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World Alzheimer Report 2014: Dementia and Risk Reduction

September 19, 2014 Comments off

World Alzheimer Report 2014: Dementia and Risk Reduction
Source: Alzheimer’s Disease International

The World Alzheimer Report 2014, Dementia and Risk Reduction: An analysis of protective and modifiable factors critically examines the evidence for the existence of modifiable risk factors for dementia.

It focuses on sets of potential modifiable risk factors in four key domains: developmental, psychological and psychosocial, lifestyle and cardiovascular conditions. The report makes recommendations to drive public health campaigns and disease prevention strategies.

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Family Caregivers Providing Complex Chronic Care to People with Cognitive and Behavioral Health Conditions

August 28, 2014 Comments off

Family Caregivers Providing Complex Chronic Care to People with Cognitive and Behavioral Health Conditions
Source: AARP Public Policy Institute

Family caregiving is difficult and stressful. Providing care and support to people with cognitive or behavioral health conditions is doubly challenging. This paper reports on results from a national survey showing that caregivers of family members with challenging behaviors were more likely to perform more than one medical/nursing task, such as managing medications, and often do so with resistance from the person they are trying to help. Yet they receive little or no instruction or guidance on how to do this important work. This analysis offers recommendations for assisting family caregivers who play this dual role.

This is the third “Insight on the Issues” series, drawn from additional analysis of data based on a December 2011 national survey of 1,677 family caregivers, 22 percent of whom were caring for someone with one or more challenging behaviors. Earlier findings were published in the groundbreaking Public Policy Institute/United Hospital Fund report Home Alone: Family Caregivers Providing Complex Chronic Care.
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HHS — Elder Justice Roadmap Project Report

July 10, 2014 Comments off

Elder Justice Roadmap Project Report (PDF)
Source: U.S. Department of Health and Human Services (National Center on Elder Abuse)

The Top Five Priorities critical to understanding and reducing elder abuse and to promoting health, independence, and justice for older adults, are:
1. Awareness: Increase public awareness of elder abuse, a multi-faceted problem that requires a holistic, well-coordinated response in services, education, policy, and research.
2. Brain health: Conduct research and enhance focus on cognitive (in)capacity and mental health – critical factors both for victims and perpetrators.
3. Caregiving: Provide better support and training for the tens of millions of paid and unpaid caregivers who play a critical role in preventing elder abuse.
4. Economics: Quantify the costs of elder abuse, which is often entwined with financial incentives and comes with huge fiscal costs to victims, families and society.
5. Resources: Strategically invest more resources in services, education, research, and expanding knowledge to reduce elder abuse.

Hat tip: PW

Geographical variation in dementia: systematic review with meta-analysis

June 27, 2014 Comments off

Geographical variation in dementia: systematic review with meta-analysis
Source: International Journal of Epidemiology

Background
Geographical variation in dementia prevalence and incidence may indicate important socio-environmental contributions to dementia aetiology. However, previous comparisons have been hampered by combining studies with different methodologies. This review systematically collates and synthesizes studies examining geographical variation in the prevalence and incidence of dementia based on comparisons of studies using identical methodologies.

Methods
Papers were identified by a comprehensive electronic search of relevant databases, scrutinising the reference sections of identified publications, contacting experts in the field and re-examining papers already known to us. Identified articles were independently reviewed against inclusion/exclusion criteria and considered according to geographical scale. Rural/urban comparisons were meta-analysed.

Results
Twelve thousand five hundred and eighty records were reviewed and 51 articles were included. Dementia prevalence and incidence varies at a number of scales from the national down to small areas, including some evidence of an effect of rural living [prevalence odds ratio (OR) = 1.11, 90% confidence interval (CI) 0.79–1.57; incidence OR = 1.20, 90% CI 0.84–1.71]. However, this association of rurality was stronger for Alzheimer disease, particularly when early life rural living was captured (prevalence OR = 2.22, 90% CI 1.19–4.16; incidence OR = 1.64, 90% CI 1.08–2.50).

Conclusions
There is evidence of geographical variation in rates of dementia in affluent countries at a variety of geographical scales. Rural living is associated with an increased risk of Alzheimer disease, and there is a suggestion that early life rural living further increases this risk. However, the fact that few studies have been conducted in resource-poor countries limits conclusions.

SAGE – A Test to Measure Thinking Abilities

June 26, 2014 Comments off

SAGE – A Test to Measure Thinking Abilities
Source: Ohio State University (Wexner Medical Center)

The Self-Administered Gerocognitive Exam (SAGE) is designed to detect early signs of cognitive, memory or thinking impairments. It evaluates your thinking abilities and helps physicians to know how well your brain is working.

You may want to take SAGE if you are concerned that you might have cognitive issues. Or you may wish to have your family or friends take the test if they are having memory or thinking problems. The difficulties listed can be early signs of cognitive and brain dysfunction. While dementia or Alzheimer’s disease can lead to these symptoms, there are many other treatable disorders that also may cause these signs.

It is normal to experience some memory loss and to take longer to recall events as you age. But if the changes you are experiencing are worrying you or others around you, SAGE can be a helpful tool to assess if further evaluation is necessary.

See: A Test for the Early Detection of Alzheimer’s Disease (New York Times)

Improving Dementia Long-Term Care: A Policy Blueprint

June 25, 2014 Comments off

Improving Dementia Long-Term Care: A Policy Blueprint
Source: RAND Corporation

In 2010, 15 percent of Americans older than age 70 had dementia, and the number of new dementia cases among those 65 and older is expected to double by the year 2050. As the baby boomer generation ages, many older adults will require dementia-related long-term services and supports (LTSS). This blueprint is the only national document to date that engages local, state, and national stakeholders to specifically focus on policy options at the intersection of dementia and LTSS.

The authors undertook five major tasks that resulted in a prioritized list of policy options and research directions to help decisionmakers improve the dementia LTSS delivery system, workforce, and financing. These were to (1) identify weaknesses in the LTSS system that may be particularly severe for persons with dementia; (2) review national and state strategies addressing dementia or LTSS policy; (3) identify policy options from the perspective of a diverse group of stakeholders; (4) evaluate the policy options; and (5) prioritize policy options by impact and feasibility.

Stakeholders identified 38 policy options. RAND researchers independently evaluated these options against prespecified criteria, settling on 25 priority options. These policy options can be summarized into five objectives for the dementia LTSS system: (1) increase public awareness of dementia to reduce stigma and promote earlier detection; (2) improve access to and use of LTSS; (3) promote high-quality, person- and caregiver-centered care; (4) provide better support for family caregivers of people with dementia; and (5) reduce the burden of dementia LTSS costs on individuals and families.

This policy blueprint provides a foundation upon which to build consensus among a larger set of stakeholders to set priorities and the sequencing of policy recommendations.

Dementia’s Mounting Toll on the U.S. Economy

June 11, 2014 Comments off

Dementia’s Mounting Toll on the U.S. Economy
Source: RAND Corporation

Dementia costs Americans hundreds of billions of dollars per year, and the annual cost could top half a trillion by 2040 due to the “graying” of the U.S. population. This infographic shows the soaring economic costs and caseload of dementia.

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