Alzheimer's disease: positive effect of direct observation on behavioral disturbances

This study evaluates the effect of direct observation at patients homes by a neurologist, on the frequency and type of behavioral disorders in Alzheim er's disease (AD) patients and on the related caregiver's reactions. Among 30 selected AD patients, 20 were positively screened for behavioral disturb ances. The sampled caregivers were asked to complete the Revised Memory and Behavior Problems Checklist (RMBPC) in order to select patients showing be havioral problems in the week prior to the interview. Caregivers were asked to record in diary form the three most frequent behavioral disturbances in order to select the most appropriate time of day for a direct observation. A neurologist stayed at home of each patient for 1 hr on 7 days and monito red the patient's behavior. After direct observation both caregiver and neu rologist completed the RMBPC separately. The total score of RMBPC provided by caregivers at baseline and after the neurologist's observation was compa red using the t-test for paired samples. After the neurologist's direct obs ervation, almost all AD patients showed an improvement in the occurrence of behavioral disturbances (p=0.04). The caregiver's reaction was also decrea sed compared to the baseline (p=0.03). Our study outlines the importance of non-pharmacological intervention in caring for AD patients whereby many of the effects of AD could be alleviated by behavioral management.