Objective: To evaluate the effectiveness of multi-dimensional (medical, psychiatric, psychological, educational, behavioral) assessment and intervention in reducing problematic behaviors in dementia patients.
Design: Prospective unblinded clinical outcomes study.
Materials and Methods: The Dementia Behavioral Assessment and Response Team (DBART) evaluated dementia patients in their living environment (nursing home, assisted living, etc). This evaluation included review of medical history, examination of patient, and interview of facility staff and family. Patient behaviors were assessed and classified into one or more of 10 established behavior categories. Frequency and severity of behaviors were noted and interventions (pharmachologic, behavioral, medical environmental) were recommended and initiated. Two weeks subsequent to initial evaluation, telephone follow-up to facility occurred for an update and to modify treatment recommendations, based upon patient progress. Four-six weeks subsequently, behavioral questionaires were completed by facility staff and family.
Results: 64% of cases reported improvement in target behaviors. 9% reported no change. 0% had a worsening of behaviors. 27% lost to follow-up (surveys not returned or patient death).
Conclusion: Multidisciplinary assessment and management of dementia patients with behavioral problems effectively reduces problematic behaviors in the majority of patients referred for DBART consultation.
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