Association of Participation in the Collaborative Care Team With Behavioral and Psychological Symptoms of Dementia and Caregiver Distress.

INTRODUCTION: The management of behavioral and psychological symptoms associated with dementia (BPSD) was challenging for the physicians and their caregivers, which placing a great burden on their caregivers, families, and communities. Our study aimed to explored the factors associated with changes in BPSD severity and caregiver distress. METHODS: This retrospective cohort study examined 738 community-dwelling individuals who were newly diagnosed with dementia and had BPSD at baseline. Participants were categorized based on a case manager-centered collaborative model that evaluated unmet needs and offered appropriate interventions to patients and caregivers. A generalized linear model with backward selection identified factors linked to changes in total NPI and NPI Distress scores one year after diagnosis. RESULTS: Participants dismissed during follow-up (compared with those with continuous follow-up, β = 3.2, 95% CI = 0.83-5.5, p = 0.008) and participants cared for by a sole informal caregiver (compared with ADL-independent participants whose caregivers only provide companionship, β = 3.9, 95% CI = 1.2-6.7, p = 0.006) were significantly associated with higher NPI total scores. Male sex (β = -3.0, 95% CI = -4.9, -1.0, p = 0.003), and using assistive devices and home modifications (β = -3.0, 95% CI = -6.0, -0.01, p = 0.05) were protective factors. Similar patterns emerged for caregiver distress, with follow-up discontinuation (β = 1.7, 95% CI = 0.18, 3.2, p = 0.029), using respite care (β = 4.4, 95% CI = 0.00, 8.7, p = 0.05), and participants cared by a sole informal caregiver (β = 2.7, 95% CI = 0.95, 4.4, p = 0.003) increasing distress. CONCLUSIONS: The case manager-centered dementia collaborative care model was associated with reduced short-term BPSD severity and caregiver distress, with sex, care mode, and social resource use as predictive factors. Integrating collaborative care models in long-term care healthcare systems is recommended to better support dementia patients and caregivers.