1
|
Chandrashekar P, Nagaraj H. Assessment of dementia knowledge in Indian speech-language pathology students. DEMENTIA 2024; 23:800-816. [PMID: 38300146 DOI: 10.1177/14713012241231145] [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] [Indexed: 02/02/2024]
Abstract
OBJECTIVES Speech-language pathologists (SLPs) have a crucial role in assisting individuals with dementia due to the communication and swallowing challenges associated with the disease. As the number of dementia cases rises in India at an increasing rate, investigating the level of dementia knowledge of SLP students can offer insight into the preparedness of the healthcare system to meet this emerging demand. METHOD A cross-sectional survey was conducted on SLP students pursuing their final year undergraduate, postgraduate and doctoral degrees from four universities across India. Dementia knowledge was assessed using the Dementia Knowledge Assessment Scale (DKAS) and information about previous dementia exposure (both formal and informal) was collected. The collected data were analysed using quantitative methods. RESULTS A total of 220 students (64.70% response rate) completed the survey. Overall dementia knowledge was inadequate with an average score of 22.08 ± 10.06. Previous dementia exposure among the students was also found to be low and did not affect dementia knowledge scores. DISCUSSION Despite the fundamental role SLPs play in the care of individuals with dementia, the lack of knowledge in this area emphasizes the need for enhancing dementia training programs through educational curricula and clinical placements.
Collapse
Affiliation(s)
- Pooja Chandrashekar
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, India
| | - Hema Nagaraj
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, India
| |
Collapse
|
2
|
Morse RM, Lang I, Rapaport P, Poppe M, Morgan-Trimmer S, Cooper C. How might secondary dementia prevention programs work in practice: a pre-implementation study of the APPLE-Tree program. BMC Geriatr 2024; 24:188. [PMID: 38408902 PMCID: PMC10895907 DOI: 10.1186/s12877-024-04762-3] [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: 06/28/2023] [Accepted: 01/30/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Over 850,000 people in the UK currently have dementia, and that number is expected to grow rapidly. One approach that may help slow or prevent this growth is personalized dementia prevention. For most people, this will involve targeted lifestyle changes. These approaches have shown promise in trials, but as of yet, the evidence for how to scale them to a population level is lacking. In this pre-implementation study, we aimed to explore stakeholder perspectives on developing system-readiness for dementia prevention programs. We focused on the APPLE-Tree program, one of several low-intensity, lifestyle-based dementia prevention interventions currently in clinical trials. METHODS We conducted semi-structured interviews with health and social care professionals without previous experience with the APPLE-Tree program, who had direct care or managerial experience in services for older adults with memory concerns, without a dementia diagnosis. We used the Consolidated Framework for Implementation Research to guide interviews and thematic analysis. RESULTS We interviewed 26 stakeholders: commissioners and service managers (n = 15) and frontline workers (n = 11) from eight NHS and 11 third sector organizations throughout England. We identified three main themes: (1) favorable beliefs in the effectiveness of dementia prevention programs in enhancing cognition and wellbeing and their potential to fill a service gap for people with memory concerns, (2) challenges related to funding and capacity to deliver such programs at organizations without staff capacity or higher prioritization of dementia services, and (3) modifications to delivery and guidance required for compatibility with organizations and patients. CONCLUSION This study highlights likely challenges in scale-up if we are to make personalized dementia prevention widely available. This will only be possible with increased funding of dementia prevention activities; integrated care systems, with their focus on prevention, may enable this. Scale-up of dementia prevention programs will also require clear outlines of their core and adaptable components to fit funding, patient, and facilitator needs.
Collapse
Affiliation(s)
- Rachel M Morse
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
| | - Iain Lang
- Department of Health and Community Sciences, University of Exeter Medical School , Exeter, UK
- UK National Institute for Health and Care Research (NIHR) Applied Research Collaboration South West Peninsula (NIHR PenARC), Exeter , UK
| | - Penny Rapaport
- Division of Psychiatry, University College London, London, UK
| | - Michaela Poppe
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Sarah Morgan-Trimmer
- Department of Health and Community Sciences, University of Exeter Medical School , Exeter, UK
| | - Claudia Cooper
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| |
Collapse
|
3
|
Veneziano M, Piazza MF, Palummeri E, Paganino C, Andreoli GB, Amicizia D, Ansaldi F. A Longitudinal Study on Cognitive Training for Cognitively Preserved Adults in Liguria, Italy. Healthcare (Basel) 2024; 12:393. [PMID: 38338278 PMCID: PMC10855271 DOI: 10.3390/healthcare12030393] [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: 12/07/2023] [Revised: 01/13/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
In this study, we examined the effects of memory training on cognitive function and depressive symptoms in a cohort of 794 healthy adults aged 50 years or older. Participants were divided into an active intervention group and a passive intervention group, with various cognitive measures assessed over a one-year period. Univariate analysis revealed that the active intervention group consistently outperformed the passive group in measures of memory self-perception (Memory Complaint Questionnaire-MACQ), depressive symptoms (Geriatric Depression Scale-GDS-4), verbal memory and recall ability (A3LP), and verbal fluency (VF). Significant differences in MACQ scores were observed between the two groups at all time points, indicating enhanced memory self-perception in the active group. GDS-4 scores consistently favored the active group, suggesting a reduction in depressive symptoms. A3LP scores demonstrated that the active group had better verbal memory and recall abilities. VF scores consistently favored the active group, indicating superior language skills and cognitive flexibility. Linear regression model and mixed linear regression model reinforced these findings, with highly significant interaction effects observed between the active/passive group, gender, age, education, and time. These effects were particularly pronounced for MACQ and A3LP scores, indicating the combined impact of these factors on memory self-perception and verbal memory. This study highlights the positive impact of memory training intervention on cognitive function and depressive symptoms in older adults and underscores the importance of considering gender, age, and education in cognitive interventions. Notably, these benefits persist for up to six months from the end of the program. The results provide valuable insights into cognitive changes in aging populations and suggest that tailored memory training programs can yield significant improvements.
Collapse
Affiliation(s)
| | - Maria Francesca Piazza
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy; (E.P.); (G.B.A.); or (D.A.); or (F.A.)
| | - Ernesto Palummeri
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy; (E.P.); (G.B.A.); or (D.A.); or (F.A.)
| | - Chiara Paganino
- Local Health Unit 3 (ASL3), 16125 Genoa, Italy; (M.V.); (C.P.)
| | | | - Daniela Amicizia
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy; (E.P.); (G.B.A.); or (D.A.); or (F.A.)
- Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy
| | - Filippo Ansaldi
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy; (E.P.); (G.B.A.); or (D.A.); or (F.A.)
- Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy
| |
Collapse
|
4
|
Mattia A, Blasimme A. From Research to Policy: Unveiling Dementia Prevention Efforts in Switzerland. J Aging Soc Policy 2024:1-21. [PMID: 38179785 DOI: 10.1080/08959420.2023.2297602] [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: 04/18/2023] [Accepted: 11/01/2023] [Indexed: 01/06/2024]
Abstract
Recent research has challenged the notion that dementia is an inevitable outcome of age-related cognitive decline, highlighting the possibility of preventing or delaying onset by addressing specific risk factors. This paradigm shift suggests that prevention through lifestyle modifications and early interventions is possible, potentially averting millions of cases worldwide. This study explores the translation of scientific evidence on dementia prevention into public health policy in Switzerland. Combining the analysis of official policy documents and qualitative interviews with stakeholders, the study explores potential barriers and challenges to implementing preventive intervenions or programs, as well as opportunities for improvement. Results indicate a significant gap in incorporating emerging scientific evidence on dementia prevention into health policies and disseminating information to the public in Switzerland. This study underscores the need for a collaborative and coordinated approach to address these barriers and effectively translate scientific findings into preventive policies and campaigns. These insights can inform policy and targeted programs in Switzerland both at the federal and the cantonal level, eventually serving as a model for other countries seeking to translate evidence-based dementia prevention strategies into public health policies. By bridging the gap between research and policy, significant progress can be made in preventing or delaying the onset of dementia, providing significant benefits to individuals, families, and society.
Collapse
Affiliation(s)
- Andreoletti Mattia
- Department of Health Sciences and Technology, Eidgenossische Technische Hochschule, Zurich, Switzerland
| | - Alessandro Blasimme
- Department of Health Sciences and Technology, Eidgenossische Technische Hochschule, Zurich, Switzerland
| |
Collapse
|
5
|
Jones D, Drewery R, Windle K, Humphrey S, de Paiva AF. Dementia prevention and the GP's role: a qualitative interview study. Br J Gen Pract 2023:BJGP.2023.0103. [PMID: 37549993 PMCID: PMC10428004 DOI: 10.3399/bjgp.2023.0103] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/26/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND GPs play an increasingly important role in proactively preventing dementia. Dementia in 40% of patients could be prevented or delayed by targeting 12 modifiable risk factors throughout life. However, little is known about how GPs perceive their role in dementia prevention and the associated barriers. AIM To explore the role of GPs in dementia prevention. DESIGN AND SETTING Qualitative study among UK GPs. METHOD Semi-structured online interviews were conducted with 11 UK GPs exploring their views regarding their role in dementia prevention. Data were analysed using thematic analysis. RESULTS GPs reported that they never explicitly discuss dementia risk with patients, even when patients are presenting with risk factors, but acknowledge that dementia prevention should be part of their role. They advocate for adopting a whole team approach to primary care preventive practice, using long-term condition/medication reviews or NHS health checks as a platform to enable dementia risk communication targeting already at-risk individuals. Barriers included a lack of time and an absence of knowledge and education about the modifiable dementia risk factors, as well as a reluctance to use 'dementia' as a term within the appointment for fear of causing health anxiety. 'Brain health' was perceived as offering a more encouraging discursive tool for primary care practitioners, supporting communication and behaviour change. CONCLUSION There needs to be a whole-systems shift towards prioritising brain health and supporting primary care professionals in their preventive role. Education is key to underpinning this role in dementia prevention.
Collapse
Affiliation(s)
- Danielle Jones
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Bradford
| | - Rachael Drewery
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Bradford
| | - Karen Windle
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Bradford
| | - Sara Humphrey
- GP with an extended role in older people, associate clinical director frailty/dementia and LD, Bradford District and Craven Health and Care Partnership, Bradford; medical director, Westcliffe Health Innovations, Bradford; clinical lead, Yorkshire and the Humber Clinical Network (Dementia and Older Peoples Mental Health); honorary visiting professor, Faculty of Health Studies, University of Bradford, Bradford
| | - Andreia Fonseca de Paiva
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Bradford
| |
Collapse
|
6
|
Tsai FJ, Shen SW. Concepts of dementia prevention in the health promotion among older adults: A narrative review. Medicine (Baltimore) 2022; 101:e32172. [PMID: 36550862 PMCID: PMC9771271 DOI: 10.1097/md.0000000000032172] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The number of older adults with dementia is predicted to markedly increase in the coming decades. A person suffers from dementia every 3 seconds globally, and one out of every 7 people suffers from dementia in Taiwan. The purpose of this narrative review is to integrate existing concepts of dementia prevention into health promotion and improve older adults' quality of life. This narrative review was performed using the PubMed database by searching for basic research and systematic reviews on dementia prevention and health promotion among older adults. We established a framework for dementia prevention and health promotion with regard to the physical, mental, spiritual, and social health aspects. We identified the following strategies related to older adults towards dementia prevention and health promotion in follows: Physical health promotion: cognitive activities, physical activities, body mass index, balanced diet, rainbow diet, Mediterranean diet, dietary approaches to stop hypertension diet, mind diet, no smoking and drinking, avoiding the "three highs" (i.e., hyperglycemia, hyperlipidemia, and hypertension), and head trauma; Mental health promotion: Positive thinking, Brief Symptom Rating Scale (BSRS-5), depression scale, and ascertained dementia 8 questionnaire (AD8) screening; Spiritual health promotion: religious beliefs, spiritual music, meditative activities, mindfulness, yoga, Qi-gong, Tai-chi, and Baduanjin; and Social health promotion: A supportive family system, socialization, social support, social networks, social interaction, and social participation. The conclusion of this narrative review was to integrate the concepts of dementia prevention and health promotion among older adults.
Collapse
Affiliation(s)
- Fu-Ju Tsai
- Department of Nursing, Fooyin University, Taiwan R.O.C
| | - Sheng-Wei Shen
- Department of Neurology, Pingtung Hospital, Ministry of Health and Welfare, Taiwan, R.O.C
- * Correspondence: Sheng-Wei Shen, 270, Ziyou Rd., Pingtung City, Pingtung County 900, Taiwan R.O.C. (e-mail: )
| |
Collapse
|
7
|
Rivera JMB, Yousefi C, Cheng CL, Norman CD, Legare J, McFarlane A, Noonan VK. Optimizing spinal cord injury care in Canada: Development of a framework for strategy and action. Front Public Health 2022; 10:921926. [PMID: 36420007 PMCID: PMC9678047 DOI: 10.3389/fpubh.2022.921926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 09/26/2022] [Indexed: 11/09/2022] Open
Abstract
National health strategies are integral in defining the vision and strategic direction for ensuring the health of a population or for a specific health area. To facilitate a national coordinated approach in spinal cord injury (SCI) research and care in Canada, Praxis Spinal Cord Institute, with support from national experts and funding from the Government of Canada, developed a national strategy to advance SCI care, health, and wellness based on previous SCI strategic documents. This paper describes the development process of the SCI Care for Canada: A Framework for Strategy and Action. Specifically, it covers the process of building on historical and existing work of SCI in Canada through a thorough review of literature to inform community consultations and co-creation design. Furthermore, this paper describes planning for communication, dissemination, and evaluation. The SCI Care Strategic Framework promotes an updated common understanding of the goals and vision of the SCI community, as well as strengths and priorities within the SCI system regarding care, health, and wellness. Additionally, it supports the coordination and scaling up of SCI advancements to make a sustainable impact nationwide focusing on the needs of people living with SCI.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Vanessa K. Noonan
- Praxis Spinal Cord Institute, Vancouver, BC, Canada,*Correspondence: Vanessa K. Noonan
| |
Collapse
|
8
|
Godbee K, Guccione L, Palmer VJ, Gunn J, Lautenschlager N, Francis JJ. Dementia Risk Reduction in Primary Care: A Scoping Review of Clinical Guidelines Using a Behavioral Specificity Framework. J Alzheimers Dis 2022; 89:789-802. [DOI: 10.3233/jad-220382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Primary care practitioners are being called upon to work with their patients to reduce dementia risk. However, it is unclear who should do what with whom, when, and under what circumstances. Objective: This scoping review aimed to identify clinical guidelines for dementia risk reduction (DRR) in primary care settings, synthesize the guidelines into actionable behaviors, and appraise the guidelines for specificity. Methods: Terms related to “dementia”, “guidelines”, and “risk reduction” were entered into two academic databases and two web search engines. Guidelines were included if they referred specifically to clinical practices for healthcare professionals for primary prevention of dementia. Included guidelines were analyzed using a directed content analysis method, underpinned by the Action-Actor-Context-Target-Time framework for specifying behavior. Results: Sixteen guidelines were included in the analysis. Together, the guidelines recommended six distinct clusters of actions for DRR. These were to 1) invite patients to discuss DRR, 2) identify patients with risk factors for dementia, 3) discuss DRR, 4) manage dementia risk factors, 5) signpost to additional support, and 6) follow up. Guidelines recommended various actors, contexts, targets, and times for performing these actions. Together, guidelines lacked specificity and were at times contradictory. Conclusion: Currently available guidelines allow various approaches to promoting DRR in primary care. Primary care teams are advised to draw on the results of the review to decide which actions to undertake and the locally appropriate actors, contexts, targets, and times for these actions. Documenting these decisions in more specific, local guidelines for promoting DRR should facilitate implementation.
Collapse
Affiliation(s)
- Kali Godbee
- Department of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Lisa Guccione
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department on Oncology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Victoria J. Palmer
- Department of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
- The ALIVE National Centre for Mental Health Research Translation, University of Melbourne, Melbourne, Australia
| | - Jane Gunn
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
- The ALIVE National Centre for Mental Health Research Translation, University of Melbourne, Melbourne, Australia
| | - Nicola Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
- The ALIVE National Centre for Mental Health Research Translation, University of Melbourne, Melbourne, Australia
| | - Jill J. Francis
- Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| |
Collapse
|
9
|
Siette J, Taylor N, Deckers K, Köhler S, Braithwaite J, Valenzuela M, Armitage CJ. Advancing Australian public health initiatives targeting dementia risk reduction. Australas J Ageing 2022; 41:e190-e195. [PMID: 35235243 PMCID: PMC9314903 DOI: 10.1111/ajag.13049] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/27/2022] [Accepted: 01/30/2022] [Indexed: 12/15/2022]
Abstract
Public health initiatives aim to improve health outcomes for populations by preventing disease and ill‐health consequences of environmental hazards and natural or human‐made disasters. Whilst public health initiatives have been used successfully to modify behaviours for chronic diseases, many initiatives targeting reduced dementia risk in older adults suffer from conceptual and statistical flaws that greatly limit their usefulness. The limited success in modifying lifestyle dementia risk factors has led us to fall short in building a successful roadmap to dementia risk reduction. Here we argue for adopting a population‐level, holistic approach to dementia risk reduction strategies across the lifespan. This approach is supplemented by 10 strategies that focus on improving social policies, harnessing existing policy, legislature and incentive schemes, and identifying feasible approaches to increase recreational and transport‐related physical activity to creating best practice health care that supports healthy brain ageing for all.
Collapse
Affiliation(s)
- Joyce Siette
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Milperra, New South Wales, Australia.,Australian Institute for Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Nathan Taylor
- Australian Institute for Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Kay Deckers
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Jeffrey Braithwaite
- Australian Institute for Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Michael Valenzuela
- Skin2Neuron Pty Ltd, Sydney, New South Wales, Australia.,School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Christopher J Armitage
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK.,Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
| |
Collapse
|
10
|
Ibarrondo O, Huerta JM, Amiano P, Andreu-Reinón ME, Mokoroa O, Ardanaz E, Larumbe R, Colorado-Yohar SM, Navarro-Mateu F, Chirlaque MD, Mar J. Dementia Risk Score for a Population in Southern Europe Calculated Using Competing Risk Models. J Alzheimers Dis 2022; 86:1751-1762. [PMID: 35253747 PMCID: PMC9108562 DOI: 10.3233/jad-215211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Dementia prevention can be addressed if the intervention is applied early. Objective: The objective of this study was to develop and validate competing risk models to predict the late risk of dementia based on variables assessed in middle age in a southern European population. Methods: We conducted a prospective observational study of the EPIC-Spain cohort that included 25,015 participants. Dementia cases were identified from electronic health records and validated by neurologists. Data were gathered on sociodemographic characteristics and cardiovascular risk factors. To stratify dementia risk, Fine and Gray competing risk prediction models were constructed for the entire sample and for over-55-year-olds. Risk scores were calculated for low (the 30% of the sample with the lowest risk), moderate (> 30% –60%), and high (> 60% –100%) risk. Results: The 755 cases of dementia identified represented a cumulative incidence of 3.1% throughout the study period. The AUC of the model for over-55-year-olds was much higher (80.8%) than the overall AUC (68.5%) in the first 15 years of follow-up and remained that way in the subsequent follow-up. The weight of the competing risk of death was greater than that of dementia and especially when the entire population was included. Conclusion: This study presents the first dementia risk score calculated in a southern European population in mid-life and followed up for 20 years. The score makes it feasible to achieve the early identification of individuals in a southern European population who could be targeted for the prevention of dementia based on the intensive control of risk factors.
Collapse
Affiliation(s)
- Oliver Ibarrondo
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Spain
- Biodonostia Health Research Institute, Epidemiology and Public Health Area, San Sebastián, Spain
| | - José María Huerta
- Murcia Biomedical Research Institute (IMIB-Arrixaca), Murcia, Spain
- Department of Epidemiology. Murcia Regional Health Council, Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Pilar Amiano
- Biodonostia Health Research Institute, Epidemiology and Public Health Area, San Sebastián, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, SanSebastián, Spain
| | - María Encarnación Andreu-Reinón
- Murcia Biomedical Research Institute (IMIB-Arrixaca), Murcia, Spain
- Section of Neurology, Department of Internal Medicine, Rafael Méndez Hospital, Murcian Health Service, Lorca, Spain
| | - Olatz Mokoroa
- Biodonostia Health Research Institute, Epidemiology and Public Health Area, San Sebastián, Spain
- Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, SanSebastián, Spain
| | - Eva Ardanaz
- Public Health Institute of Navarra, IdiSNA, Pamplona, Spain
- Neuroepigenetics Laboratory, Navarrabiomed, Public University of Navarre (UPNA), Navarre, Spain
| | - Rosa Larumbe
- Public Health Institute of Navarra, IdiSNA, Pamplona, Spain
- Neuroepigenetics Laboratory, Navarrabiomed, Public University of Navarre (UPNA), Navarre, Spain
- Department of Neurology, Complejo Hospitalario deNavarra, Pamplona, Spain
| | - Sandra M. Colorado-Yohar
- Murcia Biomedical Research Institute (IMIB-Arrixaca), Murcia, Spain
- Department of Epidemiology. Murcia Regional Health Council, Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia
| | - Fernando Navarro-Mateu
- Murcia Biomedical Research Institute (IMIB-Arrixaca), Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Unidad deDocencia, Investigación y Formación en Salud Mental(UDIF-SM), Murcian Health Service, IMIB-Arrixaca, Murcia, Spain
| | - María Dolores Chirlaque
- Murcia Biomedical Research Institute (IMIB-Arrixaca), Murcia, Spain
- Department of Epidemiology. Murcia Regional Health Council, Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Health and Social Sciences, University of Murcia, Murcia, Spain
| | - Javier Mar
- Basque Health Service (Osakidetza), Debagoiena Integrated Healthcare Organisation, Research Unit, Arrasate-Mondragón, Spain
- Biodonostia Health Research Institute, Epidemiology and Public Health Area, San Sebastián, Spain
- Kronikgune Health Services Research Institute, Barakaldo, Spain
| |
Collapse
|
11
|
Ahmad MA, Kareem O, Khushtar M, Akbar M, Haque MR, Iqubal A, Haider MF, Pottoo FH, Abdulla FS, Al-Haidar MB, Alhajri N. Neuroinflammation: A Potential Risk for Dementia. Int J Mol Sci 2022; 23:ijms23020616. [PMID: 35054805 PMCID: PMC8775769 DOI: 10.3390/ijms23020616] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 12/13/2022] Open
Abstract
Dementia is a neurodegenerative condition that is considered a major factor contributing to cognitive decline that reduces independent function. Pathophysiological pathways are not well defined for neurodegenerative diseases such as dementia; however, published evidence has shown the role of numerous inflammatory processes in the brain contributing toward their pathology. Microglia of the central nervous system (CNS) are the principal components of the brain’s immune defence system and can detect harmful or external pathogens. When stimulated, the cells trigger neuroinflammatory responses by releasing proinflammatory chemokines, cytokines, reactive oxygen species, and nitrogen species in order to preserve the cell’s microenvironment. These proinflammatory markers include cytokines such as IL-1, IL-6, and TNFα chemokines such as CCR3 and CCL2 and CCR5. Microglial cells may produce a prolonged inflammatory response that, in some circumstances, is indicated in the promotion of neurodegenerative diseases. The present review is focused on the involvement of microglial cell activation throughout neurodegenerative conditions and the link between neuroinflammatory processes and dementia.
Collapse
Affiliation(s)
- Md Afroz Ahmad
- Department of Pharmacology, Faculty of Pharmacy, Integral University, Lucknow 226021, India; (M.A.A.); (M.K.); (M.F.H.)
| | - Ozaifa Kareem
- Department of Pharmaceutical Sciences, University of Kashmir, Hazratbal, Srinagar 190006, India;
| | - Mohammad Khushtar
- Department of Pharmacology, Faculty of Pharmacy, Integral University, Lucknow 226021, India; (M.A.A.); (M.K.); (M.F.H.)
| | - Md Akbar
- Pharmaceutical Medicine, Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India; (M.A.); (A.I.)
| | - Md Rafiul Haque
- Department of Pharmacognosy, School of Pharmacy, Al-Karim University, Katihar 854106, India;
| | - Ashif Iqubal
- Pharmaceutical Medicine, Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India; (M.A.); (A.I.)
| | - Md Faheem Haider
- Department of Pharmacology, Faculty of Pharmacy, Integral University, Lucknow 226021, India; (M.A.A.); (M.K.); (M.F.H.)
| | - Faheem Hyder Pottoo
- Department of Pharmacology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia;
| | - Fatima S. Abdulla
- College of Medicine and Health Science, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates; (F.S.A.); (M.B.A.-H.)
| | - Mahia B. Al-Haidar
- College of Medicine and Health Science, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates; (F.S.A.); (M.B.A.-H.)
| | - Noora Alhajri
- Department of Medicine, Sheikh Shakhbout Medical City (SSMC), Abu Dhabi P.O. Box 127788, United Arab Emirates
- Correspondence:
| |
Collapse
|
12
|
Van Asbroeck S, van Boxtel MPJ, Steyaert J, Köhler S, Heger I, de Vugt M, Verhey F, Deckers K. Increasing knowledge on dementia risk reduction in the general population: Results of a public awareness campaign. Prev Med 2021; 147:106522. [PMID: 33744328 DOI: 10.1016/j.ypmed.2021.106522] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 03/11/2021] [Accepted: 03/14/2021] [Indexed: 11/30/2022]
Abstract
Strategies to reduce dementia risk are needed to minimize the burden of this growing public health concern. Most individuals are not aware that dementia risk reduction is possible, let alone how this could be achieved. Health education, such as public awareness campaigns on the topic of dementia risk reduction, can meet this need. A public health campaign (including social media and offering an online individual risk assessment tool) was carried out over a 7-month period in Flanders, Belgium. Impact was assessed in two independent online surveys, before (n = 1003) and after the campaign (n = 1008), in representative samples of adults aged 40-75 years. Questions regarding personal needs, wishes and barriers were also included. After the campaign, more individuals (10.3%) were aware that dementia risk reduction is possible than before the campaign, and more individuals correctly identified 10 out of 12 surveyed modifiable dementia risk and protective factors. However, no differences were observed in low-educated individuals. Further, specific differences in potential needs, wishes and barriers for future campaigns or interventions were observed between demographic strata. The majority of the respondents (89%) indicated that they would welcome more information on improving their brain-health. More than half (54%) also believed that they lacked the necessary knowledge to make brain-healthy behavior changes. In conclusion, effective public awareness campaigns on the topic of dementia risk reduction are feasible and timely, given the state of the evidence. Special efforts need to be made to develop effective campaigns, tailored towards low-educated individuals.
Collapse
Affiliation(s)
- Stephanie Van Asbroeck
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229, ET, Maastricht, the Netherlands.
| | - Martin P J van Boxtel
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229, ET, Maastricht, the Netherlands.
| | - Jan Steyaert
- Department of Sociology, University of Antwerp, Antwerp, Belgium; The Flanders Centre of Expertise on Dementia, Lokkaardstraat 8, 2018 Antwerp, Belgium.
| | - Sebastian Köhler
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229, ET, Maastricht, the Netherlands.
| | - Irene Heger
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229, ET, Maastricht, the Netherlands.
| | - Marjolein de Vugt
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229, ET, Maastricht, the Netherlands.
| | - Frans Verhey
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229, ET, Maastricht, the Netherlands.
| | - Kay Deckers
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229, ET, Maastricht, the Netherlands.
| |
Collapse
|
13
|
Rodriguez FS. Life-Course Pathways to Cognitive Aging: The Significance of Intellectual Stimulation in the Form of Education and Occupation for Public Policy and Prevention Plans. Front Psychiatry 2021; 12:719609. [PMID: 34366944 PMCID: PMC8339265 DOI: 10.3389/fpsyt.2021.719609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/29/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Francisca S Rodriguez
- German Center for Neurodegenerative Diseases (DZNE), RG Psychosocial Epidemiology and Public Health, Greifswald, Germany.,Center for Cognitive Science, University of Kaiserslautern, Kaiserslautern, Germany.,Institute of Social Medicine, Occupational Medicine and Public Health, University of Leipzig, Leipzig, Germany
| |
Collapse
|
14
|
Poppe M, Mansour H, Rapaport P, Palomo M, Burton A, Morgan-Trimmer S, Carter C, Roche M, Higgs P, Walker Z, Aguirre E, Bass N, Huntley J, Wenborn J, Cooper C. "Falling through the cracks"; Stakeholders' views around the concept and diagnosis of mild cognitive impairment and their understanding of dementia prevention. Int J Geriatr Psychiatry 2020; 35:1349-1357. [PMID: 32608171 DOI: 10.1002/gps.5373] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/08/2020] [Accepted: 06/20/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Many people live with an awareness of mild cognitive changes that increase their dementia risk. Previous authors describe the uncertainties of this liminal state, between cognitive health and dementia, where being "at risk" can itself be an illness. We ask how services respond to people with memory concerns currently, and how a future, effective and inclusive dementia prevention intervention might be structured for people with memory concerns. METHODS/DESIGN We conducted qualitative interviews with 18 people aged 60+ years with subjective or objective memory problems, six family members, 10 health and social care professionals and 11 third sector workers. Interviews were audio-recorded, transcribed and analysed using an inductive thematic approach. RESULTS Three main themes were identified: (1) acknowledging the liminal state, compounded by current, discordant health service responses: medicalising memory concerns yet situating responsibilities for their management with patients and families; (2) enabling change in challenging contexts of physical and cognitive frailty and social disengagement and (3) building on existing values, cultures and routines. CONCLUSIONS Effective dementia prevention must empower individuals to make lifestyle changes within challenging contexts. Programmes must be evidence based yet sufficiently flexible to allow new activities to be fitted into people's current lives; and mindful of the risks of pathologising memory concerns. Most current memory services are neither commissioned, financially or clinically resourced to support people with memory concerns without dementia. Effective, large scale dementia prevention will require a broad societal response.
Collapse
Affiliation(s)
- Michaela Poppe
- Division of Psychiatry, University College London, London, UK
| | - Hassan Mansour
- Division of Psychiatry, University College London, London, UK
| | - Penny Rapaport
- Division of Psychiatry, University College London, London, UK
| | - Marina Palomo
- Division of Psychiatry, University College London, London, UK
| | | | | | | | - Moïse Roche
- Division of Psychiatry, University College London, London, UK
| | - Paul Higgs
- Division of Psychiatry, University College London, London, UK
| | - Zuzana Walker
- Division of Psychiatry, University College London, London, UK.,Essex Partnership University NHS Foundation Trust, Essex, UK
| | - Elisa Aguirre
- UCL Department of Clinical, Educational and Health Psychology, North East London NHS Foundation Trust, London, UK
| | - Nicholas Bass
- Division of Psychiatry, University College London, London, UK
| | | | - Jennifer Wenborn
- Division of Psychiatry, University College London, London, UK.,North East London NHS Foundation Trust, London, UK
| | - Claudia Cooper
- Division of Psychiatry, University College London, London, UK.,Camden and Islington NHS Foundation Trust, London, UK
| |
Collapse
|
15
|
Lee WJ, Peng LN, Loh CH, Lin GZ, Lee S, Shimada H, Arai H, Chen LK. Development and validation of the NCGG-FAT Chinese version for community-dwelling older Taiwanese. Geriatr Gerontol Int 2020; 20:1171-1176. [PMID: 33128334 DOI: 10.1111/ggi.14059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/25/2020] [Accepted: 09/26/2020] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the reliability and validity of the National Center for Geriatrics and Gerontology functional assessment tool (NCGG-FAT) Chinese version among community-dwelling older Taiwanese. METHOD In total, 40 community-living older adults aged ≥65 years with intact global cognitive function (Mini-Mental State Examination ≥24) were enrolled and received a neuropsychological assessment twice using the computerized NCGG-FAT Chinese version, with an interval of 30 days to examine test-retest reliability. Conventional neurocognitive assessments were performed for all study participants within a week after the first administration of the NCGG-FAT Chinese version to determine validity. Intraclass correlation coefficients (ICC) were employed to assess test-retest reliability, and the Pearson correlation coefficient evaluated the validity. RESULTS In total, 40 participants aged 69.8 ± 3.9 years with a mean education of 11.1 ± 4.2 years and MMSE of 28.5 ± 1.8 were enrolled. The Pearson correlation coefficient showed moderate-to-high validity between the conventional neurocognitive assessments and the NCGG-FAT Chinese version components (r = 0.509-0.606, P < 0.01 for all components). High reliability was also identified in the word recognition (immediate) score (ICC = 0.833, P < 0.001), Trail Making Tests part B (ICC = 0.709, P < 0.001) and Symbol Digit Substitution Task score (ICC = 0.850, P < 0.001), whereas word recall (delayed) score and Trail Making Tests part A showed moderate test-retest reliability. CONCLUSIONS The NCGG-FAT Chinese version is a valid and reliable instrument to assess multiple dimensions of neurocognitive function of community-living Taiwanese, which may facilitate better community-based screening and intervention programs, particularly for international comparisons. Geriatr Gerontol Int 2020; 20: 1171-1176.
Collapse
Affiliation(s)
- Wei-Ju Lee
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan.,Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yilan County, Taiwan
| | - Li-Ning Peng
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ching-Hui Loh
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan.,Center of Health and Aging, Hualien Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation, Hualien County, Taiwan
| | - Guang-Zhang Lin
- Department of Psychological Medicine, Taipei Veterans General Hospital Su-Ao and Yuanshan Branch, Yilan County, Taiwan
| | - Sangyoon Lee
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hiroyuki Shimada
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hidenori Arai
- President Office, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Liang-Kung Chen
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| |
Collapse
|
16
|
Saccasan N, Scerri C. Dementia knowledge, attitudes and training needs of speech-language pathology students and practitioners: A countrywide study. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2020; 55:955-970. [PMID: 33051989 DOI: 10.1111/1460-6984.12574] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 09/04/2020] [Accepted: 09/05/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Due to dementia-related communication difficulties, speech-language pathologists (SLPs) play a significant role in supporting individuals with dementia and their caregivers. Nevertheless, SLP practitioners may not have received adequate dementia training during their undergraduate programme and skills updating post-qualification. Investigating the knowledge, attitudes and training needs of SLP students and practitioners would provide evidence on the need of enhancing training in dementia care and management at both the undergraduate level and through continuous professional development programmes. AIMS To assess the levels of dementia knowledge, attitudes and training needs of SLP students and practitioners. METHODS & PROCEDURES A countrywide survey was conducted with undergraduate students reading for a BSc degree in communication therapy and SLPs currently in practice. Dementia knowledge and attitudes were assessed using the Alzheimer's Disease Knowledge Scale (ADKS) and the Dementia Attitude Scale (DAS). Training needs were measured using a three-point Likert scale from a list of topics related to dementia management and care. Quantitative methods were used to analyse the collected data. OUTCOMES & RESULTS A total of 49 SLP students (94.2% response rate) and 113 practitioners (57.4% response rate) completed the survey. Although SLP practitioners scored significantly better than students on the ADKS and its constructs, both cohorts showed inadequate knowledge of dementia, in particular dementia risk factors. In general, both SLP students and practitioners showed positive attitudes towards individuals with dementia, even though significant differences were observed. With respect to training needs, SLP practitioners significantly scored less compared with students denoting that, in this cohort, there was the belief that less training in dementia was required. CONCLUSIONS & IMPLICATIONS Although SLPs have an important role to play in the management and care of individuals with dementia, the findings of this study indicated a shortage of in-depth knowledge in this area of practice. This continues to highlight the need of enhancing dementia training programmes through undergraduate curriculum development and continuous professional programmes for skills updating. What this paper adds What is already known on the subject One of the symptoms of dementia is that affected individuals progressively lose the ability to communicate effectively. With an increase in the number of people with dementia due to global ageing growth, SLPs are more likely to come into contact with such individuals and their caregivers. At present, there is little research on the levels of dementia knowledge, attitudes and training needs among individuals pursuing their career in this profession. What this paper adds to existing knowledge This study highlights a dearth of in-depth knowledge among undergraduate students and practising SLPs in various aspects of dementia management and care and argues on the need of enhancing training in this field of study. What are the potential or actual clinical implications of this work? Improving SLPs' knowledge on dementia can enhance their professional role in several areas, including the provision of information on risk factors, disease progression and its effect on communication abilities, screening of cognitive communication difficulties and developing management plans aimed at maintaining communication abilities at the highest level.
Collapse
Affiliation(s)
- Nicola Saccasan
- Department of Gerontology and Dementia Studies, Faculty of Social Wellbeing, University of Malta, Msida, Malta
| | - Charles Scerri
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| |
Collapse
|
17
|
Werner P, AboJabel H. Perceptions About and Engagement in Behaviors to Reduce the Risk of Dementia Among Adult Persons in Israel. J Alzheimers Dis 2020; 78:1011-1017. [PMID: 33074232 DOI: 10.3233/jad-200780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BackgroundEngagement in behaviors aimed at reducing the risk of developing dementia is a leading recommendation in most National Dementia Strategy programs. OBJECTIVE In an effort to advance knowledge regarding the implementation of this recommendation, the current study examined the perceptions and engagement of the adult population in Israel regarding behaviors aimed at reducing the risk of developing dementia, and its correlates. METHODS A cross-sectional survey was conducted among 502 Israeli adults aged 40 and over. Approximately half of the participants (51.2%) were female, and the majority (80.1%) were Jewish. RESULTS Overall, while the percentage of participants reporting that the examined activities were important for brain health was moderate, percentages reporting engaging in these behaviors were low. The most important correlate of engagement in health behaviors was participants' perceptions about the importance of these behaviors for their brain health. Increased age, being Jewish, and enhanced perceived susceptibility to develop dementia were also significantly associated with increased engagement in behaviors to reduce the risk of dementia. CONCLUSION The results of this study emphasize the need to develop intervention programs aimed at promoting engagement in behaviors to reduce the risk of dementia development. These programs will benefit from assessing participants' perceived importance of these behaviors, and from identifying the needs of unique groups, such as older persons and those pertaining to ethno-cultural groups.
Collapse
Affiliation(s)
- Perla Werner
- Department of Community Mental Health, University of Haifa, Israel
| | - Hanan AboJabel
- Department of Community Mental Health, University of Haifa, Israel
| |
Collapse
|
18
|
Affiliation(s)
- Claire E Sexton
- Department of Neurology, Global Brain Health Institute, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA.,Department of Psychiatry, University of Oxford, Oxford, UK
| | - Kristine Yaffe
- Department of Psychiatry, Neurology, and Epidemiology, Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.,San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| |
Collapse
|
19
|
Anstey KJ, Peters R. Dementia, Risk, Risk Reduction, and Translation into Practice: An International Research Network for Dementia Prevention (IRNDP) Special Issue. J Alzheimers Dis 2020; 70:S1-S3. [PMID: 31356212 PMCID: PMC6700648 DOI: 10.3233/jad-190506] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Kaarin J Anstey
- University of New South Wales, Sydney, Australia.,Neuroscience Research Australia, Sydney, Australia
| | - Ruth Peters
- University of New South Wales, Sydney, Australia.,Neuroscience Research Australia, Sydney, Australia
| |
Collapse
|
20
|
Bohlken J, Riedel-Heller S, Gothe H, Kostev K. [Dementia prevention and primary care: Estimation of the target population]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2020; 89:162-167. [PMID: 32877931 DOI: 10.1055/a-1227-6287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The prevention of dementia, especially the cardiovascular prevention of cognitive disorders, is increasingly coming into the focus of health services research. The aim of this study is to determine the possible target population for dementia prevention approaches as well as frequency of health examinations (HE) in individual general practitioner offices (GP). METHOD 987 GP practices, which are covered by the nationwide IMS Disease Analyzer database (IQVIA) have been investigated for the prevalence of the following diagnoses, which are considered risk factors for the development of dementia Hypertension, obesity, hearing loss in each age group 45-65 and diabetes and depression in the age group 65 and older. In addition, it was recorded how many of these patients received a HE). RESULTS In a sample of 2,398,405 patients receiving primary care, the target population relevant for dementia prevention measures in 2018 consisted of 191,883 patients with hypertension, 23,308 with obesity, 5,059 with hearing loss, 120,200 with diabetes and 43,233 with depression. More than a quarter of these patients have already had a HE. In 2018, patients with hypertension (N=51), diabetes (N=30.5) and depression (N=11.3) were the most frequently treated patients, less frequently patients with obesity (N=8.2) and hearing loss (N=1.6). CONCLUSION On the basis of defined diagnoses in certain phases of life, a manageable group of patients can be identified who are eligible for specific dementia preventive interventions. The implementation of dementia preventive interventions in practices will be more difficult for the less frequent treatment diagnoses obesity and hearing loss than for the much more frequent treatment diagnoses hypertension, diabetes and depression.
Collapse
Affiliation(s)
- Jens Bohlken
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP) der Medizinischen Fakultät der Universität Leipzig, Demenz-Referat im Berufsverband Deutscher Nervenärzte (BVDN)
| | - Steffi Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP) der Medizinischen Fakultät der Universität Leipzig, Demenz-Referat im Berufsverband Deutscher Nervenärzte (BVDN)
| | - Holger Gothe
- Lehrstuhl Gesundheitswissenschaften/Public Health, Medizinische Fakultät »Carl Gustav Carus«, Technische Universität Dresden.,Department für Public Health, Versorgungsforschung und Health Technology Assessment, UMIT - Private Universität für Gesundheitswissenschaften, Medizinische Informatik und Technik
| | | |
Collapse
|