Reduction of the Anticholinergic Burden Makes It Possible to Decrease Behavioral and Psychological Symptoms of Dementia
| Autor: | Vivien Noël, Yacine Jaidi, Lukshe Kanagaratnam, Sarah Badr, Vignon Nonnonhou, Rachid Mahmoudi, Laurie Anne Bertholon, Jean-Luc Novella |
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| Přispěvatelé: | UFR de Médecine, Université de Reims Champagne-Ardenne (URCA), Fluides, automatique, systèmes thermiques (FAST), Université Paris-Sud - Paris 11 (UP11)-Centre National de la Recherche Scientifique (CNRS), Hôpital de Reims - Service de neuro-gériatrie, Hôpital de Reims, MAHMOUDI, Rachid |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics medicine.drug_class Behavioral Symptoms Severity of Illness Index Cholinergic Antagonists 03 medical and health sciences 0302 clinical medicine Cost of Illness Acute care mental disorders medicine Anticholinergic Dementia Humans Prospective Studies Vascular dementia ComputingMilieux_MISCELLANEOUS Aged Aged 80 and over 030214 geriatrics [SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology business.industry [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology Caregiver burden Odds ratio medicine.disease Confidence interval Psychiatry and Mental health Caregivers [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie Physical therapy Female [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie Geriatrics and Gerontology Alzheimer's disease business 030217 neurology & neurosurgery |
| Zdroj: | The American Journal of Geriatric Psychiatry The American Journal of Geriatric Psychiatry, 2018, 26 (3), pp.280-288. ⟨10.1016/j.jagp.2017.08.005⟩ |
| ISSN: | 1064-7481 |
| DOI: | 10.1016/j.jagp.2017.08.005⟩ |
| Popis: | Objective The aim of this study was to evaluate the impact of a reduction of the anticholinergic burden (AB) on the frequency and severity of behavioral and psychological symptoms of dementia (BPSD) and their repercussions on the care team (occupational disruptiveness). Methods In this prospective, single-center study in an acute care unit for Alzheimer disease (AD) and related disorders, 125 elderly subjects (mean age: 84.4 years) with dementia presented with BPSD. The reduction of the AB was evaluated by the Anticholinergic Cognitive Burden Scale. BPSD were evaluated with the Neuropsychiatric Inventory–Nursing Home Version (NPI-NH). The effect of the reduction of the AB on the BPSD was studied using logistic regression adjusting for the variables of the comprehensive geriatric assessment. Results Seventy-one subjects (56.8%) presenting with probable AD, 32 (25.6%) mixed dementia (AD and vascular), 17 (13.6%) vascular dementia, and 5 (4.0%) Lewy body dementia were included. Reducing the AB by at least 20% enabled a significant decrease in the frequency × severity scores of the NPI-NH (adjusted odds ratio: 3.5; 95% confidence interval: 1.6–7.9) and of the occupational disruptiveness score (adjusted odds ratio: 9.9; 95% confidence interval: 3.6–27.3). Conclusion AB reduction in elderly subjects with dementia makes is possible to reduce BPSD and caregiver burden. Recourse to treatments involving an AB must be avoided as much as possible in these patients, and preferential use of nonpharmacologic treatment management plans is encouraged. |
| Databáze: | OpenAIRE |
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