Cooper, C. et al. Age Ageing (2015).
Background: UK National Dementia Strategies prioritise fair access to dementia treatments for the whole population. We investigated for the first time inequalities in NHS national dementia prescribing and how they have varied between UK countries and over time.
Method: we investigated the association between Townsend deprivation score and anti-dementia drug prescribing in 77,045 dementia patients from UK primary care records from 2002 to 2013.
Results: we included 77,045 patients with recorded dementia diagnosis or anti-dementia drug prescription. Least deprived patients were 25% more likely to be initiated on anti-dementia drugs than the most deprived (adjusted incidence rate ratio 1.25, 95% confidence interval 1.19–1.31). This was driven by data from English practices where prescribing rates were consistently lower in more deprived patients compared with Scotland, Northern Ireland and Wales, where prescribing was not related to deprivation quintile. Compared with English practices, anti-dementia medication was prescribed more often in Northern Irish (1.81, 1.41–2.34) and less in Welsh practices (0.68, 0.55–0.82), with a trend towards more prescribing in Scottish practices (1.14, 0.98–1.32). Drug initiation rates were also higher in younger people and men.
Conclusion: four years after the English National Dementia Strategy, there is no evidence that the Strategy’s key objective of reducing treatment inequalities is being achieved. Higher overall anti-dementia drug prescribing in Scottish and Northern Irish practices, and differing clinical guidelines in Scotland from other UK countries might explain greater equality in prescribing in these countries. Strategies to offer treatment to more deprived people with dementia in England are needed.
The UK’s first dementia research institute is set to receive up to £150m to tackle the disease.
Led by the Medical Research Council, the institute will bring together world-leading experts, universities and organisations to drive forward research and innovation in fighting dementia. The disease affects an estimated 850,000 in Britain, a figure that’s expected to double in the next 20 years.
The institute will have a central UK hub, with links to universities across the country and will build on the centres of excellence in dementia already operating across the UK.
Posted by Raluca Lucacel for the Mental Elf
We do not know much about the direct causes of dementia, but the evidence for possible causal associations includes (Prince et al., World Alzheimer Report 2015):
- Low education
Knowing the risk factors and acting upon the modifiable ones can lower the incidence of the disease. Our level of education is one of the most accepted risk factors in epidemiological studies for dementia. This factor is a modifiable one, so knowing more about how it influences the disease and acting upon it can lead to lower incidence levels and improved quality of life.
An explorative meta-analysis was conducted in order to find out whether a dose-response relation exists between education and dementia risk (Xu et al, 2015).
This paper presents important modifiable factors for reducing the risk of dementia. Many people consider that everyone gets dementia if they live long enough, but this is not true. Dementia is not a normal part of the ageing process and the more we know about the risk factors of the disease, the more we can do to help prevent it from occurring. – See more at: http://www.nationalelfservice.net/mental-health/dementia/can-higher-educational-attainment-help-lower-dementia-risk/#sthash.o1uC2cDQ.dpuf
via Can higher educational attainment help lower dementia risk?.
The new National Dementia Core Skills Education and Training Framework is a new resource to support health professionals and educators working with people living with dementia.
The framework sets out the essential skills and knowledge necessary for all staff involved in dementia care.
A new report serves as a call to action to help people with dementia live well at home for longer. ‘Dementia and homecare: driving quality and innovation’, part of the Prime Minister’s Challenge on Dementia, presents a series of innovative practice examples from across the country. It also identifies ways to make these examples the norm.
Informal caregivers of people with dementia face the challenge of managing the consequences of dementia in daily life. This meta-review makes an attempt to synthesize evidence from previous systematic reviews about professional self-management support interventions for this group.
Full reference: Huis in het Veld, J et al. The effectiveness of interventions in supporting self-management of informal caregivers of people with dementia; a systematic meta review. BMC Geriatrics 2015, 15:147
Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring. Volume 1, Issue 3, September 2015, Pages 316–324
Dementia with Lewy bodies (DLB) is a challenge to diagnose, particularly outside of expert centers with long delays in diagnosis leading to significant burden to patients and caregivers. Although consensus criteria have excellent specificity, there is no standardized way to assess symptoms reducing sensitivity. We developed the Lewy body composite risk score (LBCRS) from autopsy-verified cases to improve the ability to detect DLB in clinic and research populations.
The LBCRS was tested in a consecutive series of 256 patients compared with the clinical dementia rating and gold standard measures of cognition, motor symptoms, function, and behavior. Psychometric properties including floor and ceiling effects; concurrent, construct, and known-groups validity; and internal consistency of the LBCRS were determined. Receiver operator characteristic (ROC) curves assessed the ability of LBCRS to differentiate (1) DLB from Alzheimer’s disease (AD), (b) DLB from all dementia, and (c) mild cognitive impairment (MCI) due to DLB from MCI due to AD. The LBCRS was completed independent of the clinical evaluation.
Mean LBCRS scores were significantly different between DLB and AD (6.1 ± 2.0 vs. 2.4 ± 1.3, P < .001) and between MCI-DLB versus MCI-AD (3.2 ± 0.9 vs. 1.0 ± 0.8, P < .001). The LBCRS was able to discriminate DLB from other causes of dementia. Using a cutoff score of 3, areas under ROC for DLB versus AD = 0.93 (0.89–0.98) and for MCI-DLB versus MCI-AD = 0.96 (0.91–1.0).
The LBCRS increases diagnostic probability that Lewy body pathology is contributing to the dementia syndrome and should improve clinical detection and enrollment for clinical trials.
via Improving the clinical detection of Lewy body dementia with the Lewy body composite risk score.
Nada Savitch, Emily Abbott, Gillian Parker, Helen Cadbury, Eloise Ross and Katherine Ludwin for the Joseph Rowntree Foundation (JRF)
Dementia disproportionately affects women, but their experiences and voices are missing from research and literature. This project aimed to inspire people to think differently about women and dementia by using stories and reflections from individual women to inform the debate in a unique, inspiring and insightful way.
The report shows:
- there is often resistance to talking about dementia as a women’s issue;
- research needs to focus on the voices, experiences and perceptions of women affected by dementia;
- service provision needs to reflect the needs, skills and attributes of women with dementia, female carers and the female care workforce;
- the way women experience dementia is affected by gender, but also by many other factors including education, ethnicity, sexuality, class, age, and disability.
via Dementia: through the eyes of women | JRF.