Author:
Pozzi Federico Emanuele,Calì Luisa,D'Antonio Fabrizia,Altomare Arianna Ida,Sepe Monti Micaela,Panigutti Massimiliano,Di Crosta Adolfo,Palumbo Rocco,Bonanni Laura,Carlucci Valentina,Bussè Cinzia,Cagning Annachiara,Urso Daniele,Vilella Davide,Logroscino Giancarlo,Alberoni Margherita,Bellinvia Angelo,Farina Elisabetta,de Rino Francesca,Gavazzi Armando,Zuffi Marta,Bruno Giuseppe,Bessi Valentina,Cotta Ramusino Matteo,Perini Giulia,Costa Alfredo,Ferrarese Carlo,Appollonio Ildebrando,Tremolizzo Lucio
Abstract
Behavioral and Psychological Symptoms of Dementia (BPSD) are a heterogeneous set of psychological and behavioral abnormalities seen in persons with dementia (PwD), significantly impacting their quality of life and that of their caregivers. Current assessment tools, such as the Neuropsychiatric Inventory (NPI), are limited by recall bias and lack of direct observation. This study aims to overcome this limitation by making caregiver reports more objective through the use of a novel instrument, referred to as the BPSDiary. This randomized controlled trial will involve 300 caregiver-PwD dyads. The objective is to evaluate whether the use of the BPSDiary could significantly reduce caregiver burden, assessed using the Zarit Burden Interview (ZBI), compared to usual care. The study will include adult PwD, caregivers living with or close to the patient, and BPSD related to the HIDA (hyperactivity, impulsivity, irritability, disinhibition, aggression, agitation) domain. Caregivers randomized to the intervention arm will use the BPSDiary to record specific BPSD, including insomnia, agitation/anxiety, aggression, purposeless motor behavior, and delusions/hallucinations, registering time of onset, severity, and potential triggers. The primary outcome will be the change in ZBI scores at 3 months, with secondary outcomes including changes in NPI scores, olanzapine equivalents, NPI-distress scores related to specific BPSD domains, and caregiver and physician satisfaction. The study will be conducted in 9 Italian centers, representing diverse geographic and sociocultural contexts. While potential limitations include the relatively short observation period and the focus on specific BPSD disturbances, the BPSDiary could provide physicians with objective data to tailor appropriate non-pharmacological and pharmacological interventions. Additionally, it may empower caregivers by encouraging reflection on BPSD triggers, with the potential to improve the quality of life for both PwD and their caregivers.Trial registryNCT05977855.