Relationships Between Caffeine Intake and Risk for Probable Dementia

Driscoll, I. et al. The Journals of Gerontology. Biological Sciinces & Medical Sciences: Series A. P

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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.

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Using appreciative inquiry to implement person-centred dementia care in hospital wards

Scerri, A. et al. Dementia. Published online: October 6 2016

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The quality of care of persons with dementia in hospitals is not optimal and can be challenging. Moreover, staff may find difficulty in translating what they have learned during training into practice. This paper report the development and evaluation of a set of workshops using an appreciative inquiry approach to implement person-centred dementia care in two hospital wards.

Staff worked collaboratively to develop a ward vision and to implement a number of action plans. Using appreciative inquiry approach, staff attitudes towards persons with dementia improved, inter-professional collaboration was enhanced and small changes in staff practices were noted. Dementia care in hospitals can be enhanced by empowering staff to take small but concrete actions after they engage in appreciative inquiry workshops, during which they are listened to and appreciated for what they can contribute.

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The future of dementia risk reduction research

Mitchell, S. et al. The future of dementia risk reduction research: barriers and solutions. Journal of  Public Health (2016). published online 3rd October 2016

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Background:  We examine why dementia prevention and risk reduction are relatively underfunded and suggest potential remediation strategies. The paper is aimed at researchers, funders and policy-makers, both within dementia and also the wider health prevention field.

Method:  A discussion-led workshop, attended by 58 academics, clinicians, funders and policy-makers.

Results: The key barriers identified were the gaps in understanding the basic science of dementia; the complex interplay between individual risk factors; variations in study methodology; disincentives to collaboration; a lack of research capacity and leadership and the broader stigma of the condition. Recommendations were made to encourage strategic leadership, provide greater support for grant applications, promote collaboration and support randomized control trials for the research field.

Conclusion:  Having identified the barriers, the key challenge is how to implement the potential solutions. This will require engagement with decision-makers within funding, policy and research to ensure that action takes place.

Full document: The future of dementia risk reduction research: barriers and solutions

A third of people with dementia have treatable vision problems

NIHR Signal | Published online: 27 September 2016

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New data shows that around a third of people with dementia have serious vision problems, such as cataracts or short sightedness, more than the general population of that age. Levels are higher still for people with dementia in care homes – about half have vision problems.

Yet this study showed that many of the people with dementia and vision impairment had not received the right treatment. This often involves simple measures. For many, spectacles could have improved poor sight. A quarter had cataracts, which surgery could have corrected. Quality of life is known to improve if visual impairment is corrected.

Failure to receive treatment may be due to lack of awareness amongst people with dementia and their carers about the services available to them, as well as concerns about the impact of enforced spectacle wearing and surgery.

Eye examination professionals need to tailor their approach according to the needs of the individual, involving carers as far as possible. These patients would also benefit from longer consultation times.

Read the full commentary here