National Strategies to Address Dementia: Alzheimer Australia

National Strategies to Address Dementia This 12-page Australian paper provides an overview of a range of approaches that a selection of countries have taken to address dementia

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.

Global burden of dementia in the year 2050: summary of methods and data sources

��The number of people suffering dementia will triple in the next 40 years, according to a new study by the World Health Organization, leading to catastrophic social and financial costs. Dementia, a brain illness that affects memory, behavior and the ability to perform even common tasks, affects mostly older people; Alzheimer's causes many cases. Read the report:Global burden of dementia in the year 2050: summary of methods and data sources

Future dementia care in Ireland: A guide

A new guide on dementia�� in Ireland was launched June 19 by Minister of State at the Department of Health Kathleen Lynch. The guide was developed to disseminate to the public, and in lay man's terms, the key findings contained in a report entitled 'Creating Excellence in Dementia Care: A Research Review to inform Ireland's National Dementia Strategy.' The new guide is a joint collaboration between�� the Living with Dementia programme, Trinity College Dublin, and the Irish Centre for Social Gerontology (ICSG), NUI Galway. The research work was funded by The Atlantic Philanthropies and supported by the Department of Health.Access the guide here: http://livingwithdementia.tcd.ie/assets/pdf/Future_Dementia_Care_in_Irel...

Reframing Dementia: Presentations

The European Foundations’ Initiative on Dementia (EFID) held a workshop entitled 'Reframing Dementia' on 21 June at the Crown Plaza, Dundalk. This half-day workshop, hosted by CARDI, focussed on how to develop and promote new perspectives on communication about dementia. Speakers included:�� Professor Baldwin Van Gorp, KULeuven, Belgium: Click here for presentation Professor Eamon O Shea, Irish Centre for Social Gerontology: Click here for presentation����

Medication use in patients with end of life dementia:Presentations

CARDI recently launched a new report (Friday 6 July 2012) which finds considerable uncertainty and variation in the medicines doctors say they would prescribe for patients with dementia at the end of life when presented with clinical scenarios. The all-Ireland research, led by a team at QUB, finds evidence that GPs and hospital physicians indicate they would continue with dementia medications and statins and actively prescribe antibiotics when there is limited evidence of benefits to patients with dementia at end of life.Links to presentations are below:Assessment of factors which influence decision-making regarding medication use in patients with dementia at the end of life: Prof Carmel HughesMedication use in patients with end of life dementia: Dr Shaun O'Keefe

CARDI Research Brief: Medication use in patients with dementia at the end of life

��Palliative care and medication use are important issues in dealing with end-of-life stage dementia. As research into palliative care for patients with advanced dementia has been limited to date, CARDI funded a project, led by Dr. Carole Parsons of Queen’s University Belfast, as part of its grants programme. This project aimed to evaluate the extent to which patient-related factors influenced clinical decision-making with regard to medication use in patients with endstagedementia. This research brief presents a summary of the findings from the full report, Assessment of factors which influence physician decisionmaking regarding medication use in patients with dementia at the end of life (Parsons, et al., 2012).Read the research brief here: Medication use in patients with dementia at the end of lifeRead the press release here

Reframing Dementia Report

The European Foundations’ Initiative on Dementia (EFID) held a workshop entitled 'Reframing Dementia' on 21 June at the Crown Plaza, Dundalk. This half-day workshop, hosted by CARDI, focussed on how to develop and promote new perspectives on communication about dementia. Paul McGill, Strategic Research Officer, CARDI, has written this report on the event. Read it here

Guidance on starting end of life care conversations with people affected by dementia

Dementia UK, as a member of the Dying Matters coalition, contributed to a new leaflet that discusses how to begin conversations around end of life care for people with dementia. Aimed at GPs and families who have recently received a dementia diagnosis, this leaflet provides at-a-glance information about having this very necessary conversation and includes information about when to talk about it and tips about what to say. Download the leaflet

CARDI submission on the National Dementia Strategy

CARDI's submission to the Department of Health on the National Dementia Strategy is available here:CARDI: Development of a National Strategy on Dementia

Submission from the Irish Society of Physicians in Geriatric Medicine for the National Dementia strategy

The submission from the Irish Society of Physicians in Geriatric Medicine to the Minister for Health and Children for the National Dementia strategy is available to read here

Building Consensus for the Future - Report of the Feasibility Study on Palliative Care for People with Dementia

The Alzheimer Society of Ireland have launched a report "Building Consensus for the Future: Report of the Feasibility Study on Palliative Care for People with Dementia".�� The report outlines the findings of a research project carried out in association with the Irish Hospice Foundation.

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.������