Helen Green, Dementia Specialist Nurse on Dementia UK’s Admiral Nurse Dementia Helpline, charts the causes and progression of vascular dementia

Open Access Government | Feburary 15 2021 | Helen Green, Dementia Specialist Nurse on Dementia UK’s Admiral Nurse Dementia Helpline, charts the causes and progression of vascular dementia

This article charts the causes and progression of vascular dementia, it’s author Helen Green, Dementia Specialist Nurse on Dementia UK’s Admiral Nurse Dementia Helpline, explains more about the umbrella term dementia, vascular dementia and mixed dementia.

Causes and progression of vascular dementia

Number of people with dementia in Europe set to almost double by 2050

Alzheimer Europe | February 2020 |Dementia in Europe Yearbooks 

A new report from Alzheimer Europe predicts that the number of people with Alzheimer’s disease-based on current trends- will increase twofold by 2050. The report emphasises that this is despite a reduction in the prevalence of dementia. 

The 2018 Alzheimer Europe Yearbook focuses on the current status and development of national dementia strategies in Europe, detailing the content of the existing strategies, thereby providing a comparison between countries. There are currently 21 countries and regions with a dementia strategy, 2 countries whose governments have formally committed to the development of a strategy, two neurodegenerative strategies published and further work underway in other countries (Source: Alzheimer Europe)

The full publication is available to purchase from Alzheimer Europe

In the news:

OnMedica Number of people with dementia in Europe to almost double by 2050

Reducing the risk of dementia

Risk reduction of cognitive decline and dementia | The World Health Organisation

who risk
Image source: apps.who.int/

These WHO guidelines provide evidence-based recommendations on lifestyle behaviours and interventions to delay or prevent cognitive decline and dementia.  Worldwide, around 50 million people have dementia and, with one new case every three seconds, the number of people with dementia is set to triple by 2050. The increasing numbers of people with dementia, its significant social and economic impact and lack of curative treatment, make it imperative for countries to focus on reducing modifiable risk factors for dementia.

These guidelines are intended as a tool for health care providers, governments, policy-makers and other
stakeholders to strengthen their response to the dementia challenge.

Full document: Risk reduction of cognitive decline and dementia

See also: WHO press release

Dementia (update): Topic engagement [NICE]

NICE | September 2018 | Dementia (update)

NICE want to hear about the 5 key areas for quality improvement which you consider as having the greatest potential to improve the quality of care in this area. Tell NICE about the 5 key areas for quality improvement which you consider as having the greatest potential to improve the quality of care in this area (NICE).

See NICE for details

Reminiscence therapy for dementia

Woods, B.,  O’Philbin, L.Farrell, E.M.Spector, A.EOrrell, M.  | Reminiscence therapy for dementiaCochrane Database of Systematic Reviews  |  2018  | Issue 3. | DOI: 10.1002/14651858.CD001120.pub3

Cochrane Library had produced an update to a systematic review, on reminiscence therapy (RT) previously updated in 2005. RT involves the discussion of memories and past experiences with other people using tangible prompts such as photographs or music to evoke memories and stimulate conversation. It is implemented widely in a range of settings using a variety of formats (Cochrane Database of Systematic Reviews). The plain language summary is given below.

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Reminiscence therapy for dementia

Review question

We wanted to find out what effect reminiscence therapy (RT) has on people with dementia. In particular, we were interested in effects on quality of life, communication, cognition (the general ability to think and remember), mood, daily activities and relationships. We were also interested in any effects on carers.

Background

RT involves discussing events and experiences from the past. It aims to evoke memories, stimulate mental activity and improve well-being. Reminiscence is often assisted by props such as videos, pictures and objects. It can take place in a group or be done with a person on their own, when it often results in some form of life-story book being created. RT helps older people with depression. It may be suitable for people with dementia both because depression is common in dementia and because people with dementia typically have a better memory for the distant past than for recent events.

Methods

We searched for randomised, controlled trials in which RT was compared with no treatment or with a non-specific activity, such as time spent in general conversation. Our search covered all trials available up to April 2017.

Results

We found 22 trials with 1972 participants to include in the review. All the participants had dementia, mostly of mild or moderate severity. Some of the participants were living at home and some were in care homes. The length of the trials varied from four weeks to two years, and the overall amount of time spent on therapy varied from three to 39 hours. Overall, we thought most of the trials were well conducted.

Looking at all the trials together, there did not seem to be an effect of RT on the quality of life reported by the participants. However, there was probably a slight benefit of treatment in the trials done in care homes, which was not seen in the trials done in the community.

People having RT scored slightly better than the control group on tests of cognition immediately after the course of treatment, but not weeks to months later. It was not clear that the effect was large enough to be important. The effect was most evident in care home studies, which used individual RT, but not in community studies, which used group RT.

We found that group RT and RT in community settings may have a positive effect on the communication and interaction of the person with dementia immediately after the end of treatment, and probably also weeks to months later, although the effect was small.

Apart from a probable slight benefit of individual RT on scales measuring depressed mood, we found no evidence for effects of RT on other outcomes, such as agitation, ability to carry out daily activities or relationships with other people. We found no evidence of harmful effects of RT for the people with dementia themselves.

We found no effect of RT on family carers other than a suggestion that it made carers slightly more anxious in two large studies of joint reminiscence work. In this type of RT, the carers and the people with dementia were both directly involved in the reminiscence sessions.

Conclusions

We were encouraged to find that the amount and quality of research on RT for dementia has increased considerably since the last version of this review. We concluded that the effects of RT vary, depending on the way it is given and whether it takes place in care homes or the community. However, there is some evidence that RT can improve quality of life, cognition, communication and possibly mood in people with dementia in some circumstances, although all the benefits were small. More research is needed to understand these differences and to find out who is likely to benefit most from what type of RT.

The abstract and the full text systematic review is available from The Cochrane Library, alternatively it can be downloaded here