title: One-Year Evolution of Behavioral and Psychological Symptoms of Dementia in Patients Initially Hospitalized in Cognitive Behavioral Units: The EVITAL Prospective Cohort.
abstract: The 2008-2012 French Alzheimer's Plan has provided hospital Cognitive and Behavioral Units (CBU) to improve the management of patients with productive behavioral and psychological symptoms of dementia (BPSD). Little is known concerning the behavioral outcome of these patients after discharge.
  
  
  
  The present study investigated the long-term evolution of BPSD over one year after CBU discharge.
  
  
  
  The EVITAL cohort included 221 participants admitted to the CBUs of 3 French hospitals. BPSD were collected using the Neuropsychiatric Inventory (NPI) at admission and 3, 6, and 12 months after hospitalization. The global NPI score evolution was assessed using a linear mixed-effect model. A four-factor model of the NPI including behavioral dyscontrol, psychosis, mood, and agitation subscores was also analyzed.
  
  
  
  Our analysis focused on 148 patients followed up during 12 months and evaluated at each visit. The global NPI score was 48.5 (SD 21.7) at baseline, 28.8 (SD 18.7) at 3-month, 23.2 (SD 16.4) at 6-month and 20.9 (SD 15.9) at 12-month follow-up. The score significantly decreased from baseline to follow-up (F = 109.3 p < 0.0001). Moreover, the decrease was observed for each NPI subscores. The Clinical Dementia Rating (CDR) scale score was significantly linked to the baseline NPI score (t = 2.76, p = 0.009). Conversely, the NPI decline was observed whatever the CDR level.
  
  
  
  The present study showed a decrease in the global NPI score and all its subscores during the year following the CBU hospitalization, regardless of the initial CDR score.
authors.affiliation: Memory Clinical and Research Center of Saint Etienne (CMRR) Neurology Unit, University Hospital of Saint Etienne, Saint Etienne, France.|Memory Clinical and Research Center of Lyon (CMRR), Hospital of Charpennes, University Hospital of Lyon, France.|Institute of Aging I-Vie, University Hospital of Lyon, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Rouch
authors.affiliation: Memory Clinical and Research Center of Saint Etienne (CMRR) Neurology Unit, University Hospital of Saint Etienne, Saint Etienne, France.|Memory Clinical and Research Center of Lyon (CMRR), Hospital of Charpennes, University Hospital of Lyon, France.|Institute of Aging I-Vie, University Hospital of Lyon, France.
authors.forename: Elodie
authors.initials: E
authors.lastname: Pongan
authors.affiliation: Public Health and Medical Information Unit, University Hospital of Saint-Etienne, Saint Etienne, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Trombert
authors.affiliation: Memory Clinical and Research Center of Saint Etienne (CMRR) Geriatrics Unit, University Hospital of Saint Etienne, Saint Etienne, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Fabre
authors.affiliation: Memory Clinical and Research Center of Saint Etienne (CMRR) Geriatrics Unit, University Hospital of Saint Etienne, Saint Etienne, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Auguste
authors.affiliation: Department of Psychiatry, Hospital Saint Jean de Dieu, Lyon, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Sellier
authors.affiliation: Memory Clinical and Research Center of Angers (CMRR) Geriatrics Unit, University Hospital of Angers, Angers, France.
authors.forename: Magalie
authors.initials: M
authors.lastname: Freulon
authors.affiliation: Memory Clinical and Research Center of Saint Etienne (CMRR) Geriatrics Unit, University Hospital of Saint Etienne, Saint Etienne, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Jacqueline
authors.affiliation: Memory Clinical and Research Center of Lyon (CMRR), Hospital of Charpennes, University Hospital of Lyon, France.|Institute of Aging I-Vie, University Hospital of Lyon, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Federico
authors.affiliation: Memory Clinical and Research Center of Lyon (CMRR), Hospital of Charpennes, University Hospital of Lyon, France.|Institute of Aging I-Vie, University Hospital of Lyon, France.
authors.forename: Christelle
authors.initials: C
authors.lastname: Mouchoux
authors.affiliation: Institute of Aging I-Vie, University Hospital of Lyon, France.|Geriatrics Unit, Hospices Civils de Lyon, Hospital Edouard Herriot, Lyon, France.
authors.forename: Géraldine
authors.initials: G
authors.lastname: Martin-Gaujard
authors.affiliation: Memory Clinical and Research Center of Lyon (CMRR), Hospital of Charpennes, University Hospital of Lyon, France.|Institute of Aging I-Vie, University Hospital of Lyon, France.|Clinical Research Centre CRC - VCF (Vieillissement -Cerveau - Fragilité), Hospital of Charpennes, University Hospital of Lyon, Lyon, France.|INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Brain Dynamics and Cognition Team, Lyon, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Krolak-Salmon
authors.affiliation: Memory Clinical and Research Center of Saint Etienne (CMRR) Neurology Unit, University Hospital of Saint Etienne, Saint Etienne, France.|INSERM, U1028; CNRS, UMR5292, Lyon Neuroscience Research Center, Neuropain Team, Lyon, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Laurent
authors.affiliation: Memory Clinical and Research Center of Lyon (CMRR), Hospital of Charpennes, University Hospital of Lyon, France.|Department of Psychiatry, Hospital Le Vinatier, Bron, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Dorey
mesh_terms: D000369:Aged, 80 and over; D003704:Dementia / Q000523:psychology* / Q000628:therapy*; D018450:Disease Progression; D005163:Factor Analysis, Statistical; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D000073216:Mental Status and Dementia Tests; D011446:Prospective Studies; D011619:Psychotropic Drugs / Q000627:therapeutic use
chemical_list: D011619:Psychotropic Drugs
keywords: Alzheimer’s disease; BPSD; behavioral disorders; dementia; longitudinal study