GP online services

Dementia UK have produced a new leaflet with the Royal College of General Practitioners, explaining GP online services for people who care for someone with dementia. Patients can now book appointments, manage repeat prescriptions, and see test results online.

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Image source: http://www.dementiauk.org

Online GP services are designed so patients can:

  • make, change or cancel GP appointments, without having to telephone the practice. Patients can access the online services 24 hours a day, see what appointments are free in the coming days, and choose to see a particular doctor or nurse
  • request repeat prescriptions. Patients can also see a list of regularly prescribed medication, the prescribed dose, and when their next prescription is due
  • look up test results, as well as monitor their health by comparing with historic test results
  • see the medical notes on file, including diagnoses, any allergies, immunisations, and past surgery.
  • see their medical notes wherever they are. This can be useful if medical attention is required when on holiday or traveling

Find out more by reading the new leaflet:

GP online services. Information for the carer of a person with dementia

Using technology enabled care to support cognition in early onset dementia

NHS England | January 2019 | Using technology enabled care to support cognition in early onset dementia

A recent case study on NHS England’s Atlas of Shared Learning spotlights how the Nurse Manager in the Mental Health and Vascular Wellbeing Team at North Staffordshire Combined Healthcare NHS Trust (NSCHT) led a programme of work to introduce a digital application (app) into the care and treatment plans for service users at high risk of developing mild cognitive impairment (MCI).

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The app was designed to digitally link the nursing and medical staff with the service user, enabling care closer to home, empowering service users, families and carers to have greater control and input into planning their treatment and care and improving service user experience and outcomes.

Full story at NHS England

Dementia patients could remain at home longer thanks to ground breaking technology

Innovative new technology could enable people with dementia to receive round the clock observation and live independently in their own homes, a new study reports. | University of Surrey | via ScienceDaily

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Researchers from the University of Surrey in partnership with Surrey and Borders Partnership NHS Foundation Trust have developed state of the art Artificial  technologies, powered by machine learning algorithms, to monitor the wellbeing of people with dementia.

The study known as Technology Integrated Health Management (TIHM) for dementia, uses the ‘Internet of Things,’ a network of internet enabled devices (sensors, monitors and trackers) installed in homes, which can detect an immediate crisis as well as changes in people’s health and daily routines. Any change could indicate a potential health issue and if identified early could prevent a person from becoming seriously unwell and requiring emergency hospital admission.

The well-being of people with dementia can also be monitored using this innovative technology which can detect agitation and irritability.

Full story at ScienceDaily

Journal reference:  Shirin Enshaeifar, S. et al. | Health management and pattern analysis of daily living activities of people with dementia using in-home sensors and machine learning techniques | PLOS ONE |  2018; 13 (5):

 

 

‘Exergaming’ may help those at risk of Alzheimer’s or related dementias

Older adults with mild cognitive impairment (MCI) showed significant improvement with certain complex thinking and memory skills after exergaming (video games that also require physical exercise) | Frontiers in Aging Neuroscience | via ScienceDaily

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The results of a new study could encourage health care providers to pursue or prescribe exergames (video games that also require physical exercise) in hopes of slowing the debilitating effects of those with MCI, sometimes a stage between normal brain aging and dementia.

Previously published research had found that seniors who exercise using the features of interactive video games experienced greater cognitive health benefits than those who rely on traditional exercise alone.

For the latest study, researchers wanted to target older adults diagnosed with or at risk for MCI.  Researchers initially enrolled more than 100 seniors for the study. Over six months, 14 (evenly split between men and women) persisted with regular exergaming. The average age was 78.

The first group of seven was assigned to pedal along a scenic virtual reality bike path several times a week. The second group was given a more challenging task for the brain: pedal while playing a video game that included chasing dragons and collecting coins.

The results were compared against data collected from a separate group of eight seniors who played video games on a laptop but did not pedal, and also a group from the previous research who only rode a traditional stationary bike with no gaming component.

At the end of the randomized clinical trial, participants in both the group that pedaled along a virtual bike path and those that chased dragons and collected coins experienced significantly better executive function, which controls, in part, multi-tasking and decision making.

Benefits for both groups were also seen for verbal memory and physical function, suggesting it may be worth the effort for seniors to incorporate exergaming into a daily exercise regime.

The authors acknowledged that further research with a larger sample size is needed to confirm the team’s findings.  In the meantime, the research suggests benefits of exercising while also stimulating the brain with some mental challenge, such as navigating a scenic bike path or interactively playing a video game.

Full story at ScienceDaily

Full reference: Anderson-Hanley, C . et al. The Aerobic and Cognitive Exercise Study (ACES) for Community-Dwelling Older Adults With or At-Risk for Mild Cognitive Impairment (MCI): Neuropsychological, Neurobiological and Neuroimaging Outcomes of a Randomized Clinical TrialFrontiers in Aging Neuroscience, 2018; 10

 

Is use of the internet in midlife associated with lower dementia incidence?

Study suggests that use of internet by individuals aged 50 years or older is associated with a reduced risk of dementia

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Objectives: Dementia is expected to affect one million individuals in the United Kingdom by 2025; its prodromal phase may start decades before its clinical onset. The aim of this study is to investigate whether use of internet from 50 years of age is associated with a lower incidence of dementia over a ten-year follow-up.

Methods: We analysed data based on 8,238 dementia free (at baseline in 2002–2004) core participants from the English Longitudinal Study of Ageing. Information on baseline use of internet was obtained through questionnaires; dementia casesness was based on participant (or informant) reported physician diagnosed dementia or overall score on the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Cox proportional hazards regression analysis was used for examining the relationship between internet use and incident dementia.

Results: There were 301 (5.01%) incident dementia cases during the follow-up. After full multivariable adjustment for potential confounding factors, baseline internet use was associated with a 40% reduction in dementia risk assessed between 2006–2012 (HR = 0.60 CI: 0.42–0.85; p < 0.05).

Conclusion: This study suggests that use of internet by individuals aged 50 years or older is associated with a reduced risk of dementia. Additional studies are needed to better understand the potential causal mechanisms underlying this association.

Full reference: Eleonora d’Orsi, et al.  Is use of the internet in midlife associated with lower dementia incidence? Results from the English Longitudinal Study of Ageing
Aging and Mental Health |Published online: 10 Aug 2017

Touchscreen interventions and the well-being of people with dementia and caregivers

This article reviews touchscreen-based interventions designed to be used by people with dementia (PWD), with a specific focus in assessing their impact on well-being | International Psychogeriatrics

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Dementia can have significant detrimental impacts on the well-being of those with the disease and their carers. A range of computer-based interventions, including touchscreen-based interventions have been researched for use with this population in the hope that they might improve psychological well-being.

The data bases, PsycInfo, ASSIA, Medline, CINAHL, and Cochrane Reviews were searched for touchscreen-based interventions designed to be used by PWD with reported psychological well-being outcomes. Methodological quality was assessed using Pluye and Hong’s (2014) Mixed Methods Appraisal Tool (MMAT) checklist.

Sixteen papers were eligible. They covered 14 methodologically diverse interventions. Interventions were reported to be beneficial in relation to mental health, social interaction, and sense of mastery. Touchscreen interventions also reportedly benefit informal carers in relation to their perceived burden and the quality of their relationships with the people they care for. Key aspects included the user interface, provision of support, learning style, tailored content, appropriate challenge, ergonomics, and users’ dementia progression.

Whilst much of the existing research is relatively small-scale, the findings tentatively suggest that touchscreen-based interventions can improve the psychological well-being of PWD, and possibilities for more rigorous future research are suggested.

Full reference: Tyack, C & Cami, P.M. (2017) Touchscreen interventions and the well-being of people with dementia and caregivers: a systematic review. International Psychogeriatrics. Vol. 29 (Issue 8) pp. 1261-1280

Computerized game-based training method in people with dementia

This study aims to examine the effects of a computerized, game-based training on motor-cognitive performances, the transfer of training effects on untrained tasks, and the sustainability of training gains in people with dementia | Aging & Mental Health 

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Method: Ninety-nine individuals with a mean age of 82.9 (5.8) and dementia participated in a 10-week randomized controlled trial with three-month follow-up. The intervention group (IG) received a motor-cognitive training on (Physiomat®) including concurrent dual-tasks of balance control with cognitive demands (Physiomat®-Trail Making Tasks (PTMTs)). The control group (CG) performed non-specific, low-intensity exercises. Duration and accuracy at different complexity levels of trained and untrained PTMTs and the number of successfully performed tasks (PTMT score) were assessed.

Results: Physiomat® training significantly improved the duration and accuracy at almost all complexity levels of trained (P ≤ 0.001–0.047, ηp2 = 0.065–0.589) and untrained PTMTs (P < 0.001–0.005, ηp2 = 0.073–0.459). Significant effects were also found for the PTMT score of trained (P < 0.001, ηp2 = 0.211) and untrained PTMTs (P < 0.001, ηp2 = 0.184). Training gains were partly sustained at follow-up.

Conclusion: Physiomat® is feasible and has the potential to sustainably improve motor-cognitive performances in people with dementia.

Full reference: Wiloth, S. et al. (2017) Motor-cognitive effects of a computerized game-based training method in people with dementia: a randomized controlled trial. Aging & Mental Health. Published online: 6th July 2017