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Background: Behavioral and psychological symptoms of dementia (BPSD) are quite challenging problems during the dementia course. Special Care Units for people with dementia (PwD) and BPSD (SCU-B) are residential medical structures, where BPSD patients are temporarily admitted, in case of unmanageable behavioral disturbances at home.Objective: RECage (REspectful Caring for AGitated Elderly) aspires to assess the short and long-term effectiveness of SCU-Bs toward alleviating BPSD and improving the quality of life (QoL) of PwD and their caregivers.Methods: RECage is a three-year, prospective study enrolling 500 PwD. Particularly, 250 community-dwelling PwDs presenting with severe BPSD will be recruited by five clinical centers across Europe, endowed with a SCU-B, for a short period of time; a second similar group of 250 PwD will be followed by six other no-SCU-B centers solely via outpatient visits. RECage's endpoints include short and long-term SCU-B clinical efficacy, QoL of patients and caregivers, cost-effectiveness of the SCU-B, psychotropic drug consumption, caregivers' attitude toward dementia, and time to nursing home placement.Results: PwD admitted in SCU-Bs are expected to have diminished rates of BPSD and better QoL and their caregivers are also expected to have better QoL and improved attitude towards dementia, compared to those followed in no-SCU-Bs. Also, the cost of care and the psychotropic drug consumption are expected to be lower. Finally, PwD followed in no-SCU-Bs are expected to have earlier admission to nursing homes.Conclusion: The cohort study results will refine the SCU-B model, issuing recommendations for implementation of SCU-Bs in the countries where they are scarce or non-existent. [ABSTRACT FROM AUTHOR]

Introduction: Informal care estimates for use in health-economic models are lacking. We aimed to estimate the association between informal care time and dementia symptoms across Europe., Methods: A secondary analysis was performed on 13,529 observations in 5,369 persons from 9 European pooled cohort or trial studies in community-dwelling persons with dementia. A mixed regression model was fitted to time spent on instrumental or basic activities of daily living using disease severity and demographic characteristics., Results: Daily informal care time was 0.5 hours higher in moderate compared to mild and 1.3h higher in severe compared to mild cognitive impairment. Likewise, this was 1.2h and 2.7h for functional disability and 0.3h and 0.6h for behavioral symptoms in the same directions., Discussion: Estimates can be used in both single- and multi-domain health-economic models for dementia in European settings., Competing Interests: Declaration of competing interest AS No conflict of interest. BW – no conflict of interest. CB received outside this study research grants from ZonMw, Alzheimer Nederland/Dutch Alzheimer Society and Gieskes Strijbis fund. He is board member of the Dutch Young-onset Dementia Knowledge Center and member of the IPA YOD shared interest forum and member INTERDEM and its YOD Taskforce (all unpaid). CGP: No conflict of interest (IQVIA did not give any authorization or funding for this work – as shared data set was not its property and as it was used for research CGP led before integrating IQVIA). GS have participated, outside this study, at advisory boards for Eisai and Roche, regarding monoclonal antibody drugs for the treatment of Alzheimer's disease. LF – received research grants unrelated to this work from Hoffmann-LaRoche. Received case honoraria for clinical trials paid to the institution from Axon Neuroscience, Anavex, Alector, Boehringer Ingelheim, Eisai, Hummingbird, NovoNordisk, Noselab; Consulting fees unrelated to this work from Biogen, BioVie, Eisai, Eli Lilly, FOMF, Araclon/Grifols, Janssen Cilag, Medical Tribune, Medfora, Neurimmune, Noselab, NovoNordisk, Roche, TauRX, Schwabe, StreamUp; Honoraria for Clinical study committees from Avanir/Otsuka, PharmatrophiX, Charité Berlin, Neuroscios, Vivoryon. LJ received research grants unrelated to this work from Vinnova, Innovative Health Initiative, Forte and Novo Nordisk A/S. Consulting fees unrelated to this work from H. Lundbeck A/S, Janssen, Eli Lilly Inc, and license fees for the RUD instrument. LS: has no competing interest related to the topic of this paper. OR: No potential conflict of interest to declare. RH received outside this study consulting fees in the past 36 months from Lilly Nederland and from the Institute for Medical Technology Assessment (paid to institution). RK received outside this study research grants from ZonMw, Dutch Alzheimer Society and Gieskes Strijbis fund. He is board member of the International Psychogeriatric Association, member of the IPA YOD shared interest forum and member INTERDEM and its YOD Taskforce and taskforce palliative care (all unpaid). SH – no conflict of interest. YP has no conflict of interest., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)