What motivates people to care for someone with dementia?

This review looks to identify and describe informal carers’ motivations for caring for people living with dementia, including their motivations at the start of caring and motivations for continuing to care.  The authors also, where possible, aimed to qualitatively identify and describe any similarities or differences in motivations amongst different demographic groups e.g. in terms of gender and relationships (e.g. spouse versus adult child) and ethnic or cultural groups | BMC Geriatrics

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Background
Informal, often family carers play a vital role in supporting people living with dementia in the community. With ageing populations, the part played by these carers is increasing making it important that we understand what motivates them to take on the role. This systematic review aimed to identify and synthesise qualitative literature describing what motivates people to care for someone with dementia.

Methods
The review followed the Centre for Reviews and Dissemination (CRD) guidelines. Six electronic databases were searched from their first records until August 2018. Synthesis was narrative.

Results
Twenty-six studies fitting the inclusion criteria were identified. Carers described multiple, inter-related motives for caring for someone with dementia. Caring was generally described as a reflection of long-standing family relationships between carers and the care recipients, whether by blood or marriage. Commonly offered motivations included love, reciprocity, filial piety, duty and obligation.

Conclusions
Perhaps the most striking finding was the similarity in these motivations irrespective of gender or relationship with the care recipient. Family relationship and shared history underlay most motivations. Future research should include more longitudinal studies incorporating within study comparisons between different demographic groups to give greater confidence in identifying similarities and differences between demographic groups.

Full article: Nan Greenwood and Raymond Smith | Motivations for being informal carers of people living with dementia: a systematic review of qualitative literature | BMC Geriatrics | 2019 | 19:169 | published 17 June 2019

Needs and experiences of people with dementia living in nursing homes

Kate Shiells, Lara Pivodic, Iva Holmerová & Lieve Van den Block | Self-reported needs and experiences of people with dementia living in nursing homes: a scoping review | Aging & Mental Health | Published online 4th June 2019 

Objectives: With rates of dementia continuing to rise, the impetus on improving care for people with dementia is growing. Unmet needs of people with dementia living in nursing homes have been linked with worsening neuropsychiatric symptoms, higher levels of depression, and reduced quality of life. Furthermore, proxy accounts exploring the needs of people with dementia have frequently been shown to be unreliable. Therefore, this literature review aims to explore the self-reported needs and experiences of people with dementia in nursing homes.

Method: A scoping review of the literature was carried out using the databases PubMed and PsycINFO to search for relevant articles according to PRISMA guidelines. Search terms were designed to include both quantitative and qualitative study designs. Thematic synthesis was used to categorise findings into themes related to self-reported needs and experiences.

Results: A total of 41 articles met the eligibility criteria. An analysis of study characteristics revealed more than half of studies used a qualitative design. Thematic synthesis resulted in eight themes: activities, maintaining previous roles, reminiscence, freedom and choice, appropriate environment, meaningful relationships, support with grief and loss, end-of-life care.

Conclusion: Whilst the voice of people with dementia has previously been neglected in research, this review has shown that people with dementia in nursing homes are able to describe their experiences and communicate their needs. The findings in this review have provided a contribution towards guiding evidence-based practice that is tailored to the needs of nursing home residents with dementia.

Full article available at Aging & Mental Health 

Disrupted sleep – a cause or consequence of Alzheimer’s?

In this blog, Honor Pollard explores if sleep problems could have a long-term effect on the brain| Alzheimers Research UK 

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Growing evidence points to a link between poor quality of sleep and an increased risk of Alzheimer’s disease. We know that disturbed sleep can be one of the earliest signs of Alzheimer’s and it often occurs years before changes to memory and thinking skills start to show. But this is not the full story when it comes to sleep and dementia.

A number of studies have shown that interrupted sleep may speed up the progression of Alzheimer’s in the brain. But it’s difficult for researchers to tease apart cause and effect. They need to work out whether poor quality sleep might contribute to the development of the disease or vice-versa.

Full article at Alzheimers Research UK 

 

Can blood pressure drugs help reduce dementia risk?

A large study analising the medical data of thousands of people suggests that dementia incidence is lower among those who take blood pressure medication | via Medical News Today

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A large new study has found a link between taking various kinds of blood pressure-lowering drugs and a lower risk of dementia among older adults, adding to the discussion around the link between cognitive decline and high blood pressure.

In their study the researchers analised data from 12,405 people, aged 60 or over, with dementia who attended one of 739 general practices in Germany as patients in 2013–2017. The team had access to all of these participants’ blood pressure values, as well as their medication records. This data was compared with those of 12,405 participants without dementia who had visited a general practice in the same time period.

The team found that those who took certain antihypertensive drugs — including beta-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers — seemed to have a lower risk of dementia.

Moreover, among those who took calcium channel blockers — which are another type of blood pressure drug — for a longer period of time, the incidence of dementia also decreased.

Full story at Medical News Today

Full reference: Bohlken, Jensa;  Jacob, Louisb; Kostev, Karelc | The Relationship Between the Use of Antihypertensive Drugs and the Incidence of Dementia in General Practices in Germany | Journal of Alzheimer’s Disease | Published: 20 May 2019

Signs and symptoms of young onset dementia

Young Dementia Network have produced a downloadable resource for anyone who has concerns about signs and symptoms of young onset dementia.

  • Over 42,000 people are living with young onset dementia in the UK.
  • The early signs of dementia vary from person to person but often affect more than memory, particularly in a younger person.
  • Symptoms of young onset dementia can mirror, and be confused with, those of other conditions such as depression, menopause and stress. Dementia may be overlooked in a younger person.

list-2389219_1280This checklist is intended to help a person to be aware of the most common signs and  symptoms of young onset dementia and record changes and symptoms they may be experiencing. The information can be used to provide prompts for a conversation with a GP or health professional. It is not intended to be a diagnostic tool.

The leaflet can be accessed here

To find out more information about young onset dementia visit www.youngdementiauk.org

Adolescents’ experiences and perceptions of dementia

Nicolas Farina et al. | Adolescents’ experiences and perceptions of dementia | Aging & Mental Health | published online: 11 May 2019

Objectives: There is a lack of understanding about how adolescents perceive dementia, and what their dementia related experiences are. Without such information, it is hard to make a case for the need to raise awareness of dementia in adolescents, and the best strategies to achieve this.

Methods: In a cohort of 901 adolescents (aged 13–18) from the South East of England, we explored what the experiences and perceptions of dementia were using a series of questionnaires. Descriptive data of individual items were reported, comparing differences between genders.

Results: The adolescents within this study tended to have positive or neutral attitudes towards dementia, though there was evidence that a proportion of adolescents had misconceptions or held negative attitudes (e.g. 28.5% of adolescents disagreed with the statement ‘In general, I have positive attitudes about people with dementia’). We also identified that the adolescents had a range of experiences of dementia including providing some form of care for someone with dementia (23.2%), though most had indirect contact with dementia through TV and movies (77.3%), or adverts (80.2%). Females nearly always had better attitudes towards dementia and had significantly more contact with dementia.

Conclusions: Considering that adolescents are already forming negative attitudes and misconceptions of dementia, it is important that we raise awareness about dementia in this age group.

Full detail at Aging & Mental Health

Reducing the risk of dementia

Risk reduction of cognitive decline and dementia | The World Health Organisation

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Image source: apps.who.int/

These WHO guidelines provide evidence-based recommendations on lifestyle behaviours and interventions to delay or prevent cognitive decline and dementia.  Worldwide, around 50 million people have dementia and, with one new case every three seconds, the number of people with dementia is set to triple by 2050. The increasing numbers of people with dementia, its significant social and economic impact and lack of curative treatment, make it imperative for countries to focus on reducing modifiable risk factors for dementia.

These guidelines are intended as a tool for health care providers, governments, policy-makers and other
stakeholders to strengthen their response to the dementia challenge.

Full document: Risk reduction of cognitive decline and dementia

See also: WHO press release