title: Outcomes of Inpatient Treatment for Behavioral and Psychological Symptoms of Dementia in Alzheimer's Disease Versus Dementia With Lewy Bodies.
abstract: OBJECTIVE
  Most community-based studies have shown a more malignant clinical course for patients with dementia with Lewy bodies (DLB) than Alzheimer's disease (AD). We examined differences in outcomes between patients with DLB and AD hospitalized for the treatment of behavioral and psychological symptoms of dementia.
  
  
  METHODS
  A chart review was conducted of patients with either AD or DLB hospitalized in the acute psychogeriatric ward between January 2008 and December 2011 in Kahoku-City, Ishikawa, Japan. Outcome measures were discharge destinations and time to death. A diagnosis of AD was made according to DSM-5 criteria, whereas a diagnosis of DLB was made according to the Consortium on DLB International Workshop criteria for probable DLB. Pharmacologic treatment was optimized under constant monitoring of patients. Cholinesterase inhibitors and yi-gan san were tried prior to antipsychotics in DLB patients.
  
  
  RESULTS
  The study cohort consisted of 224 patients with AD and 106 with DLB. After matching for sociodemographic factors and cognitive and physical function, it was found that antipsychotics were less frequently used during hospitalization in patients with DLB than AD (63% vs 82%, respectively, P < .01), whereas cholinesterase inhibitors (88% vs 43%, P < .001) and yi-gan san (35% vs 20%, P < .05) were more frequently used in patients with DLB. There were no significant differences in discharge destinations between the 2 groups. The 5-year cumulative survival rates were similar in the AD and DLB groups (46.4% vs 45.7%, respectively, P = .6225).
  
  
  CONCLUSIONS
  Optimization of pharmacologic treatment during hospitalization could reduce the use of antipsychotics and improve the subsequent clinical course in DLB.
authors.affiliation: Department of Neuropsychiatry, Ishikawa Prefectural Takamatsu Hospital, Ya-36, Uchi-Takamatsu, Kahoku-City, Ishikawa, Japan.
authors.forename: Tatsuru
authors.initials: T
authors.lastname: Kitamura
authors.affiliation: Department of Neuropsychiatry, Ishikawa Prefectural Takamatsu Hospital, Ya-36, Uchi-Takamatsu, Kahoku-City, Ishikawa, Japan.
authors.forename: Shinnichi
authors.initials: S
authors.lastname: Tochimoto
authors.affiliation: Department of Neuropsychiatry, Ishikawa Prefectural Takamatsu Hospital, Ya-36, Uchi-Takamatsu, Kahoku-City, Ishikawa, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Kitamura
authors.affiliation: Department of Neuropsychiatry, Ishikawa Prefectural Takamatsu Hospital, Ya-36, Uchi-Takamatsu, Kahoku-City, Ishikawa, Japan.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Madachi
authors.affiliation: Department of Neuropsychiatry, Ishikawa Prefectural Takamatsu Hospital, Ya-36, Uchi-Takamatsu, Kahoku-City, Ishikawa, Japan.
authors.forename: Shoryoku
authors.initials: S
authors.lastname: Hino
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