title: Alzheimer's disease patients institutionalized in group homes run by long-term care insurance exhibit fewer symptoms of behavioural problems as evaluated by the Behavioural Pathology in Alzheimer's Disease Rating Scale.
abstract: BACKGROUND
  The behavioural and psychological symptoms of dementia (BPSD) caused by Alzheimer's disease (AD) can burden caregivers. Group homes (GH), small nursing homes, for the elderly with dementia are institutions commonly run by the public long-term care insurance system in Japan. The purpose of this study was to compare the prevalence of BPSD of AD, as evaluated by the Behavioural Pathology in Alzheimer's Disease Rating Scale, between GH patients and community residents.
  
  
  METHODS
  A total of 74 patients with AD were enrolled: 37 were patients institutionalized in GH (Hachinski score < 5) and 37 were demographic-matched community residents undergoing treatment at the Osaki-Tajiri SKIP Center. There were no significant differences in mean age (81.4 vs 81.1 years, P = 0.816), mean educational level (7.7 vs 8.0 years, P = 0.497), sex (women/men: 30/7 vs 30/7, P = 1.000) and mean Mini-Mental State Examination scores (14.1 vs 14.1, P = 0.950) between the two groups. Care level (range: 0.5-5.0, slight to bedridden), activities of daily living care level (range: 1-7, almost normal to severe), and the presence or absence BPSD based on the domains of the Behavioural Pathology in Alzheimer's Disease Rating Scale were compared.
  
  
  RESULTS
  GH patients had a significantly higher care level (P < 0.05) and activities of daily living care level (P < 0.05) but had fewer symptoms of BPSD (P < 0.05) than community residents. When the activities of daily living care level was controlled, GH patients had significantly fewer symptoms than community residents in Aggressiveness (21% vs 50%; χ2= 4.5, P = 0.035), Affective disturbances (13% vs 42%; χ2= 5.1, P = 0.023), and Anxieties and phobias (4% vs 46%; χ2= 11.1, P = 0.001).
  
  
  CONCLUSIONS
  GH run by the long-term care insurance system appear to be effective in improving environmental factors for moderate AD patients and reducing Aggressiveness, Affective disturbances, and Anxieties and phobias.
authors.affiliation: Division of Geriatric Behavioral Neurology, CYRIC, Tohoku University, Sendai, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Kasai
authors.affiliation: Division of Geriatric Behavioral Neurology, CYRIC, Tohoku University, Sendai, Japan.|The Osaki-Tajiri SKIP Center, Osaki, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Meguro
authors.affiliation: Division of Geriatric Behavioral Neurology, CYRIC, Tohoku University, Sendai, Japan.|The Osaki-Tajiri SKIP Center, Osaki, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Akanuma
authors.affiliation: The Osaki-Tajiri SKIP Center, Osaki, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamaguchi
keywords: Alzheimer's disease; BEHAVE-AD; behavioural and psychological symptoms of dementia; group home