Collaborative Care Best for Alzheimer's

Improvements noted in patients and their caregivers, study says

By Amanda Gardner
HealthDay Reporter

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TUESDAY, May 9 (HealthDay News) -- Alzheimer's patients who were treated with a so-called guided team approach, with an advanced practice nurse coordinating care, had fewer behavioral and psychological symptoms of dementia, a new study found.

At the same time, their caregivers had greatly reduced levels of stress and depression.

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Such a collaborative approach is already used to treat diseases such as diabetes and congestive heart failure.

"It really is quite effective and the collaborative care model is what I would argue is the future of chronic-care management," said Dr. Gary J. Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City.

Kennedy was not involved in the study, which appears in the May 10 issue of the Journal of the American Medical Association.

Most older adults with Alzheimer's and other forms of dementia receive the bulk of their care from a primary-care physician, not a specialist. But this may not be the best setting.

"Generalists are the most likely to take care of older adults with Alzheimer's; there aren't enough specialists," said Dr. Christopher M. Callahan, lead author of the study and director of the Indiana University Center for Aging Research. "Primary care doesn't have the resources to apply state-of-the-art recommendations."

According to the study authors, more than 90 percent of patients with dementia will have behavioral and psychological symptoms at some point.

The guided team approach guidelines for dementia treatment include easy communication among doctors within the health-care system and the community; active surveillance of patient results with feedback to the health-care team managing the patient; treatment for depression, psychoses and behavioral disturbances; and active monitoring and support of the caregiver's emotional and physical health.

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