title: Evaluation of a mobile team dedicated to behavioural disorders as recommended by the Alzheimer Cooperative Valuation in Europe joint action: observational cohort study.
abstract: OBJECTIVE
  Preventing behavioural crises appears to be crucial to promote quality of life of the patient-caregiver dyad, to reduce inappropriate hospitalizations and to delay institutionalization. The Alzheimer Cooperative Valuation in Europe promotes mobile care to prevent patients from severe behavioural and psychological symptoms in dementia. This study assessed the potential efficacy of a mobile team for Alzheimer's disease on hospitalization sparing and behavioural disorder reduction.
  
  
  METHODS
  A cohort study was set up from 1 January 2012 to 31 December 2013 by the Clinical and Research Memory Centre of Lyon (France). It included patients with behavioural and psychological symptoms living at home or in a nursing home. An interview explored the alternative patient pathways used by general practitioners (GPs) if the mobile team had not existed (hospitalization sparing). The Neuropsychiatry Inventory score was assessed at inclusion and 30 days later. The sample included 424 consecutive patients with Alzheimer's disease or related disorders and behavioural disorders at any cognitive and functional stage of the disease, taken in charge by the mobile team.
  
  
  RESULTS
  Amongst the 424 patients (84.0 ± 7.2 years), 220 (51.9%) hospitalizations were considered by their GPs and 181 (82.3%) were avoided. The Neuropsychiatric Inventory score declined after mobile team intervention (45.8-29.9, P < 0.001). Sleep and appetite disorders, endangered situation and caregiver burnout were associated with higher risk of hospitalization at 30 days.
  
  
  CONCLUSIONS
  The mobile team for Alzheimer's disease allows a high proportion of hospitalizations related to behavioural disorders to be avoided and may help to reduce behavioural disorders.
authors.affiliation: Clinical and Research Memory Centre of Lyon (CMRR), Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France.|Clinical Research Centre (CRC) - VCF (Aging - Brain - Frailty), Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France.|University Lyon 1, Lyon, France.|INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Centre, Brain Dynamics and Cognition Team, Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Krolak-Salmon
authors.affiliation: Clinical and Research Memory Centre of Lyon (CMRR), Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France.
authors.forename: C
authors.initials: C
authors.lastname: Roubaud
authors.affiliation: Ageing and Services Unit, National Institute of Health and Welfare (THL), Helsinki, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Finne-Soveri
authors.affiliation: French National Authority for Health (HAS), Saint-Denis, France.
authors.forename: N
authors.initials: N
authors.lastname: Riolacci-Dhoyen
authors.affiliation: Clinical and Research Memory Centre of Lyon (CMRR), Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France.
authors.forename: G
authors.initials: G
authors.lastname: Richard
authors.affiliation: Clinical and Research Memory Centre of Lyon (CMRR), Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France.
authors.forename: I
authors.initials: I
authors.lastname: Rouch
authors.affiliation: French National Authority for Health (HAS), Saint-Denis, France.
authors.forename: A
authors.initials: A
authors.lastname: Leperre-Desplanques
authors.affiliation: Clinical and Research Memory Centre of Lyon (CMRR), Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France.|University Lyon 1, Lyon, France.
authors.forename: V
authors.initials: V
authors.lastname: Dauphinot
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D017028:Caregivers / Q000523:psychology*; D015331:Cohort Studies; D003704:Dementia / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005060:Europe; D005260:Female; D005602:France; D006760:Hospitalization; D006801:Humans; D008297:Male; D010348:Patient Care Team; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*
keywords: Alzheimer's disease; cognitive disorders and dementia; cohort study; epidemiology; guideline; psychiatric disorders