The treatment of Behavioural and Psychological Symptoms of Dementia (BPSD) continue to raise difficult problems. Both the pharmacologic and non-pharmacologic therapies often fail to achieve the expected results. The aim of this study is to assess the short- and long-term efficacy of an intervention, the Special Care Unit for patients with BPSD (SCU-B), already implemented in some countries but not validated so far, as well as its cost-effectiveness

Two cohorts of 250 patients each will be recruited by six clinical centres endowed with a SCU-B (one cohort) and six centres lacking this structure. The follow-up will last 3 years, during which patients will be visited every 6 months and submitted to a battery exploring the severity of the BPSD and the quality of life. All adverse events will be registered, as well as some anticipated occurrences (admissions to the general hospital for intercurrent diseases, admissions to a SCU-B pertaining to the clinical participating centre and, if any, admissions to a SCU-B not pertaining to the Consortium member, nursing home placement).

At the same time the quality of life of the primary caregivers will be measured, as well as their attitude toward dementia.

A cost-effectiveness analysis will be performed comparing the cohorts. Finally the time to the nursing home placement will be recorded and compared between the two cohorts

Inclusion Criteria:

• diagnosis of primary dementia (DSM IV)
• MMSE score ≤ 24
• NPI global score ≥ 32/144
• a caregiver (informal/family member or formal caregiver) who commits her/himself to accompany the patient along the three-year course of the study
• living at home (nursing home residents are excluded).

Exclusion Criteria:

• presence of uncontrolled medical disease potentially contributing to the cognitive decline and BPSD
• concomitant psychiatric disorders or chronic alcoholism
• concomitant diseases severe enough to reduce life expectancy < 6 months

The population studied is made by the outpatients with dementia referred to the memory clinics of 12 clinical centres located in seven European countries (Italy, Germany, France, Belgium, Greece, Switzerland, Norway)

De-identified participant data both for primary and secondary outcome measures will be made available

Data will be available six months after study completion

Data access requests will be reviewed by an independent Data Safety Monitoring Board