38,811 results
Search Results
202. Understandings of mild cognitive impairment (MCI): a survey study of public and professional perspectives
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Yemm, Heather, Peel, Elizabeth, and Brooker, Dawn
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- 2023
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203. Rethinking the Education Potential of Older Adults to Delay the Onset of Dementia
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Calhoun, Denise
- Abstract
This paper demonstrates the effects of education on cognitive functioning which could serve as an alternative preventive method to halt or delay cognitive decline in older adults. The purpose of this proposal is to discuss and illustrate the benefits of improving cognitive ability through continuing education. As such, taking advantage of educational programmes that are already in place would not only provide mental stimulation for older adults, but would be a source for social networking, as well as technology training and physical education activities. To establish a link between cognition and education, this paper provides examples from a number of studies as well as a review of a longitudinal study on educational differences in the prevalence of dementia. The findings of this systematic review revealed a connection between cognitive decline and education after considering regions and economic status. Suggestions from these reviews imply that keeping one's mind stimulated could be influential in delaying the onset of dementia resulting in possibly extending the time older adults are independent.
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- 2022
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204. A mapping review of barriers and facilitators to a dementia diagnosis adopting an intersectionality lens: A protocol paper
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Farina, Nicolas, Razaghi, Leana, and Hicks, Ben
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mapping review ,barriers ,mental disorders ,facilitators ,dementia - Abstract
A protocol paper for a mapping review of the barriers and facilitators to a dementia diagnosis.
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- 2021
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205. DETERMinants of quality of life, care and costs, and consequences of INequalities in people with Dementia and their carers (DETERMIND): A protocol paper
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Louise Robinson, Carol Brayne, Margaret Dangoor, Nicolas Farina, Raphael Wittenberg, Martin Knapp, Kate Baxter, Eleanor Miles, Sube Banerjee, Ben Hicks, Alan J. Thomas, Robert Stewart, Sanna Read, Josie Dixon, Yvonne Birks, Jennifer Rusted, Peter R. Harris, Bo Hu, and Rotem Perach
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Gerontology ,Inequality ,Cost-Benefit Analysis ,media_common.quotation_subject ,Ethnic group ,Detailed data ,HV Social pathology. Social and public welfare. Criminology ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,RA0421 Public health. Hygiene. Preventive Medicine ,mental disorders ,medicine ,Humans ,Dementia ,Quality of Health Care ,media_common ,Equity (economics) ,030214 geriatrics ,Theory of change ,medicine.disease ,Psychiatry and Mental health ,Caregivers ,Socioeconomic Factors ,Cohort ,Quality of Life ,Geriatrics and Gerontology ,Psychology - Abstract
Objectives: DETERMIND (DETERMinants of quality of life, care and costs, and consequences of INequalities in people with Dementia and their carers) is designed to address fundamental, and, as yet unanswered, questions about inequalities, outcomes and costs following diagnosis with dementia. These answers are needed to improve the quality of care and equity of access to care, and therefore the quality of life, of people with dementia and their carers.\ud \ud Method: DETERMIND is a programme of research consisting of seven complementary workstreams (WS) exploring various components that may result in unequal dementia care:\ud WS1: Recruitment and follow-up of the DETERMIND cohort - 900 people with dementia and their carers from three geographically and socially diverse sites within six months following diagnosis, and follow them up for three years.\ud WS2: Investigation of the extent of inequalities in access to dementia care\ud WS3: Relationship between use and costs of services and outcomes \ud WS4: Experiences of self-funders of care \ud WS5: Decision-making processes for people with dementia and carers\ud WS6: Effect of diagnostic stage and services on outcomes \ud WS7: Theory of Change informed strategy and actions for applying the research findings\ud \ud Outcomes: During the life of the programme, analysing baseline results and then follow-up of the DETERMIND cohort over 3 years, we will establish evidence on current services and practice. DETERMIND will deliver novel, detailed data on inequalities in dementia care and what drives positive and negative outcomes and costs for people with dementia and carers, and identify factors that help or hinder living well with dementia.
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- 2019
206. 'It's like home' - A small-scale dementia care home and the use of technology: A qualitative study.
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D'Cunha NM, Isbel S, Bail K, and Gibson D
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- Humans, Aged, Nursing Homes, Australia, Qualitative Research, Dementia therapy, Dementia psychology, Cognitive Dysfunction
- Abstract
Aim: To explore the experiences of residents, families and staff in the establishment of a new small-scale home model of care for people living with dementia., Background: New and innovative small-scale models of care have the potential to improve outcomes for older people, especially those with dementia, who experience high rates of cognitive impairment in traditional residential aged care homes in Australia., Design: A qualitative descriptive study., Methods: Semi-structured interviews with 14 guests, family and staff of a new small-scale dementia home named 'Kambera House' in the Australian Capital Territory were conducted between July 2021 when the home opened and August 2022. Data were analysed using reflexive thematic analysis and reported according to the COREQ guidelines., Results: Two guests with mild-to-moderate dementia, five family and seven staff members participated in the study. The data revealed high satisfaction with Kambera House, generating five themes. Falls detection technology in the home provided a sense of safety, enabling more time for person-centred care. Free, everyday technology connected the home with families as part of an overall community of care where staff were empowered to maximize choice and dignity of risk of guests living in the home. This contributed to the sense of community, rather than an institution, where the conditions of work supported the conditions of care, and were embedded in a culture of responsiveness, change and flexibility., Conclusion: Kambera House represents a successful example of a new small-scale dementia home. Technology played an important background role in improving overall safety and flexibility as part of a model of care which demonstrated positive experiences for guests and families by being responsive to their individual needs., Impacts: Small-scale homes for people with dementia offer an alternative model that may provide more individualized, person-centred care compared with the traditional institutionalized care., Patient or Public Contribution: No patient or public contribution., (© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)
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- 2023
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207. Patient-specific cognitive profiles in the detection of dementia subtypes: A proposal.
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Mueller J and Cammermeyer G
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- Humans, Neuropsychological Tests, Mental Status and Dementia Tests, Cognition, Cognitive Dysfunction diagnosis, Dementia psychology
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Many physicians rely on sum score cognitive screening tests to evaluate patients for cognitive decline. Because the vast majority of cognitively impaired patients never receive more extensive testing, the results of these screening tests impact patients and their family members profoundly. No previous study has examined whether the metrics used by the popular Mini-Mental State Examination, Montreal Cognitive Assessment, and Saint Louis University Mental Status tests reliably identify single-domain deficits or allow clinicians to adequately track disease progression. We compare side by side the metrics used by these three tests to highlight the differences in the ways they measure domain impairments. We then contrast the sum score approach to cognitive screening with brief domain-specific tests that use extended metrics in each domain examined. Last, we suggest that moderate-to-severe domain-specific deficits on these tests should lead physicians to anticipate specific functional problems and alert family members., (© 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)
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- 2023
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208. Projections of costs and quality adjusted life years lost due to dementia from 2020 to 2050: A population-based microsimulation study.
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Brück CC, Wolters FJ, Ikram MA, and de Kok IMCM
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- Humans, Quality-Adjusted Life Years, Caregivers, Health Care Costs, Cost-Benefit Analysis, Quality of Life, Dementia epidemiology
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Introduction: Efficient healthcare planning requires reliable projections of the future increase in costs and quality-adjusted life years (QALYs) lost due to dementia., Methods: We used the microsimulation model MISCAN-Dementia to simulate life histories and dementia occurrence using population-based Rotterdam Study data and nationwide birth cohort demographics. We estimated costs and QALYs lost in the Netherlands from 2020 to 2050, incorporating literature estimates of cost and utility for patients and caregivers by dementia severity and care setting., Results: Societal costs and QALYs lost due to dementia are estimated to double between 2020 and 2050. Costs are incurred predominantly through institutional (34%), formal home (31%), and informal home care (20%). Lost QALYs are mostly due to shortened life expectancy (67%) and, to a lesser extent, quality of life with severe dementia (14%)., Discussion: To limit healthcare costs and quality of life losses due to dementia, interventions are needed that slow symptom progression and reduce care dependency., (© 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)
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- 2023
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209. Home-based care for people living with dementia at the end of life: the perspective of experts.
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Pinkert C and Holle B
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- Humans, Death, Ambulatory Care, Palliative Care, Home Care Services, Dementia therapy
- Abstract
Background: In the last phase of their lives, people living with dementia often indicate restlessness, anxiety or pain. Further, their care is considered inadequate, as they are, for example, sometimes overtreated for curative care or undertreated for pain management. These patients also face multiple barriers in accessing palliative care. This qualitative study explores the perception of experts about how people living with dementia in Germany are cared for at home toward the end of their lives., Methods: A total of 12 experts involved in outpatient/palliative care were recruited to constitute a purposive, heterogeneous sample. Interviews, which were structured using an interview guide, were conducted with physicians, nurses, representatives of health insurance funds, welfare associations, municipal counselling centres, scientists and coordinators of outpatient palliative care and voluntary work; the interviews were transcribed and analysed via thematic content analysis, based on Kuckartz's method., Results: The analysis of the results led to the establishment of four main categories that focused on formal care arrangements, the roles of relatives in care arrangements, the specifics of dementia, and restrictions on access to palliative care., Conclusions: Suitable end-of-life care for people living with dementia and support for their relatives require resources and the conceptualisation of specific care arrangements to help minimise potential barriers that prevent access to palliative care., (© 2023. BioMed Central Ltd., part of Springer Nature.)
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- 2023
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210. Exploring the connection between dementia and eating, drinking and swallowing difficulty: Findings from home-based semi-structured interviews.
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O'Neill M, Duffy O, Henderson M, Davis A, and Kernohan WG
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- Humans, Deglutition, Caregivers, Narration, Dementia, Deglutition Disorders diagnosis, Deglutition Disorders etiology
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Background: Eating, drinking and swallowing (EDS) difficulties are important to identify early. Awareness of EDS changes starts with those living with dementia or their family carers. However, little is known about early identification from the perspective of people with dementia., Aim: The aim of this study was to understand the experience of EDS by people living with dementia in their own home., Methods: Published evidence pertaining to EDS difficulties in dementia was used to inform an online semi-structured interview guide. Four people living with dementia and a third-sector Empowerment Lead were invited to become co-researchers. People living with dementia and their carers were invited to be interviewed. We enquired about their past and present experiences, and future expected changes in EDS, information needs, opinions on early problem identification, and lifestyle modifications following onset of EDS difficulty. Narrative concepts of heroes and villains in their 'stories' were identified. Responses were subjected to framework analysis informed by narrative enquiry., Results: Seven people living with dementia and five family carers were interviewed. The overarching theme was a 'missed connection' between EDS difficulty and dementia. Where EDS difficulties were identified, 'compensatory changes' and a need for 'access to information' were noted., Conclusions: The connection between potential EDS difficulties and a dementia diagnosis may not be made, even though EDS changes were recognised by people living with dementia and their family carers. This may be explained by behaviours that mask problems or allow individuals to cope or compensate. Reduced awareness may also be due to inadequate access to information and lack of specialist services. If the connection between dementia and EDS difficulty is missed it could further delay access to support services., What This Paper Adds: What is already known on the subject The prevalence of dementia is increasing and is expected to affect 9% of the population by 2040. EDS difficulties are common in people living with dementia and predispose to poorer outcomes. Better awareness of EDS changes early in the disease process of dementia or at preclinical stages can identify individuals at risk and allow for intervention prior to advanced EDS difficulties developing. What this paper adds to existing knowledge This paper reports the perspective of people living with dementia and family carers and provides insights into experiences of EDS and the challenges faced and identifies commonalities. The connection between potential EDS difficulties and dementia is missed despite various changes reported by both people living with dementia and their family carers, who tend to make compensatory lifestyle changes without support. What are the potential or actual clinical implications of this work? Lack of awareness of the connection between potential EDS difficulties and dementia may arise due to inadequate access to information to support people living with dementia and their family carers. Access to such information is needed and the quality assurance of information from reputable sources is important to people living with dementia. There is a need for greater service user awareness of signs of EDS difficulty and how to access specialist services., (© 2023 The Authors. International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.)
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- 2023
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211. Mortality risk factors among patients undergoing hemodialysis in a nursing home.
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Notomi S, Kitamura M, Otsuka E, Ejima Y, Sawase K, Nishino T, and Funakoshi S
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- Humans, Male, Aged, Aged, 80 and over, Retrospective Studies, Risk Factors, Nursing Homes, Weight Loss, Renal Dialysis, Dementia
- Abstract
Aim: This study aimed to verify the impact of low body mass index (BMI) on mortality in nursing home residents undergoing hemodialysis and to clarify other associated mortality risk factors., Methods: This retrospective study included patients admitted to a nursing home affiliated with Nagasaki Renal Center between April 2014 and March 2022. Medical data were collected on admission, and participants were divided into low and high BMI groups according to their median BMI values. The patients were followed up until March 2023. The association between survival and patient history was also analyzed., Results: Of the 106 patients (average age, 81.3 ± 7.9 years; male, 36.8%; median dialysis vintage, 32.5 [interquartile range (IQR), 13.8-79.3] months), 52 and 54 were classified into the low (median < 18.4 kg/m
2 ) and high (≥18.4 kg/m2 ) BMI groups, respectively. Multivariable Cox proportional hazards analysis indicated that BMI (hazard ratio, 0.87; 95% confidence interval [CI]: 0.82-0.94; P < 0.001) was closely associated with survival. Multivariable logistic regression revealed that dementia was associated with low BMI (odds ratio: 2.89, 95% CI: 1.07-7.83, P = 0.03)., Conclusions: Low BMI was an important factor contributing to poor patient survival. Dementia was associated with low BMI. Therefore, the management of both nutrition and dementia is essential for nursing home residents undergoing hemodialysis. Geriatr Gerontol Int 2023; 23: 660-664., (© 2023 Japan Geriatrics Society.)- Published
- 2023
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212. Dementia prediction in the general population using clinically accessible variables: a proof-of-concept study using machine learning. The AGES-Reykjavik study.
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Twait EL, Andaur Navarro CL, Gudnason V, Hu YH, Launer LJ, and Geerlings MI
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- Humans, Female, Aged, Male, Proof of Concept Study, Supervised Machine Learning, Algorithms, Machine Learning, Dementia diagnosis, Dementia epidemiology
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Background: Early identification of dementia is crucial for prompt intervention for high-risk individuals in the general population. External validation studies on prognostic models for dementia have highlighted the need for updated models. The use of machine learning in dementia prediction is in its infancy and may improve predictive performance. The current study aimed to explore the difference in performance of machine learning algorithms compared to traditional statistical techniques, such as logistic and Cox regression, for prediction of all-cause dementia. Our secondary aim was to assess the feasibility of only using clinically accessible predictors rather than MRI predictors., Methods: Data are from 4,793 participants in the population-based AGES-Reykjavik Study without dementia or mild cognitive impairment at baseline (mean age: 76 years, % female: 59%). Cognitive, biometric, and MRI assessments (total: 59 variables) were collected at baseline, with follow-up of incident dementia diagnoses for a maximum of 12 years. Machine learning algorithms included elastic net regression, random forest, support vector machine, and elastic net Cox regression. Traditional statistical methods for comparison were logistic and Cox regression. Model 1 was fit using all variables and model 2 was after feature selection using the Boruta package. A third model explored performance when leaving out neuroimaging markers (clinically accessible model). Ten-fold cross-validation, repeated ten times, was implemented during training. Upsampling was used to account for imbalanced data. Tuning parameters were optimized for recalibration automatically using the caret package in R., Results: 19% of participants developed all-cause dementia. Machine learning algorithms were comparable in performance to logistic regression in all three models. However, a slight added performance was observed in the elastic net Cox regression in the third model (c = 0.78, 95% CI: 0.78-0.78) compared to the traditional Cox regression (c = 0.75, 95% CI: 0.74-0.77)., Conclusions: Supervised machine learning only showed added benefit when using survival techniques. Removing MRI markers did not significantly worsen our model's performance. Further, we presented the use of a nomogram using machine learning methods, showing transportability for the use of machine learning models in clinical practice. External validation is needed to assess the use of this model in other populations. Identifying high-risk individuals will amplify prevention efforts and selection for clinical trials., (© 2023. BioMed Central Ltd., part of Springer Nature.)
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- 2023
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213. Biomarkers for predicting disease course in Sanfilippo syndrome: An urgent unmet need in childhood-onset dementia.
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Winner LK, Rogers ML, Snel MF, and Hemsley KM
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- Child, Infant, Infant, Newborn, Humans, Adolescent, Biomarkers, Prognosis, Mucopolysaccharidosis III diagnosis, Mucopolysaccharidosis III pathology, Dementia
- Abstract
Sanfilippo syndrome (MPS III) is an autosomal recessive inherited disorder causing dementia in children, following an essentially normal early developmental period. First symptoms typically include delayed language development, hyperactivity and/or insomnia from 2 years of age, followed by unremitting and overt loss of previously acquired skills. There are no approved treatments, and the median age of death is 18 years. Treatments under clinical trial demonstrate therapeutic benefit when applied pre-symptomatically in children diagnosed early through known familial inheritance risk. Newborn screening for Sanfilippo syndrome would enable pre-symptomatic diagnosis and optimal therapeutic benefit, however, many fold more patients with Sanfilippo syndrome are expected to be identified in the population than present with childhood dementia. Therefore, the capacity to stratify which Sanfilippo infants will need treatment in toddlerhood is necessary. While diagnostic methods have been developed, and continue to be refined, currently there are no tools or laboratory-based biomarkers available to provide pre-symptomatic prognosis. There is also a lack of progression and neurocognitive response-to-treatment biomarkers; disease stage and rate of progression are currently determined by age at symptom onset, loss of cerebral grey matter volume by magnetic resonance imaging and developmental quotient score for age. Robust blood-based biomarkers are an urgent unmet need. In this review, we discuss the development of biomarker assays for Sanfilippo based on the neuropathological pathways known to change leading into symptom onset and progression, and their performance as biomarkers in other neurodegenerative diseases. We propose that neural-derived exosomes extracted from blood may provide an ideal liquid biopsy to detect reductions in synaptic protein availability, and mitochondrial function. Furthermore, given the prominent role of neuroinflammation in symptom expression, glial fibrillary acidic protein detection in plasma/serum, alongside measurement of active brain atrophy by neurofilament light chain, warrant increased investigation for prognostic, progression and neurocognitive response-to-treatment biomarker potential in Sanfilippo syndrome and potentially other childhood dementias., (© 2023 The Authors. Journal of Neurochemistry published by John Wiley & Sons Ltd on behalf of International Society for Neurochemistry.)
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- 2023
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214. Knowledge and attitudes of community pharmacists regarding dementia: A nationwide cross-sectional study in Vietnam.
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Thanh Nguyen HT and Dinh DX
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- Humans, Female, Male, Pharmacists, Cross-Sectional Studies, Vietnam, Health Knowledge, Attitudes, Practice, Attitude of Health Personnel, Surveys and Questionnaires, Dementia drug therapy, Community Pharmacy Services
- Abstract
Objective: To investigate Vietnamese community pharmacists' knowledge and attitudes towards dementia., Methods: 1066 community pharmacists in eight provinces/centrally-governed cities were recruited using a non-probability convenience sampling technique. Their dementia knowledge was measured using a set of 14 questions developed through a literature review. The Approaches to Dementia Questionnaire was used to assess pharmacists' attitudes towards dementia. Cronbach's alpha was 0.88 for the overall questionnaire (0.70 for the knowledge part and 0.81 for the attitude part)., Results: Participants were mostly female (74.2%), 20-39 years old (79.1%), and had work experience in pharmacies of less than 10 years (77.0%). Medicines for dementia were available in only 40 community pharmacies (3.8%), including galantamine (3.0%) and donepezil (0.8%). Pharmacists' average knowledge and attitude scores were 8.03 ± 2.61 and 64.81 ± 7.34, respectively. There were considerable differences in pharmacists' knowledge and attitudes between rural and urban areas and among eight provinces (p < 0.001). Higher knowledge and attitude scores were found among those with higher education levels and longer work experience (p < 0.001). Using reliable sources to seek information on dementia, such as books and scientific articles, also helped pharmacists to have better knowledge and more positive attitudes (p < 0.001). There was a positive relationship between knowledge and attitude scores (r = 0.326, p < 0.001)., Conclusion: Community pharmacists demonstrated moderate levels of knowledge and attitudes towards dementia. Their knowledge about the symptoms of dementia was inadequate. Educational interventions and training programs are urgently needed to enhance their dementia knowledge and attitudes., (© 2023 John Wiley & Sons Ltd.)
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- 2023
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215. Development of a scale to evaluate nurses' recovery orientation in the dementia care.
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Furuno T, Fujino N, Fujimoto Y, Yamaguchi F, and Furuno N
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- Humans, Aged, Reproducibility of Results, Surveys and Questionnaires, Health Personnel, Psychometrics, Dementia, Nurses
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WHAT IS KNOWN ON THE SUBJECT?: Much research has been conducted on the relationship between recovery orientation and people diagnosed with mental illnesses such as schizophrenia and mood disorders. A recovery-oriented approach by mental health professionals can reduce hospital stays and medical costs for people diagnosed with mental illness. There are similarities and differences between recovery-oriented approaches for individuals diagnosed with dementia and those diagnosed with mental illness. This reflects the characteristics of irreversible dementia. Although dementia courses at recovery colleges are increasing, dementia recovery is in its infancy and course content varies. The core of the recovery framework for individuals diagnosed with dementia is 'Continue to be me'. Recovery-oriented approaches and programmes have been developed by mental health workers for older adults, including those with dementia, but there are no outcome measures that reflect the characteristics of dementia care. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: We developed a scale to assess nurses' recovery orientation in dementia care, which has been found to be reliable, and although some validity issues remain, it is the first scale to objectively assess recovery orientation in dementia care. The emphasis is on helping people diagnosed with dementia maintain their identity, which is not adequately covered by existing measures of recovery. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The ability to objectively assess recovery orientation in dementia care allows us to identify areas of inadequacy. It can be used to reduce variation in the content of recovery college courses and as an indicator for evaluating training in recovery-oriented approaches to dementia care., Abstract: INTRODUCTION: Programmes regarding recovery-oriented approaches for older people, including those with dementia, have been developed, but there are no clear indicators, and the process is still in its infancy., Purpose: We developed a scale to assess nurses' recovery orientation in dementia care., Methods: A draft of a 28-item scale was developed based on interviews with 10 nurses, skilled in dementia care with a Japanese mental health perspective, and a literature review. A self-administered questionnaire was developed for nurses working in a dementia ward, and an exploratory factor analysis was conducted. A confirmatory factor analysis was conducted to test for convergent and discriminant validity. The Recovery Attitude Questionnaire was used to examine criterion-related validity., Results: An exploratory factor analysis produced a 19-item scale and identified five factors (KMO value: 0.854). The Cronbach's alpha for the overall scale was .856, with each subfactor showing a range of .742-.792, validating its reliability., Discussion: The results of confirmatory factor analysis supported the five-factor construct. Reliability was verified, but some issues remained in convergent and discriminant validity., Implications for Practice: This scale can be used to objectively assess nurses' recovery orientation in dementia care and as a measure of training in recovery-oriented approaches., (© 2023 John Wiley & Sons Ltd.)
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- 2023
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216. Dementia care navigation: A systematic review on different service types and their prevalence.
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Giebel C, Reilly S, Gabbay M, Dickinson J, Tetlow H, Hogan H, Griffiths A, and Cooper C
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- Humans, Prevalence, Caregivers psychology, Social Support, Mental Health, Dementia epidemiology, Dementia therapy
- Abstract
Background: Dementia Care Navigators (DCNs) are professionals without clinical training, who provide individualised emotional and practical support to people living with dementia, working alongside clinical services. Navigator services have been implemented but the service offered vary without a consistent overview provided. The aim of this narrative systematic review was to describe and compare existing service formats, and to synthesise evidence regarding their implementation and impacts., Methods: The review was registered on PROSPERO [CRD42021292518]. Three electronic databases were searched and included studies reported on a DCN service, defined as a service in which non-clinically trained workers provide personalised advice and support to people with dementia and/or carers in the community. Two independent reviewers screened abstracts and titles and read through full papers for inclusion. Risk of bias was assessed using the Standard Quality Assessment QualSyst., Results: We included 14 papers reporting on six studies. All services were US-based and only varied by integration and training provided. Studies reported different degrees of impact on service utilisation and on symptoms and mental well-being of people with dementia and their carers, with too little evidence to draw substantial/meaningful conclusions and studies employing different outcome measures. One study evidenced greater impacts on people with more advanced dementia compared to earlier stages., Conclusions: DCN services have the potential to effectively provide non-clinical support to people with dementia and carers from the point of diagnosis. Further research from countries other than the USA, focusing on the impact on social care and social support service access and utilisation, and utilising similar established outcome measures are required., (© 2023 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.)
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- 2023
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217. Tourism, ageing and the demographic time bomb – the implications of dementia for the visitor economy: a perspective paper
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Joanne Connell and Stephen J. Page
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business.industry ,Visitor pattern ,05 social sciences ,Geography, Planning and Development ,Perspective (graphical) ,Creative commons ,Customer relationship management ,Public relations ,medicine.disease ,Tourism, Leisure and Hospitality Management ,0502 economics and business ,medicine ,Dementia ,050211 marketing ,Sociology ,Economic impact analysis ,Attribution ,business ,050212 sport, leisure & tourism ,Tourism - Abstract
Purpose This paper aims to examine the development of research on ageing and demography and the implications for the study of tourism. It examines the demographic time bomb created by an ageing population and the implications of complex health conditions, such as dementia, for the visitor economy. Practical measures are identified with an example of a “call to action” for small to medium-sized tourism businesses. Design/methodology/approach This review is based on existing knowledge of ageing and draws upon a historical timeline that stretches from the nineteenth century to 2100. Findings The impact of complex health conditions such as dementia will pose major challenges for the visitor economy and will require behavioural change within existing business practices to accommodate the needs of people with dementia and their carers. Research limitations/implications Major changes in business practices and the development of more holistic views of accessibility will be needed to accommodate an ageing population in 2100. Some of the initial changes businesses can make are outlined in a “call to action” leaflet extract. Practical implications Businesses will need to focus more on customer care practices to ensure that they can accommodate the complex needs of people with dementia and their carers as they continue to pursue the tourism and leisure activities that they have grown accustomed to. Social implications Businesses will need to become more fully engaged with new agendas on accessibility, inclusivity and good business practice that raise significant ethical, financial and legal issues for the way they do business in the future. Originality/value The paper sets out an overarching grand societal challenge around ageing that is now confronting many countries worldwide. As part of that agenda, this paper raises the issue of hidden conditions such as dementia. The paper seeks to stimulate a wider debate for researchers and policymakers going forward, framed around the following questions which arise from the paper: How is dementia understood as a hidden condition in the visitor economy? To what extent is there awareness and action in the visitor economy sector? What can the visitor economy sector do to address issues of inclusivity and dementia?
- Published
- 2019
218. A Call to Action: Now Is the Time to Screen Elderly and Treat Osteosarcopenia, a Position Paper of the Italian College of Academic Nutritionists MED/49 (ICAN-49)
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Tiziana Montalcini, Mauro Serafini, Diego Russo, Lorenzo M. Donini, Loris Pironi, Andrea Natali, Patrizia Riso, Anna Tagliabue, Lucia Frittitta, Angela A. Rivellese, Marisa Porrini, Antonino De Lorenzo, Arturo Pujia, Fabio Galvano, Giovanni Scapagnini, Montalcini T., Pujia A., Donini L.M., Frittitta L., Galvano F., Natali A., Pironi L., Porrini M., Riso P., Rivellese A.A., Russo D., Scapagnini G., Serafini M., Tagliabue A., and De Lorenzo A.
- Subjects
Gerontology ,Aging ,Sarcopenia ,Review ,Disease ,Settore MED/49 ,Elderly ,0302 clinical medicine ,Risk Factors ,Cancer screening ,sarcopenia ,bioelectrical impedance analysis ,chronic diseases ,DXA ,elderly ,fractures ,handgrip strength ,mortality ,muscle mass ,osteoporosis ,030212 general & internal medicine ,Nutrition and Dietetics ,musculoskeletal system ,Call to action ,Italy ,Bioelectrical impedance analysi ,Body Composition ,lcsh:Nutrition. Foods and food supply ,Bioelectrical impedance analysis ,lcsh:TX341-641 ,030209 endocrinology & metabolism ,Handgrip strength ,Chronic disease ,03 medical and health sciences ,medicine ,Humans ,Dementia ,Muscle Strength ,Mortality ,Risk factor ,Noncommunicable Diseases ,Aged ,business.industry ,Osteoporosi ,Muscle mass ,medicine.disease ,Fracture ,Muscle ma ,Chronic diseases ,Life expectancy ,Osteoporosis ,Position paper ,business ,Fractures ,human activities ,Food Science - Abstract
Aging is a risk factor for the development of multiple chronic diseases, including cardiovascular disease, cancer and dementia. Life expectancy has increased in certain countries but this phenomenon is associated with a reduction of years of healthy life. Aging is associated with a number of physical and functional changes, especially sarcopenia. Sarcopenia is a clinical condition associated with a decrease in skeletal muscle and muscle strength, however, sarcopenia is a reversible condition. On the basis of the current scientific literature, sarcopenia could more appropriately capture an individual’s vulnerability to negative health-related outcomes since it represents an early form of the chronic diseases. Recognition of this clinical condition can improve the management of older individuals in many different clinical settings. Despite the limitations of the indirect methods used to study body composition, the Italian College of the Academic Nutritionists ME/49 recommends that health authorities and health professionals around the world should make a greater effort to diagnose sarcopenia earlier and to manage it more effectively. In line with the development of cancer screening, the use of two diagnostic tools for sarcopenia (BIA and DXA) should be implemented.
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- 2020
219. 'Do Not Allow Me to Forget You': Daughter Care, Dementia, and Curriculum in the Moment
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Jewett, Laura M. and Williams, Zulema
- Abstract
This paper explores and performs the ways daughters make meaning of the lived curriculum of their experience of their mothers' dementia. U.S. daughters disproportionally carry the burden of caring for mothers with dementia (Bath, 2017). Rabin (2017) writes, "As Washington debates the relative merits of health care legislation, many families have already come up with what is arguably the most reliable form of care in America: It's called daughter care" (p. 1). This paper performs interwoven narratives of daughter care that bear witness to curriculum lived in the sweet epistemological now of our mothers' memories as a form of aesthetic resistance to master narratives of medicalized decline that define the experience of dementia exclusively in terms of loss.
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- 2018
220. Evaluation of Digital Drawing Tests and Paper-and-Pencil Drawing Tests for the Screening of Mild Cognitive Impairment and Dementia: A Systematic Review and Meta-analysis of Diagnostic Studies
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Timothy C. Y. Kowk, Adrian Wong, Kelvin K.F. Tsoi, Joyce Y.C. Chan, Benjamin Hon Kei Yip, Baker K.K. Bat, Tak Kit Chan, and Zhaohua Huo
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medicine.medical_specialty ,Neuropsychology ,MEDLINE ,PsycINFO ,CINAHL ,Neuropsychological Tests ,medicine.disease ,Sensitivity and Specificity ,Neuropsychology and Physiological Psychology ,Research Design ,Meta-analysis ,Physical therapy ,medicine ,Dementia ,Humans ,Cognitive Dysfunction ,Cognitive impairment ,Psychology ,Clock drawing test - Abstract
Digital drawing tests have been proposed for cognitive screening over the past decade. However, the diagnostic performance is still to clarify. The objective of this study was to evaluate the diagnostic performance among different types of digital and paper-and-pencil drawing tests in the screening of mild cognitive impairment (MCI) and dementia. Diagnostic studies evaluating digital or paper-and-pencil drawing tests for the screening of MCI or dementia were identified from OVID databases, included Embase, MEDLINE, CINAHL, and PsycINFO. Studies evaluated any type of drawing tests for the screening of MCI or dementia and compared with healthy controls. This study was performed according to PRISMA and the guidelines proposed by the Cochrane Diagnostic Test Accuracy Working Group. A bivariate random-effects model was used to compare the diagnostic performance of these drawing tests and presented with a summary receiver-operating characteristic curve. The primary outcome was the diagnostic performance of clock drawing test (CDT). Other types of drawing tests were the secondary outcomes. A total of 90 studies with 22,567 participants were included. In the screening of MCI, the pooled sensitivity and specificity of the digital CDT was 0.86 (95% CI = 0.75 to 0.92) and 0.92 (95% CI = 0.69 to 0.98), respectively. For the paper-and-pencil CDT, the pooled sensitivity and specificity of brief scoring method was 0.63 (95% CI = 0.49 to 0.75) and 0.77 (95% CI = 0.68 to 0.84), and detailed scoring method was 0.63 (95% CI = 0.56 to 0.71) and 0.72 (95% CI = 0.65 to 0.78). In the screening of dementia, the pooled sensitivity and specificity of the digital CDT was 0.83 (95% CI = 0.72 to 0.90) and 0.87 (95% CI = 0.79 to 0.92). The performances of the digital and paper-and-pencil pentagon drawing tests were comparable in the screening of dementia. The digital CDT demonstrated better diagnostic performance than paper-and-pencil CDT for MCI. Other types of digital drawing tests showed comparable performance with paper-and-pencil formats. Therefore, digital drawing tests can be used as an alternative tool for the screening of MCI and dementia.
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- 2021
221. How Many People Live with Dementia in Portugal? A Discussion Paper of National Estimates
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Gonçalves-Pereira, Manuel, Verdelho, Ana, Prina, Matthew, Marques, Maria João, Xavier, Miguel, NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), Comprehensive Health Research Centre (CHRC) - pólo NMS, and Centro de Estudos de Doenças Crónicas (CEDOC)
- Subjects
SDG 3 - Good Health and Well-being ,Epidemiology ,Health Policy ,Populational study ,Public Health, Environmental and Occupational Health ,Dementia ,Community ,Alzheimer disease ,Older people - Abstract
Funding Information: Work leading directly to this paper was not funded. The 10/66 DRG dementia prevalence study in Portugal was supported by FCT (Fundação para a Ciência e a Tecnologia; PTDC/SAU-EPI/113652/2009: “Prevalence of old age neuropsychiatric disorders: contribution to mental health policy in Portugal” – P.I. M. Xavier). Publisher Copyright: © 2021 The Author(s). Published by S. Karger AG, Basel on behalf of NOVA National School of Public Health. This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Dementia poses major public health challenges, and high-quality epidemiological data are needed for service planning. Published estimates of numbers of people with dementia in Portugal have been based, in most cases, on prevalence rates derived from international studies or expert consensus. As in many other countries, Portuguese community prevalence studies' results are nongeneralizable to a country level. Moreover, their prevalence estimates differ (not surprisingly, owing to different methodologies, e.g., design, sampling, and diagnostic criteria). Regardless, the Portuguese 10/66 Dementia Research Group (10/66 DRG) population-based survey fulfilled 10 out of 11 Alzheimer's Disease International quality criteria for prevalence studies. It relied on cross-culturally validated methods, fostering a wide comparability of results. Therefore, we can provide rough estimates of 217,549 community dwellers with dementia in Portugal according to the 10/66 DRG criteria (that would be only 85,162 according to DSM-IV criteria). This refers to people aged 65 years or older who are not institutionalized. Although broadly consistent with international projections, these estimates must be cautiously interpreted. Particularly in the context of scarce funding, which will probably last for years, we need more efficient, evidence-based dementia policies. Concerning further epidemiological studies, high-quality methods are needed but also their comparability potential should be improved at national and international levels. Most of all, fund allocation in Portugal should now privilege routine dementia information systems in both health and social services. publishersversion published
- Published
- 2021
222. Dementia specific care structures in nursing homes-Study protocol of a telephone-based survey study in a nationwide random sample.
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Hoffmann AL, Bergmann JM, Mueller-Widmer R, and Palm R
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- Cross-Sectional Studies, Germany, Humans, Nursing Homes, Telephone, Dementia
- Abstract
Aim: To describe a study protocol for a survey study in German nursing homes that (1) plans to enhance a typology of care units (2) and investigates the association between different care unit types and the provision of dementia-specific interventions based on a stratified randomized sample., Background: Many nursing homes in Germany provide Dementia Special Care Units. Existing definitions often do no justice to the complexity of their context. In this study, we define context as structural and organizational variables. It is necessary to define an empirical based set of indicators to characterize care units with respect to dementia care., Design: Observational survey study with a cross-sectional design., Methods: We will use a stratified random nationwide sample of 160 German nursing homes. Stratification variables are federal state and the existence of a Dementia Special Care Unit. The sampling frame from which the participating nursing homes are selected is a list with the total population of German nursing homes (n = 11.658). Data will be gathered on the level of the nursing homes and one of their care units via computer-assisted telephone interviews with a standardized questionnaire. The distribution of the assessed variables (contextual characteristics) will be described in absolute and relative frequencies for the whole sample in the first step in order to describe dementia-specific care structures. In the second step, factor analysis of mixed data (FAMD) with hierarchical clustering (HC) will be applied to analyze relationships between variables. The study was ethically approved in October 2018., Discussion: The typology can be used in future studies to define the context of care units in nursing homes. This may improve the interpretation of findings from future studies that investigated interventions in nursing homes., Impact: The typology will visualize and describe the complexity of contextual characteristics of several care units., (© 2021 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)
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- 2021
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223. 283 Does a Pen and Paper Assessment of Executive Skills Correlate with Functional Decline Identified Through Specialised Occupational Therapy Assessment?
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Fiona Tobin, Desmond O'Neill, Daniel Ryan, Sean Kennelly, Ronan Collins, Caitriona McGuinn, Corinne Pearson, Tara Coughlan, Joshi Dooky, and Cathy McHale
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Gerontology ,Occupational therapy ,Aging ,medicine.medical_specialty ,business.industry ,General Medicine ,medicine.disease ,medicine ,Dementia ,Geriatrics and Gerontology ,Functional decline ,Cognitive impairment ,business ,Independent living - Abstract
Background Executive skills refer to a set of cognitive skills that allow individuals to engage in goal directed behavior. They encompass planning, initiation, inhibition, monitoring and flexibility in approach to tasks, and are necessary for functional competence. Executive skills are vulnerable to disruption with damage to the brain, as occurs with dementia. Methods Participants were recruited from a tertiary memory assessment and support Service. The Assessment of Motor & Process Skills (AMPS), a standardised observational assessment of occupational performance (1Fischer, 2003) was administered by trained Occupational Therapists. In addition, the EXIT-25, a pen & paper based assessment of executive skills (2Royall et al, 1992) was administered. Process scores from the AMPS, and overall score from the EXIT 25 were utilised for correlation analysis. Results 22 participants, 12 male and 10 females, age range 60-91 (mean 75.5 years), was analysed using Spearman’s Rho correlation (-.2). Results did not identify a strong correlation Conclusion Dementia is commonly regarded as a disorder of memory. However, diagnosis is dependent on functional decline related to cognitive decline. The AMPS provides a formal assessment of functional skills, in terms of motor & process skills with cut off scores regarding safe independent living. The results of this study indicate that the AMPS is not associated with executive scores on formal cognitive assessments, highlighting the value of an extensive multi-component MDT approach (also incorporating history taking, imaging, bio marker testing etc.) in assessing and diagnosing a dementia.
- Published
- 2019
224. Participation of nurses and care workers in the decision-making process for people with dementia in Japan: Discussion paper
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Rio Miyanaga and Hemant Poudyal
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Male ,Process (engineering) ,Health Personnel ,Decision Making ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Nursing ,Patient-Centered Care ,Health care ,medicine ,Humans ,Dementia ,030212 general & internal medicine ,Decision-making ,General Nursing ,030504 nursing ,Family structure ,business.industry ,medicine.disease ,Care workers ,Female ,Nursing Staff ,0305 other medical science ,Psychology ,business ,Healthcare providers - Abstract
Numerous socio-legal factors make the process of surrogate decision-making for people living in dementia very complicated in Japan. In this discussion paper, we argue that the lack of early consultation between patients, surrogate decision-makers and healthcare providers and the overreliance of patients and their families on doctors to assume the decision-making role lead to healthcare practices that may not align with the patient's wishes. Further, we argue that lack of laws on surrogate decision-making, changing family structure and the liabilities associated with the care of people living with dementia contribute to the complexity of the decision-making process in Japan. Finally, given the rapidly changing social and healthcare norms in Japan, we call for greater involvement of nurses and care workers in the decision-making process to ensure patient-centric treatment and care are adopted.
- Published
- 2019
225. Cognitive impairment in patients with cerebrovascular disease: A white paper from the ESO Dementia Committee
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Verdelho, Ana, Wardlaw, Joanna, Pavlović, Aleksandra, Pantoni, Leonardo, Godefroy, Olivier, Duering, Marco, Charidimou, Andreas, Chabriat, Hugues, and Biessels, Geert Jan
- Subjects
Stroke ,small vessel disease ,cardiovascular diseases ,cerebrovascular disease ,cognitive impairment ,dementia - Abstract
Purpose Many daily-life clinical decisions in patients with cerebrovascular disease and cognitive impairment are complex. Evidence-based information sustaining these decisions is frequently lacking. The aim of this paper is to propose a practical clinical approach to cognitive impairments in patients with known cerebrovascular disease. Methods The document was produced by the Dementia Committee of the European Stroke Organisation (ESO), based on evidence from the literature where available and on the clinical experience of the Committee members. This paper was endorsed by the ESO. Findings Many patients with stroke or other cerebrovascular disease have cognitive impairment, but this is often not recognized. With improvement in acute stroke care, and with the ageing of populations, it is expected that more stroke survivors and more patients with cerebrovascular disease will need adequate management of cognitive impairment of vascular etiology. This document was conceived for the use of strokologists and for those clinicians involved in cerebrovascular disease, with specific and practical hints concerning diagnostic tools, cognitive impairment management and decision on some therapeutic options. Discussion and conclusions: It is essential to consider a possible cognitive deterioration in every patient who experiences a stroke. Neuropsychological evaluation should be adapted to the clinical status. Brain imaging is the most informative biomarker concerning prognosis. Treatment should always include adequate secondary prevention.
- Published
- 2021
226. Sex and gender differences in Alzheimer's disease: current challenges and implications for clinical practice: Position paper of the Dementia and Cognitive Disorders Panel of the European Academy of Neurology.
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Ferretti, M. T., Martinkova, J., Biskup, E., Benke, T., Gialdini, G., Nedelska, Z., Rauen, K., Mantua, V., Religa, D., Hort, J., Santuccione Chadha, A., and Schmidt, R.
- Subjects
- *
GENDER , *ALZHEIMER'S disease , *COGNITION disorders , *EXPERIMENTAL design , *CEREBRAL atrophy - Abstract
Alzheimer's disease (AD) is characterized by high heterogeneity in disease manifestation, progression and risk factors. High phenotypic variability is currently regarded as one of the largest hurdles in early diagnosis and in the design of clinical trials; there is therefore great interest in identifying factors driving variability that can be used for patient stratification. In addition to genetic and lifestyle factors, the individual's sex and gender are emerging as crucial drivers of phenotypic variability. Evidence exists on sex and gender differences in the rate of cognitive deterioration and brain atrophy, and in the effect of risk factors as well as in the patterns of diagnostic biomarkers. Such evidence might be of high relevance and requires attention in clinical practice and clinical trials. However, sex and gender differences are currently seldom appreciated; importantly, consideration of sex and gender differences is not currently a focus in the design and analysis of clinical trials for AD. The objective of this position paper is (i) to provide an overview of known sex and gender differences that might have implications for clinical practice, (ii) to identify the most important knowledge gaps in the field (with a special regard to clinical trials) and (iii) to provide conclusions for future studies. This scientific statement is endorsed by the European Academy of Neurology. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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227. Technologies to support community-dwelling persons with dementia : a position paper on issues regarding development, usability, effectiveness and cost-effectiveness, deployment, and ethics
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Marijke Span, Louise Robinson, J. Antonio Garcia-Casal, Michael P. Craven, Rose-Marie Dröes, Henriëtte G. van der Roest, Manuel A. Franco-Martín, Alexander Kurz, Shirley Evans, Tom Dening, Heike Felzmann, Magda Tsolaki, Dorota Szcześniak, Dianne Gove, Jochen René Thyrian, Gail Mountain, Fiona Kelly, Anthea Innes, Franka Meiland, Dympna Casey, ~, General practice, APH - Aging & Later Life, APH - Quality of Care, Psychiatry, APH - Mental Health, and EMGO - Mental health
- Subjects
Technology ,Knowledge management ,Cost effectiveness ,Physical Therapy, Sports Therapy and Rehabilitation ,PsycINFO ,CINAHL ,Evaluation studies ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Dementia ,030212 general & internal medicine ,ddc:610 ,Innovation ,Original Paper ,business.industry ,Rehabilitation ,Health technology ,Usability ,medicine.disease ,ethics ,Software deployment ,Diffusion of innovation ,H1 ,Position paper ,business ,030217 neurology & neurosurgery - Abstract
Background: With the expected increase in the numbers of persons with dementia, providing timely, adequate, and affordable care and support is challenging. Assistive and health technologies may be a valuable contribution in dementia care, but new challenges may emerge.\ud \ud \ud Objective: The aim of our study was to review the state of the art of technologies for persons with dementia regarding issues on development, usability, effectiveness and cost-effectiveness, deployment, and ethics in 3 fields of application of technologies: (1) support with managing everyday life, (2) support with participating in pleasurable and meaningful activities, and (3) support with dementia health and social care provision. The study also aimed to identify gaps in the evidence and challenges for future research.\ud \ud \ud Methods: Reviews of literature and expert opinions were used in our study. Literature searches were conducted on usability, effectiveness and cost-effectiveness, and ethics using PubMed, Embase, CINAHL, and PsycINFO databases with no time limit. Selection criteria in our selected technology fields were reviews in English for community-dwelling persons with dementia. Regarding deployment issues, searches were done in Health Technology Assessment databases.\ud \ud \ud Results: According to our results, persons with dementia want to be included in the development of technologies; there is little research on the usability of assistive technologies; various benefits are reported but are mainly based on low-quality studies; barriers to deployment of technologies in dementia care were identified, and ethical issues were raised by researchers but often not studied. Many challenges remain such as including the target group more often in development, performing more high-quality studies on usability and effectiveness and cost-effectiveness, creating and having access to high-quality datasets on existing technologies to enable adequate deployment of technologies in dementia care, and ensuring that ethical issues are considered an important topic for researchers to include in their evaluation of assistive technologies.\ud \ud \ud Conclusions: Based on these findings, various actions are recommended for development, usability, effectiveness and cost-effectiveness, deployment, and ethics of assistive and health technologies across Europe. These include avoiding replication of technology development that is unhelpful or ineffective and focusing on how technologies succeed in addressing individual needs of persons with dementia. Furthermore, it is suggested to include these recommendations in national and international calls for funding and assistive technology research programs. Finally, practitioners, policy makers, care insurers, and care providers should work together with technology enterprises and researchers to prepare strategies for the implementation of assistive technologies in different care settings. This may help future generations of persons with dementia to utilize available and affordable technologies and, ultimately, to benefit from them.
- Published
- 2017
228. Rachael Maskell ask the Secretary of State for Health and Social Care, if he will integrate his White Paper on Social Care with the dementia strategy
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Dementia ,Business, international - Abstract
London: UK Parliament has issued the following written answer: Answer Gillian Keegan Answered on 7 January 2022 We are committed to delivering a standalone dementia strategy later this year. Although [...]
- Published
- 2022
229. Class Imbalance ML Methods for Classification of Dementia Stage: Kurtosis Fractional Anisotropy: ML-based classification of dementia stage (paper subtitle)
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V. P. Subramanyam Rallabandi and Krishnamoorthy Seetharaman
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Computer science ,business.industry ,Pattern recognition ,medicine.disease ,030218 nuclear medicine & medical imaging ,Random forest ,03 medical and health sciences ,Statistical classification ,0302 clinical medicine ,Sample size determination ,Fractional anisotropy ,Classifier (linguistics) ,medicine ,Kurtosis ,Dementia ,Artificial intelligence ,business ,Diffusion Kurtosis Imaging ,030217 neurology & neurosurgery - Abstract
The aim of this work is to classify the dementia stage using microstructural white matter (WM) diffusion kurtosis indices. We develop various class imbalance machine learning methods in classifying the cognitive normals (CN), Alzheimer's disease (AD) and mild cognitive impairment (MCI) individuals. Diffusion-weighted images of 155 subjects were collected with 44 CN, 88 MCI and 23 AD individuals aged between 60 to 96 years. We first perform skull striping using FSL tool along with head motion and artifact correction. We calculate the mean diffusivity, fractional anisotropy from various brain regions of WM indices from diffusion kurtosis imaging (DKI) using tract based spatial statistics. Then we estimate the kurtosis fractional anisotropy of various WM regions. After estimation of all the regional KFA indices, we trained these indices using various class imbalance machine learning classification algorithms, as the sample size is different in all the three groups. We found that balanced random forest classifier was the best classifier with an accuracy of 74% when compared to other methods for 5-fold cross-validation. We conclude that class imbalance machine learning methods are potential in classifying cognitive normals, AD and cognitive impairment individuals.
- Published
- 2021
230. Thangam Debbonaire ask the Secretary of State for Health and Social Care, with reference to the Dementia Strategy in the People at the heart of care: adult social care reform White Paper, what budget will be allocated to the delivery of the Dementia Strategy
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Business plans ,Dementia ,Business planning ,Business, international - Abstract
London: UK Parliament has issued the following written answer: Answer Gillian Keegan Answered on 23 December 2021 We will be setting out our plans on dementia for England for future [...]
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- 2021
231. Papers That Have Changed My Practice: Treating Diabetes And Dementia
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Cox, I. G.
- Published
- 1983
232. Provisions for people living with dementia in housing with care settings in England
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Barrett, Julia
- Published
- 2023
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233. Risk Negotiation With People With Dementia: From Co-designed Paper Version to Implementation Preparation of an Electronic Conversation Tool.
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Meyer, Claudia, Dickins, Marissa, O'Keefe, Fleur, Hall, Kylie, and Lowthian, Judy
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HOME health aides ,AT-risk people ,DEMENTIA ,MEDICAL care ,OLDER people - Abstract
The home care workforce provides essential support for older people with dementia to live a life of fulfillment. " Enabling Choices," an evidence-informed conversation tool, aims to negotiate risk around everyday activities between home care workers, people with dementia and their informal carers. This paper describes tool conversion into electronic format and preparation for implementation throughout a large Australian health and aged care service provider, utilizing the Implementation Framework for Aged Care (IFAC). Using codesign principles, the tool was converted from paper-based to electronic format involving frontline, operational and Information Management Services staff, and people with dementia/carers. Focus groups and interviews identified tool acceptability, feasibility, and appropriateness. For implementation preparation, the wider socio-cultural-political context was mapped, and key questions of the IFAC addressed. Environment, workflow, and training requirements were determined, and strategies for behavior change ascertained. Numerous opportunities and challenges exist for the widespread upscale of an evidence-informed tool into practice. [ABSTRACT FROM AUTHOR]
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- 2023
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234. Naming as a Window to Word Retrieval Changes in Healthy and Pathological Ageing: Methodological Considerations
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Silvia Martínez-Ferreiro
- Abstract
Background: Word retrieval skills change across the lifespan. Permanent alterations in the form of decreased accuracy or increased response time can be a consequence of both normal ageing processes or the presence of acquired and neurodegenerative disorders (e.g., aphasia and dementia). Despite the extensive literature exploring the neuroanatomical underpinnings of word retrieval, psycholinguistic, biolinguistic and theoretical explanations, and the vast amount of evidence from primary and secondary language disorders, the best approach to consistently capture these changes is yet to be discovered. Aims: The goal of this paper is to determine which method(s) stand(s) as the most suitable candidate(s) to provide an accurate picture of word retrieval in the oral production of different groups of adult speakers, including cases of healthy ageing, preclinical Alzheimer's disease (AD), mild cognitive impairment (MCI), aphasia and dementia. Methods & Procedures: Using an integrative review of recent peer-reviewed journal articles, we provide an overview of the different behavioural methods traditionally used to measure oral naming skills in research-oriented and clinical protocols and discuss their main advantages and limitations. Main Contribution: Most existing studies are based on the results of people with diagnosed language disorders. Despite the growing interest, the reliability of the majority of the tasks to detect subtle changes associated with healthy ageing, MCI and preclinical AD are yet to be demonstrated, and the delicate balance between informativeness and efficiency (especially in terms of administration time and variable control) in experimental protocols is yet to be achieved. In this article we propose the pursuit of an integrative overarching methodology to characterize all naming deficits (from anecdotal to permanent) and all adult populations (from healthy to pathological ageing). Conclusions & Implications: A combination of spontaneous speech data and results from structured tasks stands as the best approach to capture changes in word retrieval skills of adult speakers with and without observable deficits. This review can guide future reflections on the necessary prerequisites of purpose-oriented, sensitive and reliable protocols for the detection of incipient word retrieval problems, thus contributing to the early diagnosis and the design of personalized multicomponent treatments.
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- 2024
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235. Wayfinding in People with Alzheimer’s Disease: Perspective Taking and Architectural Cognition—A Vision Paper on Future Dementia Care Research Opportunities
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Martina Roes, Saskia Kuliga, and Martin Berwig
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Geography, Planning and Development ,TJ807-830 ,Context (language use) ,Environmental design ,Management, Monitoring, Policy and Law ,TD194-195 ,Renewable energy sources ,03 medical and health sciences ,ddc:690 ,0302 clinical medicine ,Orientation (mental) ,mental disorders ,medicine ,Dementia ,GE1-350 ,dementia ,Alzheimer’s disease ,wayfinding ,spatial orientation ,support ,built space ,environmental psychology ,architectural cognition ,perspective taking ,demographic sustainability ,030212 general & internal medicine ,Environmental psychology ,Environmental effects of industries and plants ,Renewable Energy, Sustainability and the Environment ,Perspective (graphical) ,Cognition ,medicine.disease ,Environmental sciences ,Perspective-taking ,ddc:333.7 ,Psychology ,030217 neurology & neurosurgery ,Cognitive psychology - Abstract
Based on a targeted literature review, this vision paper emphasizes the importance of dementia-sensitive built space. The article specifically focuses on supporting spatial orientation and wayfinding for people living with dementia. First, we discuss types of wayfinding challenges, underlying processes, and consequences of spatial disorientation in the context of dementia of the Alzheimer’s type. Second, we focus on current efforts aimed at planning and evaluating dementia-sensitive built space, i.e., environmental design principles, interventions, evaluation tools, strategies, and planning processes. Third, we use our findings as a starting point for developing an interdisciplinary research vision aimed at encouraging further debates and research about: (1) the perspective of a person with dementia, specifically in the context of wayfinding and spatial orientation, and (2) how this perspective supplements planning and design processes of dementia-sensitive built space. We conclude that more closely considering the perspective of people with dementia supports the development of demographically sustainable future cities and care institutions.
- Published
- 2021
236. Joining the dots: Day to day challenges for practitioners in delivering integrated dementia care.
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Chase M, Lloyd CEM, Peters BJ, Chase E, and Lee K
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- Focus Groups, Humans, Dementia therapy, Negotiating
- Abstract
Despite the increasing policy focus on integrated dementia care in the UK, little is known about the opportunities and challenges encountered by practitioners charged with implementing these policies on the ground. We undertook an extensive, mixed-methods analysis of how a contemporary multidisciplinary dementia pathway in the UK was experienced and negotiated by service providers. Our pragmatic mixed methods design incorporated three types of research interaction with practitioners: (a) Semi-structured interviews (n = 31) and focus group discussions (n = 4), (b) Practitioner 'shadowing' observations (n = 19), and (c) Service attendance and performance metrics reviews (n = 8). Through an abductive analysis of practitioner narratives and practice observations, we evidenced how inter-practitioner prejudices, restrictive and competitive commissioning frameworks, barriers to effective data sharing and other resource constraints, all challenged integrative dementia care and led to unintended consequences such as practice overlap and failure to identify and respond to people's needs. In order to more successfully realise integrated dementia pathways, we propose innovative commissioning frameworks which purposefully seek to diffuse power imbalances, encourage inter-provider respect and understanding, and determine clear lines of responsibility., (© 2020 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd.)
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- 2021
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237. Association between marital status and cognitive function in Japan: results from the Toyama Dementia Survey.
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Nakahori N, Sekine M, Yamada M, Tatsuse T, Kido H, and Suzuki M
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- Humans, Japan, Marital Status, Risk Factors, Surveys and Questionnaires, Cognition, Dementia
- Abstract
Background: This study aims to clarify the association between marital status and dementia in Japan, adjusting for socioeconomic, lifestyle, and lifestyle-related disease factors., Methods: Data from the Japanese Toyama Dementia Survey were used. Individuals aged ≥65 years living in Toyama Prefecture were randomly selected, and 1171 participants were analysed, with a sampling rate of 0.5%. The participants' marital status, socioeconomic status, lifestyle factors, and lifestyle-related diseases were assessed. The odds ratio (OR) of marital status for each lifestyle factor and medical histories were calculated by logistic regression analysis. The OR of marital status for dementia was also calculated by logistic regression analysis., Results: The prevalence of dementia was 7.4% for married, and 20.6% for non-married participants. Non-married participants showed a higher prevalence of a history of stroke than married participants. The age- and sex-adjusted OR of marital status for dementia was 1.99 (95% confidence interval (CI) 1.24-3.18) for non-married compared with married participants. Following variable adjustments, the OR for dementia was higher for non-married participants (adjusted OR 1.71; 95% CI 1.03-2.85)., Conclusions: Non-marital status was an independent risk factor for dementia in Japan even after adjusting for socioeconomic, lifestyle, and lifestyle-related disease factors. Non-married people were more likely to have dementia because of their history of stroke., (© 2021 Japanese Psychogeriatric Society.)
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- 2021
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238. Facilitators and barriers associated with the implementation of a Swedish psychosocial dementia care programme in Japan: a secondary analysis of qualitative and quantitative data.
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Nakanishi M, Ziylan C, Bakker T, Granvik E, Nägga K, and Nishida A
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- Humans, Japan, Sweden, Dementia, Home Care Services
- Abstract
Background: A psychosocial dementia care programme for challenging behaviour (DEMBASE
® ) was developed in collaboration with a Swedish BPSD-registry team for in-home care services use in Japan. The programme consisted of a web-based tool for the continued assessment of challenging behaviours and interdisciplinary discussion meetings. Effectiveness of the adapted programme was verified through a cluster-randomised controlled trial. The Tokyo Metropolitan Government provided municipal funding to introduce the programme into daily practice beginning in April 2018., Objectives: To investigate both facilitators and barriers associated with programme implementation., Design: A secondary analysis of qualitative and quantitative data., Settings: Data were collected in naturalistic long-term care settings from April 2018 to March 2019., Participants: A total of 138 professionals and 157 people with dementia participated in the programme., Methods: Challenging behaviour in persons with dementia was assessed by professionals using a total Neuropsychiatric Inventory score. Data on expected facilitators and barriers were extracted for qualitative analysis from a debriefing meeting between professionals., Results: Of the 157 persons with dementia, 81 (51.6%) received follow-up behavioural evaluations by March 2019. The average level of challenging behaviour was significantly reduced for 81 persons from baseline to their most recent follow-up evaluations. Facilitators included 'programme available for care managers', 'visualised feedback on professionals' work', 'affordable for providers and professionals' and 'media coverage'. Barriers included 'professionals from different organisations', 'unpaid work', 'operation requirement for municipalities' and 'conflict with daily benefit-oriented framework'., Conclusions: A follow-up evaluation was not fully achieved. Further strategies to address barriers may include the development of a benefit-rewarding scheme for interdisciplinary discussion meetings, an e-learning system capable of substituting training course portions and a cross-municipality training course., (© 2020 Nordic College of Caring Science.)- Published
- 2021
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239. Effect of financial incentives for participation in dementia prevention and support activities: results of a web survey with persons aged 60 and older.
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Takao M, Maki Y, and Suzuki T
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- Aged, Female, Humans, Japan, Male, Middle Aged, Reward, Surveys and Questionnaires, Dementia prevention & control, Motivation
- Abstract
Background: This study aims to elucidate the impact of financial incentives on the motivation to participate in dementia prevention activities and to provide support to people with dementia., Methods: An online survey was completed by 1500 men and women, aged 60 or above, from the general community in Japan. When responding to questions regarding motivation for participating in dementia prevention activities and providing support to people with dementia, respondents were randomly assigned different incentive conditions. Two incentive options were used for dementia prevention activities (no incentives, and a small number of reward points). Three incentive options were used for support activities (no incentives, a small cash reward, or an in-kind time reward that allowed respondents or their family members to use similar services at a later time (time credits))., Results: Financial incentives decreased motivation for participating in dementia prevention activities, while time credits significantly increased motivation to participate in providing support to people with dementia for going out of their home, when receiving a cash reward was compared with receiving no reward. No significant differences by incentive were found for participating in daily living support for those with dementia or for providing support at a dementia café where people with dementia and their families interact., Conclusions: The adverse influence of financial incentives on motivation to participate in dementia prevention suggested that financial incentives may reduce intrinsic motivation for dementia prevention activities. The positive effects of time credits in providing support to people with dementia in going out suggested that time credits might be effective for some support activities for people with dementia. Different incentive measures should be considered to raise awareness of dementia prevention and dementia support activities., (© 2021 Japanese Psychogeriatric Society.)
- Published
- 2021
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240. “What have YOU done in the past few years?” Deaf BSL users’ experiences of caring for people with dementia during COVID-19
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Ferguson-Coleman, Emma and Young, Alys
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- 2023
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241. Complexity and practice on NHS mental health in-patient dementia assessment wards
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Jones, Lesley, Cullum, Nicky, Watson, Ruth, and Keady, John
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- 2023
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242. A framework for nurses working in partnership with substitute decision-makers for people living with advanced dementia: A discursive paper
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Susan Fiona Lee, Sarah Jane Cresp, and Cheryle Moss
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media_common.quotation_subject ,Decision Making ,Context (language use) ,Trust ,InformationSystems_GENERAL ,03 medical and health sciences ,Nursing care ,0302 clinical medicine ,Quality of life (healthcare) ,ComputerApplications_MISCELLANEOUS ,Health care ,medicine ,Dementia ,Humans ,030212 general & internal medicine ,health care economics and organizations ,General Nursing ,media_common ,Medical education ,030504 nursing ,business.industry ,Negotiating ,General Medicine ,Proactivity ,medicine.disease ,humanities ,Negotiation ,General partnership ,Quality of Life ,0305 other medical science ,business ,Psychology - Abstract
Aim To describe and discuss clinical strategies for nurses working in partnership with substitute decision-makers for people living with advanced dementia. Background By providing person-centred care to patients living with advanced dementia, nurses are positioned to work in partnership with substitute decision-makers who make healthcare decisions related to advanced care. Because the experience of being substitute decision-makers is complex and stressful, nurses need skillsets for working in partnership with substitute decision-makers. Design In this discursive paper, an innovative framework for working in partnership with substitute decision-makers is proposed. Method Evidence-based findings from a systematic review provided five domain foci for the partnership framework. In each domain, two clinical strategies were discursively proposed. Clinical strategies were hypothesised from research findings and insights from the authors' nursing experiences. Then, topical literature was searched, and findings were used to support the discursively argued strategies. Discussion To deal with complexities and reduce stress for substitute decision-makers, an innovative Nurse-Substitute Decision-Maker Partnership Framework for use in the context of advanced dementia is proposed and discussed. The partnership framework consists of five domains: Building trust, Exploring emotions, Translating quality of life, Encouraging proactivity and Negotiating families. Within these domains, ten strategies to support the practices of clinical nurses to work in partnership with substitute decision-makers are discussed. Relevance to clinical practice In the framework, the ten clinical nursing strategies are designed to provide targeted care to substitute decision-makers in areas that are known to cause complexity and stress to them. The Nurse-Substitute Decision-Maker Partnership Framework has been designed to improve nurse-substitute decision-maker partnerships and reduce the stress experienced by substitute decision-makers as they work through the complexities associated with advanced dementia.
- Published
- 2020
243. Tools for deprescribing in severe dementia: A scoping review.
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Wang C, Roberts E, Smith G, Carland JE, and Cordato NJ
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- Humans, Quality of Life, Deprescriptions, Dementia drug therapy
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Objectives: Identification of inappropriate medications in people living with severe dementia is a complex task which has the potential to reduce avoidable adverse events and increase quality of life. This scoping review (i) identifies published tools intended to aid deprescribing in people living with severe dementia and (ii) describes evaluations of their usefulness in clinical practice., Methods: A scoping review was undertaken, with Medline, Medline in Process, EMBASE, Cochrane Library, CINAHL, Scopus and Web of Science databases, from inception to April 2023, identifying tools for deprescribing in severe dementia. A tool was considered as any resource for deprescribing, including clinical study, scientific publication, health guideline, website, algorithm, model or framework. Two reviewers assessed the eligibility of articles through abstract and full text review. Data extracted from included studies were summarized through narrative synthesis., Results: Twelve studies were identified from 18,633 articles screened. Tools were categorized into three groups: deprescribing interventions (n = 2), consensus-based deprescribing criteria (n = 5), and medication-specific recommendations (n = 5). Six studies developed tools using expert opinion and ten tools were tested in people living with severe dementia. Only one of the four studies that evaluated patient outcomes (cognitive change and adverse events) identified clear clinical benefit from medication withdrawal., Conclusions: Clinical application of current deprescribing tools is limited due to the lack of evidence-based research on the clinical effects of individual medication deprescribing in people with severe dementia. Further research on patient outcomes, including cognitive change and adverse events, will help clarify the role of these tools in clinical care., (© 2023 John Wiley & Sons Ltd.)
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- 2023
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244. A predictive model of carer resilience in dementia family caregiving: A structural equation modelling approach.
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Leung P, Orrell M, Yates L, and Orgeta V
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- Humans, Latent Class Analysis, Emotions, Caregivers psychology, Dementia psychology
- Abstract
Objectives: This study aimed to investigate the mediating effects of quality of the caregiving relationship and other carer and person with dementia variables in predicting carer resilience over time., Method: Carers of people with mild and moderate dementia in community settings completed baseline (n = 176 dyads) and six-month follow-up assessments (n = 139 dyads). Causal mediation analysis was conducted using Pearson Correlation and Structural Equation Modelling (SEM) to examine longitudinal predictors of carer resilience, and the effect of several mediating person with dementia, and carer factors on carer resilience over time., Results: At 6-month follow-up, higher levels of carer resilience were longitudinally correlated with higher ratings of perceived relationship quality by people with dementia (r = 0.53 p ≤ 0.01), and lower levels of emotional distress symptoms by carer's (r = -0.59 p ≤ 0.01). Mediation analyses showed that people with dementia perspectives of the quality of the caregiving relationship mediated the relationship between carer distress specific to neuropsychiatric symptoms (β = -0.32, p ≤ 0.001) and carer resilience (β = 0.53, p ≤ 0.001) over time. The final SEM provided a good fit for the data (X
2 = 0.12, p = 0.72, CFI = 1.00, NFI = 0.99, and Root Mean Square Error of Approximation = 0.001)., Conclusion: Higher ratings of perceived relationship quality by people with dementia, and lower levels of carer emotional distress predicted higher carer resilience at follow-up. People with dementia perspectives of the quality of the caregiving relationship mediated the relationship between carer distress specific to neuropsychiatric symptoms and carer resilience over time. Our findings indicate that interventions aimed at strengthening the caregiving relationship might have a protective long-term effect for carer resilience in dementia caregiving., (© 2023 University College London. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.)- Published
- 2023
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245. Exploring access to community care and emergency department use among people with dementia: A qualitative interview study with people with dementia, and current and bereaved caregivers.
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Williamson LE, Sleeman KE, and Evans CJ
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- Male, Humans, Qualitative Research, Emergency Service, Hospital, Social Support, Caregivers, Dementia therapy
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Objectives: Emergency department (ED) attendance is common among people with dementia and associated with poor health outcomes. Literature suggests a link between access to community care and the ED, but we know little about the mechanisms behind this link. This study aimed to explore experiences of accessing community and emergency care among people affected by dementia., Methods: Informed by critical realism, semi-structured online and telephone interviews were conducted with people with dementia and family caregivers, with and without experience of using the ED. Participants were recruited from across the United Kingdom using purposive sampling with maximum variation. A mostly experiential reflexive thematic analysis approach was used, applying the candidacy model of access to deepen interpretation., Results: Two dyad and 33 individual interviews were conducted with 10 people with dementia, 11 current caregivers and 16 bereaved caregivers (men = 11, 70-89 years = 18, white ethnicity = 32). Three themes are reported: (1) Navigating a 'push system', (2) ED as the 'last resort', and (3) Taking dementia 'seriously'. Themes describe a discrepancy between the configuration of services and the needs of people affected by dementia, who resort to the ED in the absence of accessible alternatives. Underlying this discrepancy is a lack of systemic prioritisation of dementia and wider societal stigma., Conclusion: Although a last resort, ED attendance is frequently the path of least resistance for people with dementia who encounter multiple barriers for timely, responsive access to community health and social care. Greater systemic prioritisation of dementia as a life-limiting condition may help to reduce reliance on the ED through essential development of post-diagnostic care, from diagnosis to the end of life., (© 2023 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.)
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- 2023
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246. How tablets/applications enhance social connections and social support in people with dementia: A qualitative systematic review.
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Zhu X, He M, Dong Y, Zhang S, Fang S, Wang W, Zhang M, and Sun J
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- Humans, Pandemics, Social Support, Social Isolation, Caregivers, COVID-19, Dementia
- Abstract
The 2020 Lancet issue identified social isolation as one of 12 modifiable risk factors for dementia and revealed that enhanced social connections and social support can effectively reduce the incidence of social isolation. During the COVID-19 pandemic, technology attracted an increasing amount of attention, and it is necessary to synthesize ideas from existing evidence. First, we explored how people with dementia experienced changes in social connection and social support due to tablet/app use. Second, we explored the attitudes of people with dementia towards tablets and mobile applications. Third, we explored the feasibility of using tablets and mobile applications to enhance social connection and social support among people with dementia. We systematically searched the PubMed, Web of Science, Cochrane Library, Embase, CINAHL, CNKI, WanFang, and VIP databases. Two reviewers independently screened the titles and abstracts of studies, extracted the data and performed critical appraisals of each included study. The data synthesis was conducted using thematic analysis. A total of nine studies were included. Eight studies used mobile applications via tablets, and one study collected textual data from Twitter for analysis. Four themes were synthesized: (1) change from the perspective of caregivers; (2) growth of nonsingle aspects; (3) emotional feeling of belonging; and (4) feasibility of using digital technology. Tablet- and mobile application-based interventions can enhance both online and offline social connections and provide multiple types of social support among people with dementia. People with dementia have positive attitudes towards tablets and mobile applications. Overall, it is feasible for people with dementia to use technology., (© 2023 John Wiley & Sons Australia, Ltd.)
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- 2023
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247. Is dementia more likely following traumatic brain injury? A systematic review.
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Hanrahan JG, Burford C, Nagappan P, Adegboyega G, Rajkumar S, Kolias A, Helmy A, and Hutchinson PJ
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- Humans, Retrospective Studies, Cohort Studies, Case-Control Studies, Brain Injuries, Traumatic complications, Brain Injuries, Traumatic diagnosis, Brain Injuries, Traumatic epidemiology, Dementia diagnosis, Dementia epidemiology, Dementia etiology
- Abstract
Background: The association between traumatic brain injury (TBI) and dementia is controversial, and of growing importance considering the ageing demography of TBI., Objective: To review the scope and quality of the existing literature investigating the relationship between TBI and dementia., Methods: We conducted a systematic review following PRISMA guidelines. Studies that compared TBI exposure and dementia risk were included. Studies were formally assessed for quality with a validated quality-assessment tool., Results: 44 studies were included in the final analysis. 75% (n = 33) were cohort studies and data collection was predominantly retrospective (n = 30, 66.7%). 25 studies (56.8%) found a positive relationship between TBI and dementia. Clearly defined and valid measures of assessing TBI history were lacking (case-control studies-88.9%, cohort studies-52.9%). Most studies failed to justify a sample size (case-control studies-77.8%, cohort studies-91.2%), blind assessors to exposure (case-control-66.7%) or blind assessors to exposure status (cohort-3.00%). Studies that identified a relationship between TBI and dementia had a longer median follow-up time (120 months vs 48 months, p = 0.022) and were more likely to use validated TBI definitions (p = 0.01). Studies which clearly defined TBI exposure (p = 0.013) and accounted for TBI severity (p = 0.036) were also more likely to identify an association between TBI and dementia. There was no consensus method by which studies diagnosed dementia and neuropathological confirmation was only available in 15.5% of studies., Conclusions: Our review suggests a relationship between TBI and dementia, but we are unable to predict the risk of dementia for an individual following TBI. Our conclusions are limited by heterogeneity in both exposure and outcome reporting and by poor study quality. Future studies should; (a) use validated methods to define TBI, accounting for TBI severity; (b) follow consensus agreement on criteria for dementia diagnosis; and (c) undertake follow-up that is both longitudinal, to determine if there is a progressive neurodegenerative change or static post-traumatic deficit, and of sufficient duration., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)
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- 2023
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248. Well-Being as a Protective Factor Against Cognitive Decline and Dementia: A Review of the Literature and Directions for Future Research.
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Willroth EC, Pfund GN, McGhee C, and Rule P
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- Humans, Prospective Studies, Protective Factors, Cognition, Dementia psychology, Cognitive Dysfunction prevention & control, Cognitive Dysfunction complications
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Objectives: Treatments that target the biological causes of dementia remain limited, making prevention critically important. Well-being-defined broadly as living in accordance with one's potential and experiencing one's life as enjoyable and satisfying-is a promising avenue for prevention. It can be targeted by large-scale, noninvasive interventions and has been linked with better cognitive health and lower dementia risk. In the current review, we begin by summarizing empirical evidence linking well-being to cognitive functioning, cognitive decline, dementia diagnosis, and dementia-related neuropathology. Then, we highlight 3 key areas for future research., Methods: We searched the literature on wellbeing, cognitive decline, and dementia, focusing on prospective and longitidinal evidence., Results: The research reviewed here provides consistent evidence for associations of well-being with cognitive decline, dementia risk, and cognitive resilience to neuropathology. However, several open questions remain regarding (1) causality and mechanism(s), (2) specificity versus generalizability of associations, and (3) timing., Discussion: To inform potential intervention efforts, the field must address complex open questions about whether, how, when, and for whom well-being influences dementia risk. The majority of existing research on well-being and cognitive health is correlational, and few studies have tested potential mechanisms that may explain those associations. Further, relatively little is known about the generalizability of associations across different aspects of well-being and for different sociocultural groups. Finally, we do not yet understand when in the life span and on what timescale well-being might influence cognitive health. We discuss challenges and opportunities for addressing each of these open questions, including concrete recommendations for research designs and use of open science practices., (© The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2023
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249. Com-mens: a home-based logopaedic intervention program for communication problems between people with dementia and their caregivers - a single-group mixed-methods pilot study.
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Olthof-Nefkens MWLJ, Derksen EWC, Debets F, de Swart BJM, Nijhuis-van der Sanden MWG, and Kalf JG
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- Male, Humans, Pilot Projects, Quality of Life, Communication, Caregivers psychology, Dementia psychology
- Abstract
Background: Communication difficulties are common in people with dementia, and often present from an early stage. However, direct treatment options for people with dementia that positively influence their daily communication are scarce., Aims: To evaluate the potential impact and feasibility of a personalized logopaedic intervention., Methods & Procedures: A total of 40 community-dwelling persons with dementia and their caregivers were recruited. Five experienced speech and language therapists (SLTs) delivered the six-session Com-mens intervention at home. Com-mens aims to improve positive communication between people with dementia and their primary caregivers and comprises five elements: interactive history-taking, dynamic observational assessment, education about the consequences of dementia on communication, development and use of personalized communication tools, use motivational, and person-centred strategies by the SLT. We conducted a single-group mixed-methods pilot study with five measurements: baseline, directly after intervention, and at 3, 6 and 9 months follow-up. Semi-structured interviews and questionnaires for Experienced Communication in Dementia, quality of life, psychological well-being and caregiver burden were conducted. Process evaluation was performed by interviewing participants, drop-outs, SLTs and other stakeholders., Outcomes & Results: A total of 32 dyads completed the intervention. Repeated measures analyses revealed no significant changes over time. In the interviews, participants reported a positive impact on their feelings, increased communication skills and better coping with the diagnosis. Participants would recommend the intervention to others. Facilitators were timely delivery, personalized content and adequate reimbursement. Barriers were unfamiliarity with Com-mens among referrers, an overburdened caregiver or disrupted family relationships., Conclusions & Implications: This newly developed logopaedic intervention is feasible and has a perceived positive impact on both people with dementia and their caregivers, which is confirmed by a stable pattern over a period of 1 year. Future comparative studies are needed to test the effectiveness of personalized interventions in this patient population., What This Paper Adds: What is already known on the subject? SLTs are experts in the field of communication, but even though communication problems are common between people with dementia and their caregivers, there is a lack of logopaedic guidelines and materials for the direct treatment for this population. Interventions that are available either focus on (professional) caregivers only or aim to enhance cognitive functioning and do not target on joined communication. What this paper adds to the existing knowledge? A newly developed intervention called Com-mens can be provided by trained SLTs and takes an average of six 1-h sessions. The intervention is perceived to be valuable and feasible for people with dementia and their caregivers, by the participants themselves, as well as by healthcare professionals and other stakeholders. What are the potential or actual clinical implications of this work? Dissemination of this intervention will give SLTs skills, tools and materials to provide meaningful care to home-dwelling persons with dementia and their caregivers. Also, persons with dementia and their caregivers will receive education and materials that can help them increase their understanding of communication problems, enhance their communication skills and better cope with the communication problems that result from dementia. We consider the Com-mens intervention to be a valuable addition to the field of speech language therapy and dementia., (© 2022 The Authors. International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.)
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- 2023
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250. Healthcare professionals' perception of using a web-based reminiscence therapy to support person with dementia during the COVID-19 pandemic.
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Akhter R, Sun W, Quevedo AJU, Lemonde M, Liscano R, and Horsburgh S
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- Humans, Pandemics, Delivery of Health Care, Perception, Dementia therapy, COVID-19
- Abstract
Background: Reminiscence therapy (RT) is the most common non-pharmacological treatment for dementia care. The therapy stimulates the senses to evoke memories having the potential to reduce Behavioral and Psychological Symptoms of Dementia (BPSD). Digital RT, such as web-based reminiscence therapy (WBRT), has the potential to support dementia care and reduce the caregiving burden., Aims: This study aimed to explore healthcare professionals (HCPs) perceptions of utilizing WBRT in institutionalized settings to support persons with dementia during the COVID-19 pandemic., Methods: A qualitative phenomenological descriptive study was adopted and guided by Graham's Knowledge to Action framework. Online training on the use of WBRT was conducted, followed by interviews with HCPs., Results: Four major themes were identified on the potential use of WBRT in dementia care, including usability and efficacy, impact on caregiving, capability of reducing BPSD, and. feasibility during COVID-19 social distancing., Discussion: This study recognized the potential use of WBRT to support the person with dementia during the pandemic in institutionalized settings., Conclusion: The knowledge generated from this study will guide the future application of WBRT to support dementia care in diverse healthcare settings., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
- Published
- 2023
- Full Text
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