Special care plan does not slow decline in patients with Alzheimer's

Jun 04, 2010

A special dementia care plan, involving regular assessments of patients with Alzheimer's disease in specialist memory clinics, does not slow functional decline compared with usual care, finds a study published in the British Medical Journal today.

Guidelines for the care of patients with recommend regular evaluation and follow-up. However, questions remain over the feasibility and real impact of these guidelines, and whether assessments are better carried out in primary care or specialist memory clinics.

So a team of researchers in France tested the effectiveness of a comprehensive care plan in reducing the rate of functional decline in patients with Alzheimer's disease compared with usual care.

The study was conducted over two years at 50 memory clinics in France and involved 1,131 community dwelling patients with mild to moderate Alzheimer's disease. Patients were randomised to either a comprehensive care plan (intervention group) or usual care (control group).

Patients in the intervention group received regular 6-monthly assessments, while the control group received only an annual consultation.

After two years, there was no significant difference in functional decline between the two groups. There was also no difference in the risk of being admitted to an institution or death between the two groups.

The authors say: "This finding underlines the fact that this kind of broad intervention does not convey benefit in activities of daily living and may have little public health value."

They add: "it may be that interventions must be targeted towards patients at particular risk of decline or we may need to develop a more effective intervention and ensure that it is correctly implemented in all patients."

Future research is needed to determine whether functional decline can be improved by more direct involvement of or by using case manager programmes, they conclude.

In an accompanying editorial, Professor Lon Schneider from the University of Southern California acknowledges that care plans are not simple to implement, but says the trial "provides an important basis from which to assess the feasibility and effectiveness of care plans delivered by doctors. It also highlights the need to develop effective comprehensive care plans that can be integrated into practice."

Explore further: Study IDs risk factors for severe hidradenitis suppurativa

add to favorites email to friend print save as pdf

Related Stories

Exercise therapy best for knee pain

Oct 21, 2009

For patients with severe knee pain, supervised exercise therapy is more effective at reducing pain and improving function than usual care, finds a study published on BMJ.com today.

Recommended for you

How the world is underestimating Ebola: WHO

6 hours ago

The Ebola epidemic tearing through western Africa is by far the deadliest known outbreak of the disease, yet the magnitude of the spread is believed to be severely underestimated.

Last Ebola-free region of Liberia falls to virus

6 hours ago

Every region of Liberia has now been hit by Ebola, officials said Friday, as the World Health Organization warned the fight against the worst-ever outbreak of the killer disease would take months.

Ebola death toll rises to 1,427: WHO

17 hours ago

The death toll from the Ebola outbreak sweeping through west African countries has risen to 1,427 out of more than 2,600 cases, the World Health Organization said Friday.

User comments : 0