Brain Health: A new way to think about dementia risk reduction

Alzheimer’s Research UK and Royal Society for Public Health| January 2021  |Brain Health: A new way to think about dementia risk reduction

A report published earlier this month by the Royal Society for Public Health and Alzheimer’s Research UK makes the case for introducing the term ‘brain health’ as a new way for the public and policy-makers to engage with and discuss dementia. Their research shows that ‘brain health’ has the potential to help far more people start managing their risk of dementia. The new research reveals that a little over two thirds of UK adults believe they can influence their brain health (69 per cent) – this is double the number who believe they can reduce their risk of getting dementia (34 per cent).

Image source: rsph.org.uk Image description: Front cover of the publication, it shows a photograph of two older men smiling on a sunny day

The report makes several key arguments in favour of making the public more aware of their ‘brain health’:

  • Brain health is recognised as being important at all ages, unlike dementia risk reduction, which is associated with older adulthood;
  • Health-conscious behaviours are driven more by brain health than dementia risk reduction, with nearly 60 per cent of UK adults polled stating they stay mentally active to improve or maintain brain health;
  • Almost nine in ten (86 per cent) agree that brain health is about keeping the brain working properly.

The report makes several key arguments in favour of making the public more aware of their ‘brain health’:

  • Brain health is recognised as being important at all ages, unlike dementia risk reduction, which is associated with older adulthood;
  • Health-conscious behaviours are driven more by brain health than dementia risk reduction, with nearly 60 per cent of UK adults polled stating they stay mentally active to improve or maintain brain health;
  • Almost nine in ten (86 per cent) agree that brain health is about keeping the brain working properly.

Over two thirds of UK adults believe they can influence their brain health

See also: One in 10 UK adults say brain health has deteriorated in pandemic [report]

One in 10 UK adults say brain health has deteriorated in pandemic

Alzheimer’s Research UK |  January 2021| One in 10 UK adults say brain health has deteriorated in pandemic

A poll conducted by Alzheimer’s Research UK shows that 14 per cent of UK adults feel that brain health has declined since the start of the COVID-19 pandemic. Two thirds of the respondents in this survey said they would consider making changes to improve their health as a result of the pandemic.

The charity’s findings in the poll, underline that people’s awareness of dementia has increased, 16 per cent of respondents reporting an increased awareness. The charity believes now is the opportune time to support people to take positive action, particularly with new lockdown measures in place.

Image is a still from the video Think Brain Health. It shows how looking after our brain can reduce our risk, by keeping connected, staying sharp and doing things to keep our hear healthy can also reduce

To this end they have launched a new campaign Think Brain Health, which aims to increase awareness of three rules for improving brain health:

  • Looking after heart health, by exercising regularly, eating a healthy diet and keeping blood pressure, weight and cholesterol in check.
  • Staying sharp, by taking part in activities that keep the brain active.
  • And keeping connected, by staying socially active and connecting with other people.

Alzheimer’s Research UK One in 10 UK adults say brain health has deteriorated in pandemic

High-intensity functional exercise in older adults with dementia: A systematic review and meta-analysis

Yeh, S-W et al. (2020) |High-intensity functional exercise in older adults with dementia: A systematic review and meta-analysis |Clinical Rehabilitation | https://doi.org/10.1177/0269215520961637

This systematic review underlines the impact of high intensity exercise on older people with dementia. The researchers reviewed some 15 articles describing six trials including older adults and controlled groups. They report that facilitated activities had an effect on of daily living and psychiatric well-being; with effects on activities of daily living being the most long-lasting. This review also highlights how adverse effects of high-intensity functional exercise were minimal to none.

Abstract

Objective:

This study aimed to investigate the efficacy of high-intensity functional exercise among older adults with dementia.

Methods:

In this systematic review and meta-analysis of randomized controlled trials, we collected articles published before August 2020 from PubMed, Embase, and the Cochrane Library to evaluate the effect of high-intensity functional exercise on older adults with dementia. Primary outcomes included improvements in balance function and gait performance (speed, cadence, and stride length). The secondary outcomes included lower limb strength, activities of daily living, psychiatric well-being, depression, and cognition. Furthermore, we performed subgroup analysis with two high-intensity functional exercise programs: the Umeå program and Hauer’s program.

High-intensity functional exercise in older adults with dementia: A systematic review and meta-analysis – Shu-Wei Yeh, Li-Fong Lin, Hung-Chou Chen, Li-Kai Huang, Chaur-Jong Hu, Ka-Wai Tam, Yi-Chun Kuan, Chien-Hsiung Hong, 2020

Results:

We identified 15 articles describing six trials including older adults with dementia undergoing high-intensity functional exercise or control activity. The meta-analysis indicated that high-intensity functional exercise, both in Hauer’s program and in the Umeå program, significantly improved balance function (pooled standardized mean difference 0.57, 95% confidence interval 0.31–0.83). Hauer’s program significantly improved gait speed, cadence, stride length, and lower limb strength. Beneficial effects on speed, cadence, and lower limb strength were retained for several months. The Umeå program facilitated activities of daily living and psychiatric well-being, with effects on activities of daily living lasting several months. In the only eligible trial, no effects on cognition were observed. Adverse effects of high-intensity functional exercise were minimal to none.

Conclusions:

High-intensity functional exercise is generally safe and is recommended for older individuals with mild or moderate dementia to provide benefits in motor performance and daily functioning (Source: Yeh, S-W et al., 2020).

Rotherham NHS staff can request this article from the Library

NIHR: Informal dementia carers had to make difficult decisions about paid care during COVID-19

NIHR | January 2021 | Informal dementia carers had to make difficult decisions about paid care during COVID-19

Often people in the community living with dementia rely on informal, unpaid carers such as family and friends. Researchers wanted to find out how the first nationwide COVID-19 lockdown affected unpaid carers, and how they made decisions about accessing paid care. They conducted telephone interviews with 15 unpaid carers during the first wave of the pandemic (April and May 2020 ). From this sample almost three quarters (73.3%) of the carers lived with the person they were caring for. A little over half (53.3%) of carers were caring for their spouse.

Now this, the first study to report on the impact of COVID-19 on paid home care for people living with dementia, highlights how unpaid carers had to increase their care hours, but also areas of concern and difficult decisions carers had to make.

The researchers drew three themes from the interviews:

  • Carers felt concerned by the risk of paid carers bringing coronavirus into the home. Lack of personal protective equipment (PPE) and feeling unprepared to provide additional care heightened these fears: “I didn’t know how to use all the equipment and I didn’t feel safe and also didn’t know how to protect myself from injury and well and being of risk to Mum”.
  • Carers had difficult choices to make. Many avoided hospitals and other health providers. They struggled to weigh up the options of cancelling or continuing paid care and some described real fears of re-obtaining paid care post-COVID if they cancelled during lockdown.: “..a family friend of ours who’s already been told by their social worker that because they’ve managed without the [paid] care then they’re not likely to get it back after the coronavirus”.
  • Implications for unpaid carers included increased workload and difficulty in accessing food deliveries: “At the moment I can’t get an online shopping slot. Trying to get through to the helpline to get us put on the vulnerable list has proved an impossibility, I’ve spent hours and hours and hours on the phone which gives you a layer of angst that on top of everything else you don’t need”.

Lead author Clarissa Giebel, Research Fellow, Department of Primary Care & Mental Health, University of Liverpool & NIHR ARC NWC

When we did these interviews in April, most family carers were so afraid of the virus that they cancelled paid care, even though they desperately needed it. As a result, they got overburdened. I’ve spoken to people as part of a new study who said they got so burnt out during COVID that they had to send their loved one to a care home. We need to remember those carers are people in their own right and they need psychological support and care support too.

Clarissa Giebel, Research Fellow, Department of Primary Care & Mental Health, University of Liverpool

Read the full NIHR Evidence update Informal dementia carers had to make difficult decisions about paid care during COVID-19

Primary paper available from BMC Geriatrics

SCIE: Safeguarding adults with dementia during the COVID-19 pandemic

Social Care Institute for Excellence| updated 5 January 2021| Safeguarding adults with dementia during the COVID-19 pandemic

Social Care Institute for Excellence in partnership with the Alzheimer’s Society has published a quick guide to support care providers and staff to safeguard people with dementia during the pandemic. There are increased concerns that, during this time, people may be more vulnerable to abuse or neglect.

This may be a result of:

The guide is available online from SCIE