Dementia podcast

Dementia Researcher Cochrane Dementia and Cognitive Improvement Group | 7 June 2021 | Cochrane Dementia and Cognitive Improvement Group

Cochrane’s dementia podcast is produced in association with Alzheimer’s Research UK and Alzheimer’s Society. In this edition of the biweekly podcast Dr Anna Volkmer talks with the joint co-ordinating editors of the Cochrane Dementia Group. This bring together panels of early career researchers and other dementia experts to discuss their research and career topics to support other early career researchers. The podcast covers research investigating Alzheimer’s and other dementias, exploring prevention, diagnosis, treatments, care and how they’re working to better understand the disease and the brain.

The latest edition of the podcast is available on SoundCloud

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US approves first new Alzheimer’s drug in 20 years

via BBC News | US approves first new Alzheimer’s drug in 20 years

The first new treatment for Alzheimer’s disease for nearly 20 years has been approved by regulators in the United States, paving the way for its use in the UK.

Aducanumab targets the underlying cause of Alzheimer’s, the most common form of dementia, rather than its symptoms.

At least 100,000 people in the UK with a mild form of the disease could be suitable for the drug.

But approval from the UK regulator could take more than a year.

Charities have welcomed the news (Source: BBC News)

Full story from BBC News

Using Zoom could help older people avoid dementia, study reveals

Rafnsson, S.B., Maharani, A. & Tampubolon, G. | 2021| Social Contact Mode and 15-Year Episodic Memory Trajectories in Older Adults With and Without Hearing Loss: Findings From the English Longitudinal Study of Ageing | The Journals of Gerontology: Series B| gbab029| https://doi.org/10.1093/geronb/gbab029

The findings of a longitudinal study add new evidence to the body of research on social networks and cognition in later life, they indicate that social interactions through online communication such as Zoom or Skype may help older adults, sustain, and benefit cognitively from, personal relationships. This was particularly apparent for older people living with hearing loss. The researchers used data from ELSA sought to determine whether frequent offline social interactions, as compared to infrequent contact, were independently and longitudinally associated with episodic memory.

Abstract

Objectives

Frequent social contact benefits cognition in later life although evidence is lacking on the potential relevance of the modes chosen by older adults, including those living with hearing loss, for interacting with others in their social network.

Method

11 418 participants in the English Longitudinal Study of Ageing provided baseline information on hearing status and social contact mode and frequency of use. Multilevel growth curve models compared episodic memory (immediate and delayed recall) at baseline and longitudinally in participants who interacted frequently (offline only or offline and online combined), compared to infrequently, with others in their social network.

Results

Frequent offline (B equal to 0.23; SE  equal to 0.09) and combined offline and online (B equal to 0.71; SE  equal to 0.09) social interactions predicted better episodic memory after adjustment for multiple confounders. We observed positive, longitudinal associations between combined offline and online interactions and episodic memory in participants without hearing loss (B  equal to 0.50, SE  equal to 0.11) but not with strictly offline interactions (B equal to 0.01, SE  equal to 0.11). In those with hearing loss, episodic memory was positively related to both modes of engagement (offline only: B  equal to 0.79, SE  equal to 0.20; combined online and offline: B  equal to 1.27, SE  equal to 0.20). Sensitivity analyses confirmed the robustness of these findings.

Discussion

Supplementing conventional social interactions with online communication modes may help older adults, especially those living with hearing loss, sustain, and benefit cognitively from, personal relationships.

Paper Social Contact Mode and 15-Year Episodic Memory Trajectories in Older Adults With and Without Hearing Loss: Findings From the English Longitudinal Study of Ageing

In the news:

The Guardian Using Zoom could help older people avoid dementia, study reveals

Alzheimer’s Society: Emergency admissions from dementia care failures soaring, and worse to come

Alzheimer’s Society | 17 May 2021 | Emergency admissions from dementia care failures soaring, and worse to come warns charity

Emergency admissions for patients with a diagnosis of dementia have increased by more than a quarter during the last four years, reports the Alzheimer’s Society. The findings of an investigation commissioned by the charity show that people with dementia were being rushed to hospital each year, up 27%, because inadequate social care left them unprotected from infections, falls and dehydration. 

The investigation was based on freedom of information (FOIs) to NHS Trusts, found a 27 per cent rise between 2015 – 2019 of people with dementia sped to hospitals with avoidable emergencies. And in 2019, nearly two thirds (65 per cent) of all emergency admissions of people with dementia were for avoidable illnesses and injuries caused by failures in care. The charity says that while an increase in the number of people with dementia has contributed in part to the rise in avoidable admissions, much of the increase is thought to be due to cuts in spending on adult social care piling pressure on A&E and ambulance services.

Full details are available from the Alzheimer’s Society

In the news:

Guardian Social care cuts mean thousands with dementia taken to A&E, charity says

Alzheimer’s Society: Cure the Care System

Alzheimer’s Society | nd | Cure the care system

This week -17-23 May 2021- is Dementia Action Week. The Alzheimer’s Society is calling on the Government to cure the care system now. The charity has produced a short film, showing the impact the broken social care system has on carers. Without support, dementia claims more than one life.

The Cure the Care system campaign highlights the broken social care system means that in the UK, nearly 1 million people with dementia and their families are struggling to get the support and care that they need and deserve.  

Decades of underfunding and neglect have led to a care system that’s difficult to access, costly, inadequate and deeply unfair. The coronavirus pandemic has exposed these problems like never before. 

Until things change, a dementia diagnosis will continue to claim more than one life, as families facing dementia feel its destructive effects.   The charity underlines that it doesn’t have to be this way.

With the right support people with dementia can live a good quality of life, doing what matters most to them for as long as possible (Source: Alzheimer’s Society).

There are also a range of resources including the poster below

Poster from the charity’s Cure the Care System campaign shows a photograph of a man and the text ” My wife has dementia I’m forgetting who I am”

Further details are available from The Alzheimer’s Society

Music app for patients with dementia

Lancashire Teaching Hospital Trusts has trialled the use of a music app in patients with dementia (n equal to 25). The app uses an algorithm that selects music based on listeners’ personal backgrounds and this patient group experienced reductions in heart rate by a fifth (22 per cent) as well as lowering agitation and distress in some cases. The algorithm uses the  patient’s age, gender, nationality, and ethnicity and based on sociological and psychological science, it then compiles in seconds the perfect 20-minute playlist of soothing music to calm them.

“There has been an up to 22% reduction in heart rates in these patients,” said Dr Jacqueline Twamley, academic research and innovation manager. “Some people it doesn’t affect the heart rate at all, but you can see the effect in their facial expressions and in them tapping along. One patient burst out crying. He said the song brought back happy memories and they were happy tears.”

“The results have been very impressive. We believe that dispensing music as medicine could revolutionise the treatment of dementia and other similar neurological conditions such as Alzheimer’s.” (Source: The Guardian & The Yorkshire Post).

Story featured in:

The Guardian Alzheimer’s patients and hospital staff prescribed music in NHS trial

Yorkshire Post Revolutionary new app ‘dispenses music as medicine’ to reduce anxiety and pain

Understanding health-care outcomes of older people with cognitive impairment and/or dementia admitted to hospital

Hapca, R. E. et al | 2021| Understanding health-care outcomes of older people with cognitive impairment and/or dementia admitted to hospital: a mixed-methods study | NIHR | Health Services and Delivery Research| Vol. 9 | Issue 8 | Published in April 2021 | https://doi.org/10.3310/hsdr09080

Researchers’ analysis of hospital records indicates that a third of people aged 65 or over admitted to hospital had confusion and that they had higher mortality and had longer hospital stays than those without confusion.

Adopting a mixed-methods approach, the researchers behind this study carried out this piece of research in four ways:

  1. all available research publications were reviewed.
  2. hospital records were analysed to calculate the health-care outcomes (e.g. mortality, length of stay and re-admission).
  3. The hospital costs of patients with and of those without confusion were compared.
  4. The researchers surveyed people with confusion who had been patients in hospital and their families to see what was important to them.

From the research publications, they found that there is overlap between the conditions that cause confusion and there is no agreement on how to test for and define these conditions.

The analysis showed that patients with confusion had an overall higher cost for their hospital admission than patients without confusion; however, this was because they stayed in hospital longer. Their daily cost was lower.

When surveyed, patients and their families told the research team that they expect the patient to leave the hospital in the same or a better condition than they were in on admission. Failing that, they expect patients to have a satisfactory experience of their hospital stay.

These findings will be used to inform the development of a standardised management plan to improve the identified outcomes and, therefore, the quality of care. This will be evaluated in a future study.

Understanding health-care outcomes of older people with cognitive impairment and/or dementia admitted to hospital: a mixed-methods study

Family carers’ narratives of the financial consequences of young onset dementia

Bayly, M., O’Connell, M. E., Kortzman, A., Peacock, S., Morgan, D. G. & Kirk, A. | 2021| Family carers’ narratives of the financial consequences of young onset dementia | Dementia | https://doi.org/10.1177/14713012211009341

This study takes a qualitative approach to explore how family carers of persons with young onset dementia understand their experiences (n equal to 8), with a focus on financial consequences and how they may be ameliorated by support

Abstract

Individuals with young onset dementia and their families face unique challenges, such as disruptions to their life cycle and relationships and a dearth of appropriate supports. Financial consequences have also been noted in the literature yet have not been explored in-depth. The purpose of this research was to qualitatively explore carers’ experiences of financial consequences resulting from the young onset dementia of a family member and how these consequences may be managed. Eight carers (7 women and 1 man) provided a written online narrative about their journey with young onset dementia and any financial consequences experienced, with open-ended prompts to elicit details not yet shared. Narratives were inductively coded and analyzed using a thematic narrative approach. Carers described a voluntary or involuntary end to employment for the person with young onset dementia around the time of diagnosis. This engendered ongoing and anticipated financial consequences, combined with the need for carers to balance employment with the provision of care (which often meant early retirement for spousal carers). Common themes were tension between the needs to provide care and earn income, altered financial prospects, costs of care, and lack of available and accessible supports to ameliorate financial consequences. Findings illustrate the reality of financial consequences across the trajectory of young onset dementia. These consequences may manifest differently for spousal and child carers and are not being adequately addressed by existing supports.

Full paper available from Dementia

The experiences, priorities, and perceptions of informal caregivers of people with dementia in nursing homes: A scoping review

Harper, A. E. et al | 20201 | The experiences, priorities, and perceptions of informal caregivers of people with dementia in nursing homes: A scoping review | Dementia | https://doi.org/10.1177/14713012211012606

This review examined the comprehensive experiences, priorities, and perceptions of informal caregivers of nursing home residents with dementia in the published literature in the period from 2000 to July 2020

Abstract

Background

Person-centered care has been shown to increase desired outcomes for people with dementia, yet informal caregivers’ dissatisfaction with care is often reported. For those living in a nursing home, informal caregivers are uniquely situated to provide key insights into the individual’s care. However, little is known of the informal caregivers’ perspective, which hinders efforts to improve their satisfaction with person-centered nursing home care. Thus, we examined the comprehensive experiences, priorities, and perceptions of informal caregivers of nursing home residents with dementia.

Methods

In collaboration with stakeholders, a scoping review of Medline (Ovid), EMBASE.com, CINAHL (EBSCO), the Cochrane Library (Wiley), and PsycINFO (Ovid) databases from January 2000 to July 2020 was conducted. Data were extracted reflecting the experiences, priorities, and preferences of caregivers of people with dementia residing in nursing homes.

Results

We identified 114 articles that revealed nine themes: (1) communication, (2) transition to nursing home, (3) quality of care, (4) quality of life, (5) informal caregiver role, (6) knowledge of dementia, (7) end-of-life preferences, (8) medication use to manage neuropsychiatric behaviors, and (9) finances.

Conclusion

Informal caregivers described aspects of care that led to both positive and negative experiences with and perceptions of nursing home care. The shortcomings in communication were discussed most frequently, indicating a high priority area. While researchers define the identified themes individually, informal caregivers perceive them to be interwoven as they relate to person-centered care delivery. Although we did not assess the quality of included articles, by identifying themes relevant to caregivers’ perspectives of nursing home care, our findings may help to inform efforts to optimize caregivers’ satisfaction with nursing home care for residents with dementia.

Abstract only The experiences, priorities, and perceptions of informal caregivers of people with dementia in nursing homes: A scoping review

Rotherham NHS staff can request this paper from their Library Service

Alzheimer’s Society: 5 ways our new early career researchers are helping defeat dementia

The Alzheimer’s Society | 26 April 2021 | 5 ways our new early career researchers are helping defeat dementia

The Alzheimer’s Society has announced, that thanks to its supporters generosity over the past year, they are now able to fund early career researchers whose work has hung in the balance due to the pandemic.

The Alzheimer’s Society are investing over £800,000 into exciting research projects led by PhD students and postdoctoral fellows. Not only will these projects advance dementia research but they will help secure the positions for our dementia researcher leaders of tomorrow. 

It outlines five research projects they are funding:

  1. How certain factors could increase the risk of developing dementia
  2. How brain cells die in diseases causing dementia
  3.  How we could treat dementia
  4. How we can improve the quality of life for those living with dementia
  5. How we can support with quality end-of-life care planning-

The full details about each of these projects plus links to the project homepage are available from The Alzheimer’s Society

5 ways our new early career researchers are helping defeat dementia