Dementia: Published online October 29, 2015
Depression, agitation, and wandering are common behaviors associated with dementia and frequently observed among nursing home residents. Even with pharmacological treatment, behaviors often persist, hindering quality of life for elders, their family, and paid caregivers.
This study examined the use of music therapy for treatment of these symptoms among 132 people with moderate to severe dementia in nursing homes. Participants were evaluated for depressive symptoms, agitation, and wandering to determine their predominate behavior. There were two assessments, two weeks apart, prior to intervention, followed by a two-week intervention, and two follow-up assessments, also two weeks apart. A repeated measures ANOVA determined that after two weeks of music therapy, symptoms of depression and agitation were significantly reduced; there was no change for wandering.
Multivariate analyses confirmed a relationship between music therapy and change in neuropsychiatric symptoms associated with dementia. Results suggest widespread use of music therapy in long-term care settings may be effective in reducing symptoms of depression and agitation.
via Music therapy: A nonpharmacological approach to the care of agitation and depressive symptoms for nursing home residents with dementia.
Analysis of data from the DOMINO-AD Trial indicates that the drug Donepezil may be effective in avoiding care home admissions in more advanced cases of Alzheimer’s Disease. Discontinuation of donepezil appears to be associated with an increased risk of nursing home admissions in community-living patients with moderate-to-severe Alzheimer’s Disease during the first 12 months following drug cessation.
Full reference: Nursing home placement in the Donepezil and Memantine in Moderate to Severe Alzheimer’s Disease (DOMINO-AD) trial: secondary and post-hoc analyses. The Lancet Neurology. [Epub ahead of print].
Related: Dementia drug ‘keeps patients out of nursing homes’ BBC News
Latest guidance from NICE recommends people should be encouraged to stop smoking, be more physically active, reduce their alcohol consumption, and adopt a healthy diet to help lower the risk of developing dementia, disability and frailty in later life.
Full reference: Dementia, disability and frailty in later life – mid-life approaches to delay or prevent onset
The Health and Social Care Information Centre has published quality and outcomes framework (QOF) recorded dementia diagnoses data for September 2015.
Alzheimer’s & Dementia: September 2015 Volume 1, Issue 2, Pages 103–110
This study examined whether, among subjects with mild cognitive impairment (MCI), women progressed at faster rates than men.
We examine longitudinal rates of change from baseline in 398 MCI subjects (141 females and 257 males) in the Alzheimer’s Disease Neuroimaging Initiative-1, followed for up to 8 years (mean, 4.1 ± 2.5 years) using mixed-effects models incorporating all follow-ups (mean, 8 ± 4 visits).
Women progressed at faster rates than men on the Alzheimer’s disease assessment scale-cognitive subscale (ADAS-Cog; P = .001) and clinical dementia rating-sum of boxes (CDR-SB; P = .003). Quadratic fit for change over time was significant for both ADAS-Cog (P = .001) and CDR-SB (P = .004), and the additional acceleration in women was 100% for ADAS-Cog and 143% for CDR-SB. The variability of change was greater in women. The gender effect was greater in apolipoprotein E (APOE) ε4 carriers.
Women with MCI have greater longitudinal rates of cognitive and functional progression than men. Studies to confirm and uncover potential mechanisms appear to be warranted.
Dementia, disability and frailty in later life – mid-life approaches to delay or prevent onset
This guideline covers mid-life approaches to delay or prevent the onset of dementia, disability and frailty in later life. The guideline aims to increase the amount of time that people can be independent, healthy and active in later life.
Who is it for?
- Commissioners, managers and practitioners with public health as part of their remit, working in the public, private and third sector
- The public.
The guideline includes recommendations on promoting a healthy lifestyle to reduce the risk of or delay the onset of disability, dementia and frailty by helping people to:
- stop smoking
- be more active
- reduce their alcohol consumption
- improve their diet and,
- lose weight and maintain a healthy weight if necessary.
Evidence used to create this guideline (full guideline)
Guideline development process
How we develop NICE guidelines
Read the full Guidelines and via Dementia, disability and frailty in later life – mid-life approaches to delay or prevent onset | Guidance and guidelines | NICE.
The Department of Health has published has published the following guidance document for the use of social workers:
A Patient and Public Involvement (PPI) event was organised to give members of the public from the East of England an opportunity to offer their perspectives and to comment on the findings of a systematic literature review looking at attitudes and preferences towards screening for dementia.
A total of 23 key themes emerged in relation to the carer and general population. The most frequent themes which emerged were the low levels of understanding and awareness around the dementia syndrome; the acceptability and validity of any tests; costs to the National Health Service (NHS); an individual’s existing health status existing health status; financial/profit motive for screening; the inability to change prognosis; and the importance and availability of support.
Martin S, et al. Exploring attitudes and preferences for dementia screening in Britain: contributions from carers and the general public BMC Geriatrics 2015, 15 :110 (9 September 2015)