[Canopy-enclosed bed: the state of the art]. / Het tentbed: hoe staan de zaken?

Due to the persistence and complexity of problem behaviour in patients with dementia, doctors often prescribe psychotropic drugs for long periods of time. The need for psychosocial interventions in patients with dementia and psychological or psychiatric problems remains high and, according to the existing guidelines on problem behavior, they are the treatment of first choice. 5 years ago we described that the canopy-enclosed bed seemed to be able to meet this need. We observed that within a few weeks of patients getting a canopy-enclosed bed, psychotropic drugs could be reduced or even stopped. In this article, we would like to argue once again for more research into psychosocial interventions for problem behaviour.

[Canopy-enclosed bed for dementia patients with behavioural problems]. / Tentbed voor dementiepatiënten met gedragsproblemen.

Patients with dementia almost all have one or more symptoms of problem behaviour. This problem behaviour includes a wide range of symptoms including depression, anxiety and apathy, and behavioural problems such as aggression, general restlessness, compulsion to walk, disinhibition and calling, and psychotic disorders such as delusions and hallucinations. Due to the persistence and complexity of problem behaviour in patients with dementia, doctors often prescribe psychotropic drugs for long periods of time. In nursing homes there is a great need for non-pharmacological treatments for patients with psychological or psychiatric problems. The canopy-enclosed bed seems to meet this need and has positive effects. We observed that within a few weeks of patients getting a canopy-enclosed bed, psychotropic drugs could be reduced or even stopped. Using a canopy-enclosed bed is a measure of restraint. Therefore it remains important to carefully trade off its deployment with the intended goal.

Assessment of working-memory deficits in patients with mild cognitive impairment and Alzheimer's dementia using Wechsler's Working Memory Index.

BACKGROUND AND AIMS: Although episodic memory deficits are a hallmark in mild cognitive impairment (MCI) and Alzheimer's dementia (AD), little attention has been paid so far to the ability to maintain and manipulate information during a brief period of time, i.e. working memory. In this study, we examine verbal working memory in both cognitively unimpaired older people and MCI and AD patients. METHODS: Seventy- five participants were examined with either no cognitive impairment (n=25), MCI (n=25) or AD (n=25). Working memory was investigated with Wechsler's Working Memory Index tests (Digit Span, Letter-Number Sequencing and Arithmetic). RESULTS: Both MCI and AD patients performed worse on all three working-memory tests compared with controls, the subtest Letter-Number Sequencing also revealing worse performance in AD compared with MCI patients. CONCLUSIONS: Workingmemory deficits are already present in MCI patients and worsen in AD patients, suggesting that working memory should be assessed as part of neuropsychological testing.