Skip to main content
Top
Published in: BMC Psychiatry 1/2014

Open Access 01-12-2014 | Study protocol

Initial and long-term evaluation of patients with Alzheimer’s after hospitalization in cognitive and behavioural units: the EVITAL study design

Authors: Elodie Pongan, Magalie Freulon, Floriane Delphin-Combe, Florence Dibie-Racoupeau, Géraldine Martin-Gaujard, Denis Federico, Aziza Waissi, Gaëlle Richard, Sophie Jacqueline, Florence Fabre, Béatrice Trombert-Paviot, Pierre Krolak-Salmon, Bernard Laurent, Isabelle Rouch

Published in: BMC Psychiatry | Issue 1/2014

Login to get access

Abstract

Background

Alzheimer’s disease and related disorders are characterized by cognitive impairment associated with behavioral and psychological symptoms of dementia. These symptoms have significant consequences for both the patient and his family environment. While risk factors for behavioral disorders have been identified in several studies, few studies have focused on the evolution of these disorders. Moreover, it is important to identify factors linked to the long-term evolution of behavioral disorders, as well as patients’ and caregivers’ quality of life. Our purpose is to present the methodology of the EVITAL study, which primary objective is to determine the factors associated with the evolution of behavioral disorders among patients with Alzheimer’s disease and related disorders during the year following their hospitalization in cognitive and behavioral units. Secondary objectives were 1) to assess the factors related to the evolution of behavioral disorders during hospitalization in cognitive and behavioral units; 2) to identify the factors linked to patients’ and caregivers’ quality of life, as well as caregivers’ burden; 3) to assess the factors associated with rehospitalization of the patients for behavioral disorders in the year following their hospitalization in cognitive and behavioral units.

Method/Design

A multicenter, prospective cohort of patients with Alzheimer’s disease and related disorders as well as behavioral disorders who are hospitalized in cognitive and behavioral units.
The patients will be included in the study for a period of 24 months and followed-up for 12 months. Socio-demographic and environmental data, behavioral disorders, medications, patients’ and caregivers’ quality of life as well as caregivers’ burden will be assessed throughout hospitalization in cognitive and behavioral units. Follow-up will be performed at months 3, 6 and 12 after hospitalization. Socio-demographic and environmental data, behavioral disorders, medications, patients’ and caregivers’ quality of life, unplanned rehospitalization as well as caregivers’ burden will also be assessed at each follow-up interview.

Discussion

The present study should help better identify the factors associated with reduction or stabilization of the behavioral and psychological symptoms of dementia in patients with Alzheimer’s disease. It could therefore help clinicians to better manage these symptoms.

Trial registration

Clinical Trials NCT01901263. Registered July 9, 2013.
Appendix
Available only for authorised users
Literature
1.
go back to reference Finkel SI, Costa e Silva J, Cohen G, Miller S, Sartorius N: Behavioral and psychological signs and symptoms of dementia: a consensus statement on current knowledge and implications for research and treatment. Int Psychogeriatr. 1996, 8 (Suppl 3): 497-500.PubMed Finkel SI, Costa e Silva J, Cohen G, Miller S, Sartorius N: Behavioral and psychological signs and symptoms of dementia: a consensus statement on current knowledge and implications for research and treatment. Int Psychogeriatr. 1996, 8 (Suppl 3): 497-500.PubMed
2.
go back to reference Wragg RE, Jeste DV: Overview of depression and psychosis in Alzheimer’s disease. Am J Psychiatry. 1989, 146 (5): 577-587.CrossRefPubMed Wragg RE, Jeste DV: Overview of depression and psychosis in Alzheimer’s disease. Am J Psychiatry. 1989, 146 (5): 577-587.CrossRefPubMed
3.
go back to reference Lyketsos CG, Steinberg M, Tschanz JT, Norton MC, Steffens DC, Breitner JC: Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. Am J Psychiatry. 2000, 157 (5): 708-714. 10.1176/appi.ajp.157.5.708.CrossRefPubMed Lyketsos CG, Steinberg M, Tschanz JT, Norton MC, Steffens DC, Breitner JC: Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. Am J Psychiatry. 2000, 157 (5): 708-714. 10.1176/appi.ajp.157.5.708.CrossRefPubMed
4.
go back to reference Benoit M, Staccini P, Brocker P, Benhamidat T, Bertogliati C, Lechowski L, Tortrat D, Robert PH: [Behavioral and psychologic symptoms in Alzheimer’s disease: results of the REAL.FR study]. Rev Med Interne. 2003, 24 (Suppl 3): 319s-324s. 10.1016/S0248-8663(03)80690-2.CrossRefPubMed Benoit M, Staccini P, Brocker P, Benhamidat T, Bertogliati C, Lechowski L, Tortrat D, Robert PH: [Behavioral and psychologic symptoms in Alzheimer’s disease: results of the REAL.FR study]. Rev Med Interne. 2003, 24 (Suppl 3): 319s-324s. 10.1016/S0248-8663(03)80690-2.CrossRefPubMed
5.
go back to reference Robert PH, Verhey FR, Byrne EJ, Hurt C, De Deyn PP, Nobili F, Riello R, Rodriguez G, Frisoni GB, Tsolaki M, Kyriazopoulou N, Bullock R, Burns A, Vellas B: Grouping for behavioral and psychological symptoms in dementia: clinical and biological aspects. Consensus paper of the European Alzheimer disease consortium. Eur Psychiatry. 2005, 20 (7): 490-496. 10.1016/j.eurpsy.2004.09.031.CrossRefPubMed Robert PH, Verhey FR, Byrne EJ, Hurt C, De Deyn PP, Nobili F, Riello R, Rodriguez G, Frisoni GB, Tsolaki M, Kyriazopoulou N, Bullock R, Burns A, Vellas B: Grouping for behavioral and psychological symptoms in dementia: clinical and biological aspects. Consensus paper of the European Alzheimer disease consortium. Eur Psychiatry. 2005, 20 (7): 490-496. 10.1016/j.eurpsy.2004.09.031.CrossRefPubMed
6.
go back to reference Aalten P, Verhey FR, Boziki M, Bullock R, Byrne EJ, Camus V, Caputo M, Collins D, De Deyn PP, Elina K, Frisoni G, Girtler N, Holmes C, Hurt C, Marriott A, Nobili F, Ousset PJ, Reynish E, Salmon E, Tsolaki M, Vellas B, Robert PH: Neuropsychiatric syndromes in dementia. Results from the European Alzheimer Disease Consortium: part I. Dement Geriatr Cogn Disord. 2007, 24 (6): 457-463. 10.1159/000110738.CrossRefPubMed Aalten P, Verhey FR, Boziki M, Bullock R, Byrne EJ, Camus V, Caputo M, Collins D, De Deyn PP, Elina K, Frisoni G, Girtler N, Holmes C, Hurt C, Marriott A, Nobili F, Ousset PJ, Reynish E, Salmon E, Tsolaki M, Vellas B, Robert PH: Neuropsychiatric syndromes in dementia. Results from the European Alzheimer Disease Consortium: part I. Dement Geriatr Cogn Disord. 2007, 24 (6): 457-463. 10.1159/000110738.CrossRefPubMed
7.
go back to reference Gonzalez-Salvador MT, Arango C, Lyketsos CG, Barba AC: The stress and psychological morbidity of the Alzheimer patient caregiver. Int J Geriatr Psychiatry. 1999, 14 (9): 701-710. 10.1002/(SICI)1099-1166(199909)14:9<701::AID-GPS5>3.0.CO;2-#.CrossRefPubMed Gonzalez-Salvador MT, Arango C, Lyketsos CG, Barba AC: The stress and psychological morbidity of the Alzheimer patient caregiver. Int J Geriatr Psychiatry. 1999, 14 (9): 701-710. 10.1002/(SICI)1099-1166(199909)14:9<701::AID-GPS5>3.0.CO;2-#.CrossRefPubMed
8.
go back to reference Stern Y, Tang MX, Albert MS, Brandt J, Jacobs DM, Bell K, Marder K, Sano M, Devanand D, Albert SM, Bylsma F, Tsai WY: Predicting time to nursing home care and death in individuals with Alzheimer disease. JAMA. 1997, 277 (10): 806-812. 10.1001/jama.1997.03540340040030.CrossRefPubMed Stern Y, Tang MX, Albert MS, Brandt J, Jacobs DM, Bell K, Marder K, Sano M, Devanand D, Albert SM, Bylsma F, Tsai WY: Predicting time to nursing home care and death in individuals with Alzheimer disease. JAMA. 1997, 277 (10): 806-812. 10.1001/jama.1997.03540340040030.CrossRefPubMed
9.
go back to reference Black W, Almeida OP: A systematic review of the association between the Behavioral and Psychological Symptoms of Dementia and burden of care. Int Psychogeriatr. 2004, 16 (3): 295-315. 10.1017/S1041610204000468.CrossRefPubMed Black W, Almeida OP: A systematic review of the association between the Behavioral and Psychological Symptoms of Dementia and burden of care. Int Psychogeriatr. 2004, 16 (3): 295-315. 10.1017/S1041610204000468.CrossRefPubMed
10.
go back to reference Donaldson C, Tarrier N, Burns A: The impact of the symptoms of dementia on caregivers. Br J Psychiatry. 1997, 170: 62-68. 10.1192/bjp.170.1.62.CrossRefPubMed Donaldson C, Tarrier N, Burns A: The impact of the symptoms of dementia on caregivers. Br J Psychiatry. 1997, 170: 62-68. 10.1192/bjp.170.1.62.CrossRefPubMed
11.
go back to reference Sink KM, Covinsky KE, Barnes DE, Newcomer RJ, Yaffe K: Caregiver characteristics are associated with neuropsychiatric symptoms of dementia. J Am Geriatr Soc. 2006, 54 (5): 796-803. 10.1111/j.1532-5415.2006.00697.x.CrossRefPubMed Sink KM, Covinsky KE, Barnes DE, Newcomer RJ, Yaffe K: Caregiver characteristics are associated with neuropsychiatric symptoms of dementia. J Am Geriatr Soc. 2006, 54 (5): 796-803. 10.1111/j.1532-5415.2006.00697.x.CrossRefPubMed
13.
go back to reference Lyketsos CG, Lopez O, Jones B, Fitzpatrick AL, Breitner J, DeKosky S: Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study. JAMA. 2002, 288 (12): 1475-1483. 10.1001/jama.288.12.1475.CrossRefPubMed Lyketsos CG, Lopez O, Jones B, Fitzpatrick AL, Breitner J, DeKosky S: Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study. JAMA. 2002, 288 (12): 1475-1483. 10.1001/jama.288.12.1475.CrossRefPubMed
14.
go back to reference Hope T, Keene J, Gedling K, Fairburn CG, Jacoby R: Predictors of institutionalization for people with dementia living at home with a carer. Int J Geriatr Psychiatry. 1998, 13 (10): 682-690. 10.1002/(SICI)1099-1166(1998100)13:10<682::AID-GPS847>3.0.CO;2-Y.CrossRefPubMed Hope T, Keene J, Gedling K, Fairburn CG, Jacoby R: Predictors of institutionalization for people with dementia living at home with a carer. Int J Geriatr Psychiatry. 1998, 13 (10): 682-690. 10.1002/(SICI)1099-1166(1998100)13:10<682::AID-GPS847>3.0.CO;2-Y.CrossRefPubMed
15.
go back to reference Sink KM, Holden KF, Yaffe K: Pharmacological treatment of neuropsychiatric symptoms of dementia: a review of the evidence. JAMA. 2005, 293 (5): 596-608. 10.1001/jama.293.5.596.CrossRefPubMed Sink KM, Holden KF, Yaffe K: Pharmacological treatment of neuropsychiatric symptoms of dementia: a review of the evidence. JAMA. 2005, 293 (5): 596-608. 10.1001/jama.293.5.596.CrossRefPubMed
16.
go back to reference Koskas P, Feugeas MC, Saad S, Belqadi S, Daraux J, Drunat O: Management of behavioral and psychological symptoms of dementia in a dedicated psychogeriatric unit: a pilot experience. Alzheimer Dis Assoc Disord. 2011, 25 (2): 184-186. 10.1097/WAD.0b013e3181fa2f81.CrossRefPubMed Koskas P, Feugeas MC, Saad S, Belqadi S, Daraux J, Drunat O: Management of behavioral and psychological symptoms of dementia in a dedicated psychogeriatric unit: a pilot experience. Alzheimer Dis Assoc Disord. 2011, 25 (2): 184-186. 10.1097/WAD.0b013e3181fa2f81.CrossRefPubMed
17.
go back to reference Delphin-Combe F, Roubaud C, Martin-Gaujard G, Fortin ME, Rouch I, Krolak-Salmon P: Effectiveness of a cognitive-behavioral unit on behavioral and psychological symptoms of dementia. Rev Neurol. 2013, 169 (6-7): 490-494. 10.1016/j.neurol.2012.10.017.CrossRefPubMed Delphin-Combe F, Roubaud C, Martin-Gaujard G, Fortin ME, Rouch I, Krolak-Salmon P: Effectiveness of a cognitive-behavioral unit on behavioral and psychological symptoms of dementia. Rev Neurol. 2013, 169 (6-7): 490-494. 10.1016/j.neurol.2012.10.017.CrossRefPubMed
18.
go back to reference Folstein MF, Folstein SE, McHugh PR: “Mini Mental State”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975, 12: 189-198. 10.1016/0022-3956(75)90026-6.CrossRefPubMed Folstein MF, Folstein SE, McHugh PR: “Mini Mental State”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975, 12: 189-198. 10.1016/0022-3956(75)90026-6.CrossRefPubMed
19.
go back to reference Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J: The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994, 44 (12): 2308-2314. 10.1212/WNL.44.12.2308.CrossRefPubMed Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J: The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994, 44 (12): 2308-2314. 10.1212/WNL.44.12.2308.CrossRefPubMed
20.
go back to reference Robert PH, Médecin I, Vincent S, Staccini P, Cattelin F, Goni S: L’inventaire Neuropsychiatrique: validation de la version Française d’un instrument destiné à évaluer les troubles du comportement chez les sujets déments. L’année Gérontologique. 1998, 5: 63-87. Robert PH, Médecin I, Vincent S, Staccini P, Cattelin F, Goni S: L’inventaire Neuropsychiatrique: validation de la version Française d’un instrument destiné à évaluer les troubles du comportement chez les sujets déments. L’année Gérontologique. 1998, 5: 63-87.
21.
go back to reference Rabin R, deCharro F: EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001, 33: 337-343. 10.3109/07853890109002087.CrossRefPubMed Rabin R, deCharro F: EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001, 33: 337-343. 10.3109/07853890109002087.CrossRefPubMed
22.
go back to reference Thomas P, Hazif-Thomas C, Delagnes V, Bonduelle P, Clement JP: [Facilitating environment for dementia patients-the Pixel study]. Encéphale. 2007, 33 (3 Pt 1): 317-325. 10.1016/S0013-7006(07)92045-X.CrossRefPubMed Thomas P, Hazif-Thomas C, Delagnes V, Bonduelle P, Clement JP: [Facilitating environment for dementia patients-the Pixel study]. Encéphale. 2007, 33 (3 Pt 1): 317-325. 10.1016/S0013-7006(07)92045-X.CrossRefPubMed
23.
go back to reference Revel Da Rocha V, Haritchabalet I, Kervinio C, Drode M, Sauvanier M, Geny C, Placines B, Roux C, Albert D, Delafournière F, Dartigues JF: Construction d’une échelle simplifiée pour la détection en médecine générale du fardeau de l’aidant d’une personne âgée dépendante. L’année Gérontologique. 2002, 16: 131-137. Revel Da Rocha V, Haritchabalet I, Kervinio C, Drode M, Sauvanier M, Geny C, Placines B, Roux C, Albert D, Delafournière F, Dartigues JF: Construction d’une échelle simplifiée pour la détection en médecine générale du fardeau de l’aidant d’une personne âgée dépendante. L’année Gérontologique. 2002, 16: 131-137.
24.
go back to reference Thomas P, Hazif-Thomas C, Delagnes V, Bonduelle P, Clément JP: La vulnérabilité de l’aidant principal des malades déments à domicile L’étude Pixel. Psychol NeuroPsychiatr Viell. 2005, 3: 207-220. Thomas P, Hazif-Thomas C, Delagnes V, Bonduelle P, Clément JP: La vulnérabilité de l’aidant principal des malades déments à domicile L’étude Pixel. Psychol NeuroPsychiatr Viell. 2005, 3: 207-220.
Metadata
Title
Initial and long-term evaluation of patients with Alzheimer’s after hospitalization in cognitive and behavioural units: the EVITAL study design
Authors
Elodie Pongan
Magalie Freulon
Floriane Delphin-Combe
Florence Dibie-Racoupeau
Géraldine Martin-Gaujard
Denis Federico
Aziza Waissi
Gaëlle Richard
Sophie Jacqueline
Florence Fabre
Béatrice Trombert-Paviot
Pierre Krolak-Salmon
Bernard Laurent
Isabelle Rouch
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2014
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-014-0308-6

Other articles of this Issue 1/2014

BMC Psychiatry 1/2014 Go to the issue