Implications for practice and research:
> Care for older adults with Down syndrome should be organised with the exceptional risk of developing dementia in mind as this will improve their medical outcomes.
> There is an urgent need for research into effective treatments for dementia in adults with Down syndrome to prevent or delay the onset of dementia. To read the full article, log in using your MPFT NHS OpenAthens details.
Editorial . To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
As the UK's older population continues to rise, the more likely it is for practice nurses to encounter patients living with Alzheimer's and frailty. Kirsty Smith and Sophie Wallington explore the definitions and models of frailty available in medical literature. To read the full article, log in using your MPFT NHS OpenAthens details.
Implications for practice and research:
>Carers of partners with young-onset dementia have strong perceptions of stress associated with predeath grief which are worsened by help seeking behaviours.
>Carers of partners with young-onset dementia have different support needs from those with older onset dementia. Provision of services need to reflect these differences. To read the full article, log in using your NHS OpenAthens details.
Anxiety and depression are common and deleterious comorbidities in people living with dementia (PLWD). Cognitive behavioural therapy (CBT) is one of the few promising treatments; however, it is unclear whether PLWD have the necessary prerequisites to engage in this. Having an understanding of cognitive mediation, that a thought mediates the relationship between an antecedent event and its emotional consequence, is key for engaging with CBT and is also a critical component of emotion regulation. There are no measures of this construct validated for PLWD. This study aims to adapt and validate an existing measure for this population. A secondary aim is to assess its applicability in older adults (OA) without a recognised neurocognitive impairment.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
Free access. Cognitive impairment is underdiagnosed in primary care. Understanding factors that precipitate memory‐related discussion could inform strategies to improve diagnosis and counseling. We assessed whether: 1) having a cognitive impairment or dementia diagnosis, 2) ratings of cognition by clinicians, or 3) ratings of cognition by family companions were associated with memory‐related discussion during primary care visits.
Psychotic symptoms may occur in any dementia, including Alzheimer’s disease (AD), but are particularly common in Lewy body dementia (LBD). The mechanisms of psychotic symptoms are largely unknown. Psychosis has been found to be associated with more severe AD and Lewy body pathology in patients with AD and cerebrovascular disease-related vasculopathy.1 One form of vascular pathology, cerebral amylod angiopathy (CAA), is defined as deposits of amyloid in the vessel walls that increase risk of haemorrhage and ischaemia. CAA contributes to neurodegeneration, but its relation to clinical symptoms and course in dementia is not fully understood.2. To read the full article, log in using your NHS OpenAthens details.
Memory clinic patients commonly also have declined physical performance. This may be attributable to white matter injury, due to vascular damage or neurodegeneration. Quantifying white matter injury is made possible by new magnetic resonance imaging (MRI) techniques, including diffusion‐weighted imaging (DWI) of network connectivity. We investigated whether physical performance in memory clinic patients is related to white matter network connectivity.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
Open access. Dying in one’s preferred place is a quality marker for end-of-life care. Little is known about preferred place of death, or the factors associated with achieving this, for people with dementia.
Open access. antipsychotic drugs are regularly prescribed as first-line treatment for neuropsychiatric symptoms in persons with dementia although guidelines clearly prioritise non-pharmacological interventions.
We are in the process of developing a standardised treatment and management plan for people with confusion in hospital. (By confusion we mean people with dementia, delirium, or unspecified cognitive impairment.)
dementia is a common cause of altered decision-making capacity. Determining whether an individual has the ability to make a specific decision can be very challenging for both clinicians and researchers. The UK legislation requires that we both promote residual capacity where possible, and protect vulnerable adults who cannot make independent decisions. We evaluated published instruments designed to aid in the assessment of capacity, focussing on those meeting the UK legal requirements. We also consider further disease and culture-specific factors which may influence decision making.. To read the full article, log in using your MPFT NHS OpenAthens details.
Open access. Caregivers of persons with dementia (PWD) can experience loss and grief long before the death of the person. While such phenomenon of pre‐death grief (PDG) has been increasingly described, we are uncertain how it can be distinct from the well‐studied construct of caregiver burden.
Open access. One third of older people are estimated to die with dementia, which is a principal cause of death in developed countries. While it is assumed that people die with severe dementia this is not based on evidence. A cohort study was conducted using a large secondary care mental healthcare database in North London.
Open access. Dementia presents a significant challenge to health systems and to the person and family affected. Home care is increasingly seen as a key service in addressing this challenge in a person-centred and cost-effective way. Intensive Home Care Packages (IHCPs) were introduced in Ireland to provide personalised and high levels of support for people with dementia to remain at home or be discharged home from hospital, and to build on the work of the HSE & Genio Dementia Programme. This realist evaluation is concerned with real world questions of feasibility and effectiveness; specifically understanding in what ways IHCPs work, how optimum outcomes are achieved, for whom and in what contexts do IHCPs work best.
Existing models fail to account for the complexity and multidimensionality of new data and the growing scientific understanding of neurodegeneration.
With the acceptance that the disease processes leading to dementia begin at least as early as mid-life, there is now a major drive to understand and model this period of ‘disease before dementia’ for a variety of reasons. First, to gather a better understanding of the interplay between disease and risk or resilience factors that have been identified epidemiologically (eg, what is the mechanism by which exercise protects the brain) is necessary. Second, to develop algorithms for use in clinical practice to forecast changes in brain health that may lead to dementia that will underpin the design of tailored risk modification interventions and ‘personalised prevention plans’. And third, with an improved knowledge of the genesis and sequence of neuropathological changes in the predementia phase, there will be an expansion of and assurance in …..... To read the full article, log in using your NHS OpenAthens details.
To objectively quantify patients’ physical activity and analyze the relationships between physical activity levels, psychopathology and sedative medication in acute hospital dementia care.. To read the full article, log in using your MPFT NHS OpenAthens details.
The aetiology of dementia is not yet fully understood. Stress can have a damaging effect on brain health. The prognostic effect of anxiety is still unclear regarding Alzheimer's disease as well as vascular dementia.. To read the full article, log in using your MPFT NHS OpenAthens details.