LKS Current Awareness Bulletin Dementia - Alzheimer's - Old Age Psychiatry September 2019 A current awareness update service from Library and Knowledge Services. If you know anyone who could benefit from receiving this please ask them to sign up by emailing [email protected]or [email protected]We hope this bulletin is useful. We are keen to promote our services at your team meetings/huddles. If you feel that this would be useful, then please contact me to arrange a brief induction to how we can support you in education and training, researching for information, literature support, critical appraisal skills, free article requests, social media training (learn to Tweet!) and much much more. Kind regards Abbas Abbas Bismillah Head of Library and Knowledge Services Email [email protected]01254 784308 (Ext: 84308) Mobile 0778 996 0868 ELHT Library @elhtlibrary Abbas - @bazzie1967 NHS hospitals go back to the future for dementia care NHS hospitals are going back to the future to help patients with dementia by decorating their wards, rooms and corridors in 1940s and 1950s style – creating a calming, familiar environment which can help jog memories, reduce anxiety and distress. Source: NHS England World Alzheimer's Day A House of Lords Library Briefing has been issued which provides information to mark World Alzheimer's Day on 21 September 2019. Source: House of Lords Library How virtual reality is helping people with dementia An NHS pilot is seeing if virtual reality could improve the lives of people with dementia, by taking them back in time to relive formative experiences. The Marston Court care home in Oxford has been trialling the SIGN UP TO OTHER BULLETINS
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LKS Current Awareness Bulletin
Dementia - Alzheimer's - Old Age Psychiatry
September 2019 A current awareness update service from Library and Knowledge Services. If you know anyone
who could benefit from receiving this please ask them to sign up by emailing
We hope this bulletin is useful. We are keen to promote our services at your team meetings/huddles. If you feel that this would be useful, then please contact me to arrange a brief induction to how we can support you in education and training, researching for information, literature support, critical appraisal skills, free article requests, social media training (learn to Tweet!) and much much more.
Kind regards
Abbas Abbas Bismillah Head of Library and Knowledge Services Email [email protected] 01254 784308 (Ext: 84308) Mobile 0778 996 0868 ELHT Library @elhtlibrary Abbas - @bazzie1967 NHS hospitals go back to the future for dementia care NHS hospitals are going back to the future to help patients with dementia by decorating their wards, rooms and corridors in 1940s and 1950s style – creating a calming, familiar environment which can help jog memories, reduce anxiety and distress. Source: NHS England World Alzheimer's Day A House of Lords Library Briefing has been issued which provides information to mark World Alzheimer's Day on 21 September 2019. Source: House of Lords Library How virtual reality is helping people with dementia An NHS pilot is seeing if virtual reality could improve the lives of people with dementia, by taking them back in time to relive formative experiences. The Marston Court care home in Oxford has been trialling the
technology. Source: BBC News Government to invest over £130 million in new tech to tackle cancer and debilitating illnesses Thousands of NHS patients could receive faster diagnosis and better treatment for life-changing diseases like cancer, dementia and Parkinson’s. Source: Department for Business, Energy & Industrial Strategy, Department of Health and Social Care, UK Research and Innovation, Baroness Blackwood, The Rt Hon Matt Hancock MP, and The Rt Hon Andrea Leadsom MP Sheffield scientists’ £600K boost from dementia research charity The UK’s leading dementia research charity Alzheimer’s Research UK is committing over £610,000 to fund new pioneering dementia research projects at the University of Sheffield. Dementia is a condition caused by physical diseases in the brain, most commonly Alzheimer’s disease. Vital £50,000 boost for dementia research at St Andrews University Today, Alzheimer’s Research UK has committed nearly £50,000 to fund a pioneering dementia research project at the University of St Andrews. Dementia is a condition caused by physical diseases in the brain, most commonly Alzheimer’s disease. Leading dementia research charity funds vital equipment at the University of Exeter Alzheimer’s Research UK has committed nearly £30,000 to support pioneering dementia research at the University of Exeter. Dementia is a condition caused by physical diseases in the brain. £420K funding boost for dementia research in Bristol Alzheimer’s Research UK has committed nearly £420,000 to fund pioneering new dementia research at the University of Bristol. The announcement comes as the charity launches a major new awareness campaign fronted by Hollywood star Samuel L. Jackson. Alcohol intake linked to dementia risk Researchers in the US have revealed that alcohol intake in later life is linked with dementia risk. Their findings are published today (Friday 27 September) in the journal JAMA. The research team looked at over 3000 people living in the US. New global dementia perceptions report shows stigma still rife Alzheimer’s Disease International, have published the ‘World Alzheimer Report 2019, a global analysis that suggests that as many two in three people across the world still think of the condition as normal ageing. Dementia deaths in Scotland rise nearly 6% year on year Alzheimer’s Research UK, the UK’s leading dementia research charity, is calling for a government commitment to fund more dementia research than ever before following new figures from National Records of Scotland released today. Body’s ageing process accelerated by DNA changes, study suggests DNA changes throughout a person’s life can significantly increase their susceptibility to heart conditions and other age-related diseases, research suggests. The work by Alzheimer’s Research UK is published in Current Biology. Brain scans reveal tau tangles present after serious blow to the head Science Translational Medicine: In vivo detection of cerebral tau pathology in long-term survivors of traumatic brain injury A UK team of researchers including scientists from the UK Dementia Research Institute have revealed that the tau protein is increased in people who have a traumatic brain injury (TBI).
For references where there is a link to the full text, you may need to
use your NHS Athens username & password to access https://openathens.nice.org.uk/ Gum disease bacteria could be responsible for Alzheimer's disease Sarah Palmer Nursing and Residential Care Volume 21, Issue 10 24 Sep 2019 A study investigating the link between gum disease bacteria and Alzheimer's disease has found compelling correlational evidence, with implications for treatment. What do relatives value most in end-of-life care for people with dementia? Sascha Bolt Jenny van der Steen Jos Schols Sandra Zwakhalen Judith Meijers International Journal of Palliative Nursing Volume 25, Issue 9 02 Sep 2019 Background: End-of-life care for older people with dementia is often sub-optimal. Understanding the experiences of the relatives involved in the care of the person with dementia may help to improve care practice. Potential of emotional freedom techniques to improve mood and quality of life in older adults Lynn Harbottle British Journal of Community NursingVolume 24, Issue 9 02 Sep 2019 Emotional freedom techniques (EFTs) are an innovative combined somatic and cognitive therapy. Derived from key principles within traditional Chinese medicine, they incorporate elements of exposure, cognitive and other conventional psychotherapies. Increasing evidence suggests that EFTs are effective in treating various physical and psychological conditions and across several population groups. Studies indicate that the somatic component is essential to its ease of use, rapid effect and durability of results. EFTs can be used as self-help tools or applied therapeutically in groups or individually. There is a lack of research specifically examining its applicability to older adults, but a ground-breaking project with nurses in France suggests that EFTs may offer significant potential to moderate pain and stress levels and to improve mood, interaction and quality of life among this group, including those with multiple and complex comorbidities Managing lymphoedema in patients with dementia: how to address compliance Josephine Stoney Journal of Prescribing PracticeVolume 1, Issue 9 02 Sep 2019 As practitioners, our primary goal is to do our best for our patients. We give information, advice and recommendations and strive to ensure patients comprehend what we have said to them. Our desire and expectation is that they will carry out our recommended actions, in order to support their treatment and gain a positive outcome. Here, we explore some of the factors that may affect this compliance, particularly for the patient with dementia who has lymphoedema. Recognition and assessment of dementia in primary care Karen Harrison-Dening Practice NursingVolume 30, Issue 9 02 Sep 2019 Abstract While patients diagnosed with dementia will require management from specialist neurology clinics, practice nurses play an important role in their health. Karen Harrison-Dening explains what assessment tools are available for patients with particular health needs Prognosis and Interplay of Cognitive Impairment and Sarcopenia in Older Adults Discharged from Acute Care Hospitals.
Author(s): Zengarini E; Giacconi R; Mancinelli L; Riccardi GR; Castellani D; Vetrano DL; Onder G; Volpato S; Ruggiero C; Fabbietti P; Cherubini A; Guarasci F; Corsonello A; Lattanzio F Source: Journal of clinical medicine; Oct 2019; vol. 8 (no. 10) Publication Date: Oct 2019 Publication Type(s): Journal Article PubMedID: 31619001 Available at Journal of clinical medicine - from Europe PubMed Central - Open Access Available at Journal of clinical medicine - from Unpaywall Abstract:Sarcopenia and cognitive impairment are associated with an increased risk of negative outcomes, but their prognostic interplay has not been investigated so far. We aimed to investigate the prognostic interaction of sarcopenia and cognitive impairment concerning 12-month mortality among older patients discharged from acute care wards in Italy. Our series consisted of 624 patients (age = 80.1 ± 7.0 years, 56.1% women) enrolled in a prospective observational study. Sarcopenia was defined following the European Working Group on Sarcopenia in Older People (EWGSOP) criteria. Cognitive impairment was defined as age- and education-adjusted Mini-Mental State Examination (MMSE) score < 24 or recorded diagnosis of dementia. The study outcome was all-cause mortality during 12-month follow-up. The combination of sarcopenia and cognitive ability was tested against participants with intact cognitive ability and without sarcopenia. Overall, 159 patients (25.5%) were identified as having sarcopenia, and 323 (51.8%) were cognitively impaired. During the follow-up, 79 patients (12.7%) died. After adjusting for potential confounders, the combination of sarcopenia and cognitive impairment has been found associated with increased mortality (HR = 2.12, 95% CI = 1.05-4.13). Such association was also confirmed after excluding patients with dementia (HR = 2.13, 95% CI = 1.06-4.17), underweight (HR = 2.18, 95% CI = 1.03-3.91), high comorbidity burden (HR = 2.63, 95% CI = 1.09-6.32), and severe disability (HR = 2.88, 95% CI = 1.10-5.73). The co-occurrence of sarcopenia and cognitive impairment may predict 1-year mortality in older patients discharged from acute care hospitals. Database: PubMed Standardized acquisition and post-processing of dynamic susceptibility contrast perfusion in patients with brain tumors, cerebrovascular disease and dementia: comparability of post-processing software. Author(s): Schmidt M; Knott M; Hoelter P; Engelhorn T; Elna Marie L; Than N; Marco E; Doerfler A Source: The British journal of radiology; Oct 2019 ; p. 20190543 Publication Date: Oct 2019 Publication Type(s): Journal Article PubMedID: 31617743 Available at The British journal of radiology - from Wiley Online Library Medicine and Nursing Collection 2019 - NHS Abstract: OBJECTIVE: MR-perfusion post-processing still lacks standardization. This study evaluates the results of perfusion analysis with two established software solutions in a large series of patients with different diseases when a highly standardized processing workflow is ensured.METHODS: Multicenter data of 260 patients (80 with brain tumors, 124 with cerebrovascular disease and 56 with dementia examined with the same MR protocol) were analyzed. Raw data sets were processed with two software suites: Olea sphere and NordicICE. Group differences were analyzed with paired t-tests and one-way ANOVA.RESULTS: Perfusion metrics were significantly different for all examined diseases in the unaffected brain for both software suites [ratio cortex/white matter left hemisphere: mean transit time (MTT) 0.991 vs 0.847, p < 0.05; relative cerebral bloodflow (rBF) 3.23 vs 4.418, p < 0.001; relative cerebral bloodvolume (rBVc) 2.813 vs 3.884, p < 0.001; right hemisphere: MTT 1.079 vs 0.854, p < 0.05; rBF 3.262 vs 4.378, p < 0.001; rBVc 2.762 vs 3.935, p < 0.001). Perfusion results were also significantly different in patients with stroke (ratio cortex/white matter affected hemisphere: MTT 1.058 vs 0.784; p < 0.001), dementia (ratio cortex/white matter left hemisphere: rBVc 1.152 vs 1.795, p < 0.001; right hemisphere: rBVc 1.396 vs 1.662, p < 0.05) and brain tumors (ratio cortex/whole tumor rBVc: 0.778 vs 0.919, p < 0.001 and ratio cortex/tumor hotspot rBVc: 0.529 vs 0.512, p < 0.05).CONCLUSION: Despite a highly standardized workflow, parametric perfusion maps are depended on the chosen software. Radiologists should consider software related variances when using dynamic susceptibility contrast perfusion for clinical imaging and research.ADVANCES IN
KNOWLEDGE: This multicenter study compared perfusion parameters calculated by two commercial dynamic susceptibility contrast perfusion post-processing software solutions in different central nervous system disorders with a large sample size and a highly standardized processing workflow. Despite, parametric perfusion maps are depended on the chosen software which impacts clinical imaging and research. Database: PubMed Establishing links between abnormal eating behaviours and semantic deficits in dementia. Author(s): Vignando M; Rumiati RI; Manganotti P; Cattaruzza T; Aiello M Source: Journal of neuropsychology; Oct 2019 Publication Date: Oct 2019 Publication Type(s): Journal Article PubMedID: 31617330 Available at Journal of neuropsychology - from Wiley Online Library Medicine and Nursing Collection 2019 - NHS Abstract:The hypothesis that semantic deficits in dementia may contribute in producing changes in eating preferences has never been experimentally investigated despite this association has been clinically observed. We administered tasks assessing semantic memory and the Appetite and Eating Habits Questionnaire (APEHQ) to 23 patients with dementia (behavioural frontotemporal dementia, primary progressive aphasia, and Alzheimer's disease) and to 21 healthy controls. We used voxel-based morphometry and diffusion tensor imaging to identify regions and white matter tracts of significant atrophy associated with the performance at the semantic tasks and the pathological scores at the APEHQ. We observed that the lower the patients' scores at semantic tasks, the higher their changes in eating habits and preferences. Both semantic disorders and eating alterations correlated with atrophy in the temporal lobes and white matter tracts connecting the temporal lobe with frontal regions such as the arcuate fasciculus, the cingulum, and the inferior longitudinal fasciculus. These results confirm that semantic deficits underlie specific eating alterations in dementia patients. Database: PubMed Apathy as a behavioural marker of cognitive impairment in Parkinson's disease: a longitudinal analysis. Author(s): Martin GP; McDonald KR; Allsop D; Diggle PJ; Leroi I Source: Journal of neurology; Oct 2019 Publication Date: Oct 2019 Publication Type(s): Journal Article PubMedID: 31616991 Available at Journal of neurology - from Unpaywall Abstract:BACKGROUND: Understanding the longitudinal course of non-motor symptoms, and finding markers to predict cognitive decline in Parkinson's disease (PD), are priorities. Previous work has demonstrated that apathy is one of the only behavioural symptoms that differentiates people with PD and intact cognition from those with mild cognitive impairment (MCI-PD). Other psychiatric symptoms emerge as dementia in PD develops.OBJECTIVE: We explored statistical models of longitudinal change to detect apathy as a behavioural predictor of cognitive decline in PD.METHODS: We followed 104 people with PD intermittently over 2 years, undertaking a variety of motor, behavioural and cognitive measures. We applied a linear mixed effects model to explore behavioural factors associated with cognitive change over time. Our approach goes beyond conventional modelling based on a random-intercept and slope approach, and can be used to examine the variability in measures within individuals over time.RESULTS: Global cognitive scores worsened during the two-year follow-up, whereas the longitudinal evolution of self-rated apathy scores and other behavioural measures was negligible. Level of apathy was negatively (- 0.598) correlated with level of cognitive impairment and participants with higher than average apathy scores at baseline also had poorer cognition. The model indicated that departure from the mean apathy score at any point in time was mirrored by a corresponding departure from average global cognitive score.CONCLUSION: High levels of apathy are predictive of negative cognitive and behavioural outcomes
over time, suggesting that apathy may be a behavioural indicator of early cognitive decline. This has clinical and prognostic implications. Database: PubMed Behavioral and Psychiatric Symptoms of Dementia and Rate of Decline in Alzheimer's Disease. Author(s): Gottesman RT; Stern Y Source: Frontiers in pharmacology; 2019; vol. 10 ; p. 1062 Publication Date: 2019 Publication Type(s): Journal Article; Review PubMedID: 31616296 Available at Frontiers in pharmacology - from Europe PubMed Central - Open Access Available at Frontiers in pharmacology - from Unpaywall Abstract:Alzheimer's disease causes both cognitive and non-cognitive symptoms. There is increasing evidence that the presentation and course of Alzheimer's disease is highly heterogenous. This heterogeneity presents challenges to patients, their families, and clinicians due to the difficulty in prognosticating future symptoms and functional impairment. Behavioral and psychiatric symptoms are emerging as a significant contributor to this clinical heterogeneity. These symptoms have been linked to multiple areas of neurodegeneration, which may suggest that they are representative of network-wide dysfunction in the brain. However, current diagnostic criteria for Alzheimer's disease focus exclusively on the cognitive aspects of disease. Behavioral and psychiatric symptoms have been found in multiple studies to be related to disease severity and to contribute to disease progression over time. A better understanding of how behavioral and psychiatric symptoms relate to cognitive aspects of Alzheimer's disease would help to refine the models of disease and hopefully lead to improved ability to develop therapeutic options for this devastating disease. Database: PubMed The Interaction Between Sleep and Metabolism in Alzheimer's Disease: Cause or Consequence of Disease? Author(s): Carroll CM; Macauley SL Source: Frontiers in aging neuroscience; 2019; vol. 11 ; p. 258 Publication Date: 2019 Publication Type(s): Journal Article; Review PubMedID: 31616284 Available at Frontiers in aging neuroscience - from Europe PubMed Central - Open Access Available at Frontiers in aging neuroscience - from Unpaywall Abstract:Alzheimer's disease (AD) is the most common form of dementia and affects over 45 million people worldwide. Both type-2-diabetes (T2D), a metabolic condition associated with aging, and disrupted sleep are implicated in the pathogenesis of AD, but how sleep and metabolism interact to affect AD progression remains unclear. In the healthy brain, sleep/wake cycles are a well-coordinated interaction between metabolic and neuronal activity, but when disrupted, are associated with a myriad of health-related issues, including metabolic syndrome, cardiovascular disease, T2D, and AD. Therefore, this review will explore our current understanding of the relationship between metabolism, sleep, and AD-related pathology to identify the causes and consequences of disease progression in AD. Moreover, sleep disturbances and metabolic dysfunction could serve as potential therapeutic targets to mitigate the increased risk of AD in individuals with T2D or offer a novel approach for treating AD. Database: PubMed Burden of caring for people with dementia - comparing family caregivers and professional caregivers. A descriptive study. Author(s): Seidel D; Thyrian JR Source: Journal of multidisciplinary healthcare; 2019; vol. 12 ; p. 655-663 Publication Date: 2019 Publication Type(s): Journal Article
PubMedID: 31616154 Available at Journal of multidisciplinary healthcare - from Europe PubMed Central - Open Access Available at Journal of multidisciplinary healthcare - from Unpaywall Abstract:Purpose: Caring for people with dementia is known to be accompanied by burden for the caregiver. This study aims at describing family caregivers' and professional caregivers' burden immediately after hospitalization of the person with dementia.Materials and methods: Twenty-five family caregivers and twenty-five professional caregivers of the locked gerontopsychiatric ward of a hospital in Northern Germany completed a questionnaire (BIZA-D-PV), which was evaluated in matched samples. The distribution of frequencies, differences in mean values and correlations were determined. Furthermore, family caregivers were categorized into risk groups.Results: Family caregivers perceived a higher burden due to cognitive impairment as well as aggressive and disoriented behavior of the person with dementia compared to professional caregivers. Differences with regard to care tasks were not detected. Female family caregivers rated a higher burden compared to male family caregivers, whereas in the sample of professional caregivers males perceived a higher burden. Correlations between several dimensions of burden and caregivers' age, severity of dementia as well as physical symptoms were described. Categorizing family caregivers into risk groups showed high risks for depression of the caregiver, violence against the person with dementia and institutionalization of the person with dementia within the next months in 44-72% of cases.Conclusion: Our findings emphasize the importance of acquiring knowledge about caregivers' burden in the course of time in order to develop targeting interventions to decrease caregivers' burden and to prevent hospital admissions of people with dementia due to a crisis of home caring. Database: PubMed Farm-based day care services - a prospective study protocol on health benefits for people with dementia and next of kin. Author(s): Eriksen S; Pedersen I; Taranrød LB; Ellingsen-Dalskau LH; Finnanger Garshol B; Ibsen TL; Kirkevold Ø; Strandli E; Patil GG Source: Journal of multidisciplinary healthcare; 2019; vol. 12 ; p. 643-653 Publication Date: 2019 Publication Type(s): Journal Article PubMedID: 31616153 Available at Journal of multidisciplinary healthcare - from Europe PubMed Central - Open Access Available at Journal of multidisciplinary healthcare - from Unpaywall Abstract:Introduction: The increasing number of people with dementia will place a considerable challenge on the health care system and will necessitate innovation and new solutions. Day care services aim to provide meaningful activities and coping experiences for the target group. The aim of the present study is to explore the experience and potential health benefits for people with dementia attending farm-based day care services in Norway and their next of kin.Methods and design: The present study is a prospective study organized into several qualitative and quantitative sub-studies. Study period will last from 2016-2020. We use a multi-method approach and both an empirical and a constructivist view on knowledge to explore this multi-facetted phenomenon.Discussion: Several challenges are expected, for instance, the ability to include participants with dementia and keep them within the study for the whole study period. The functioning level of participants regarding language and understanding could challenge their ability to answer. Despite having several limitations, we believe that this study with its different approaches and methods will add important knowledge to the field. Knowledge from our study could be essential for creating day care services of good quality for people with dementia and such services could reduce the burden of care for their next of kin. Database: PubMed Place of death preference among people with dementia: an important conversation. Author(s): Reed J Source: Evidence-based nursing; Oct 2019 Publication Date: Oct 2019
Publication Type(s): Journal Article PubMedID: 31615833 Available at Evidence-based nursing - from BMJ Journals - NHS Database: PubMed The trial to reduce antimicrobial use in nursing home residents with Alzheimer's disease and other dementias: study protocol for a cluster randomized controlled trial. Author(s): Loizeau AJ; D'Agata EMC; Shaffer ML; Hanson LC; Anderson RA; Tsai T; Habtemariam DA; Bergman EH; Carroll RP; Cohen SM; Scott EME; Stevens E; Whyman JD; Bennert EH; Mitchell SL Source: Trials; Oct 2019; vol. 20 (no. 1); p. 594 Publication Date: Oct 2019 Publication Type(s): Journal Article PubMedID: 31615540 Available at Trials - from EBSCO (MEDLINE Complete) Available at Trials - from BioMed Central Available at Trials - from Europe PubMed Central - Open Access Abstract:BACKGROUND: Infections are common in nursing home (NH) residents with advanced dementia but are often managed inappropriately. Antimicrobials are extensively prescribed, but frequently with insufficient evidence to support a bacterial infection, promoting the emergence of multidrug-resistant organisms. Moreover, the benefits of antimicrobials remain unclear in these seriously ill residents for whom comfort is often the goal of care. Prior NH infection management interventions evaluated in randomized clinical trials (RCTs) did not consider patient preferences and lack evidence to support their effectiveness in 'real-world' practice.METHODS: This report presents the rationale and methodology of TRAIN-AD (Trial to reduce antimicrobial use in nursing home residents with Alzheimer's disease and other dementias), a parallel group, cluster RCT evaluating a multicomponent intervention to improve infection management for suspected urinary tract infections (UTIs) and lower respiratory tract infections (LRIs) among NH residents with advanced dementia. TRAIN-AD is being conducted in 28 facilities in the Boston, USA, area randomized in waves using minimization to achieve a balance on key characteristics (N = 14 facilities/arm). The involvement of the facilities includes a 3-month start-up period and a 24-month implementation/data collection phase. Residents are enrolled during the first 12 months of the 24-month implementation period and followed for up to 12 months. Individual consent is waived, thus almost all eligible residents are enrolled (target sample size, N = 410). The intervention integrates infectious disease and palliative care principles and includes provider training delivered through multiple modalities (in-person seminar, online course, management algorithms, and prescribing feedback) and an information booklet for families. Control facilities employ usual care. The primary outcome, abstracted from the residents' charts, is the number of antimicrobial courses prescribed for UTIs and LRIs per person-year alive.DISCUSSION: TRAIN-AD is the first cluster RCT testing a multicomponent intervention to improve infection management in NH residents with advanced dementia. Its findings will provide an evidence base to support the benefit of a program addressing the critical clinical and public health problem of antimicrobial misuse in these seriously ill residents. Moreover, its hybrid efficacy-effectiveness design will inform the future conduct of cluster RCTs evaluating nonpharmacological interventions in the complex NH setting in a way that is both internally valid and adaptable to the 'real-world'.TRIAL REGISTRATION: ClinicalTrials.gov, NCT03244917 . Registered on 10 August 2017. Database: PubMed Using sensor-based technology for safety and independence - the experiences of people with dementia and their families. Author(s): Malmgren Fänge A; Carlsson G; Chiatti C; Lethin C Source: Scandinavian journal of caring sciences; Oct 2019 Publication Date: Oct 2019 Publication Type(s): Journal Article PubMedID: 31614031
Available at Scandinavian journal of caring sciences - from Wiley Online Library Medicine and Nursing Collection 2019 - NHS Abstract: BACKGROUND: The majority of people with dementia prefer to live independently and safely in their own home cared for by their family members. Much effort has been invested in the development of technology, such as sensor-based networks. Many challenges remain, in particular gaining more knowledge about their experiences and perceived benefits. This study aimed to explore experiences, needs and benefits with using sensor-based technology for safety and independence in the homes of people with dementia and their family members. METHODS: This study is part of the TECH@HOME project, aiming to evaluate the effects of sensor-based technology on independence among people with dementia and caregiver stress among their family members. This study applied an inductive, qualitative approach with semi-structured interviews of people with dementia (n = 9) and family members (n = 21). The participants were interviewed between June and September 2018 after using the technology for at least 6 months. The interviews were analysed with manifest content analysis.RESULTS: Our findings highlighted that technology was considered as a precaution and a safety measure that could provide a sense of having control of the everyday life of the person with dementia. Understanding and acceptance of the technology were as important, together with the reliability of the technology. Ethical dilemmas related to the monitoring of the person with dementia in the home were also raised.CONCLUSION: This study provides insights into how people with dementia and family members experience and benefit from using sensor-based technology in their own homes. The knowledge generated is essential for healthcare professionals and policymakers developing and implementing care and service systems including technology, as well as for the industry. Database: PubMed Psychosis and longitudinal outcomes in Huntington disease: the COHORT Study. Author(s): Connors MH; Teixeira-Pinto A; Loy CT Source: Journal of neurology, neurosurgery, and psychiatry; Oct 2019 Publication Date: Oct 2019 Publication Type(s): Journal Article PubMedID: 31611263 Available at Journal of neurology, neurosurgery, and psychiatry - from BMJ Journals - NHS Abstract: OBJECTIVE: Huntington disease (HD) is an autosomal dominant neurodegenerative disease involving motor disturbances, cognitive decline and psychiatric symptoms. Psychotic symptoms occur in a significant proportion of patients. We sought to characterise the clinical outcomes of this group of patients. METHODS: Data were drawn from the Cooperative Huntington Observational Research Trial, a prospective, multi-centre observational study. 1082 patients with HD were recruited. Measures of cognition, function, behavioural disturbance and motor function were completed annually over 5 years. RESULTS: Overall, 190 patients (17.6%) displayed psychotic symptoms. These patients demonstrated worse cognition, function and behavioural disturbances than patients without psychosis over time. Patients with psychosis also demonstrated lower levels of chorea than patients without psychosis, despite adjusting for concurrent antipsychotic and tetrabenazine use.CONCLUSIONS: Psychosis in HD is associated with poorer outcomes in cognition, function and behavioural symptoms. Patients with psychotic symptoms may also have less chorea. Altogether, the findings suggest patients with psychosis have a distinct clinical course. Database: PubMed
Predictors and prognosis of delirium among older subjects in cardiac intensive care unit: focus on potentially preventable forms. Author(s): Mossello E; Baroncini C; Pecorella L; Giulietti C; Chiti M; Caldi F; Cavallini MC; Simoni D; Baldasseroni S; Fumagalli S; Valoti P; Stroppa S; Parenti K; Ungar A; Masotti G; Marchionni N; Bari MD Source: European heart journal. Acute cardiovascular care; Oct 2019 ; p. 2048872619882359 Publication Date: Oct 2019 Publication Type(s): Journal Article PubMedID: 31617374 Abstract: BACKGROUND: Delirium is a common and potentially preventable condition in older individuals admitted to acute and intensive care wards, associated with negative prognostic effects. Its clinical
relevance is being increasingly recognised also in cardiology settings. The aim of the present study was to assess the prevalence, incidence, predictors and prognostic role of delirium in older individuals admitted to two cardiology intensive care units. METHODS: All patients aged over 65 years consecutively admitted to the two participating cardiology intensive care units were enrolled. Assessment on admission included acute physiological derangement (modified rapid emergency medicine score, REMS), chronic comorbidity, premorbid disability and dementia. The Confusion Assessment Method-Intensive Care Unit was applied daily for delirium detection. RESULTS: Of 497 patients (40% women, mean age 79 years), 18% had delirium over the entire cardiology intensive care unit course, half of whom more than 24 hours after admission (incident delirium). Advanced age, a main diagnosis of ST-segment elevation myocardial infarction or acute respiratory failure, modified REMS, comorbidity and dementia were independent predictors of delirium. Adjusting for patient's features on admission, incident delirium was predicted by invasive procedures (insertion of peripheral arterial catheter, urinary catheter, central venous catheter, naso-gastric tube and intra-aortic balloon pump). In a logistic regression model, delirium was an independent predictor of inhospital mortality (odds ratio 3.18, 95% confidence interval 1.02, 9.93).CONCLUSIONS: Eighteen per cent of older cardiology intensive care unit patients had delirium, with half of the cases being incident, thus potentially preventable. Invasive procedures were independently associated with incident delirium. Delirium was an independent predictor of inhospital mortality. Awareness of delirium should be increased in the cardiology intensive care unit setting and prevention studies are warranted. Database: PubMed Request this article from the library
Meaningful engagement between secondary school students and older patients in an acute hospital. Author(s): Mashlan W; Ralston S; Jones L Source: Nursing older people; Oct 2019 Publication Date: Oct 2019 Publication Type(s): Journal Article PubMedID: 31617337 Abstract:This article discusses the development and outcomes of a project involving a shared care acute hospital ward (mental health and medical) and a local secondary school in South Wales. The project enabled meaningful interaction between school pupils and patients with dementia, depression and delirium. It also provided secondary school pupils with the opportunity to understand the role of hospital-based healthcare staff and the needs of older patients. Database: PubMed Request this article from the library
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