Objective: To determine the impact of a multidisciplinary longitudinal evaluation of Alzheimer's disease (AD) on the number of hospitalizations.
Design: Prospective study with a semi-annual multidisciplinary evaluation.
Materials and Methods: Thirty-eight AD patients were followed semi-annually at 6-month intervals for up to 5 years by a multidisciplinary team including a neurologist, a clinical psychologist and a neuropsychologist. Each visit consisted of 1) a neurological examination; 2) data collection from the family informant about functional ability in the daily life, general evolution, medication and change in medical condition; 3) a psychological individual interview with patients to appreciate the psychological and psychiatric status: depression, delusions, hallucinations and behavioral disturbances; 4) an interview with the caregivers to complement these information, to evaluate the level of dependency and patient's quality of life and to assess the caregivers distress; 5) a specific neuropsychological battery assessing episodic and semantic memory, executive functions and instrumental cognitive domains. To conclude the visit, both patients and caregivers meet all the team in order to discuss and explain the clinical observations and anticipate the potential difficulties. Psychological counselling and psycho-educative measures were given. Advice was also proposed according to the cognitive and behavioral deficits in order to improve activities of daily life. Each visit lasted approximately 3 hours. Additionally, patient's relatives, dispatched in three groups according to patient's MMSE score, were proposed participating a psycho-educative annual meeting.
Results: After 5 years of follow-up, five patients dropped out. Among them, three refused further participation and two were unable to reach the research center because of the severity of the disease. Five patients died (2 hemorrhagic cerebral stroke and 3 unknown causes). Twenty-eight patients remained in the study. None of them were hospitalized during the follow up either because of AD complications and behavioral changes or because of caregiver's distress.
Conclusion: Semi-annual multidisciplinary follow-up of AD patients has a favorable impact on hospitalization and quality of life of patients and relatives.
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