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UK — Prime Minister’s challenge on dementia 2020

February 24, 2015 Comments off

Prime Minister’s challenge on dementia 2020
Source: Department of Health, Cabinet Office and Prime Minister’s Office

It sets out what this government wants to see in place by 2020 in order for England to be:

+ the best country in the world for dementia care and support and for people with dementia, their carers and families to live; and
+ the best place in the world to undertake research into dementia and other neurodegenerative diseases

It also highlights the progress to date on improving dementia care, support and research.

A Clinical Index to Predict Progression from Mild Cognitive Impairment to Dementia Due to Alzheimer’s Disease

February 10, 2015 Comments off

A Clinical Index to Predict Progression from Mild Cognitive Impairment to Dementia Due to Alzheimer’s Disease
Source: PLoS ONE

Background
Mild cognitive impairment is often a precursor to dementia due to Alzheimer’s disease, but many patients with mild cognitive impairment never develop dementia. New diagnostic criteria may lead to more patients receiving a diagnosis of mild cognitive impairment.

Objective
To develop a prediction index for the 3-year risk of progression from mild cognitive impairment to dementia relying only on information that can be readily obtained in most clinical settings.

Design and Participants
382 participants diagnosed with amnestic mild cognitive impairment enrolled in the Alzheimer’s Disease Neuroimaging Initiative (ADNI), a multi-site, longitudinal, observational study.

Main Predictors Measures
Demographics, comorbid conditions, caregiver report of participant symptoms and function, and participant performance on individual items from basic neuropsychological scales.

Main Outcome Measure
Progression to probable Alzheimer’s disease.

Categories: dementia, PLoS ONE, science

Alzheimer’s Aware: A Guide for Implementing a Law Enforcement Program to Address Alzheimer’s in the Community

February 10, 2015 Comments off

Alzheimer’s Aware: A Guide for Implementing a Law Enforcement Program to Address Alzheimer’s in the Community (PDF)
Source: Bureau of Justice Assistance

As the nation’s population continues to age, there will be more cases of Alzheimer’s disease and therefore, more and more opportunities where those with Alzheimer’s or other forms of dementia may come in contact with local law enforcement and public safety officials.

Law enforcement could become involved with individuals with Alzheimer’s and their caregivers under a variety of every‐day circumstances. Below are a few examples of behaviors or situations that could get the attention of law enforcement:

  • Exhibiting erratic driving or breaking general rules of the road
  • Crossing a road way or walking through traffic seemingly unaware of the danger
  • Wandering with a dazed/lost like appearance
  • Sitting in a car along the side of the road (perhaps the car is out of gas)
  • Being out of place in a particular situation (on a hiking trail/park late at night)
  • Inappropriately dressed for the situation or weather (not wearing a coat in winter, or inappropriately barefoot)
  • A call to police regarding missing items or a “break‐in”
  • Inability to follow or understand simple requests (May I see your driver’s license and car registration, please?)
  • Difficulty interacting appropriately with others
  • A domestic violence or physical abuse call that turns out to be a situation with a caregiver and an individual with Alzheimer’s disease
  • A shop‐lifting accusation, “stealing” from local businesses but actually believing they paid for the item or that the item is already theirs
  • Responding to a call for a welfare check and having concerns about abuse, neglect or domestic violence, based on observations

Whatever the situation, it can be difficult for an officer to know what to do, and how to address the problem, and, as the world’s population ages, these types of situations will only increase in frequency and will impact all law enforcement agencies at some point or another. Many law enforcement agencies across the nation are already working to increase positive outcomes when someone with Alzheimer’s or other form of dementia is reported missing, or when an officer encounters someone with Alzheimer’s, or a caregiver, during the normal course of their duties, through specialized trainings, resources and policy development which may include:

  • Recognizing the signs of Alzheimer’s disease
  • Learning best practices in approaching and communicating with persons who have Alzheimer’s
  • Being aware of situations where an officer might encounter individuals with Alzheimer’s and effective ways to respond during those interactions
  • Insights and best practices in conducting searches for missing persons with Alzheimer’s – which is different than the manner one would plan or conduct a search for other missing persons

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.

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.

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