Hudson, J.M & Pollux, P.M.J. Dementia. Published online: October 7 2016
The Cognitive Daisy is an innovative assessment system created to provide healthcare staff with an instant snapshot of the cognitive status of older adults in residential care. The Cognitive Daisy comprises a flower head consisting of 15 colour coded petals depicting information about: visual-spatial perception, comprehension, communication, memory and attention.
This study confirmed the practicality of the Cognitive Daisy protocol for assessing cognition in a sample of 33 older adults living in residential care and endorsed the use of the Cognitive Daisy as a tool for recognising the cognitive status of care home residents.
Driscoll, I. et al. The Journals of Gerontology. Biological Sciinces & Medical Sciences: Series A. Published online: September 27, 2016
Background: Nonhuman studies suggest a protective effect of caffeine on cognition. Although human literature remains less consistent, reviews suggest a possible favorable relationship between caffeine consumption and cognitive impairment or dementia. We investigated the relationship between caffeine intake and incidence of cognitive impairment or probable dementia in women aged 65 and older from the Women’s Health Initiative Memory Study.
Methods: All women with self-reported caffeine consumption at enrollment were included (N = 6,467). In 10 years or less of follow-up with annual assessments of cognitive function, 388 of these women received a diagnosis of probable dementia based on a 4-phase protocol that included central adjudication. We used proportional hazards regression to assess differences in the distributions of times until incidence of probable dementia or composite cognitive impairment among women grouped by baseline level of caffeine intake, adjusting for risk factors (hormone therapy, age, race, education, body mass index, sleep quality, depression, hypertension, prior cardiovascular disease, diabetes, smoking, and alcohol consumption).
Results: Women consuming above median levels (mean intake = 261mg) of caffeine intake for this group were less likely to develop incident dementia (hazard ratio = 0.74, 95% confidence interval [0.56, 0.99], p = .04) or any cognitive impairment (hazard ratio = 0.74, confidence interval [0.60, 0.91], p = .005) compared to those consuming below median amounts (mean intake = 64mg) of caffeine for this group.
Conclusion: Our findings suggest lower odds of probable dementia or cognitive impairment in older women whose caffeine consumption was above median for this group and are consistent with the existing literature showing an inverse association between caffeine intake and age-related cognitive impairment.
UCL Institute of Health Equity | Published online: 30 September 2016
This report focuses on inequalities in the experience and prevalence of poor mental health, cognitive impairment and dementia and the impact of social isolation, lack of mental stimulation and physical activity, before and after retirement, and in later old age. These issues can exacerbate the risks of poor mental health, cognitive impairment and dementia in later life and are experienced disproportionately by people in lower socio economic groups.
The report also provides a brief summary of life course social determinants that increase the risk of poor mental health, early onset of cognitive decline and the symptoms of dementia. In particular, the report examines the role of ‘cognitive reserve’, built throughout the life course, through educational and employment opportunities, and providing older people with a wider and more flexible set of skills, abilities and resources to delay onset of cognitive decline and dementia, and to cope better with the conditions should they occur.
The report also makes recommendations, at a national and local policy level, in addition to providing example interventions for action on the social determinants of poor mental health, cognitive decline and dementia.
Millenaar, J. et al. Aging & Mental Health. Published online: 27 September 2016
Background: Promoting adaptation, improving well-being and maintaining an optimal quality of life (QOL) is an important aspect in dementia care. The purpose of this study was to identify determinants of QOL in young onset dementia, and to assess differences in QoL domains between people with Alzheimer’s disease (AD) and frontotemporal dementia (FTD).
Methods: In total 135 persons with AD and 58 persons with FTD were included from two prospective cohort studies. QOL was assessed with the proxy reported quality of life in Alzheimer’s disease questionnaire (QoL-AD). Possible determinants were explored using multiple linear regression and included sociodemographic variables, diagnosis, dementia severity, disease awareness, neuropsychiatric symptoms, met and unmet needs and hours of personal and instrumental care. Differences between QOL domains in people with AD and FTD were calculated using Mann-Whitney U tests.
Results: Lower QOL was associated with more depressive symptoms, lower disease awareness, and a higher amount of needs, both met and unmet. People with AD scored lower on the memory and higher on the friends’ subscale. No differences were found for the other items.
Conclusion: This study demonstrates a unique set of determinants of QOL in AD and FTD. Interventions directed towards these specific factors may improve QOL.
Public Health England has published a range of products which examine the deaths of people recorded with dementia between 2012 and 2014.
Figures show the number of deaths with a mention of dementia was:
6.6% of all deaths in 2001
15.8% of deaths in 2014
This is most likely due to an increase in awareness and recording of dementia.
New reports have been produced by the Dementia Intelligence Network (DIN) in collaboration with the National End of Life Care Intelligence Network (NEoLCIN) and draw on national data to see if there have been changes in dementia deaths over time, who the people dying with dementia are, where they die and the cause of their death.
The findings suggest that people who live in more deprived areas die with dementia at a younger age than those who live in more affluent areas.
There are also considerable differences between the place of death for people who have dementia and the general population. People with dementia are considerably more likely to die in hospitals and care homes and less likely to die at home or in end of life care settings such as hospices.
Read the Dementia Intelligence Network (DIN) and the National End of Life Care Intelligence Network (NEOLCIN) reports here
Scerri, A. et al. Ageing & Mental Health. Published online: 23 Sep 2016
Objectives: Although literature describing and evaluating training programmes in hospital settings increased in recent years, there are no reviews that summarise these programmes. This review sought to address this, by collecting the current evidence on dementia training programmes directed to staff working in general hospitals.
Method: Literature from five databases were searched, based on a number of inclusion criteria. The selected studies were summarised and data was extracted and compared using narrative synthesis based on a set of pre-defined categories. Methodological quality was assessed.
Results: Fourteen peer-reviewed studies were identified with the majority being pre-test post-test investigations. No randomised controlled trials were found. Methodological quality was variable with selection bias being the major limitation. There was a great variability in the development and mode of delivery although, interdisciplinary ward based, tailor-made, short sessions using experiential and active learning were the most utilised. The majority of the studies mainly evaluated learning, with few studies evaluating changes in staff behaviour/practices and patients’ outcomes.
Conclusion: This review indicates that high quality studies are needed that especially evaluate staff behaviours and patient outcomes and their sustainability over time. It also highlights measures that could be used to develop and deliver training programmes in hospital settings.
Kim, J.-P. et al. Geriatric Nursing. Published online: September 2016
The purpose of this study was to develop a small-group-focused suicide prevention program for elders with early-stage dementia and to assess its effects. This was a quasi-experimental study with a control group pretest–posttest design.
A total of 62 elders diagnosed with early-stage dementia who were receiving care services at nine daycare centers in J City Korea participated in this study. The experimental group participated in the suicide prevention program twice a week for 5 weeks with a pretest and two posttests.
The developed suicide prevention program had a significant effect on the perceived health status, social support, depression, and suicidal ideation of elders with early-stage dementia. Nurses should integrate risk factors such as depression and protective factors such as health status and social support into a suicide prevention program. This community-based program in geriatric nursing practice can be effective in preventing suicide among elders with early-stage dementia.
This strategy sets out how nurses can provide high quality compassionate care and support for people with dementia, so they can live well with dementia within all care settings, including a person’s own home.
It aims to support all nurses to be responsive to the needs of people with dementia, continue to develop their skills and expertise, and achieve the best outcomes for people with dementia, their carers and families.
This refreshed strategy builds on the original strategy, published in March 2013.
Alzheimer’s Disease International | Published online: September 2016
September is World Alzheimer’s Month, an international campaign to raise awareness and challenge stigma. It’s a time for action, a global movement united by its call for change, but also a time to reflect on the impact of dementia, a disease that will affect more and more people as the years pass.
Sudo, F.K. & Laks, J. Aging & Mental Health. Published online: 20 September 2016
Objectives: Financial capacity (FC) refers to a set of cognitively mediated abilities related to one’s competency to manage propriety and income. Identifying intact from impaired FC in older persons with dementia is a growing concern in geriatric practice, but the best methods to assess this function still need to be determined. This study aims to review data on FC in dementia and on instruments used to assess this domain of capacity.
Methods: Database search was performed in Medline, ISI Web of Knowledge, LILACS and PsycINFO. Studies that objectively assessed FC in dementia of any etiology were included.
Results: Of a total of 125 articles, 10 were included. Mild Alzheimer’s Disease (AD) was associated with impaired complex FC abilities, namely checkbook management, bank statement management and financial judgment, but simple FC skills were preserved. Moderate AD was associated with impairment in all domains of FC. The Financial Capacity Instrument (FCI) was applied in most of the selected studies and correlated with neuropsychological and neuroimaging variables.
Conclusions: Early dementia is associated with partially preserved FC. More validation studies using objective and evidence-based FC assessment tools, such as the FCI, are still needed.