Social support group interventions in people with dementia and mild cognitive impairment: a systematic review of the literature

Abstract Despite the large number of studies evaluating social support groups for people with dementia, there are no systematic reviews of current evidence.The aim of this study was to evaluate the effectiveness of social support group interventions for people with dementia and mild cognitive impairment.A systematic review was performed. We searched electronic databases for randomised controlled trials. Two reviewers worked independently to select trials, extract data and assess risk of bias. A total of 546 studies were identified of which two met the inclusion criteria. We were not able to pool data for further analyses, as the interventions tested in the studies meeting the inclusion criteria were too dissimilar in content.The first trial (n = 136) showed a benefit of early-stage memory loss social support groups for depression and quality of life in people with dementia.The second trial (n = 33) showed that post-treatment self-reported self-esteem was higher in the group receiving a multicomponent intervention of social support compared with that in the no intervention control group.Limited data from two studies suggest that support groups may be of psychological benefit to people with dementia by reducing depression and improving quality of life and self-esteem.These findings need to be viewed in light of the small number, small sample size and heterogeneous characteristics of current trials, indicating that it is difficult to draw any conclusions. More multicentre randomised controlled trials in social support group interventions for people with dementia are needed.������������

Cognitive Impairment and Dementia: A Practical Guide to Daily Living for Family Caregivers

The Dementia Services Information and Development Centre based at St. James’s Hospital, Dublin recently launched a new booklet for family caregivers of people with dementia. The booklet has been written to provide practical information to family care-givers of people living at home with a cognitive impairment or a dementia and to help them better cope with the day-to-day choices and dilemmas they may confront. To download the booklet please follow this link: Cognitive Impairment and Dementia: A Practical Guide to Daily Living for Family Caregivers

2009 Alzheimer's Disease

Alzheimer’s disease triples healthcare costs for Americans aged 65 or older��2009 Alzheimer’s Disease Facts and Figures provides a statistical resource for U.S. data related to Alzheimer’s disease, the most common type of dementia, as well as other dementias. Background and context for interpretation of the data are contained in the Overview. This includes definitions of the types of dementias and a summary of current knowledge about Alzheimer’s disease. Additional sections address prevalence, mortality and lifetime risk of Alzheimer’s disease and other dementias, as well as paid and family caregiving and use and costs of care and services. The Special Report for 2009 focuseson the emerging issue of mild cognitive impairment (MCI).

Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment

Physical activity is beneficial for healthy ageing. It may also help maintain good cognitive function in older age. Aerobic activity improves cardiovascular fitness, but it is not known whether this sort of fitness is necessary for improved cognitive function.��Eleven studies of aerobic physical activity programmes for healthy people over the age of 55 years have been included in this review. Eight of these 11 studies reported that aerobic exercise interventions resulted in increased fitness of the trained group and an improvement in at least one aspect of cognitive function. The largest effects were on cognitive speed, auditory and visual attention. However, the cognitive functions which improved were not the same in each study and the majority of comparisons yielded no significant results.��The data are insufficient to show that the improvements in cognitive function which can be attributed to physical exercise are due to improvements in cardiovascular fitness.

The last taboo: A guide to dementia, sexuality, intimacy and sexual behaviour in care homes ILC-UK

The International Longevity Centre - UK��launched a new paper (Wednesday, 6th July 2011). The last taboo: A guide to dementia, sexuality, intimacy and sexual behaviour in care homes, provides care home workers and managers with information and practical advice on this complex, controversial and sensitive issue.The need for affection, intimacy and relationships for people with dementia in care homes has too often been ignored and side-lined in policy and practice. The onset of old age or a cognitive impairment does not erase the need for affection, intimacy and/or relationships. While the issues involved can be complex, controversial and sensitive and may challenge our own beliefs and value system, it is essential that we understand more about them to foster a more person-centred approach to dementia care. Care home residents with dementia often have complex care needs and trying to understand and respond to the more intimate and sexual aspects of a resident’s personality can be challenging.Aimed at care home workers and managers, the guide not only provides essential information on this aspect of dementia care but offers practical advice to support current work-based practices. Set out in an accessible and easy-to-read format, this guide includes case studies, questions, suggestions and a self assessment quiz to promote easy learning. It also provides a possible pathway for care home managers to develop a guiding policy on sexual expression in dementia.The guide for care staff is summarised in 10 key points:1. Some residents with dementia will have sexual or sensual needs.2. Affection and intimacy contribute to overall health and wellbeing for residents.3. Some residents with dementia will have the capacity to make decisions about their needs.4. If an individual in care is not competent to decide, the home has a duty of care towards the individual to ensure they are protected from harm.5. There are no hard and fast rules. Assess each situation on an individual basis6. Remember not everyone with dementia is heterosexual.7. Inappropriate sexual behaviour is not particularly common in dementia.8. Confront your own attitudes and behaviour towards older people and sex generally.9. Communicate – look at how you can improve communication with your colleagues, managers, residents and carers on this subject10. Look after yourself and remember your own needs as a care professional��The full paper is available: The Last Taboo

Losing Track of Time: Dementia and the ageing prison population

Dementia and the ageing prison population: treatment challenges and examples of good practice.The aims of this report are to scope existing research on treating and managing male offenders with cognitive impairment to identify and share examples of good practice employed by a handful of prisons around the globe.Read full report here (pdf).��

Symposium on Dementia and Caregiving 23 May - Presentations

This Symposium, hosted by Dementia Services Information and Development Centre, opened up debate on formal and informal care for people with dementia living in the community and in residential care. ��It also discussed recent research findings on dementia care in Ireland and the United States.Click the link to view the following presentation slides:Professor Steve Zarit - Caregiving at a Cross-Roads; Bridging the Gap between Science and PracticeProfessor Eamon O'Shea - Costing Care for People with Dementia in IrelandDr Caroline O'Nolan - Longterm Residential Care for People with Dementia in Ireland: New Findings from a National SurveyDr Ana Diaz - "I Have a Good Life, I just want to Keep it"; Subjective Understandings and Objective Evaluations of Quality of Life after Diagnosis of DementiaProfessor Charles Normand - Burdens and Paradoxes in Caregiving

The Costs of Caring for People with Dementia and Related Cognitive Impairments

The National Council on Ageing and Older People has undertaken a programme of research into dementia in Ireland. An Action Plan for Dementia provided a framework for the provision and planning of services for people with dementia in Ireland The Costs of Caring for People with Dementia and Related Cognitive Impairments is a complementary report to the Action Plan but with a more quantitative focus. The role of carers is one that is often taken for granted and is seen by many as a free resource. Dr Oâ?TShea explores what caring for a person with dementia entails in terms of the carers time, finances and stress. Evaluating the cost of caring for a person with dementia is the main focus of this study Download the Report here

Screening for memory disorders, dementia and Alzheimer's disease

Dementia and its most common cause, Alzheimer’s disease, affect memory and occur predominantly in the elderly. Dementia has become increasingly prevalent in the world as health has improved and life expectancy has increased. However, the fields of clinical care have not responded adequately to develop diagnostic tools and treatments for this rapidly increasing group of conditions. While scientists search for cures for the numerous causes of dementia, improvement of diagnostic measures are needed now and should begin with screening elderly populations for memory difficulties and other cognitive problems. This review examines the history of cognitive screening tests, the numerous excellent tests that are currently available and ready for use, and directions and methods that will lead to progressively better evaluations.

Women and Dementia - Not forgotten ILC-UK

ILC-UK recently (31 Aug 2011)��published a report calling for a gendered approach and response to dementia at the national and international level. The report posits that women will disproportionately bear the burden of dementia in terms of numbers, but also impact in the coming years. The ‘feminization of ageing’ is a widely recognised trend and yet hitherto a comprehensive approach to the impact of dementia on women remains largely under explored.Invariably women and men as they age, share many of the same fundamental needs. Yet, as is acknowledged in many parts of the world, older women are particularly vulnerable and are subject to prolonged inequalities experienced since childhood, for example, lower levels of education and a greater risk of poverty. This report assumes a life course approach to the challenge of dementia and women, arguing from a global perspective that women face a ‘triple jeopardy’ as a result of the associated stigma attached to their age, gender and decline in cognitive functions. ILC-UK make a number of recommendations for improving outcomes and interventions for women, which include: 1. Dementia health policies and programmes should incorporate a gender dimension in their design, delivery and evaluation2. Gender should be included as a key health determinant in the promotion and disease prevention of dementia3. Dementia research at the regional, national and international level needs to be disaggregated by gender and age4. Women and men should be equally represented and involved at the micro and macro level of decision-making with regard to the development of health and social care policies and resource allocation as they pertain to dementia5. There is a need for greater interdisciplinary research incorporating the biological and social models of health for men and women to improve health interventions and outcomesDownload the full pdf report here��

Building Evidence for Dementia Prevention

As was the case in 2010 when the National Institutes of Health issued a consensus statement on the prevention of Alzheimer’s and other dementias, there remains a lack of firm evidence for dementia prevention. Because of the difficulties in studying this phenomenon, no modifiable risk factors for dementia have been definitively established, and no pharmaceutical or nutritional supplements been proven to prevent Alzheimer’s disease or cognitive decline. However, longitudinal observational studies have identified several factors associated with dementia. A recent review article summarizes the current epidemiological evidence about Alzheimer’s and other dementias, and presents three ongoing large scale randomized control trials (RCTs) that focus on preventing dementia. The review argues that there is substantial evidence for many factors that, in combination, might reduce the risk of, or delay the onset of, dementia. Although no specific cure for dementia exists, and no specific pathway between risk factor and disease onset has been identified, several cardiovascular, stress, toxicity, and psychosocial variables have been repeatedly associated with dementia. Protective factors, such as high education, physical exercise, and not smoking cigarettes, have been identified as well. Intervention studies that account for these multiple factors may well identify strategies for preventing or delaying dementia. However, the protective effects and risk factors suggested by observational data have yet to be assessed in RCT research. The role of such factors in reducing or increasing the risk for dementia needs to be more specifically defined. Three ongoing RCT studies in Europe show promise in this area, as they target multiple risk and protective factors by promoting healthy lifestyle changes and medical treatment of vascular diseases. These are: FINGER, a Finnish trial involving 1,200 older adults at risk for dementia. This intervention features nutritional guidance, physical activity, cognitive and social engagement, and medical management of risk factors. Participants were involved in previous, intensive observational studies of vascular health and health behavior, so FINGER will provide a level of relevant information about its research subjects that is normally impossible for clinical RCTs to attain;MAPT, a multicenter study of 1,680 frail older adults in France. This study will compare the efficacy of omega-3 dietary supplementation with a multidomain training intervention that involves physical and cognitive training. The study will include follow-up assessments after five years;PreDIVA, a Dutch study of 3,534 community dwelling participants between 70 and 78 years old, recruited from primary care clinics. This study will compare standard medical care with a multicomponent vascular health intervention. The study will last for six years and measure both dementia and disability outcomes. These studies are an important step in dementia research, using earlier observational studies as the basis for rigorously assessed interventions. Although a cure for dementia has not been identified, this new research may identify preventive strategies against dementia. �� Source: Mangialasche F, Kivipelto M, et al. (2012). Dementia prevention: current epidemiological evidence and future perspective. Alzheimer’s Research and Therapy 4:6.

Dementia Research Impact Report (1990-2012)

Impact of Alzheimer's Society's dementia research programme 1990-2012. Full details and the publication can be accessed here.

New Alzheimer's Association report reveals 1 in 3 seniors dies with Alzheimer's or another dementia

2.3 Million Americans are “Long-Distance Caregivers” for people with Alzheimer’s; Costs for Long-Distance Caregivers are Almost Twice as High.According to the Alzheimer's Association 2013 Alzheimer's Disease Facts and Figures report released today, one in three seniors dies with Alzheimer’s or another dementia in the United States. The new report shows that while deaths from other major diseases, such as heart disease, HIV/AIDS and stroke, continue to experience significant declines, Alzheimer’s deaths continue to rise — increasing 68 percent from 2000-2010.��“Unfortunately, today there are no Alzheimer’s survivors. If you have Alzheimer's disease, you either die from it or diewith it,” said Harry Johns, president and CEO of the Alzheimer’s Association. “Now we know that 1 in 3 seniors dies with Alzheimer’s disease or another dementia. Urgent, meaningful��action is necessary, particularly as more and more people age into greater risk for developing a disease��that today has no cure and no way to slow or stop its progression.”Read more here.����������

Dementia 2013: The hidden voice of loneliness

Dementia 2013: The hidden voice of loneliness is Alzheimer's Society's annual report examining the quality of life for people with dementia.The report found that over half of the general public (54 per cent) believe that people with dementia have a bad quality of life. This was echoed in the feedback from people with dementia with 70 per cent saying they had stopped doing things they used to due because of lack of confidence. The majority of people with dementia also felt anxious or depressed (63 per cent) and a third of people (35 per cent) said they’d lost friends after a diagnosis.��Other key statistics in Dementia 2013 include:38 per cent of all people with dementia said they felt lonelyPeople with dementia said they relied on relatives and friends for social contact and yet almost a quarter (21 per cent) speak to friends or family on the telephone less than once a month. ��Only 23 per cent of the general public thought it was possible for a person with dementia to live alone ��16 per cent answered that they would not be comfortable talking to someone with dementia, 19 per cent were unsure.The findings from Dementia 2013 are based on a survey of 510 people with dementia or carers on their behalf and a YouGov poll of 2,287 UK adults.Download the full report here.������

The global impact of dementia 2013-2050

‘The Global Impact of Dementia 2013-2050’ reports a 17% increase in the number of people living with dementia, compared to the original ADI estimates in the 2009 World Alzheimer Report.An Alzheimer's Disease International policy brief for the G8 Dementia Summit has revealed that the number of people living with dementia worldwide in 2013 is now estimated at 44 million, reaching 76 million in 2030 and 135 million by 2050. Read the policy brief