title: Management of behavioral and psychological symptoms of dementia in a dedicated psychogeriatric unit: a pilot experience.
abstract: BACKGROUND
  The French government gave a consensual definition of reinforced care units for Behavioral and Psychological Symptoms in Dementia (BPSD) within the project "Plan Alzheimer 2008/2012." These Cognitive and Behavioral Units (CBU) differ in resources from the traditional reference units for BPSD management, the Acute Psychogeriatric Units (APU). However, a better understanding of their operational specificities may enhance the CBU and APU synergies.
  
  
  OBJECTIVE
  To describe one of the first CBU experiments, with regard to preexisting BPSD management in an APU in the same geriatric hospital.
  
  
  METHODS
  A total of 129 patients with BPSD, 35 from the CBU and 94 admitted to the APU before opening the colocated CBU.
  
  
  RESULTS
  Patients from the CBU often showed comorbidities and a lower nutritional status, but these conditions were more frequent in the APU (P ≤ 10(-4)). Severe dementia, night time and aberrant motor behavior, and agitation were more frequent in the CBU (P ≤ 0.0015). In both the units, about 80% of patients were improved without increased use of psychotropic medications and there was a high discharge rate back home of about 30%.
  
  
  CONCLUSIONS
  These findings that are still preliminary support a particular role for the CBU for elderly patients showing the most advanced dementia and disruptive BPSD. Colocated APU and CBU may allow for more effective integration of medical and psychiatric care in elderly patients with BPSD with frequent comorbidities.
authors: Department of Psychogeriatrics, Bretonneau Hospital, Paris, France. pierre.koskas@brt.aphp.fr
authors: Pierre
authors: P
authors: Koskas
authors: Marie Cécile Henry
authors: MC
authors: Feugeas
authors: Sawsan
authors: S
authors: Saad
authors: Sana
authors: S
authors: Belqadi
authors: Jacques
authors: J
authors: Daraux
authors: Olivier
authors: O
authors: Drunat