Tsatali
- Alzheimer Hellas, Thessaloniki, Greece
- Laboratory of Neurodegenerative diseases, Center for Interdisciplinary Research and Innovation (CIRI-AUTh), Balkan Center, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Β Teichmann
- Alzheimer Hellas, Thessaloniki, Greece
- Laboratory of Neurodegenerative diseases, Center for Interdisciplinary Research and Innovation (CIRI-AUTh), Balkan Center, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
6
|
Mendes A, Bergh S, Cesana BM, Handels R, Ciccone A, Cognat E, Fabbo A, Fascendini S, Frisoni GB, Froelich L, Jori MC, Mecocci P, Merlo P, Peters O, Tsolaki M, Defanti CA. Respectful Caring for the Agitated Elderly (ReCAGE): A Multicentre, Prospective, Observational Study to Evaluate the Effectiveness of Special Care Units for People with Dementia. J Alzheimers Dis 2023; 96:1083-1096. [PMID: 37927262 DOI: 10.3233/jad-230708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
BACKGROUND Behavioral and psychological symptoms of dementia (BPSD) bring complexity in the clinical management of people with dementia; therefore, it is important to evaluate different models of care, such as Special Care Units (SCU-B).∥Objective:To evaluate the SCU-B effectiveness toward alleviating BPSD and improving the quality of life (QoL) of patients and their caregivers.∥Methods:ReCAGE was a multicenter, controlled, longitudinal study where 508 patients with BPSD were enrolled in two cohorts: 262 patients from centers endowed with a SCU-B, and 246 from centers without SCU-B. Statistical analyses included factorial ANCOVA for comparison among centers. The primary endpoint was effectiveness of the SCU-B, measured through the Neuropsychiatric Inventory (NPI) changes. Secondary endpoints were change in QoL of patients and caregivers, and the tertiary endpoint was time to nursing home admission.∥Results:The NPI scores decreased in both arms, with a statistically significant difference from baseline to 36 months (p < 0.0001) in both cohorts. Over time, NPI decreased more steeply during the first year in the SCU-B arm, but in the following two years the slope was clearly in favor of the control arm. This different pattern of the two cohorts reached statistical significance at the interaction "cohort by time" (p < 0.0001). Conflicting results were found regarding the outcomes of quality of life, while there were no differences in time to institutionalization in both cohorts.∥Conclusion:The RECage study did not confirm the long-term superiority of the pathway comprising a SCU-B. A post-hoc analysis revealed data supporting their acute effectiveness during behavioral crises.
Collapse
Affiliation(s)
- Aline Mendes
- Division of Geriatrics and Rehabilitation, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
| | - Sverre Bergh
- Research Center for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Bruno Mario Cesana
- Department of Clinical Sciences and Community Health, Unit of Medical Statistics, Biometry and Bioinformatics "Giulio A. Maccacaro" Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | - Ron Handels
- Faculty of Health Medicine and Life Sciences, Department of Psychiatry and Neuropsychology School for Mental Health and Neuroscience Alzheimer Centre Limburg Maastricht University Medical Centre Maastricht the Netherlands
| | - Alfonso Ciccone
- Department of Neurology with Neurosurgical Activity "Carlo Poma" Hospital, ASST di Mantova, Mantua, Italy
| | - Emmanuel Cognat
- Cognitive Neurology Centre, Lariboisière-Fernand Widal Hospital GHU AP-HP Nord, Paris, France
| | - Andrea Fabbo
- Department of Primary Care, Geriatric Service-Cognitive Disorders and Dementia, Local Health Authority of Modena (AUSL), Modena, Italy
| | | | - Giovanni B Frisoni
- Memory Centre, Division of Geriatrics and Rehabilitation, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
| | - Lutz Froelich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Patrizia Mecocci
- Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, Italy
- Division of Clinical Geriatrics; NVS Department, Karolinska Institutet Stockholm, Sweden
| | - Paola Merlo
- Neurological Unit (PM), U.V.A. Centre, Humanitas Gavazzeni, Bergamo, Italy
| | - Oliver Peters
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Magdalini Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Makedonia, Hellas. 1st Department of Neurology, School of Medicine, Aristotle University of Thessaloniki (AUTh), Macedonia, Hellas
| | | |
Collapse
|
7
|
Guazzarini AG, Casanova G, Buchholz F, Kozori M, Lavolpe S, Lichtwarck B, Margioti E, Mendes A, Montandon ML, Murasecco I, Myhre J, Poptsi E, Reda V, Ulshöfer DE, Fascendini S. The Special Care Unit for People with Behavioral and Psychological Symptoms of Dementia (SCU- B) in the Context of the Project "RECage-Respectful Caring for Agitated Elderly": A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16913. [PMID: 36554794 PMCID: PMC9778697 DOI: 10.3390/ijerph192416913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/26/2022] [Accepted: 12/10/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Dementia is a priority for global public health. The management of behavioral and psychological symptoms of dementia (BPSD) is one of the highest ongoing challenges and needs new approaches. The special care unit for people with dementia and BPSD (SCU-B) is viewed in this context as a further medical intervention. AIM this study aims to explore SCU-B units in order to describe their main characteristics in relation to different implementation contexts, identify the characteristics of their replicability, and examine the social innovation elements promoted by SCU-B units. METHOD This qualitative study is based on focus groups (FGs) and interviews involving nine international centers. Five of the centers have a memory clinic unit and SCU-B, compared with six that only have a memory clinic unit. A total number of 18 FGs were held, which altogether involved 164 participants. All data were transcribed verbatim and analyzed by means of a content analysis and a SWOT (strengths, weaknesses, opportunities, and threats) analysis. RESULTS The qualitative analysis offers a vision of the SCU-B model as an innovative care unit for BPSD, promoting social innovation in the long-term care (LTC) sector. This system mainly targets people with dementia and BPSD and their informal caregivers but encourages collaboration between dementia care stakeholders at the micro and meso levels. CONCLUSIONS Specific characteristics of the country's LTC systems and the organization of specialized units are determinants for the success of the SCU-B experience. The replicability of the entire SCU-B model was considered low; however, the implementation of single elements composing the SCU-B model may foster innovation. This study provides relevant suggestions on how to implement the SCU-B unit and innovative solutions for dementia care.
Collapse
Affiliation(s)
- Anna Giulia Guazzarini
- Department of Medicine and Surgery, Section of Gerontology and Geriatrics, University of Perugia, 06123 Perugia, Italy
| | - Georgia Casanova
- National Institute of Health & Science on Aging, Centre for Socio-Economic Research on Aging INRCA (IRCCS), 60124 Ancona, Italy
- Instituto de Investigación en Políticas de Bienestar Social (POLIBIENESTAR)—Research Institute on Social Welfare Policy, Universitat de València, 46022 Valencia, Spain
| | - Friederike Buchholz
- Department of Psychiatry, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, 12203 Berlin, Germany
- German Center for Neurodegenerative Diseases (DZNE), 12203 Berlin, Germany
| | - Mahi Kozori
- Greek Association of Alzheimer’s Disease and Related Disorders (GAADRD), 54643 Thessaloniki, Greece
| | - Sara Lavolpe
- Department of Neurology, Humanitas Gavazzeni, 24125 Bergamo, Italy
| | - Bjørn Lichtwarck
- The Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, 2313 Ottestad, Norway
| | - Eleni Margioti
- National Observatory for Dementia and Alzheimer’s Disease, Health Ministry Aristotelous 17, 10433 Athina, Greece
| | - Aline Mendes
- Department of Rehabilitation and Geriatrics, University Hospital of Geneva and Geneva University, 1205 Geneva, Switzerland
| | - Marie-Louise Montandon
- Department of Rehabilitation and Geriatrics, University Hospital of Geneva and Geneva University, 1205 Geneva, Switzerland
- Department of Psychiatry, Geneva University, 1205 Geneva, Switzerland
| | - Ilenia Murasecco
- Department of Medicine and Surgery, Section of Gerontology and Geriatrics, University of Perugia, 06123 Perugia, Italy
| | - Janne Myhre
- The Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, 2313 Ottestad, Norway
| | - Elena Poptsi
- Greek Association of Alzheimer’s Disease and Related Disorders (GAADRD), 54643 Thessaloniki, Greece
- Laboratory of Psychology, Section of Cognitive and Experimental Psychology, Faculty of Philosophy, School of Psychology, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece
| | - Valentina Reda
- Primary Care Department, Dementia Programme, Azienda Unità Sanitaria Locale Di Modena, 41124 Modena, Italy
| | | | - Sara Fascendini
- Fondazione Europea di Ricerca Biomedica (FERB Onlus), 24025 Gazzaniga, Italy
| |
Collapse
|
8
|
Tsolaki M, Tsatali M, Gkioka M, Poptsi E, Tsolaki A, Papaliagkas V, Tabakis IM, Lazarou I, Makri M, Kazis D, Papagiannopoulos S, Kiryttopoulos A, Koutsouraki E, Tegos T. Memory Clinics and Day Care Centers in Thessaloniki, Northern Greece: 30 Years of Clinical Practice and Experience. Front Neurol 2021; 12:683131. [PMID: 34512506 PMCID: PMC8425245 DOI: 10.3389/fneur.2021.683131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/25/2021] [Indexed: 11/17/2022] Open
Abstract
Background: This review describes the diagnostic and interventional procedures conducted in two university memory clinics (established network of G. Papanikolaou Hospital: 1988–2017 and AHEPA hospital: 2017–today) and 2 day care centers (established network of DCCs: 2005–today) in North Greece and their contribution in the scientific field of dementia. The aims of this work are (1) to provide a diagnosis and treatment protocol established in the network of memory clinics and DCCs and (2) to present further research conducted in the aforementioned network during the last 30 years of clinical practice. Methods: The guidelines to set a protocol demand a series of actions as follows: (1) set the diagnosis criteria, neuropsychological assessment, laboratory examinations, and examination of neurophysiological, neuroimaging, cerebrospinal fluid, blood, and genetic markers; and (2) apply non-pharmacological interventions according to the needs and specialized psychosocial interventions of the patient to the caregivers of the patient. Results: In addition to the guidelines followed in memory clinics at the 1st and 3rd Department of Neurology and two DCCs, a database of patients, educational programs, and further participation in international research programs, including clinical trials, make our contribution in the dementia field strong. Conclusion: In the current paper, we provide useful guidelines on how major and minor neurocognitive disorders are being treated in Thessaloniki, Greece, describing successful practices which have been adapted in the last 30 years.
Collapse
Affiliation(s)
- Magda Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece.,1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI - AUTh) Balkan Center, Buildings A & B, Aristotle University of Thessaloniki, Thessaloniki, Greece.,3rd University Department of Neurology "G. Papanikolaou" Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Marianna Tsatali
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece
| | - Mara Gkioka
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece.,1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Poptsi
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece
| | - Anthoula Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece.,1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Papaliagkas
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece.,Department of Biomedical Sciences International Hellenic University, Thessaloniki, Greece
| | - Irene-Maria Tabakis
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece
| | - Ioulietta Lazarou
- 1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Marina Makri
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece.,1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Kazis
- 3rd University Department of Neurology "G. Papanikolaou" Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sotirios Papagiannopoulos
- 3rd University Department of Neurology "G. Papanikolaou" Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Kiryttopoulos
- 1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efrosyni Koutsouraki
- 1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Thomas Tegos
- 1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|