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BIOGRAPHY
Dr. Sytse Zuidema is Professor of Elderly Care Medicine and Dementia at University Medical Center Groningen (UMCG). Sytse Zuidema has been a specialist in geriatric medicine since 2000. He earned his PhD in 2008 on problem behaviors in people with dementia in nursing homes and from 2012 worked in the Courts. Since 2011 he has been head of the geriatrics section at the general medicine department of the University Medical Center Groningen.Dr. Zuidema is an elderly care physician with a focus of consultation on elderly care physicians and team on complex care problems / neuropsychiatric symptoms in people with dementia. His research focuses on psychotropic drug use and psychosocial interventions for people with dementia in long-term care and community. He runs transition and implementation projects to improve care for frail people in community and long-term care in order to stimulate scientific research interest and competencies of the specialist training programme for elderly care physicians. Prof Zuidema is head of UNO-UMCG, a care home network linked to the UMCG aimed at improving quality of elderly care through scientific research (www.uno-umcg.nl).
MEDIA APPEARANCES
Living with dementia magazine
Alzheimer’s SocietyOctober 01, 2010
"A cross cultural nursing homes study aimed at identifying causes of agitation in people with dementia suggests that structural and cultural changes can improve quality of life.”Professor Sytse Zuidema’s research is cited in this article for the Alzheimer’s Society.
Articles
Focus on mental health issues in long-term-care homes
International Psychogeriatrics3 September 2010Background: Psychosocial interventions in long-term care have the potential to improve the quality of care and quality of life of persons with dementia. Our aim is to explore the evidence and consensus on psychosocial interventions for persons with dementia in long-term care.Methods: This study comprises an appraisal of research reviews and of European, U.S. and Canadian dementia guidelines.Results: Twenty-eight reviews related to long-term care psychosocial interventions were selected. Behavioral management techniques (such as behavior therapy), cognitive stimulation, and physical activities (such as walking) were shown positively to affect behavior or physical condition, or to reduce depression. There are many other promising interventions, but methodological weaknesses did not allow conclusions to be drawn. The consensus presented in the guidelines emphasized the importance of care tailored to the needs and capabilities of persons with dementia and consideration of the individual's life context.Conclusions: Long-term care offers the possibility for planned care through individualized care plans, and consideration of the needs of persons with dementia and the individual life context. While using recommendations based on evidence and consensus is important to shape future long-term care, further well-designed research is needed on psychosocial interventions in long-term care to strengthen the evidence base for such care.
Course of Neuropsychiatric Symptoms in Residents with Dementia in Nursing Homes Over 2-Year Period
The American Journal of Geriatric PsychiatryDecember 2010ObjectiveTo determine the course of neuropsychiatric symptoms (NPSs) in nursing home residents with dementia and to determine their variability across diagnosis.DesignProspective cohort study over 2 years.SettingFourteen dementia special care units in nine nursing homes in The Netherlands.ParticipantsOne hundred seventeen residents with dementia.MeasurementsNPSs were measured using the Neuropsychiatric Inventory-Nursing Home version (NPI-NH).ResultsThe majority of residents had moderately severe to severe dementia. All but a few residents (97%) showed any NPS, and co-occurrence of NPSs was high. Agitation, irritability, and aberrant motor behavior were the most prevalent over the 2 years. Depression and anxiety as well as NPI total score decreased over time, whereas apathy tended to increase. Agitation and aberrant motor behavior were the most persistent symptoms. In asymptomatic residents, highest incidence rates were found for apathy, aggression/agitation, irritability, and aberrant motor behavior. Anxiety and apathy were more prevalent in Alzheimer disease (AD) compared with vascular disease (VaD); vice versa, aggression and depression were more prevalent in VaD. Differences in change over time between AD and VaD were found for irritability and disinhibition.ConclusionThis is the first study examining the 2-year course of NPSs in a large group of nursing home residents with dementia. Virtually all residents demonstrated and/or developed NPSs. Although affective symptoms decreased, apathy tended to increase. Agitated behaviors were particularly persistent. Our data may contribute to improve mental healthcare for demented nursing home residents.
Prevalence and correlates of psychotropic drug use in Dutch nursing-home patients with dementia
International Psychogeriatrics16 April 2009Background: Neuropsychiatric symptoms in dementia patients are common and are often treated with psychotropic drugs. The aim of this study was to determine the prevalence and correlates of psychotropic drug use in Dutch nursing home patients with dementia.Methods: Psychotropic drug use of 1322 patients on 59 dementia special care units (SCUs) in 25 nursing homes was registered. Drugs were categorized according to the Anatomical Therapeutical Chemical classification (ATC). The influence of age, gender, dementia stage measured by the Global Deterioration Scale (GDS), and type of neuropsychiatric symptoms on psychotropic drug use was analyzed using binomial logistic regression analysis.Results: 63% of the patients used at least one psychotropic drug. Psychotropics in general and antipsychotics in particular were most frequently prescribed in GDS stage 6, and in patients aged between 65 and 75 years. Psychotropics in general were positively associated with depression, night-time behavior and agitation. Antipsychotic drug use was positively associated with psychosis, agitation and night-time behavior and was negatively associated with apathy. Anxiolytics were associated with age, psychosis, agitation and night-time behavior. Antidepressants were most frequently prescribed in GDS stage 6 and associated with female gender, agitation and depression. Sedatives were only associated with night-time behavior.Conclusion: Nursing home patients with dementia have a high prevalence of psychotropic drug use. In particular, the association with neuropsychiatric symptoms raises questions of efficacy of these drugs and the risk of chronic use.
Neuropsychiatric Symptoms in Nursing Home Patients: Factor Structure Invariance of the Dutch Nursing Home Version of the Neuropsychiatric Inventory in Different Stages of Dementia
Dementia and Geriatric Cognitive Disorders3 November 2007Background/Aims: To examine the influence of dementia stage and psychoactive medication use on the factor structure of the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) in Dutch nursing home patients. Methods: The NPI-NH was administered to a large sample of 1,437 patients with mild to severe dementia receiving nursing home care. Exploratory factor analysis was used to examine behavioural dimensions underlying neuropsychiatric symptoms indicated by the NPI-NH across dementia stages (as assessed with the Global Deterioration Scale – GDS) and in patients with or without psychoactive medication prescribed. Results: In GDS stages 4/5, 6 and 7, a 4- or 5-factor solution was found, with factors referred to as agitation/aggression, depression, psychosis, psychomotor agitation and apathy. These symptom clusters were replicated in the group of drug-naive patients, but only partially in the group of patients on psychoactive medication. Conclusion: The factor structure of the NPI-NH in nursing home patients is consistent with the clinical taxonomy of symptoms, is relatively stable across dementia stages, and is only moderately influenced by psychoactive medication use. The division of depression and apathy into separate behavioural dimensions – also in patients with severe dementia – may have important therapeutic consequences.
Prevalence and Predictors of Neuropsychiatric Symptoms in Cognitively Impaired Nursing Home Patients
Journal of Geriatric Psychiatry and NeurologyMarch 2007The prevalence of neuropsychiatric symptoms and the influence of predictive factors in cognitively impaired nursing home patients were reviewed. Articles were identified by means of a MEDLINE and PsychInfo literature search. Neuropsychiatric symptoms were present in more than 80% of the cognitively impaired patients. Prevalences ranged considerably, from 3% to 54% for delusions, 1% to 39% for hallucinations, 8% to 74% for depressed mood, 7% to 69% for anxiety, 17% to 84% for apathy, 48% to 82% for aggression or agitation, and 11% to 44% for physical aggression. Neuropsychiatric symptoms seemed to be predicted not only by dementia type or stage but also by the psychosocial environment and the amount of psychoactive medication and physical restraints used. Neuropsychiatric symptoms are common and influenced by both the disease itself and the psychosocial environment of the institutional setting. The latter may have important consequences for staff planning and education and the future design of care facilities.
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Area of Expertise
Dementia
Frailty
Geriatric Medicine
Long-term Care and Community
Affiliation
UNO-UMCG : Head
Industry
Research
Education/Learning
Elder Care
Writing and Editing
Health and Wellness
Education
University of Groningen : Medicine
Media
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