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Awareness weeks

Health Awareness Week

Dementia Action Week

There are 487,500 Australians living with dementia and the almost 1.6 million Australians involved in their care. Dementia action week will be held from 19-25 September, this includes World Alzheimer’s day on the 21 September.  Alzheimer’s Australia

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Evaluation and Diagnosis

Treatment

Articles

Screening and diagnosis

Research

Treatment and care

e-Books

Journals

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Screening and diagnosis

Perceptions of community members in Australia about the risk factors, symptoms and impacts of dementia: A cross-sectional questionnaire study There remains a need for increased community education to address knowledge gaps regarding modifiable risk factors, behavioural symptoms and potential impacts of dementia on the individual diagnosed and their carers. Australasian journal of aging 18 July 2022

Cognitive screening via comprehensive geriatric assessment of older patients for the risk factors of hospital revisit/readmission after emergency department visit at 3-month follow-up Dementia and geriatric cognitive disorders 22 August 2022
Older patients with cognitive impairment (COIM) had a higher rate of hospital admission and mortality at the 3-month follow-up than older patients without COIM. Among the no-COIM, cognitive mpairment, no dementia (CIND), and dementia groups, patients with dementia had significantly increased risks of hospital admission and revisit/readmission. The early detection of COIM, and even dementia, could help ED physicians formulate strategies with geriatric specialists to improve mortality outcomes and revisit/readmission. Dementia and geriatric cognitive disorders 22 August 2022

Accuracy of telephone screening tools to identify dementia patients remotely: systematic review
The COVID19 pandemic highlighted the need for remote diagnosis of cognitive impairment and dementia. Telephone screening for dementia may facilitate prompt diagnosis and optimisation of care. However, it is not clear how accurate telephone screening tools are compared with face-to-face screening. The authors searched Cochrane, MEDLINE, Embase, Web of Science, PubMed and Scopus for all English language papers published between January 1975 and February 2021 which compared telephone screening for dementia/ mild cognitive impairment and an in-person reference standard, performed within six-weeks. We subsequently searched paper reference lists and contacted authors if data were missing. Three reviewers independently screened studies for inclusion, extracted data, and assessed study quality using an adapted version of the Joanna Briggs Institute's critical appraisal tool. Twenty-one studies including 944 participants were found. No one test appears more accurate, with similar validities as in-person testing. Cut-offs for screening differed between studies based on demographics and acceptability thresholds and meta-analysis was not appropriate. Overall the results suggest telephone screening is acceptably sensitive and specific however, given the limited data, this finding must be treated with some caution. It may not be suitable for those with hearing impairments and anxiety around technology. Few studies were carried out in general practice where most screening occurs and further research is recommended in such lower prevalence environments. JRMS open 1 September 2022

The Alzheimer's Association appropriate use recommendations for blood biomarkers in Alzheimer's disease
Blood-based markers (BBMs) have recently shown promise to revolutionize the diagnostic and prognostic work-up of Alzheimer's disease (AD), as well as to improve the design of interventional trials. Here we discuss in detail further research needed to be performed before widespread use of BBMs. We already now recommend use of BBMs as (pre-)screeners to identify individuals likely to have AD pathological changes for inclusion in trials evaluating disease-modifying therapies, provided the AD status is confirmed with positron emission tomography (PET) or cerebrospinal fluid (CSF) testing. We also encourage studying longitudinal BBM changes in ongoing as well as future interventional trials. However, BBMs should not yet be used as primary endpoints in pivotal trials. Further, we recommend to cautiously start using BBMs in specialized memory clinics as part of the diagnostic work-up of patients with cognitive symptoms and the results should be confirmed whenever possible with CSF or PET. Additional data are needed before use of BBMs as stand-alone diagnostic AD markers, or before considering use in primary care. Alzheimer’s and dementia 31 July 2022

The knowledge and attitudes of primary care and the barriers to early detection and diagnosis of Alzheimer’s disease
Primary care physicians play a vital role in the clinical care of their patients, early identification of dementia, and disease advocacy. It is essential to assess the knowledge and attitudes of physicians in the diagnosis of Alzheimer’s disease and other dementias. In primary care, the diagnosis of Alzheimer’s disease is often missed or delayed. With the increased prevalence of Alzheimer’s disease and the growing impact of dementia on health care resources, early detection by primary care physicians (PCP) is essential. Thus, their knowledge and attitudes about early detection and diagnosis are crucial. This article identifies several interrelated obstacles to early detection and diagnosis in primary dementia care, including gaps in knowledge, attitudes, skills, and resources for person with dementia (PWD)/caregivers and their primary care providers and systematic and structural barriers that negatively impact dementia care. Research shows that Alzheimer’s disease has gone underdiagnosed and undertreated. Delays in detection, diagnosis, and resource utilization may have social and clinical implications for individuals affected by Alzheimer’s disease and their families, including challenges in obtaining an accurate diagnosis. Until the issues of missed and delayed Alzheimer’s screening become more compelling, efforts to promote early detection and diagnosis should focus on the education of physicians and removing the barriers to diagnosis. Medicina 7 July 2022

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Research

Association of daily step count and intensity with incident dementia in 78 430 adults living in the UK
In this cohort study, a higher number of steps was associated with lower risk of all-cause dementia. The findings suggest that a dose of just under 10 000 steps per day may be optimally associated with a lower risk of dementia. Steps performed at higher intensity resulted in stronger associations. JAMA 6 September 2022

Association of serum antioxidant vitamins and carotenoids with incident Alzheimer disease and all-cause dementia among US adults
Incident all-cause dementia was inversely associated with serum lutein+zeaxanthin and β-cryptoxanthin levels. Further studies with time-dependent exposures and randomized trials are needed to test neuroprotective effects of supplementing the diet with select carotenoids. Neurology 4 May 2022

The relationship between alcohol use and dementia in adults aged more than 60 years: a combined analysis of prospective, individual-participant data from 15 international studies
Abstinence from alcohol appears to be associated with an increased risk for all-cause dementia. Among current drinkers, there appears to be no consistent evidence to suggest that the amount of alcohol consumed in later life is associated with dementia risk. Addiction 22 August 2022

Global prevalence of young-onset dementia: A systematic review and meta-analysis
This systematic review and meta-analysis found an age-standardized prevalence of YOD of 119.0 per 100 000 population, although estimates of the prevalence in low-income countries and younger age ranges remain scarce. These results should help policy makers organize sufficient health care for this subgroup of individuals with dementia. JAMA 19 July 2021

Mortality rates in Alzheimer’s disease and non-Alzheimer’s dementias: a systematic review and meta-analysis
Alzheimer’s disease is the most common type of dementia and one of the major causes of mortality worldwide. However, the findings from the current study suggest that non-Alzheimer’s disease dementias were associated with higher morality rates and shorter life expectancy than Alzheimer’s disease. Developing tailored treatment and rehabilitation programmes for different types of dementia is important for mental health providers, patients, and their families. The Lancet healthy longevity 20 July 2021

Periodontal health, cognitive decline, and dementia: A systematic review and meta-analysis of longitudinal studies
Poor periodontal health and tooth loss appear to increase the risk of both cognitive decline and dementia. However, the available evidence is limited (e.g., highly heterogenous, lacking robust methodology) to draw firm conclusions. Further well-designed studies involving standardized periodontal and cognitive health assessment and addressing reverse causality are highly warranted. Journal of the American Geriatrics Society 8 September 2022

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Treatment and care

Demographic and clinical profile of residents living with dementia and depressive symptoms in Australian private residential aged care: Data from the Music Interventions for Dementia and Depression in ELderly care (MIDDEL) cluster-randomised controlled trial
The findings from our study highlight the diverse and complex care needs of people living with dementia in the Australian private RAC setting, which can be used to inform targeted, person-centred dementia care planning, staff training and allocation of resources. Australasian journal on aging 8 July 2022

Managing neuropsychiatric symptoms in patients with dementia
What you need to know

  • Non-medical interventions such as psychological treatments and psychosocial and environmental modifications are recommended for people with dementia who experience neuropsychiatric symptoms such as agitation, aggression, and depression
  • Evidence of low to moderate quality shows that multidisciplinary care and non-medication interventions are as effective, or more so, than medications (eg, antipsychotics) for reducing neuropsychiatric symptoms
  • Avoid prescribing medications in lieu of antipsychotics (eg, antidepressants and anticonvulsants) because they are associated with potential harms in people with dementia (eg, risk of fall or fracture)
  • Develop person centred and measurable treatment goals and re-evaluate these at regular intervals
  • Support change at an organisational level by establishing an interprofessional team responsible for psychotropic medication stewardship, and agree on criteria for appropriateness of psychotropic medication, educate care staff, inform and involve family and friend carers, and establish a process for regular review of medications

BMJ 25 January 2022

Ward based management of behavioural and psychological symptoms of dementia
What you need to know

  • Behavioural and psychological symptoms of dementia (BPSD) can be exacerbated by a plethora of underlying reversible factors (eg, poor pain control)
  • Identifying possible environmental or clinical triggers for a patient’s symptoms is the main aim of assessment in someone with an exacerbation of BPSD
  • Non-pharmacological interventions, such as managing environmental factors, are first line and should be tailored to the individual patient
  • When considering pharmacological intervention, focus on medications with evidence of benefit in BPSD. Drug interventions will not be able to address all symptoms
  • Pharmacological sedation should only be used in emergency situations

BMJ 4 August 2021

The relationship between alcohol use and dementia in adults aged more than 60 years: a combined analysis of prospective, individual-participant data from 15 international studies
Abstinence from alcohol appears to be associated with an increased risk for all-cause dementia. Among current drinkers, there appears to be no consistent evidence to suggest that the amount of alcohol consumed in later life is associated with dementia risk. Addiction 22 August 2022

New horizons for caring for people with dementia in hospital: the DEMENTIA CARE pointers for service change
Key Points

  • Hospitalisation for an older adult with dementia is very challenging.
  • We propose 12 ‘DEMENTIA CARE’ pointers for service change, developed from robust evidence and informed by stakeholders.
  • The pointers for service change provide actionable strategies relating to personal, environmental and institutional practices.
  • Implementing best practice in dementia care needs a hospital wide approach.

Age and aging 2 September 2022

Non-pharmacological interventions for the hallucinations in patients with Dementia. A cross-over randomized controlled trial
Validation therapy (VT)/Psycho-educational program followed by Music therapy (MT), followed by Reminiscence therapy (RT) is an effective combination of non-pharmacological interventions that can reduce hallucinations in patients with dementia and caregivers' burden. Non-pharmacological interventions should be further examined as an effective alternative for the reduction of the hallucinations in dementia. Journal of clinical case reports 2 September 2022

Treatment preferences among adults with normal cognition and cognitive impairment
Compared to those with normal cognition, cognitive impairment was associated with greater uncertainty about treatment preferences and higher rates of aggressive care preferences among those who specified preferences. Further research should assess whether preferences for aggressive care become more common as cognition declines in order to improve preference-concordant care delivery for patients with cognitive impairment. Journal of the American Geriatrics Society 12 September 2022

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E-books

This is a sample of the e-books the library subscribes to – you will need your library login

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Journals

This is a sample of the journals the library subscribes to – you will need your library login

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Previous Awareness Weeks

Missed out on a previous awareness week? You can now see previous awareness weeks here.