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Latest & greatest articles for dementia
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on dementia or other clinical topics then use Trip today.
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Physical inactivity, cardiometabolic disease, and risk of dementia: an individual-participant meta-analysis. To examine whether physical inactivity is a risk factor for dementia, with attention to the role of cardiometabolic disease in this association and reverse causation bias that arises from changes in physical activity in the preclinical (prodromal) phase of dementia.Meta-analysis of 19 prospective observational cohort studies.The Individual-Participant-Data Meta-analysis in Working (...) Populations Consortium, the Inter-University Consortium for Political and Social Research, and the UK Data Service, including a total of 19 of a potential 9741 studies.The search strategy was designed to retrieve individual-participant data from prospective cohort studies. Exposure was physical inactivity; primary outcomes were incident all-cause dementia and Alzheimer's disease; and the secondary outcome was incident cardiometabolic disease (that is, diabetes, coronary heart disease, and stroke). Summary
Scam Awareness Related to Incident Alzheimer Dementia and Mild Cognitive Impairment: A Prospective Cohort Study. Decreased scam awareness may be an early indicator of impending Alzheimer dementia and its precursor, mild cognitive impairment, but prior studies have not systematically examined the associations between scam awareness and adverse cognitive outcomes.To test the hypothesis that low scam awareness is associated with increased risk for incident Alzheimer dementia, mild cognitive (...) impairment, and Alzheimer disease pathology in the brain.Prospective cohort study of aging.Community-based study in the greater Chicago metropolitan area.935 older persons initially free of dementia.Scam awareness was measured via questionnaire, incident Alzheimer dementia and mild cognitive impairment were documented in detailed annual cognitive and clinical evaluations, and Alzheimer disease neuropathology was quantified after death among a subset of persons who died (n = 264). Proportional hazards
Association of Amyloid Positron Emission Tomography With Subsequent Change in Clinical Management Among Medicare Beneficiaries With Mild Cognitive Impairment or Dementia. Amyloid positron emission tomography (PET) detects amyloid plaques in the brain, a core neuropathological feature of Alzheimer disease.To determine if amyloid PET is associated with subsequent changes in the management of patients with mild cognitive impairment (MCI) or dementia of uncertain etiology.The Imaging Dementia (...) -Evidence for Amyloid Scanning (IDEAS) study was a single-group, multisite longitudinal study that assessed the association between amyloid PET and subsequent changes in clinical management for Medicare beneficiaries with MCI or dementia. Participants were required to meet published appropriate use criteria stating that etiology of cognitive impairment was unknown, Alzheimer disease was a diagnostic consideration, and knowledge of PET results was expected to change diagnosis and management. A total
Evidence Brief: Traumatic Brain Injury and Dementia Management Briefs eBrief-no150 -- Traumatic Brain Injury and Dementia Enter search terms Button to search HSRD ® Inside VA Budget and Performance Inside the News Room National Observances Special Events » » » » » Management Briefs eBrief-no150 -- Traumatic Brain Injury and Dementia Health Services Research & Development Management eBrief no. 150 » Issue 150 March 2019 The report is a product of the VA/HSR&D Evidence Synthesis Program. Evidence (...) Brief: Traumatic Brain Injury and Dementia Traumatic brain injury (TBI) is a common condition among both civilian and military populations. While some TBIs cause acute symptoms that resolve over several weeks or months, evidence accumulated over nearly three decades suggests that TBI may lead to chronic neurodegenerative diseases such as dementia. More public awareness about TBI in active-duty service members as a risk factor for earlier onset of dementia and/or of Chronic Traumatic Encephalopathy
Cognitive training for people with mild to moderate dementia. Cognitive impairment, a defining feature of dementia, plays an important role in the compromised functional independence that characterises the condition. Cognitive training (CT) is an approach that uses guided practice on structured tasks with the direct aim of improving or maintaining cognitive abilities.• To assess effects of CT on cognitive and non-cognitive outcomes for people with mild to moderate dementia and their caregivers (...) .• To compare effects of CT with those of other non-pharmacological interventions, including cognitive stimulation or rehabilitation, for people with mild to moderate dementia and their caregivers.• To identify and explore factors related to intervention and trial design that may be associated with the efficacy of CT for people with mild to moderate dementia and their caregivers.We searched ALOIS, the Cochrane Dementia and Cognitive Improvement Group Specialised Register, on 5 July 2018. ALOIS contains
Computerised cognitive training for preventing dementia in people with mild cognitive impairment. The number of people living with dementia is increasing rapidly. Clinical dementia does not develop suddenly, but rather is preceded by a period of cognitive decline beyond normal age-related change. People at this intermediate stage between normal cognitive function and clinical dementia are often described as having mild cognitive impairment (MCI). Considerable research and clinical efforts have (...) been directed toward finding disease-modifying interventions that may prevent or delay progression from MCI to clinical dementia.To evaluate the effects of at least 12 weeks of computerised cognitive training (CCT) on maintaining or improving cognitive function and preventing dementia in people with mild cognitive impairment.We searched to 31 May 2018 in ALOIS (www.medicine.ox.ac.uk/alois) and ran additional searches in MEDLINE, Embase, PsycINFO, CINAHL, ClinicalTrials.gov, and the WHO portal/ICTRP
Association of Midlife Diet With Subsequent Risk for Dementia. Observational studies suggest that diet is linked to cognitive health. However, the duration of follow-up in many studies is not sufficient to take into account the long preclinical phase of dementia, and the evidence from interventional studies is not conclusive.To examine whether midlife diet is associated with subsequent risk for dementia.Population-based cohort study established in 1985-1988 that had dietary intake assessed (...) in 1991-1993, 1997-1999, and 2002-2004 and follow-up for incident dementia until March 31, 2017.Food frequency questionnaire to derive the Alternate Healthy Eating Index (AHEI), an 11-component diet quality score (score range, 0-110), with higher scores indicating a healthier diet.Incident dementia ascertained through linkage to electronic health records.Among 8225 participants without dementia in 1991-1993 (mean age, 50.2 years [SD, 6.1 years]; 5686 [69.1%] were men), a total of 344 cases of incident
AD-8 for detection of dementia across a variety of healthcare settings. Dementia assessment often involves initial screening, using a brief tool, followed by more detailed assessment where required. The AD-8 is a short questionnaire, completed by a suitable 'informant' who knows the person well. AD-8 is designed to assess change in functional performance secondary to cognitive change.To determine the diagnostic accuracy of the informant-based AD-8 questionnaire, in detection of all-cause (...) (undifferentiated) dementia in adults. Where data were available, we described the following: the diagnostic accuracy of the AD-8 at various predefined threshold scores; the diagnostic accuracy of the AD-8 for each healthcare setting and the effects of heterogeneity on the reported diagnostic accuracy of the AD-8.We searched the following sources on 27 May 2014, with an update to 7 June 2018: ALOIS (Cochrane Dementia and Cognitive Improvement Group), MEDLINE (Ovid SP), Embase (Ovid SP), PsycINFO (Ovid SP
Psychosocial interventions for pain management in older adults with dementia: A systematic review of randomized controlled trials To assess the effectiveness of psychosocial interventions on pain in older adults living with dementia.A systematic review with meta-analysis of randomized controlled trials.Scopus, ProQuest, EBSCO (CINAHL and MEDLINE), PubMed, OVID (PsycINFO), Web of Science, and Cochrane Library were searched from their inception up to 2 May 2018.Risk of bias assessment and meta (...) with dementia.Findings suggest that psychosocial interventions may be potentially effective alternatives for pain management in people with dementia. However, caution is needed in interpreting these results due to limited studies, risk of bias and heterogeneity across studies. Furthermore, well-designed research is needed on psychosocial interventions to strengthen quality of pain management in people with dementia.This review synthesized current evidence using psychosocial interventions to manage pain in people
Quick guide: National clinical guideline on dementia and medicine National clinical guideline on dementia and medicine Published by the Danish Health Authority, December 2018 NATIONAL CLINICAL GUIDELINE ON DEMENTIA AND MEDICINE Quick guide It is good practice to consider a break in treatment in terms of discontinuation of dementia drugs during clinical observation for persons with very severe dementia. Good practice In the event of clinical worsening, including declining functional level (...) , increased need for care or increased incidence of behavioural disorders and psychological symptoms within 2-4 weeks of starting the break in treatment, the treatment should be resumed. It is essential to involve relatives and nursing staff in this assessment. Upon discontinuation of dementia drugs, clinical follow-up is recommended. Discontinue antipsychotic medication (as a general rule with tapering) in persons with dementia in long-term (> 3 months) treatment. Strong recommendation In general, long
Traumatic Brain Injury and Dementia 4 February 2019 Prepared for: Department of Veterans Affairs Veterans Health Administration Health Services Research & Development Service Washington, DC 20420 Prepared by: Evidence Synthesis Program (ESP) Coordinating Center Portland VA Health Care System Portland, OR Mark Helfand, MD, MPH, MS, Director Evidence Brief: Traumatic Brain Injury and Dementia Authors: Kim Peterson, MS Stephanie Veazie, MPH Donald Bourne, MPH Johanna Anderson, MPH Evidence (...) Synthesis Program 4 Evidence Brief: TBI and Dementia Evidence Synthesis Program i PREFACE The VA Evidence Synthesis Program (ESP) was established in 2007 to provide timely and accurate syntheses of targeted healthcare topics of importance to clinicians, managers, and policymakers as they work to improve the health and healthcare of Veterans. These reports help: · Develop clinical policies informed by evidence; · Implement effective services to improve patient outcomes and to support VA clinical practice
Development and Validation of a Dementia Risk Prediction Model in the General Population: An Analysis of Three Longitudinal Studies Identification of individuals at high risk of dementia is essential for development of prevention strategies, but reliable tools are lacking for risk stratification in the population. The authors developed and validated a prediction model to calculate the 10-year absolute risk of developing dementia in an aging population.In a large, prospective population-based (...) cohort, data were collected on demographic, clinical, neuropsychological, genetic, and neuroimaging parameters from 2,710 nondemented individuals age 60 or older, examined between 1995 and 2011. A basic and an extended model were derived to predict 10-year risk of dementia while taking into account competing risks from death due to other causes. Model performance was assessed using optimism-corrected C-statistics and calibration plots, and the models were externally validated in the Dutch population
Peri-operative care of people with dementia. Online Supporting Information Online Supporting Information S1 Sources of further information S2 Quality assessment/quality improvement (QA/QI) toolkit S4 Abbey pain scale  S1 Sources of further information • Alzheimer’s Society, Royal College of Nursing. This is me. A support tool to enable person-centred care. This proforma can be completed pre- operatively by a person with cognitive impairment or their carers, to provide information (...) for hospital staff about how to care for that person when they are admitted for surgery. https://www.alzheimers.org.uk/download/downloads/id/3423/this_is_me.pdf (accessed 20/02/2018). • Alzheimer’s Society. Fix Dementia Care: Hospitals. January, 2016. This document describes the experiences of people with dementia admitted to hospital, and recommends care improvements that should be made. https://www.alzheimers.org.uk/download/downloads/id/2907/fix_dementia_care_- _hospitals.pdf (accessed 20/02/2018
Peri-operative care of people with dementia Guidelines Peri-operative care of people with dementia February 2019Guidelines Guidelinesfortheperi-operativecareofpeoplewithdementia GuidelinesfromtheAssociationofAnaesthetists S.White, 1 R.Grif?ths, 2 M.Baxter, 3 T.Beanland, 4 J.Cross, 5 J.Dhesi, 6 A.B.Docherty, 7 I.Foo, 8 G.Jolly, 9 J.Jones, 10 I.K.Moppett, 11 E.Plunkett 12 andK.Sachdev 13 1ConsultantAnaesthetist,RoyalSussexCountyHospital,Brighton,UKandco-Chair,AssociationofAnaesthetists (...) 13ConsultantinOlderAdultPsychiatry,HomertonUniversityHospitalNHSFoundationTrust,London,UK Summary Ageing populations have greater incidences of dementia. People with dementia present for emergency and, increasingly, elective surgery, but are poorly served by the lack of available guidance on their peri-operative management, particularly relating to pharmacological, medico-legal, environmental and attitudinal considerations. These guidelines seek to deliver such guidance, by providing information for peri-operative care
Antidepressants do not help treat depression in people living with dementia Antidepressants do not help treat depression in dementia Discover Portal Discover Portal Antidepressants do not help treat depression in people living with dementia Published on 8 January 2019 doi: Antidepressants do not reduce symptoms of depression in people with dementia compared with placebo (dummy pills). Measured 6 to 13 weeks after starting the treatment, there is little or no difference in participants’ symptoms (...) , but an increased chance of unwanted side effects. The review did not identify enough data to determine if antidepressants have an effect in the longer-term. This Cochrane review included randomised controlled trials of any antidepressant drugs compared to placebo. Participants were aged 75 years on average, with mild or moderate dementia. The quality of the included trials was mixed, with not enough information reported to fully assess the risk of bias, though the main result is reliable. This review supports
Person-centred care improves quality of life for care home residents with dementia Person-centred care improves quality of life for care home residents with dementia Discover Portal Discover Portal Person-centred care improves quality of life for care home residents with dementia Published on 20 March 2018 doi: A person-centred care intervention for people with dementia living in care homes improved their quality of life, reduced agitation and improved interactions with staff. It may also save (...) to start with, which is in line with policy to limit use. It supports the feasibility of the intervention, but there is a need to understand which components are most effective and could be implemented on a wide scale with sustainable effects. Share your views on the research. Why was this study needed? Over 400,000 older people currently live in care homes in the UK. This includes over a third of the UK population with dementia. Many people with dementia have complex care needs that can affect
Coordinating care for people with long term conditions and dementia: room for improvement Coordinating care for people with long term conditions and dementia: room for improvement Discover Portal Discover Portal Coordinating care for people with long term conditions and dementia: room for improvement Published on 26 May 2016 doi: New evidence shows that almost one fifth of people with dementia also have other serious conditions such as stroke, diabetes and visual impairment. Services (...) are not currently designed to provide adequate integrated care for people with dementia plus other conditions. For instance, people with dementia are less likely to get diabetes checks or cataract surgery than those without dementia. Carers are not routinely contacted, and there is a lack of guidance for health professionals covering more than one condition. Implications for practice include incorporating the impact of a diagnosis of dementia on pre-existing conditions into care planning. Second, professionals
A third of people with dementia have treatable vision problems A third of people with dementia have treatable vision problems Discover Portal Discover Portal A third of people with dementia have treatable vision problems Published on 27 September 2016 doi: New data shows that around a third of people with dementia have serious vision problems, such as cataracts or short sightedness, more than the general population of that age. Levels are higher still for people with dementia in care homes (...) – about half have vision problems. Yet this study showed that many of the people with dementia and vision impairment had not received the right treatment. This often involves simple measures. For many, spectacles could have improved poor sight. A quarter had cataracts, which surgery could have corrected. Quality of life is known to improve if visual impairment is corrected. Failure to receive treatment may be due to lack of awareness amongst people with dementia and their carers about the services
Case managers improve outcomes for people with dementia and their carers Case managers for people with dementia and their carers Discover Portal Discover Portal Case managers improve outcomes for people with dementia and their carers Published on 24 April 2018 doi: Using a case manager to coordinate health and social care improves the challenging behaviour of people with dementia and reduces the burden on caregivers. Quality of life of caregivers improves the most when case managers have (...) a professional background in nursing. This NIHR-funded review compared the effectiveness of standard community treatment and interventions with case managers overseeing the interventions for people living with dementia. It considered evidence from 14 trials in a number of countries, with different health systems and support. Care coordination is variable across the UK, but this is often not provided by a qualified professional, so they are not able to develop and update the care plan. Though the review did
Communication training and its effects on carer and care-receiver outcomes in dementia settings: A systematic review To review communication interventions that aim to improve regular care interactions between people with dementia and their carers in various settings; and to examine the impact of such interventions on both carer and care-receiver outcomes.Effective communication is imperative to ensure quality of care for people living with dementia. Due to neurodegenerative changes, people (...) with dementia encounter ongoing and progressive difficulties in both understanding and expressing themselves. This in turn creates challenges for carers, which highlights the need for equipping them with necessary communication skills to respond to the specific communication needs of people with dementia.Systematic review and meta-analysis.Medline, Embase, CINAHL, ProQuest and PsycINFO databases were searched for eligible interventions with any date of the publication. Hand searching was also conducted