National dementia diagnosis rates and monthly workbook published

The National Clinical Director for Dementia, Professor Alistair Burns has been writing to CCGs with the national dementia diagnosis rate in order to achieve and maintain the national ambition of diagnosing 2/3rd of the estimated population living with dementia.

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The monthly CCG letters can be found below with the national dementia diagnosis rates alongside general updates on national priorities. Commissioners are asked to cascade this information to member practices.

CCG Letter – Dementia Diagnosis Rates – November 2016
CCG Letter – Dementia Diagnosis Rates – October 2016

Read the full overview here

Palliative care interventions in advanced dementia

Murphy, E. et al. (2016) Cochrane Database of Systematic Reviews. Issue 12. Art. No.: CD011513.

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Image source: Cochrane

Background: Dementia is a chronic, progressive and ultimately fatal neurodegenerative disease. Advanced dementia is characterised by profound cognitive impairment, inability to communicate verbally and complete functional dependence. Usual care of people with advanced dementia is not underpinned universally by a palliative approach. Palliative care has focused traditionally on care of people with cancer but for more than a decade, there have been increased calls worldwide to extend palliative care services to include all people with life-limiting illnesses in need of specialist care, including people with dementia.

Authors’ conclusions: Very little high quality work has been completed exploring palliative care interventions in advanced dementia. There were only two included studies in this review, with variation in the interventions and in the settings that made it impossible to conduct a meta-analysis of data for any outcome. Thus, we conclude that there is insufficient evidence to assess the effect of palliative care interventions in advanced dementia. The fact that there are six ongoing studies at the time of this review indicates an increased interest in this area by researchers, which is welcome and needed.

Read the full review here

How Britain plans to lead the global science race to treat dementia

It has struck nearly a million people in the UK, yet even its cause is still unclear | The Guardian

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Early next year, Professor Bart De Strooper will sit down in an empty office in University College London and start to plan a project that aims to revolutionise our understanding and treatment of dementia. Dozens of leading researchers will be appointed to his £250m project which has been set up to create a national network of dementia research centres – with UCL at its hub.

The establishment of the UK Dementia Research Institute – which was announced last week – follows the pledge, made in 2012 by former prime minister David Cameron, to tackle the disease at a national level and comes as evidence points to its increasing impact on the nation. Earlier this year, it was disclosed that dementia is now the leading cause of death in England and Wales. At the same time, pharmaceutical companies have reported poor results from trials of drugs designed to slow down the progress of Alzheimer’s disease, the most common form of dementia.

Read the full news story here

Dementia support and pathway for culturally and linguistically diverse communities

Goeman, D. et al. BMJ Open 6:e013064

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Objective: To develop an inclusive model of culturally sensitive support, using a specialist dementia nurse (SDN), to assist people with dementia from culturally and linguistically diverse (CALD) communities and their carers to overcome barriers to accessing health and social care services.

Conclusions: Our culturally sensitive model of dementia care and accompanying pathway allows for the tailoring of health and social support to assist people from CALD backgrounds, their carers and families to adjust to living with memory loss and remain living in the community as long as possible. The model and accompanying pathway also have the potential to be rolled out nationally for use by health professionals across a variety of health services.

Read the full article here

New tool to help predict dementia risk in older people

A machine learning method analyzing large amounts of health information has potential in assessing the risk of cognitively healthy older people for later dementia, according to research published in the Journal of Alzheimer’s Disease | ScienceDaily

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The research team used data from the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study conducted in Eastern Finland. Study participants were cognitively normal individuals aged 65-79 years from the general Finnish population who underwent detailed health-related assessments, including memory and other cognitive tests. The dementia risk index performed well in identifying comprehensive profiles for predicting dementia development up to 10 years later. The main included predictors were cognition, vascular factors, age, subjective memory complaints and apolipoprotein E (APOE) genotype.

The researchers conclude that the risk index could be useful for identifying older individuals who are most at risk, and who may also benefit most from preventive interventions. They emphasize that the risk index is not meant for dementia diagnosis, but as a tool to help with making decisions about dementia prevention strategies, i.e. to whom these should be targeted, and what risk factors should be specifically addressed based on the visual risk profile.

Read the full overview here

Read the original research abstract here

The family’s experience of the progression of dementia.

Trine H Clemmensen et. al . The family’s experience and perception of phases and roles in the progression of dementia: An explorative, interview-based study. Dementia. Published online ahead of print, December 6, 2016.

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This paper examines how the relatives of a person with dementia experience challenges in everyday life. A model of phases is developed on the basis of interviews with 14 relatives from eight families. Data were subjected to a thematic content analysis, which found that the progression of dementia – from the perspective of the family – had three phases.

These phases involved small changes in everyday life, adaptations to everyday life, and the loss of everyday life. The analysis further identified the following two archetypes of relatives that develop throughout the progression of dementia: the protective relative and the decisive relative.

The study found that the two types of relatives experience different challenges during the three phases. It is important for health professionals to be familiar with these changes, when they evaluate whether the relatives of a person with dementia require help.

Full paper available here

Activities in dementia care

Elizabeth Lokon, et. al. Activities in dementia care: A comparative assessment of activity types. Dementia.  First published online ahead of print December 5, 2016.

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This exploratory study compares the impact of five activity types on the well-being of institutionalized people with dementia: the intergenerational art program Opening Minds through Art, art and music therapies, creative activities, non-creative activities, and no activities at all.

We validated the Scripps Modified Greater Cincinnati Chapter Well-Being Observational Tool, and used that instrument to systematically observe N = 67 people with dementia as they participated in different activity types.

People with dementia showed the highest well-being scores during Opening Minds through Art compared to all other activities. No significant well-being differences were found between creative activities led by licensed art/music therapist versus regular activity staff. Furthermore, no significant well-being differences were found between creative and non-creative activities that were both led by regular activity staff.

Overall, people with dementia benefit from participating in activities, regardless of the type (creative or non-creative), or who conducts them (licensed therapists or activity staff). However, in order for people with dementia to reach significantly high levels of overall well-being, we recommend that activities are specifically designed for people with dementia and incorporate a 1:1 ratio between people with dementia and well-trained volunteers/staff members.