Validation of two short dementia screening tests in Indonesia

Validation of two short dementia screening tests in Indonesi

Oophorectomy and hysterectomy may increase dementia risk but only when performed prematurely

Oophorectomy and hysterectomy may increase dementia risk but only when performed prematurel

Healthy lifestyles to prevent dementia and reduce dementia symptoms

© Emerald Publishing Limited. Purpose - Dementia is a growing problem worldwide, due to an ageing population. It has significant human and economic costs. There is no effective medical treatment. The paper aims to discuss these issues. Design/methodology/approach - Using earlier reviews, the author discussed the difference between dementia and cognitive ageing and the different types of dementia, in terms of manifestation and pathology. The author reviewed non-modifiable risk factors for dementia, such as age, gender, genetics and education. Education can possibly have lifelong protective effects, as it may promote cognitive reserve. This paper focussed on lifestyle interventions to further increase brain reserve capacity. Findings from earlier reviews were summarised to provide guidelines for policymakers and practioners. Findings - The reviews suggested that most nutritional approaches may have limited effectiveness, and should be implemented in midlife, before dementia symptoms are present and probably only in people who are actually nutritionally deficient. The author found a reasonable positive evidence base of engagement in cognitive and physical activities to prevent dementia, which may also help reduce symptoms of dementia. Practical implications - From the studies reviewed, it was suggested that keeping physically and mentally active may help in all stages of life to prevent, but also reduce dementia symptoms. A focus on nutrition and treating heart disease risk factors is possibly limited to midlife, or before dementia symptoms are present. Originality/value - The author used an evidence based approach to review which lifestyle interventions could help prevent dementia or reduce dementia symptoms. The main outcome of this paper was that stage of life and ability (dementia present or not) may interact with success of the intervention

Research with and for Older People at Loughborough University

Our Dementia research is part of Loughborough University Health and Wellbeing (HWB) Global Challenge http://www.lboro.ac.uk/research/excellence/challenges/health-wellbeing/). This strategic approach supports multi-disciplinary research in bringing complex real world solutions to promote health and wellbeing across the life course. Other research priorities within HWB include Planetary Health and Anti-Microbial Resistance. Research with and for older people in Loughborough University is carried out by a number of multi-disciplinary research units/groups with different specialist interests for example: - Dementia research for design, diagnostics and interventions http://www.lboro.ac.uk/research/dementia/ - Centre for Research in Social Policy (http://www.lboro.ac.uk/research/crsp/) - Healthcare Ergonomics & Patient Safety (http://www.lboro.ac.uk/departments/design-school/research/environmentalergonomics/) - Life Long determinants of health and wellbeing (http://www.lboro.ac.uk/departments/ssehs/research/lifestyle-healthwellbeing/life-course-determinants-health-wellbeing/) We describe our research in these five overlapping and closely-related topic areas: (1) New Dynamics of Ageing; (2) Dementia: Diagnosis, Design and Interventions; (3) Getting out and about (Transport ); (4) Working Later; (5) Health, Wellbeing and Safety for Older Peopl

Are optimal levels of testosterone associated with better cognitive function in healthy older women and men?

Background Sex steroids can positively affect the brain and from this it would follow that high levels of sex steroids could be associated with better cognitive function in older men and women. Methods This Healthy Ageing Study sample comprised of 521 older participants (51% women) without dementia at baseline, with an age range from 64 to 94 years. Testosterone and sex hormone binding globulin were measured using the automated Immulite 2000 and analyzed in association with baseline memory, global cognitive function and decline (assessed using the Mini-Mental Status Examination or MMSE) and controlling for potential confounds such as age, education, vascular disease, smoking, diabetes, thyroid function, and body mass index. Results In healthy older men and women, optimal levels of testosterone were associated with better MMSE scores at baseline. Follow-up analyses indicated that in men, low testosterone levels (OR = .94, 95% CI = .88 to 1.00) were a risk factor for a sharp cognitive decline after 2 years, perhaps indicative of dementia. Associations were independent of covariates and baseline MMSE. Conversely, women at risk for a sharp drop in cognitive function showed some evidence for higher calculated free testosterone levels at baseline. Conclusions Results replicate earlier cross-sectional findings that high levels of sex steroids are not associated with better cognitive function in older people. In men, age accelerated endocrinological change could be associated with dementia pathology. General significance These data do not support increasing testosterone levels to prevent cognitive decline in men and women over 65 years of age

The Hopkins verbal learning test: an in-depth analysis of recall patterns

© 2017 Informa UK Limited, trading as Taylor & Francis Group One of the earliest signs of dementia is memory issues and verbal word lists, such as the Hopkins Verbal Learning Test (HVLT), are successfully used for screening. To gain insight in how memory is affected in dementia, and to further improve the efficacy of the HVLT, in-depth analysis of the recall patterns of dementia cases and controls was conducted. Dementia cases and controls were matched for factors that can affect performance, such as age, gender and education level. Word frequency, syllable length, and orthographic neighbourhood size did not differ in the Indonesian version of the HVLT, nor did these characteristics affect recall. However dementia cases showed consistent and poor recall across the three trials; with the worst recall for the “human shelter” category and best recall for the “animals” category. Dementia cases also showed impaired accessibility of all categories with reduced subsequent recall from accessed categories and reduced primacy and recency levels. Finally, dementia cases exhibited lower levels of re-remembering and recalling new words, and higher levels of immediate forgetting and never recalling words. It was concluded that utilising the extra information provided by the in-depth analyses of the recall patterns could be beneficial to improve dementia screening

Acute cognitive effects of physical activity for people who have dementia

Background: Physical activity has the potential to improve cognition for those with dementia, as demonstrated by randomised controlled trials lasting at least 6 weeks. Research is yet to explore the acute cognitive effects of physical activity for people with dementia. Acute resistance physical activity with healthy late-middle aged individuals has been shown to facilitate general cognition, as well as benefit executive function specifically. This study therefore aimed to establish if people with dementia experience cognitive benefits from acute resistance physical activity over and above a social control.Methods: A cross-sectional study design was applied to compare resistance physical activity to bingo between 10 participants with dementia to 15 age-matched controls. Following University ethical approval, participants were recruited from Alzheimer’s or dementia activity and support groups held in the community. Acute cognitive effects were assessed using the Mini Mental Status Examination (MMSE), Hopkins Verbal Learning Test (HVLT), Verbal Fluency (VF) and The Cognitive Computerised Test Battery for Individual’s with Intellectual Disabilities (CCIID); before and after a short bout of seated resistance band physical activity or a social control, bingo. The participants then completed the opposing activity 6 weeks later, and then cognitive assessments alone a further 6 weeks later. This allowed to analyse cognitive effects immediately and 6 weeks after. Statistical analysis included Mann Whitney U test, Chi-square test and Mix-measured ANOVA to compare scores across time-points.Results: Participants had a mean age of 76 years, 40% were male and 60% were female. For participants with dementia immediately after the resistance band activity improvements can be observed on the MMSE, VF, HVLT, Series, Jigsaw and Total CCIID. Only the MMSE, Series and Total CCIID still showed improvements at 6-week follow-up. Immediately following the psychosocial intervention, participants with dementia only showed improvements on the HVLT, which were not sustained after 6-weeks. For age-matched controls, bingo appeared to be more beneficial than physical activity.Conclusion: These results indicate that there are differential acute effects of activity depending upon pre-existing cognitive ability. Specific cognitive benefits may be available for people with dementia following resistance band physical activity. This pilot study shows promising indications for physical activity as a therapy for dementia, however results should be interpreted with caution due to the small sample size of this study.</div

Applying human factors and ergonomics principles to the design of dementia care environments

Applying human factors and ergonomics principles to the design of dementia care environment

Risk factors for possible dementia using the Hopkins verbal learning test and the mini-mental state examination in Shanghai

Using a combination of the Hopkins Verbal Learning Test (HVLT) and the Mini-Mental State Examination (MMSE), we investigated the prevalence of possible dementia (DEM) in community-dwelling elderly in Shanghai. Subsequently, we investigated significant risk factors for DEM and generated a DEM self-checklist for early DEM detection and case management. We found that among a total of 521 participants using a HVLT cut-off score of <19 and a MMSE cut-off score of <24, a total of 69 DEM cases were identified. Risk factors, such as advanced age (≥68 years), low education (no or primary level), self-reported history of hypertension, and self-reported subjective memory complaints (SMC) were significantly predictive of DEM. The presence of ≥3 out of four of the above mentioned risk factors can effectively discriminate DEM cases from non-DEM subjects

Developing personas for use in the design of dementia care environments

Context: Dementia has a high global prevalence, and the number of people with dementia (PWDem) worldwide is expected to rise in coming years. The various symptoms associated with dementia can cause difficulties for PWDem when engaging with activities of daily living (ADLs) as the disease progresses. However, designing a care environment which enables PWDem to successfully engage with ADLs is not a simple task, in part because PWDem may find it difficult to communicate their needs to a design team. For this reason, design personas which aimed to represent PWDem at different stages of the disease were created as a means of communicating these needs to designers. This paper describes an evaluation study on these personas. Objectives: To consult design stakeholders and obtain feedback on the use of the personas in the process of designing a dementia care home. Methodology: Interviews and focus groups were used to obtain feedback on the personas. Main results: Participants suggested several improvements for the personas. These included (1) diagrams (images and symbols) rather than text, (2) focusing less on specific design guidance, and (3) including a wider range of symptoms and needs. Conclusion: The wide range of suggested changes from the participants indicated both engagement with, and potential for, the initial personas. The personas have been revised and will be tested in care homes to explore how far they accurately represent the needs of PWDem both with caregivers and PWDem