[Behavioral disorders in dementia: intervention study in a long-term care unit]

Behavioral disorders are frequent in the course of dementia. They often result in inappropriate drug prescription, and an increased risk of morbidity and mortality. They also have a major negative impact on the caregiver's burden. We present an intervention study on the carers of demented patients in a long-term care unit.

We studied 26 patients with dementia (mean age -/+ 86.6 +/- 6.4 years) hospitalized in a long-term care unit at the Toulouse university hospital. Frequency and related distress of behavioral disturbances were assessed using the Neuropsychiatric Inventory (NPI). After a first patient evaluation, the staff of the unit underwent a specific program of education and training to cope with these behavioral problems. This was followed by a second comparative evaluation of the patients.

We observed a significant decrease of frequency, severity and related distress of behavioral symptoms. Significant changes in severity were found in depression, delusions, hallucinations, apathy and irritability. Distress related to agitation, depression and irritability was significantly reduced.

Our study shows a positive effect of an educative intervention on patient is behavior and caregiver distress. Similar actions reported in the literature note a variability in the response depending on the type of population and nature of the intervention. Due to the lack of a control group, we are unable to assess the specificity of the intervention programme. However, the magnitude of the observed changes support its general methodology. The use of quantitative tools such as the NPI is very helpful to improve the understanding of behavioral problems in demented people and to assess their management.