Antidepressants do not help treat depression in people living with dementia

Dudas R, Malouf R, McCleery J and Dening T. Antidepressants for treating depression in dementia. Cochrane Database Syst Rev. 2018;(8):CD003944.

Antidepressants do not reduce symptoms of depression in people with dementia compared with placebo (dummy pills). Measured 6 to 13 weeks after starting the treatment, there is little or no difference in participants’ symptoms, but an increased chance of unwanted side effects. The review did not identify enough data to determine if antidepressants have an effect in the longer-term.

This Cochrane review included randomised controlled trials of any antidepressant drugs compared to placebo. Participants were aged 75 years on average, with mild or moderate dementia. The quality of the included trials was mixed, with not enough information reported to fully assess the risk of bias, though the main result is reliable.

This review supports the NICE guideline, which recommends that antidepressants are not routinely offered to people with dementia and depression, but that psychological treatments are considered instead.

Decreased deep sleep linked to early signs of Alzheimer’s disease

Researchers have uncovered part of the explanation for why poor sleep is linked to Alzheimer’s disease. | via ScienceDaily

Poor sleep is a hallmark of Alzheimer’s disease. People with the disease tend to wake up tired, and their nights become even less refreshing as memory loss and other symptoms worsen. But how and why restless nights are linked to Alzheimer’s disease is not fully understood.

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Now, researchers at Washington University School of Medicine in St. Louis may have uncovered part of the explanation. They found that older people who have less slow-wave sleep — the deep sleep needed to consolidate memories and wake up feeling refreshed — have higher levels of the brain protein tau. Elevated tau is a sign of Alzheimer’s disease and has been linked to brain damage and cognitive decline.

The findings, published in Science Translational Medicine, suggest that poor-quality sleep in later life could be a red flag for deteriorating brain health.

Full story at ScienceDaily

Link to research: Lucey BP, et al. | Reduced non-rapid eye movement sleep is associated with tau pathology in early Alzheimer’s disease | Science Translational Medicine | Jan. 9, 2019

See also: Lack of deep sleep and more day time naps could be early sign of Alzheimer’s, study suggests | The Independent

Alzheimer’s study to look at gut health link

University of Aberdeen | December 2018 | Alzheimer’s study to look at gut health link

A new study led by experts at the University of Aberdeen will recruit patients in the local are to its study which will determine if there is a link between diet in managing the behavioural and psychological symptoms of the disease. 

There is increasing evidence that suggests the gut microbiota is a key link between specific nutrients and brain function.

The study will collect samples from three groups of people: people with dementia and challenging behaviour; people with dementia without challenging behaviour; and a control group of people without dementia.

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Professor Alex Johnstone from the University of Aberdeen said:

“This study is the first of its kind and could lead to the possibility of dietary intervention as a solution to prevent behavioural and psychosocial issues which are associated with adverse outcomes as well as distressing to people with dementia, their family and carers.

“We want to explore whether or not the gut-brain axis plays a key role in behavioural changes in dementia.” (Source: University of Aberdeen)

For further details of this study read the release from University of Aberdeen

Supporting carers: guidance and case studies

Local Government Association | December 2018 |  Supporting carers: guidance and case studies

6.5 million people in the UK are classed as carers, a figure equivalent to 10 per cent of the population.  This includes the more than 3 million carers between the ages of 50 and 64 (2 million) and 65+ (1.3 million). As well as approximately 166,000 under 18s with caring
responsibilities in England currently. The majority of carers (approximately 40 per cent), care for their parents or parents-in-law, while over a quarter look after their spouse or partner. Caring for disabled children, both adult and under 18, accounts for 1 in 7 cases.

The care that is provided by carers is worth an estimated £132 billion, about the same amount that is spent on the NHS in England.

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Key statistics

  • 1 in 10 people are carers
  • 40 per cent increase in carers predicted over next 20 years
  • £132 billion worth of care provided by carers
  • 1 in 5 carers are aged over 65
  • 1.4 million carers provide over 50 hours of care a week
  • 7 in 10 have suffered mental ill health and 6 in 10 physical ill health from caring
  • 166,363 young carers in England – a fifth higher than a decade previously
  • 1 in 12 young carers is caring for more than 15 hours a week
  • 1 in 20 misses school because of their caring responsibilities
  • young carers are 1.5 times more likely to have a long-term illness, special educational needs or a disability
  • there are 670,000 unpaid carers of people with dementia in the UK
  • two thirds of people with dementia live at home and most are supported by unpaid carers.

The pressures of being a carer can place a burden on physical and mental health. Carers
are more likely to suffer depression, anxiety and stress and nearly two-thirds of carers
have a long-standing health condition.

Supporting carers: guidance and case studies, a publication from Local Government Association highlights current examples of how councils support adult and young carers locally in a range of different ways from respite breaks to discount cards to tailored information and advice.

The publication includes a case study from Carers Leeds (Source: Local Government Association).