Social health in dementia

Social health in dementia. Towards a positive dementia discourse | Marjolein de Vugt and Rose-Marie Dröes  | Aging & Mental Health  Vol. 21 , Iss. 1,2017

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Abstract:

A shift in focus from symptoms and disability towards the capacity and potential of the person with dementia is urgently needed to create a more balanced view of dementia and a more dementia-friendly society, which enables people and their families to adapt to the changes dementia brings in their lives.

The new concept of social health suggested by Huber and colleagues seems helpful to make such a shift. In this dedicated special issue, a consensus-based operationalization of the concept of social health in dementia is proposed and several aspects of social health and related dementia care are addressed within the framework of European collaborative projects of the INTERDEM network.

Delirium could accelerate dementia-related mental decline

When hospitalized, people can become acutely confused and disorientated. This condition, known as delirium, affects a quarter of older patients and new research shows it may have long-lasting consequences, including accelerating the dementia process. | via ScienceDaily

 

 

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New research by UCL and the University of Cambridge shows delirium may have long-lasting consequences, including accelerating the dementia process. Episodes of delirium in people who are not known to have dementia, might also reveal dementia at its earliest stages, the research found.

Scientists looked at three European populations — in Finland, Cambridge and UK-wide — and examined brain specimens in 987 people aged 65 and older. Each person’s memory, thinking and experience of delirium had been recorded over 10 years towards the end of their life.

When these were linked with pathology abnormalities due to Alzheimer’s and other dementias, those with both delirium and dementia-changes had the most severe change in memory.

Journal Reference: Daniel H. J. Davis et al. Association of Delirium With Cognitive Decline in Late Life  A Neuropathologic Study of 3 Population-Based Cohort Studies JAMA Psychiatry, January 2017

New horizons: the management of hypertension in people with dementia

Harrisson, J.K. et al. (2016) Age Ageing. 45(6). pp. 740-746

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The optimal management of hypertension in people with dementia is uncertain. This review explores if people with dementia experience greater adverse effects from antihypertensive medications, if cognitive function is protected or worsened by controlling blood pressure (BP) and if there are subgroups of people with dementia for whom antihypertensive therapy is more likely to be harmful.

Read the full abstract here

The use of non-pharmacological interventions for dementia behaviours in care homes

Backhouse, T. et al. (2016) Age Ageing. 45(6) pp.856-863

Background: Antipsychotic medications have been used to manage behavioural and psychological symptoms of dementia (BPSD). Due to the potential risks associated with these medications for people with dementia, non-pharmacological interventions (NPIs) have been recommended as safer alternatives. However, it is unknown if, or how, these interventions are used in care homes to help people experiencing BPSD.

Conclusions: There is a gap between rhetoric and practice with most NPIs in care homes used as social activities rather than as targeted interventions. If NPIs are to become viable alternatives to antipsychotic medications in care homes, further work is needed to embed them into usual care practices and routines. Training for care-home staff could also enable residents with high needs to gain better access to suitable activities.

Read the full abstract here

Perceptions vs. evidence:therapeutic substitutes for antipsychotics

Olivieri-Mui, B.L. et al. Aging & Mental Health. Published online: 12 Jan 2017

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Objective: To compare differences between clinician perceptions of therapeutic substitutes for antipsychotics prescribed to patients with dementia in long term care (LTC) and published evidence.

 

Conclusion: Perceptions of LTC clinicians regarding substitutes for antipsychotics in LTC patients with dementia vary widely and are often discordant with published evidence.

Read the full abstract here

Dementia rates ‘higher near busy roads’

People who live near major roads have higher rates of dementia, research published in the Lancet suggests | The Lancet | BBC News

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As many as 11% of dementia cases in people living within 50m of a major road could be down to traffic, a study published earlier this month suggests.

The researchers, who followed nearly two million people in Canada over 11 years, say air pollution or noisy traffic could be contributing to the brain’s decline. UK dementia experts said the findings needed probing but were “plausible”.

The study in the Lancet followed nearly two million people in the Canadian province of Ontario, between 2001 and 2012. There were 243,611 cases of dementia diagnosed during that time, but the risk was greatest in those living closest to major roads.

Compared with those living 300m away from a major road the risk was:

  • 7% higher within 50m
  • 4% higher between 50-100m
  • 2% higher between 101-200m

The analysis suggests 7-11% of dementia cases within 50m of a major road could be caused by traffic. The researchers adjusted the data to account for other risk factors like poverty, obesity, education levels and smoking so these are unlikely to explain the link.

Full reference: Chen, Hong et al. Living near major roads and the incidence of dementia, Parkinson’s disease, and multiple sclerosis: a population-based cohort study published online 4th January 2017

Related: BBC News

Effects of smartphone-based memory training

Seo Jin Oh et. al. Effects of smartphone-based memory training for older adults with subjective memory complaints: a randomized controlled trial. Aging & Mental Health.  Published online: 10 Jan 2017

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Objectives: We explored whether newly developed application (Smartphone-based brain Anti-aging and memory Reinforcement Training, SMART) improved memory performance in older adults with subjective memory complaints (SMC).

Method: A total of 53 adults (range: 50-68 years; 52.8% female) were randomized into either one of two intervention groups [SMART (n = 18) vs. Fit Brains® (n = 19)] or a wait-list group (n = 16). Participants in the intervention groups underwent 15-20 minutes of training per day, five days per week for 8 weeks. We used objective cognitive measures to evaluate changes with respect to four domains: attention, memory, working memory (WM), and response inhibition. In addition, we included self-report questionnaires to assess levels of SMC, depression, and anxiety.

Results: Total WM quotient [t(17) = 6.27, p < .001] as well as auditory-verbal WM score [t(17) = 4.45, p < .001] increased significantly in the SMART group but not in the control groups. Self-reports of memory contentment, however, increased in the Fit Brains® group only [t(18) = 2.12, p < .05).

Conclusion: Use of an 8-week smartphone-based memory training program may improve WM function in older adults. However, objective improvement in performance does not necessarily lead to decreased SMC.