Abstract：
Behavioral and psychological symptoms of dementia (BPSD) bring complexity in the clinical management of people with dementia; therefore, it is important to evaluate different models of care, such as Special Care Units (SCU-B).∥Objective:To evaluate the SCU-B effectiveness toward alleviating BPSD and improving the quality of life (QoL) of patients and their caregivers.∥Methods:ReCAGE was a multicenter, controlled, longitudinal study where 508 patients with BPSD were enrolled in two cohorts: 262 patients from centers endowed with a SCU-B, and 246 from centers without SCU-B. Statistical analyses included factorial ANCOVA for comparison among centers. The primary endpoint was effectiveness of the SCU-B, measured through the Neuropsychiatric Inventory (NPI) changes. Secondary endpoints were change in QoL of patients and caregivers, and the tertiary endpoint was time to nursing home admission.∥Results:The NPI scores decreased in both arms, with a statistically significant difference from baseline to 36 months (p < 0.0001) in both cohorts. Over time, NPI decreased more steeply during the first year in the SCU-B arm, but in the following two years the slope was clearly in favor of the control arm. This different pattern of the two cohorts reached statistical significance at the interaction \"cohort by time\" (p < 0.0001). Conflicting results were found regarding the outcomes of quality of life, while there were no differences in time to institutionalization in both cohorts.∥Conclusion:The RECage study did not confirm the long-term superiority of the pathway comprising a SCU-B. A post-hoc analysis revealed data supporting their acute effectiveness during behavioral crises.
摘要：
背景：痴呆症的行为和心理症状（BPSD）给痴呆症患者的临床管理带来了复杂性；因此，评估不同的护理模式很重要，如特殊护理单位（SCU-B）。目的：评价SCU-B对减轻BPSD和改善患者及其照顾者生活质量（QoL）的有效性。SEL方法：ReCAGE是一个多中心的，控制,纵向研究，508例BPSD患者被纳入两个队列：262例患者来自给予SCU-B的中心，和246来自没有SCU-B的中心统计分析包括用于中心之间比较的阶乘ANCOVA。主要终点是SCU-B的有效性，通过神经精神量表(NPI)的变化来衡量。次要终点是患者和护理人员的QoL变化，第三个终点是入住疗养院的时间.结果：两组NPI评分均下降，在两个队列中，从基线到36个月（p<0.0001）具有统计学上的显着差异。随着时间的推移,在SCU-B分支的第一年，NPI下降得更快，但在接下来的两年中，斜坡显然有利于控制臂。这两个队列的这种不同模式在相互作用“按时间分组”时达到了统计显著性(p<0.0001)。关于生活质量的结果发现相互矛盾的结果，而两个队列在住院时间上没有差异。结论：RECage研究未证实包含SCU-B的途径的长期优越性。事后分析显示，数据支持其在行为危机期间的急性有效性。
