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

August, 2010

A large French study has found no evidence that special care plans for dementia patients improve the outcomes.

A study involving over 1100 patients with mild to moderate Alzheimer's disease at 50 French clinics has revealed that receiving a comprehensive care plan involving regular 6-monthly assessments (with standardised guidelines for the management of problems) produced no benefits compared to receiving the usual care (an annual consultation). After two years, there was no significant difference in functional decline between the two groups, and no difference in the risk of being admitted to an institution or death. While this argues against guideline-based interventions for dementia care (widely recommended), it may be that the treatment received by both groups was superior to that received by those who do not attend a specialized memory clinic. It remains to be seen whether the findings would be different for patients being treated in general practice.

It should also be noted that this study only measured the effects on daily activities, institutionalization, and death. A number of studies have found improvements in specific behaviors (eg, reduced behavioral problems, reduced agitation, or improved quality of life) as a result of particular care programs. The fact that, in this case, interventions were more frequent early in the study compared to later, suggests that the care plan may not have been all that easy to implement.

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