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Karamacoska D, Heins P, Branco RM, Wallcook S, Truong A, Leung I, Sawan M, Page ZA, Borelli WV, Arroyo‐Miranda ML, Demnitz N, Folarin R, Guo T, Shaaban CE, Smith A, Bartels SL. How are early-career dementia researchers considered and supported on a national level by dementia plans and organizations? An overview of global policy approaches. Alzheimers Dement 2024; 20:4727-4736. [PMID: 38865429 PMCID: PMC11247705 DOI: 10.1002/alz.13906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/25/2024] [Accepted: 04/25/2024] [Indexed: 06/14/2024]
Abstract
INTRODUCTION Despite representing an essential workforce, it is unclear how global policy efforts target early-career dementia researchers (ECDRs). Thus, this study aimed to provide an overview of policies through which ECDRs are considered and supported by dementia plans and organizations. METHODS G20 member states were evaluated for their national dementia plan alongside policies of leading dementia organizations. Data targeting support for ECDRs were extracted and subject to content analysis using inductive coding. Findings were categorized and narratively synthesized. RESULTS Only China, Denmark, England, Greece, Northern Ireland, Scotland, Spain, and the United States mentioned ECDRs in their national plan. Additionally, 17 countries formalized ECDR support via dementia organizations. Support efforts included research funding, dissemination and networking, career development, and research advice. DISCUSSION Few nations formally recognized ECDRs in dementia plans or through dementia organizations. To facilitate equal prospects for ECDRs, top-down approaches are urged to enhance and align their efforts. HIGHLIGHTS Few G20 countries (8/46) had national dementia plans for early-career researchers. Targeted support comes from government and nongovernmental dementia organizations. Support includes funding, training, advice, research dissemination, and networking. Inconsistent definitions and eligibility criteria are barriers to accessing support. Global coordination and top-down policy will aid early-career dementia researchers.
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Affiliation(s)
- Diana Karamacoska
- NICM Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
| | - Pascale Heins
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and NeurosciencesMaastricht UniversityMaastrichtThe Netherlands
| | - Rita Maldonado Branco
- Research Institute of Design, Media and Culture (ID+), Department of Communication and ArtUniversity of AveiroAveiroPortugal
| | - Sarah Wallcook
- The Care Research Group, Department of Social WorkStockholm UniversityStockholmSweden
| | - Annie Truong
- Brain and Mind CentreUniversity of SydneyCamperdownNew South WalesAustralia
| | - Isabella Leung
- School of Health SciencesWestern Sydney UniversityCampbelltownNew South WalesAustralia
| | - Mouna Sawan
- School of PharmacyFaculty of Medicine and HealthUniversity of SydneyCamperdownNew South WalesAustralia
| | - Zara Alana Page
- Centre for Healthy Brain AgeingUniversity of New South WalesSydneyNew South WalesAustralia
| | - Wyllians Vendramini Borelli
- Pharmacology and Therapeutics Research Program, Federal University of Rio Grande do Sul (UFRGS) AND Neurology ServiceHospital de Clinicas de Porto Alegre (HCPA)Porto AlegreBrazil
| | | | - Naiara Demnitz
- Danish Research Centre for Magnetic ResonanceCentre for Functional and Diagnostic Imaging and ResearchCopenhagen University Hospital ‐ Amager and HvidovreHvidovreDenmark
| | - Royhaan Folarin
- Department of AnatomyOlabisi Onabanjo UniversitySagamuNigeria
| | - Tengfei Guo
- Institute of Biomedical EngineeringShenzhen Bay LaboratoryShenzhenChina
| | - C. Elizabeth Shaaban
- Department of EpidemiologySchool of Public HealthUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Adam Smith
- Institute of NeurologyUniversity College LondonLondonUK
| | - Sara Laureen Bartels
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and NeurosciencesMaastricht UniversityMaastrichtThe Netherlands
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Dukelow T, Vassilev P, Lawrence EG, Jacobson L, Koychev I, Muhammed K, Kennelly SP. Barriers to brain health behaviours: results from the Five Lives Brain Health Ireland Survey. Front Psychol 2023; 14:1101514. [PMID: 37691817 PMCID: PMC10483831 DOI: 10.3389/fpsyg.2023.1101514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 04/17/2023] [Indexed: 09/12/2023] Open
Abstract
Modifiable risk factors for dementia remain prevalent in Ireland. A detailed examination of barriers to risk reduction behaviours in an Irish context has heretofore been lacking. Many existing studies examining barriers to brain health behaviours fail to examine how they might vary across different modifiable risk factors. This study undertook a detailed assessment of barriers to individual risk reduction behaviours. As existing research suggests that barriers may vary across sociodemographic factors, we sought to investigate the distribution of barriers across age, gender, educational status, and household income. The Five Lives Brain Health Ireland Survey is a cross-sectional survey that was distributed online amongst a non-patient population. The survey captured the following: (1) Sociodemographic factors; (2) Barriers to brain health behaviours; (3) Exposure to, and knowledge of, modifiable risk factors for dementia, namely diet, social interaction, exercise, hypertension, sleep, current low mood/depression, current smoking, alcohol consumption, cognitive stimulation, hearing impairment, diabetes, air pollution, and head injury; (4) Participants' perceptions regarding potential for dementia prevention, and risk reduction. Lack of motivation was the most prevalent barrier to consuming a healthy diet (64%, n = 213), physical activity (77.7%, n = 167), smoking cessation (68%, n = 85), and moderation of alcohol intake (56.3%, n = 67). Practical factors were the most prevalent barriers to addressing low mood (56.5%, n = 87), air pollution (30.1%, n = 58), hearing impairment (63.8%, n = 44), diabetes (11.1%, n = 5), and head injury (80%, n = 8). Emotional factors were the most prevalent barriers to engaging in mentally stimulating activity (56.9%, n = 66), social activity (54.9%, n = 302), and good sleep (70.1%, n = 129). Lack of knowledge was the most prevalent barrier to hypertension control (14.4%, n = 29). Distribution of barriers varied across age, gender, educational status, and household income. This study investigated barriers to lifestyle change to improve brain health in an Irish sample of adults aged 50 and above. Detailed subtyping of barriers, as well as examination of differences according to age, gender, education, and income were undertaken. The heterogeneity of barriers to brain health behaviours revealed in this study highlights the necessity to tailor public health interventions to their target population, taking into account the gender, age, educational status, and income of recipients.
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Affiliation(s)
- Tim Dukelow
- Cork University Hospital (CUH), Cork, Ireland
| | | | - Erin Grace Lawrence
- Five Lives SAS, Tours, France
- Unit of Psychological Medicine, Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary, University of London, London, United Kingdom
| | | | - Ivan Koychev
- Five Lives SAS, Tours, France
- Department of Psychiatry, University of Oxford, Oxford, England, United Kingdom
| | - Kinan Muhammed
- Nuffield Department of Clinical Neurosciences, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, Oxford, England, United Kingdom
| | - Sean P. Kennelly
- Department of Age Related Health Care, Tallaght University Hospital, Dublin, Ireland
- Trinity College Dublin, Dublin, Ireland
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Chen J, Wang X, Xu Z. The Relationship Between Chronic Pain and Cognitive Impairment in the Elderly: A Review of Current Evidence. J Pain Res 2023; 16:2309-2319. [PMID: 37441267 PMCID: PMC10335316 DOI: 10.2147/jpr.s416253] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
Chronic pain and cognitive impairment are prevalent geriatric syndromes in the population of older adults, and they are the main cause of disability in people over sixty-five years of age. As the global population continues to age, chronic pain and cognitive impairment will affect an increasing number of older adults. While numerous studies in recent years have shown that chronic pain is associated with cognitive decline, the exact mechanisms linking the two remain unclear. In this review, we aim to present the available evidence on the connection between chronic pain and cognitive impairment and to discuss the potential mechanisms by which chronic pain affects cognitive function. In addition, we review potential therapeutic interventions targeting psychological factors, microglia activation, and altered gut flora that may improve and prevent cognitive decline in people with chronic pain.
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Affiliation(s)
- Jintao Chen
- Department of Geriatrics, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, People’s Republic of China
| | - Xinyi Wang
- Department of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Zherong Xu
- Department of Geriatrics, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, People’s Republic of China
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Eyting M, Xie M, Heß S, Geldsetzer P. Causal evidence that herpes zoster vaccination prevents a proportion of dementia cases. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.23.23290253. [PMID: 37292746 PMCID: PMC10246135 DOI: 10.1101/2023.05.23.23290253] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The root causes of dementia are still largely unclear, and the medical community lacks highly effective preventive and therapeutic pharmaceutical agents for dementia despite large investments into their development. There is growing interest in the question if infectious agents play a role in the development of dementia, with herpesviruses attracting particular attention. To provide causal as opposed to merely correlational evidence on this question, we take advantage of the fact that in Wales eligibility for the herpes zoster vaccine (Zostavax) for shingles prevention was determined based on an individual's exact date of birth. Those born before September 2 1933 were ineligible and remained ineligible for life, while those born on or after September 2 1933 were eligible to receive the vaccine. By using country-wide data on all vaccinations received, primary and secondary care encounters, death certificates, and patients' date of birth in weeks, we first show that the percentage of adults who received the vaccine increased from 0.01% among patients who were merely one week too old to be eligible, to 47.2% among those who were just one week younger. Apart from this large difference in the probability of ever receiving the herpes zoster vaccine, there is no plausible reason why those born just one week prior to September 2 1933 should differ systematically from those born one week later. We demonstrate this empirically by showing that there were no systematic differences (e.g., in pre-existing conditions or uptake of other preventive interventions) between adults across the date-of-birth eligibility cutoff, and that there were no other interventions that used the exact same date-of-birth eligibility cutoff as was used for the herpes zoster vaccine program. This unique natural randomization, thus, allows for robust causal, rather than correlational, effect estimation. We first replicate the vaccine's known effect from clinical trials of reducing the occurrence of shingles. We then show that receiving the herpes zoster vaccine reduced the probability of a new dementia diagnosis over a follow-up period of seven years by 3.5 percentage points (95% CI: 0.6 - 7.1, p=0.019), corresponding to a 19.9% relative reduction in the occurrence of dementia. Besides preventing shingles and dementia, the herpes zoster vaccine had no effects on any other common causes of morbidity and mortality. In exploratory analyses, we find that the protective effects from the vaccine for dementia are far stronger among women than men. Randomized trials are needed to determine the optimal population groups and time interval for administration of the herpes zoster vaccine to prevent or delay dementia, as well as to quantify the magnitude of the causal effect when more precise measures of cognition are used. Our findings strongly suggest an important role of the varicella zoster virus in the etiology of dementia.
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Affiliation(s)
- Markus Eyting
- Division of Primary Care and Population Health, Department of
Medicine, Stanford University; Stanford, CA 94305, USA
- Heidelberg Institute of Global Health (HIGH), Heidelberg
University; 69120 Heidelberg, Germany
- Gutenberg School of Management and Economics, Johannes Gutenberg
University Mainz; 55128 Mainz, Germany
| | - Min Xie
- Division of Primary Care and Population Health, Department of
Medicine, Stanford University; Stanford, CA 94305, USA
- Heidelberg Institute of Global Health (HIGH), Heidelberg
University; 69120 Heidelberg, Germany
| | - Simon Heß
- Department of Economics, University of Vienna; 1090 Vienna,
Austria
| | - Pascal Geldsetzer
- Division of Primary Care and Population Health, Department of
Medicine, Stanford University; Stanford, CA 94305, USA
- Department of Epidemiology and Population Health, Stanford
University; Stanford, CA 94305, USA
- Chan Zuckerberg Biohub – San Francisco; San Francisco, CA
94158, USA
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Zhu Z, Zheng Z, Zhou C, Cao L, Zhao G. Trends in Prevalence and Disability-Adjusted Life-Years of Alzheimer's Disease and Other Dementias in China from 1990 to 2019. Neuroepidemiology 2023; 57:206-217. [PMID: 37231950 DOI: 10.1159/000530593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 03/21/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION China has the largest population of people with dementia in the world and is estimated to have approximately a quarter of the entire population with dementia worldwide, bringing a heavy burden on the public and healthcare systems. We aimed to analyze the burden of Alzheimer's disease and other dementias in China over the past three decades. METHODS The data on disease burden owing to Alzheimer's disease and other dementias in China from 1990 to 2019 were extracted from the Global Burden of Disease (GBD) 2019 datasets. The estimated annual percentage changes (EAPCs) were calculated to assess the temporal trends, and the ratio of years lived with disability (YLDs) to disability-adjusted life-years (DALYs) was used as an indicator to evaluate the healthcare system. RESULT In China, the overall age-standardized rates (ASRs) of the prevalence and DALYs of Alzheimer's disease and other dementias increased from 1990 to 2019, and their EAPCs were 0.66 (95% confidence interval [CI], 0.57-0.75) and 0.26 (95% CI, 0.21-0.31), respectively. ASRs and the total number of dementia in females remained higher than in males, but the upward trend in ASRs among men was more pronounced than in women. The female-to-male ratio of the age-standardized DALY rate peaked in the 75-79 year age group in 2019 (female-to-male ratio of 1.32). The YLDs:DALYs ratio in China experienced a gradual increase and finally stayed above the global average since 2011. CONCLUSION China has experienced a remarkably rising burden of dementia over the past three decades. The more significant burden of dementia was in females, but the potentially increasing burden of dementia in males cannot be underestimated.
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Affiliation(s)
- Zeyu Zhu
- Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Zhilin Zheng
- Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Chen Zhou
- Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Lanxiao Cao
- Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Guohua Zhao
- Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Wu Y, Zheng H, Xu F, Guo J, Liu Z, Wang S, Chen X, Cao Y, Zou W, Hu S. Population attributable fractions for risk factors and disability burden of dementia in Jiangxi Province, China: a cross-sectional study. BMC Geriatr 2022; 22:811. [PMID: 36271341 PMCID: PMC9587554 DOI: 10.1186/s12877-022-03507-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 10/08/2022] [Indexed: 11/26/2022] Open
Abstract
Background In view of the fact that there is no effective treatment for dementia, the number of years that dementia patients have to live with dementia will gradually increase for the rest of their lives, and the disability loss caused by dementia will increase. It is urgent to study the influence of risk factors on dementia by making use of the potential of prevention. The purpose of this study is to quantify the burden of dementia disability attributable to risk factors by assessing the population attributable fractions (PAFs) in Jiangxi Province, which is one of the regions of moderate aging process of China. Methods The prevalence data of nine risk factors were obtained through the Sixth National Health Service Survey in 2018, which covered 2713 older people. Levin’s formula was used to calculate the PAF for each risk factor for dementia. We adjusted the PAF for communality between risk factors, and used these values to calculate overall weighted PAFs and the years lived with disability (YLDs), which were attributable to nine risk factors. Results The number of dementia cases and their proportions that can theoretically be prevented by nine identified risk factors were 111636 (99595-120877) and 66.8% (59.6-72.3), respectively. The total YLDs of dementia were estimated to be 61136 (46463-78369) (males: 36434 [24100-49330], females: 23956 [14716-34589]). Physical inactivity (11639 [8845-14920]), low social contact (9324 [7086-11952]), and hearing loss (5668 [4307-7265] were the top three contributors to dementia. Conclusions The moderate aging areas represented by Jiangxi Province have great potential in the prevention of dementia. Targeted interventions and management of risk factors can effectively reduce the disability burden of dementia. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03507-4.
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Affiliation(s)
- Yuhang Wu
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, 330006, Jiangxi, China.,Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Huilie Zheng
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Fenfei Xu
- Health Development Center of Jiangxi Province, Nanchang, China
| | - Jin Guo
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Zhitao Liu
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Shengwei Wang
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Xiaoyun Chen
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Yu Cao
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Wei Zou
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Songbo Hu
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, 330006, Jiangxi, China.
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Prendergast L, Toms G, Seddon D, Tudor Edwards R, Anthony B, Jones C. 'It was just - everything was normal': outcomes for people living with dementia, their unpaid carers, and paid carers in a Shared Lives day support service. Aging Ment Health 2022:1-9. [PMID: 35848206 DOI: 10.1080/13607863.2022.2098921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Short breaks support the wellbeing of people living with dementia (PLWD) and their unpaid carers. However, little is known about the benefits of community-based short breaks. The objective of this study was to conduct interviews with stakeholders of a Shared Lives (SL) day support service to explore mechanisms and outcomes for the service. The aim of the study was to refine a logic model for a SL day support service for PLWD, their unpaid carers, and paid carers. This logic model shall form the basis for a Social Return on Investment evaluation to identify the social value contributed by the service. METHODS Thirteen interviews were conducted with service stakeholders including PLWD, unpaid carers and paid carers. Framework analysis assisted in the synthesis of the findings into a logic model. RESULTS The logic model refined through the interviews, detailed service mechanisms (inputs, activities, outputs) and outcomes. An overarching theme from the interviews concerned the importance of triadic caring relationships, which conferred benefits for those involved in the service. CONCLUSION SL day support fosters triadic caring relationships, and interview data suggests that these relationships are associated with meaningful outcomes for PLWD, their unpaid carers, and paid carers. We highlight the implications for policy, practice, and future research.
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Affiliation(s)
- Louise Prendergast
- School of Medical and Health Sciences, Bangor University, Bangor, Wales, UK
| | - Gill Toms
- School of Medical and Health Sciences, Bangor University, Bangor, Wales, UK
| | - Diane Seddon
- Centre for Ageing and Dementia Research (CADR), Dementia Services Development Centre (DSDC) Wales Research Centre, School of Medical and Health Sciences, Bangor University, Bangor, Wales, UK
| | - Rhiannon Tudor Edwards
- Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Bangor, Wales, UK
| | - Bethany Anthony
- Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Bangor, Wales, UK
| | - Carys Jones
- School of Medical and Health Sciences, Bangor University, Bangor, Wales, UK
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Sriram V, Jenkinson C, Peters M. Carers using assistive technology in dementia care at home: a mixed methods study. BMC Geriatr 2022; 22:490. [PMID: 35672662 PMCID: PMC9173970 DOI: 10.1186/s12877-022-03167-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 05/23/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Informal carers support persons with dementia to live at home, even with deteriorating physical, social and cognitive issues. This study aims to examine the experiences and impact of Assistive Technology (AT) on carers, providing care for a person with dementia. METHODS This is an explanatory sequential mixed methods study. The quantitative phase was an online and postal survey using the Carers Assistive Technology Experience Questionnaire and Short Form-12 (SF-12) questionnaire, with carers of persons with dementia in the UK, who used AT. The qualitative phase involved in-depth telephone interviews with a purposive sample of survey respondents and was analysed using hermeneutic phenomenology to develop, compare and explain the findings of the survey. RESULTS The survey included data from 201 carers. Smartphones (45.5%) and tablet computers (45.0%) were the most frequently used AT. Multiple AT were used in the care of persons with dementia predominantly for safety (78.5%), communication (66.0%), and reminders (62.5%). The SF-12 indicated that carers in the 46-65 age group and carers who were not extremely satisfied with AT had lower mental component scores whilst carers who lived with the person with dementia and older carers had lower physical component scores. Twenty-three carers participated in the interviews, and 5 themes with 14 sub-themes were identified. The interviews helped confirm data from the survey on the impact of AT on the physical, mental and social wellbeing of the carers. It helped describe reasons for satisfaction with AT; how AT was used in daily life and strengthened caring relationships and how wider support systems enhanced the care of a person with dementia using AT. CONCLUSIONS This study describes the use of AT in the real-world context. AT supplements the care provided to people with dementia in the community. Appropriate use, access to AT and abilities of the carer can enhance the support provided through AT to both carers and the person with dementia.
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Affiliation(s)
- Vimal Sriram
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF UK
| | - Crispin Jenkinson
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF UK
| | - Michele Peters
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF UK
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Sallnow L, Smith R, Ahmedzai SH, Bhadelia A, Chamberlain C, Cong Y, Doble B, Dullie L, Durie R, Finkelstein EA, Guglani S, Hodson M, Husebø BS, Kellehear A, Kitzinger C, Knaul FM, Murray SA, Neuberger J, O'Mahony S, Rajagopal MR, Russell S, Sase E, Sleeman KE, Solomon S, Taylor R, Tutu van Furth M, Wyatt K. Report of the Lancet Commission on the Value of Death: bringing death back into life. Lancet 2022; 399:837-884. [PMID: 35114146 PMCID: PMC8803389 DOI: 10.1016/s0140-6736(21)02314-x] [Citation(s) in RCA: 203] [Impact Index Per Article: 101.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 10/06/2021] [Accepted: 10/14/2021] [Indexed: 02/07/2023]
Affiliation(s)
| | | | | | - Afsan Bhadelia
- Harvard T H Chan School of Public Health, Boston, MA, USA
| | | | - Yali Cong
- Peking University Health Science Center, Beijing, China
| | | | | | | | | | | | | | | | | | | | | | | | - Julia Neuberger
- University College London Hospitals NHS Foundation Trust, London, UK
| | | | | | - Sarah Russell
- Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | - Eriko Sase
- Georgetown University, Washington, DC, USA
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Making personalised short breaks meaningful: a future research agenda to connect academia, policy and practice. QUALITY IN AGEING AND OLDER ADULTS 2021. [DOI: 10.1108/qaoa-10-2020-0050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Purpose
There is a growing policy impetus to promote carer well-being through the provision of personalised short breaks. However, understanding of what makes for a successful personalised short break is limited. This paper aims to identify key evidence gaps and considers how these could be addressed.
Design/methodology/approach
A scoping review mapping the evidence base relevant to respite and short breaks for carers for older people, including those living with dementia, was completed. National and international literature published from 2000 onwards was reviewed. The scoping review focused on well-being outcomes, identified by previous research, as being important to carers.
Findings
Most studies investigating the outcomes of short breaks for carers supporting older people focus on traditional day and residential respite care. Although there have been developments in more personalised break options for carers, research exploring their impact is scarce. There is limited knowledge about how these personalised breaks might support carers to realise important outcomes, including carer health and well-being; a life alongside caring; positive caregiving relationships; choices in caring; and satisfaction in caring. Three priority lines of inquiry to shape a future research agenda are identified: understanding what matters – evidencing personalised short break needs and intended outcomes; capturing what matters – outcomes from personalised short breaks; and commissioning, delivering and scaling up personalised short breaks provision to reflect what matters.
Originality/value
This paper contributes to the development of an outcome-focused research agenda on personalised short breaks.
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Autio J, Stenbäck V, Gagnon DD, Leppäluoto J, Herzig KH. (Neuro) Peptides, Physical Activity, and Cognition. J Clin Med 2020; 9:jcm9082592. [PMID: 32785144 PMCID: PMC7464334 DOI: 10.3390/jcm9082592] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/31/2020] [Accepted: 08/06/2020] [Indexed: 02/06/2023] Open
Abstract
Regular physical activity (PA) improves cognitive functions, prevents brain atrophy, and delays the onset of cognitive decline, dementia, and Alzheimer’s disease. Presently, there are no specific recommendations for PA producing positive effects on brain health and little is known on its mediators. PA affects production and release of several peptides secreted from peripheral and central tissues, targeting receptors located in the central nervous system (CNS). This review will provide a summary of the current knowledge on the association between PA and cognition with a focus on the role of (neuro)peptides. For the review we define peptides as molecules with less than 100 amino acids and exclude myokines. Tachykinins, somatostatin, and opioid peptides were excluded from this review since they were not affected by PA. There is evidence suggesting that PA increases peripheral insulin growth factor 1 (IGF-1) levels and elevated serum IGF-1 levels are associated with improved cognitive performance. It is therefore likely that IGF-1 plays a role in PA induced improvement of cognition. Other neuropeptides such as neuropeptide Y (NPY), ghrelin, galanin, and vasoactive intestinal peptide (VIP) could mediate the beneficial effects of PA on cognition, but the current literature regarding these (neuro)peptides is limited.
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Affiliation(s)
- Juho Autio
- Institute of Biomedicine, Medical Research Center, Faculty of Medicine, University of Oulu, Oulu University Hospital, 90220 Oulu, Finland; (J.A.); (V.S.); (D.D.G.); (J.L.)
| | - Ville Stenbäck
- Institute of Biomedicine, Medical Research Center, Faculty of Medicine, University of Oulu, Oulu University Hospital, 90220 Oulu, Finland; (J.A.); (V.S.); (D.D.G.); (J.L.)
- Biocenter Oulu, 90220 Oulu, Finland
| | - Dominique D. Gagnon
- Institute of Biomedicine, Medical Research Center, Faculty of Medicine, University of Oulu, Oulu University Hospital, 90220 Oulu, Finland; (J.A.); (V.S.); (D.D.G.); (J.L.)
- Laboratory of Environmental Exercise Physiology, School of Human Kinetics, Laurentian University, Sudbury, ON P3E 2C6, Canada
- Center of Research in Occupational Safety and Health, Laurentian University, Sudbury, ON P3E 2C6, Canada
| | - Juhani Leppäluoto
- Institute of Biomedicine, Medical Research Center, Faculty of Medicine, University of Oulu, Oulu University Hospital, 90220 Oulu, Finland; (J.A.); (V.S.); (D.D.G.); (J.L.)
| | - Karl-Heinz Herzig
- Institute of Biomedicine, Medical Research Center, Faculty of Medicine, University of Oulu, Oulu University Hospital, 90220 Oulu, Finland; (J.A.); (V.S.); (D.D.G.); (J.L.)
- Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, 60-572 Poznan, Poland
- Correspondence:
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