Combining music and life story work to enhance participation in family interaction in semantic dementia: a longitudinal study of one family's experience.

Background: Semantic dementia is a rarer dementia, classified as a type of frontotemporal dementia and a variant of primary progressive aphasia. Studies examining conversation in this condition and interventions to enhance participation in family life present as gaps in the research literature. Methods: Working with one family on a longitudinal basis, this study used conversation analysis and narrative analysis to provide a detailed assessment of communication . This information was used to design an individually tailored life story intervention to facilitate family interaction: a co-produced life story music DVD. Results: This intervention offered the family a resource that allowed the person with semantic dementia to display areas of retained competence and enhanced participation in interaction in a way that was not typically present in everyday conversation. Conclusions: It is argued that fostering greater opportunities for such in-the-moment connections is an important goal for intervention, particularly when language may be significantly compromised

Gender-specific mental health care: The case for women-centred care

Dementia has an estimated global prevalence of 35 million individuals (Alzheimer’s Disease International, 2009). In the UK 570,000 people live with dementia – a figure that will double over the next 30 years, reflecting global predictions (Alzheimer’s Disease International, 2009; Department of Health, 2009). With increasing demand and timescales of at least 5-10 years for the next possible disease modifying breakthrough, services are and have had to undergo change to cope with the increasing levels of need

People living with dementia and their family carers’ adherence to home-based Tai Chi practice

Objectives: The aim of this study was to understand what influenced people living with dementia and their family carers’ adherence to the home-based component of a Tai Chi exercise intervention. Method: Dyads, of people living with dementia and their family carers, who participated in the intervention arm of the TAi ChI for people living with demenTia (TACIT) trial, were invited to join weekly Tai Chi classes for 20 weeks and practice at home. Semi-structured dyadic home-interviews were conducted on average after 16 weeks of classes. The views of 15 dyads with a range of home practice adherence were sought in semi-structured interviews. The interviews were analysed using an inductive thematic approach. Results: Most participants found time to practise Tai Chi at home and practised for 17 hours on average. Amongst the barriers to adherence were participants’ competing commitments and a booklet not sufficiently conveying the Tai Chi movements. Hence, a video or DVD was requested by participants. Facilitators of their adherence to the home-based component of the intervention were their enjoyment of the practice and the development of a habit, which was supported by their commitment to the study and their willingness to benefit from Tai Chi. Conclusion: Enjoyment and perceived benefits had a great impact on participants living with dementia and their carers’ adherence to home-based Tai Chi practice. However, difficulties to perceive the Tai Chi movements through images might be hindering sustained participation and hence alternative aids such as videos and DVDs should be explored to facilitate adherence

Dementia 3: Preventing and diagnosing dementia

Dementia and cognitive impairment are the most significant of all chronic diseases in contributing to disability and the need for care (Alzheimer’s Disease International 2015). Indeed it has been estimated that the health and social care costs for dementia almost match the combined costs for cancer, heart disease and stroke in the UK (Leungo-Fernadez et al 2010). Yet despite the scale of this issue and the recommendations for improvement in the National Dementia Strategy (2009), poor recognition and diagnosis remain a problem which is important because without that, people with dementia do not always have access to the support, advice and treatment that could be of benefit to them (Alzheimer’s Disease International 2011). Consequently the focus of this article will be on the factors that are thought to contribute to dementia, common signs and symptoms, and current methods of diagnosis. The stigma attached to a diagnosis of dementia and the effect that this can have on individuals is also discussed

Un análisis del perfil del cuidador y su impacto sobre la situación laboral: cuidadores principales de enfermos de Alzheimer y otras demencias en el Sur Oeste de España

The aim of this paper is to analyse the main demographic and socio-economic conditions of the primary caregivers of Alzheimer's and dementia sufferers, and their relationship to the employment situation of the caregiver. Material and Methods: Empirical analysis of the data obtained from surveys of 694 primary caregivers of Alzheimer's and dementia sufferers through the Andalusian Associations of Relatives of Alzheimer’s Patients. The sampling procedure was selective non-probabilistic sampling. The SPSS 19 statistical software package was used to process the data. The verification of the hypothesis of independence of variables was performed using the chi square test under the usual parameters. Results: The employment rate of working-age caregivers is much lower than that of the general population, especially in older women with low levels of education who live with the patient. The data revealed that caregiving which takes place in the home represents the main restriction preventing access to the labour market, i.e. living with the patient is an additional handicap, and an even greater one for women. Conclusions: Those who care for dementia patients have greater limitations in accessing the labour market than the rest of the population, and this limitation is significantly greater when care is provided in the home. As such, health and social policy, with a view towards encouraging employment, needs to take into account the option of boosting available resources outside of family care.El objetivo es analizar las principales características demográficas y socio-económicas de los cuidadores principales de enfermos de Alzheimer y otras demencias, y buscar una la relación entre dichas características y su vinculación con el mercado laboral. Material y Métodos: Análisis empírico de los datos obtenidos de 694 encuestas realizadas a cuidadores principales de enfermos de Alzheimer y otras demencias, a través de Asociaciones de familiares de enfermos de Alzheimer andaluzas. El procedimiento de muestreo fue el muestreo no probabilístico selectivo. Para el tratamiento de los datos se ha utilizado el paquete estadístico SPSS 19. El contraste de las hipótesis de independencia de variables se ha realizado con el test de la chi cuadrado bajo los parámetros habituales. Resultados: La tasa de ocupación de los cuidadores en edad laboral es muy inferior a la de la población general, especialmenteen mujeres, de mayor edad, nivel de formación bajo y que conviven con el enfermo. De los datos analizados se revela como principal restricción para el acceso al mercado laboral el modelo de cuidado en casa, es decir, la convivencia con el enfermo es un hándicap adicional, mayor para el colectivo femenino. Conclusiones: Cuidar de un enfermo es una limitación superior respecto a población no cuidadora para el acceso al mercado laboral, y esta limitación es significativamente superior cuando el enfermo se atiende en el domicilio, por lo que de cara a políticas socio-sanitarias con incidencia en el fomento del empleo es necesario considerar la opción de incrementar recursos externos al cuidado familiar

World Alzheimer report 2015: the global impact of dementia

Today, over 46 million people live with dementia worldwide, more than the population of Spain. This number is estimated to increase to 131.5 million by 2050. Dementia also has a huge economic impact. Today, the total estimated worldwide cost of dementia is US $818 billion, and it will become a trillion dollar disease by 2018. This means that if dementia care were a country, it would be the world’s 18th largest economy, more than the market values of companies such as Apple (US$ 742 billion), Google (US$368 billion) and Exxon (US$ 357 billion). In many parts of the world, there is a growing awareness of dementia, but across the globe it remains the case that a diagnosis of dementia can bring with it stigma and social isolation. Today, we estimate that 94% of people living with dementia in low and middle income countries are cared for at home. These are regions where health and care systems often provide limited or no support to people living with dementia or to their families. The 2015 World Alzheimer Report updates data on the prevalence, incidence, cost and trends of dementia worldwide. It also estimates how these numbers will increase in the future, leaving us with no doubt that dementia, including Alzheimer’s disease and other causes, is one of the biggest global public health and social care challenges facing people today and in the future. Authors Prof Martin Prince The Global Observatory for Ageing and Dementia Care, King’s College London, UK Prof Anders Wimo Department of Neurobiology, Care sciences and Society, Karolinska Institute, Stockholm, Sweden Dr Maëlenn Guerchet The Global Observatory for Ageing and Dementia Care, King’s College London, UK Miss Gemma-Claire Ali The Global Observatory for Ageing and Dementia Care, King’s College London, UK Dr Yu-Tzu Wu Cambridge Institute of Public Health, University of Cambridge, UK Dr Matthew Prina The Global Observatory for Ageing and Dementia Care, King’s College London, UK Alzheimer\u27s Disease Internationa

A systematic review and meta-analysis on the prevalence of dementia in europe. estimates from the highest-quality studies adopting the dsm iv diagnostic criteria

BACKGROUND: Dementia, including Alzheimer's disease (AD), is one of the most burdensome medical conditions. Usually, the reviews that aim at calculating the prevalence of dementia include estimates from studies without assessing their methodological quality. Alzheimer's Disease International (ADI) proposed a score to assess the methodological quality of population-based studies aimed at estimating the prevalence of dementia. During the last three years, the European Commission has funded three projects (Eurodem, EuroCoDe, and ALCOVE) in order to estimate the prevalence of dementia in Europe. OBJECTIVE: The aim of this study was to perform a systematic review and meta-analysis of data on the prevalence of dementia in Europe derived from studies that included only subjects with a diagnosis of dementia according to the DSM IV criteria, and that had a high quality score according to ADI criteria. METHODS: We considered the studies selected by the two projects EuroCoDe (1993-2007) and Alcove (2008-2011), and we performed a new bibliographic search. For the systematic review, we only selected the subset of articles that included subjects with a diagnosis of dementia according to the DSM IV criteria. The studies were qualitatively assessed using the ADI tool. RESULTS: The meta-analysis considered 9 studies that were carried out in Europe between 1993 and 2018 including a total of 18,263 participants, of which 2,137 were diagnosed with dementia. The prevalence rate standardized for age and sex resulted 7.1%. DISCUSSION: This is the first systematic review on the prevalence of dementia in Europe considering only high-quality studies adopting the same diagnostic criteria (i.e., DSM IV)

Aboriginal and Torres Strait Islander People and dementia: a review of the research

This report outlines the prevalence of dementia and modifiable risk factors in Aboriginal and Torres Strait Islander communities. Executive summary The high rate of dementia in Aboriginal and Torres Strait Islander communities requires urgent attention. Aboriginal and Torres Strait Islander people experience dementia at an earlier age then the general population and this, combined with the steadily growing number of older Aboriginal and Torres Strait Islander people, will result in the number of people effected by  dementia growing significantly in the coming years. Although higher rates of dementia have been reported in Aboriginal and Torres Strait Islander people, the disease is often overlooked by Aboriginal and Torres Strait Islander  communities, health workers and service providers. Geographical constraints in the provision of services, a lack of education and awareness in communities and by health workers and the prevalence of other chronic diseases have all posed considerable barriers to the recognition of dementia as an emerging health issue. This paper includes the following recommendations to ensure that Aboriginal and Torres Strait Islander people, family members and communities have access to awareness, information, and appropriate support services for people with dementia

Depressive symptoms in the elderly : an early symptom of dementia? A systematic review

Background Depression and dementia are common incapacitating diseases in old age. The exact nature of the relationship between these conditions remains unclear, and multiple explanations have been suggested: depressive symptoms may be a risk factor for, a prodromal symptom of, or a coincidental finding in dementia. They may even be unrelated or only connected through common risk factors. Multiple studies so far have provided conflicting results. Objectives To determine whether a systematic literature review can clarify the nature of the relation between depressive symptoms and dementia. Methods Using the Patient/Problem/Population, Intervention, Comparator, Outcome or PICO paradigm, a known framework for framing healthcare and evidence questions, we formulated the question "whether depressive symptoms in cognitively intact older adults are associated with a diagnosis of dementia later in life." We performed a systematic literature review of MEDLINE and PsycINFO in November 2018, looking for prospective cohort studies examining the aforementioned question. Results We critically analyzed and listed 31 relevant papers out of 1,656 and grouped them according to the main hypothesis they support: depressive symptoms as a risk factor, not a risk factor, a prodromal symptom, both, or some specific other hypothesis. All but three studies used clinical diagnostic criteria for dementia alone (i.e., no biomarkers or autopsy confirmation). Several studies contain solid arguments for the hypotheses they support, yet they do not formally contradict other findings or suggested explanations and are heterogeneous. Conclusions The exact nature of the relationship between depressive symptoms and dementia in the elderly remains inconclusive, with multiple studies supporting both the risk factor and prodromal hypotheses. Some provide arguments for common risk factors. It seems unlikely that there is no connection at all. We conclude that at least in a significant part of the patients, depressive symptoms and dementia are related. This may be due to common risk factors and/or depressive symptoms being a prodromal symptom of dementia and/or depression being a risk factor for dementia. These causal associations possibly overlap in some patients. Further research is warranted to develop predictive biomarkers and to develop interventions that may attenuate the risk of "conversion" from depressive symptoms to dementia in the elderly

Legal medical consideration of alzheimer’s disease patients’ dysgraphia and cognitive dysfunction: a 6 month follow up

Background: The purpose of this study was to investigate the ability of Alzheimer’s disease (AD) patients to express intentions and desires, and their decision-making capacity. This study examines the findings from a 6-month follow-up of our previous results in which 30 patients participated. Materials and methods: The patient’s cognition was examined by conducting the tests of 14 questions and letter-writing ability over a period of 19 days, and it was repeated after 6 months. The difference between these two cognitive measures (PQ1 before–PQ2 before), tested previously and later the writing test, was designated DΔ before. The test was repeated after 6 months, and PQ1 after–PQ2 after was designated DΔ after. Results: Several markedly strong relationships between dysgraphia and other measures of cognitive performance in AD patients were observed. The most aged patients (over 86 years), despite less frequency, maintain the cognitive capacity manifested in the graphic expressions. A document, written by an AD patient presents an honest expression of the patient’s intention if that document is legible, clear, and comprehensive. Conclusion: The identification of impairment/deficits in writing and cognition during different phases of AD may facilitate the understanding of disease progression and identify the occasions during which the patient may be considered sufficiently lucid to make decisions. Keywords: cognition, intentions, unfit to plead, consen