title: Development and validation of clinical profiles of patients hospitalized due to behavioral and psychological symptoms of dementia.
abstract: Patients hospitalized on acute psychogeriatric wards are a heterogeneous population. Cluster analysis is a useful statistical method for partitioning a sample of patients into well separated groups of patients who present common characteristics. Several patient profile studies exist, but they are not adapted to acutely hospitalized psychogeriatric patients with cognitive impairment. The present study aims to partition patients hospitalized due to behavioral and psychological symptoms of dementia into profiles based on a global evaluation of mental health using cluster analysis.
  
  
  
  Using nine of the 13 items from the Health of the Nation Outcome Scales for elderly people (HoNOS65+), data were collected from a sample of 542 inpatients with dementia who were hospitalized between 2011 and 2014 in acute psychogeriatric wards of a Swiss university hospital. An optimal clustering solution was generated to represent various profiles, by using a mixed approach combining hierarchical and non-hierarchical (k-means) cluster analyses associated with a split-sample cross-validation. The quality of the clustering solution was evaluated based on a cross-validation, on a k-means method with 100 random initial seeds, on validation indexes, and on clinical interpretation.
  
  
  
  The final solution consisted of four clinically distinct and homogeneous profiles labeled (1) BPSD-affective, (2) BPSD-functional, (3) BPSD-somatic and (4) BPSD-psychotic according to their predominant clinical features. The four profiles differed in cognitive status, length of hospital stay, and legal admission status.
  
  
  
  In the present study, clustering methods allowed us to identify four profiles with distinctive characteristics. This clustering solution may be developed into a classification system that may allow clinicians to differentiate patient needs in order to promptly identify tailored interventions and promote better allocation of available resources.
authors.affiliation: Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Route de la Corniche 10, 1010, Lausanne, Switzerland. claudia.ortolevabucher@unil.ch.
authors.forename: Claudia
authors.initials: C
authors.lastname: Ortoleva Bucher
authors.affiliation: Research Centre on Aging, Sherbrooke University Geriatrics Institute, Quebec, Canada.|School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Quebec, Canada.
authors.forename: Nicole
authors.initials: N
authors.lastname: Dubuc
authors.affiliation: Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Armin
authors.initials: A
authors.lastname: von Gunten
authors.affiliation: Research Centre on Aging, Sherbrooke University Geriatrics Institute, Quebec, Canada.
authors.forename: Lise
authors.initials: L
authors.lastname: Trottier
authors.affiliation: Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Route de la Corniche 10, 1010, Lausanne, Switzerland.|Faculty of Nursing Sciences, Laval University, Quebec, Canada.
authors.forename: Diane
authors.initials: D
authors.lastname: Morin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057565:Apathy; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D007902:Length of Stay; D008297:Male; D063189:Symptom Assessment
keywords: Aged; Clustering; Dementia; Inpatients; Psychogeriatrics