van der Steen, J.T, Smaling, H.J.A., van der Wouden, J.C., Bruinsma, M.S., Scholten, R.J.P.M., Vink, A.C.| 2018| Music‐based therapeutic interventions for people with dementia.| Cochrane Database of Systematic Reviews| Issue 7| Art. No.: | CD003477. DOI: 10.1002/14651858.CD003477.pub4.
The Cochrane Library has produced a new systematic review which looks at the evidence for music‐based therapeutic interventions for people with dementia.
People with dementia gradually develop difficulties with memory, thinking, language and daily activities. Dementia is often associated with emotional and behavioural problems and may decrease a person’s quality of life. In the later stages of dementia it may be difficult for people to communicate with words, but even when they can no longer speak they may still be able to hum or play along with music. Therapy involving music may therefore be especially suitable for people with dementia. Music therapists are specially qualified to work with individuals or groups of people, using music to try to help meet their physical, psychological and social needs. Other professionals may also be trained to provide similar treatments.
Purpose of this review
We wanted to see if we could find evidence that treatments based on music improve the emotional well‐being and quality of life of people with dementia. We were also interested in evidence about effects on emotional, behavioural, social or cognitive (e.g. thinking and remembering) problems in people with dementia.
What we did
We searched for clinical trials that measured these effects and in which people with dementia were randomly allocated to a music‐based treatment or to a comparison group. The comparison groups might have had no special treatment, or might have been offered a different activity. We required at least five sessions of treatment because we thought fewer sessions than five were unlikely to have much effect. We combined results of trials to estimate the effect of the treatment as accurately as possible. The evidence is current to 19 June 2017.
What we found
We found 22 trials to include in the review and we were able to combine results for at least some outcomes from 890 people. All of the people in the trials stayed in nursing homes or hospitals. Some trials compared music‐based treatments with usual care, and some compared them with other activities, such as cooking or painting. The quality of the trials and how well they were reported varied, and this affected our confidence in the results. First, we looked at outcomes immediately after a course of therapy ended. From our results, we could be moderately confident that music‐based treatments improve symptoms of depression and overall behavioural problems, but not specifically agitated or aggressive behaviour. They may also improve anxiety and emotional well‐being including quality of life, although we were less confident about these results. They may have little or no effect on cognition. We had very little confidence in our results on social interaction. Some studies also looked to see whether there were any lasting effects four weeks or more after treatment ended. However, there were few data and we were uncertain or very uncertain about the results. Further trials are likely to have a significant impact on what we know about the effects of music‐based treatments for people with dementia, so continuing research is important.
The full review is available from The Cochrane Library
NIHR | June 2018 | New NICE guidelines recommend telling people about dementia research opportunities
NICE recently advised that every patient diagnosed with dementia should be provided with information of research opportunities they could potentially participate in.
NIHR New NICE guidelines recommend telling people about dementia research opportunities
NIHR & Join Dementia Research | July 2018 |10,000 research participants recruited through Join Dementia Research
Over 10000 participants have become involved in dementia research as a result of campaigns by NIHR and Join Dementia Research. These latest figures are an important milestone for Join Dementia Research, which was launched 3 years’ ago in response to the then Prime Minister’s Challenge on Dementia, the success since its launch can be seen by participants and researchers alike at Join Dementia Research.
Full details are available from Join Dementia Research
NIHR Join Dementia Research Champions
Related: New NICE guidelines recommend telling people about dementia research opportunities
British Psychological Society |June 2018 | New dementia briefing suggests that behaviour that challenges can be a result of unmet needs 21 June 2018
The British Psychological Society have recently published an evidence briefing which outlines the importance of having a psychological understanding of the complex causes of behaviour that challenges in dementia.
The key messages of the briefing, prepared by the Society’s Dementia Advisory Group, include:
- Behaviour that challenges can be a consequence of a person’s unmet needs
- Non-pharmacological approaches are the first-line treatments
- Service pathways for people living at home require different workforce skills and resources compared with those living in 24 hour care settingsThe evidence briefing can be read in full here
Public Health England | August 2018 | Dementia profile: August 2018 data update
Public Health England (PHE) has published the latest statistics on the estimated diagnosis rate for dementia broken down by geographical area.
The Dementia Profile is designed to improve the availability and accessibility of information on dementia. The data is presented in an interactive tool that allows users to view and analyse it in a user-friendly format. The profile provides a snapshot of dementia care, broken down by geographical area, to help local government and health services improve dementia care.
The profile includes the estimated dementia diagnosis rate, which shows the number of people with a formal diagnosis of dementia as a percentage of those estimated to have the disease. A timely diagnosis helps those living with dementia, their carers and healthcare staff to improve health and care outcomes as outlined within the Prime Minister’s challenge (Source: PHE)
Further details are available from PHE
The profile can be accessed here
Yorkshire Post | July 2018 | The fight against dementia
A news article in the Yorkshire Post looks at clinical trials that are currently taking place which are investigating new ways to treat some of the symptoms associated with dementia.
The full story is available from The Yorkshire Post
Alzheimer’s Association | July 2018 | Sprint for Discovery: New Dementia and Cardiovascular Findings
New research presented at the recent Alzheimer’s Association 2018 conference in Chicago, indicates that aggressive treatment of high blood may reduce new cases of slight but noticeable and measurable decline in cognitive abilities that is not severe enough to interfere with daily life and dementia.
The findings from the randomized controlled trial (RCT) show that there are things we can do, especially regarding cardiovascular disease risk factors, to reduce our risk of mild cognitive impairment and dementia.
The participants (n= 9361) (all hypertensive adults), though none had a diagnosis of diabetes, dementia or had experienced a stroke, were divided in two groups. The trial investigated the effects of one group’s blood pressure was aggressively treated to reduce it, in the other the target blood pressure was treated less intensively. The researcher’s findings show that the group that had their blood pressure treated aggressively 120 mm Hg), 19 percent less people developed mild cognitive impairment.
When the researchers looked at reduction in risk of mild cognitive impairment and dementia, they found that 15 percent less people developed mild cognitive impairment or dementia (regardless of the underlying cause). The researchers looked at reduction in risk of mild cognitive impairment and dementia, they found that 15 percent less people developed mild cognitive impairment or dementia. According to the research team this is the first time an RCT has demonstrated a significant reduction in the risk for developing cognitive decline and dementia.
Full details about the research are available from the Alzheimer’s Association blog
The Alzheimer’s Association has published a systematic review which looks at the global prevalence of dementia. The SR and meta-analysis look at international literature between 1980 to 2009, the meta analysis estimates prevalence of dementia and the number of people aged over 60 years affected globally.
Health Education England, Skills for Health & Skills for Care, | July 2018 |Dementia Training Standards Framework
Health Education England (HEE) have released the Dementia Training Standards Framework, the resource was previously known as Dementia Core Skills Education and Training Framework, its recent update and review included a number of additions regarding food, drink and oral health.
The framework is an extraordinarily useful resource which details the essential skills and knowledge necessary across the health and social care spectrum. Three tiers are described:
- Awareness, which everyone should have;
- Basic skills which are relevant to all staff in settings where people with dementia are likely to appear and;
This framework will help ensure quality and consistency in dementia education and training if you are an organisation or an individual working in health, social care or housing.
The framework will allow the differentiation of high quality services, ensure personalised care and support for people living with dementia, and support organisations and individuals to meet requirements of regulators (source: HEE).
You can access the framework here
Alternatively, the framework can be downloaded from the Skills for Health website
Stites, S. D., Rubright, J. D., & Karlawish, J. |2018| What features of stigma do the public most commonly attribute to Alzheimer’s disease dementia? Results of a survey of the US general public| Alzheimer’s & Dementia | Vol. 14 | 7 | P. 925- 932 | DOI: https://doi.org/10.1016/j.jalz.2018.01.006
A new abstract presented at last month’s Alzheimer’s Association Conference in Chicago has been published as a journal article in Alzheimer & Dementia, the journal of the Alzheimer’s Association.