August dementia current awareness by Musgrove Park Hospital Library

Library Services Musgrove Park and Somerset Partnership

Current Awareness Dementia This monthly Current Awareness Bulletin is produced by the Library, Musgrove Park Academy to provide staff with a range of dementia-related resources to support practice. It includes recently published guidelines and research articles, news and policy items.

This guide provides a selection of resources relevant to the subject area and is not intended to be a comprehensive list. All websites have been evaluated and details are correct at the time of publications. Details correct at time of going to print. Please note that resources are continuously updated. For further help or guidance, please contact a member of library staff.

This guide has been compiled by: Jess Pawley Senior Library Assistant Musgrove Park Hospital Library Service jessica.pawley@tst.nhs.uk Issue 14 August 2016

Contents Click on a section title to navigate contents Page Results of Library Current Awareness Survey

Colleague App

Recent journal articles

Books

Cochrane library

Guidelines

UpToDate & DynaMed Plus

Dementia in the News

Reports, publications and resources

Topic Alerts and Updates

Twitter

Training & Networking Opportunities, Conferences, Events

Literature search service

Training and Athens

Library contact details: Library Musgrove Park Academy Musgrove Park Hospital Taunton Somerset TA1 5DA Tel: 01823 34 (2433)

Email: library@tst.nhs.uk Blog: http://librarymph.wordpress.com @musgrovesompar

RESULTS OF LIBRARY CURRENT AWARENESS SURVEY BACK TO TOP

During 2015-6 the library team introduced a number of new current awareness bulletins as a result of feedback from staff. Along with the fortnightly Library Alert monthly updates were produced for: Dementia Stroke End of life Sign up to safety

Mentorship Cancer ITU

While we had some feedback that these bulletins were useful, we felt due to the cost in library staff time, it would be better to have more detailed evidence. We circulated the survey via email to the various email lists, added a link on the Library webpage and also put reminders in the Library Alert and Staff Bulletin. During the month when we received 211 replies on all bulletins covering both Taunton and Somerset and Somerset Partnership staff. The final report can be found here

COLLEAGUE APP BACK TO TOP The MPH Staff App has specifically been produced and designed to offer both current and future employees relevant information related to their work. Whether seeking information about policies and procedures, following us on Twitter or even taking advantage of special offers, all can be found here.

Library monthly current awareness bulletins are also available. To download, please follow this link Please note- The app has not been created by the library. If you have any problems downloading or accessing the app then you will need to contact the IT department.

RECENT JOURNAL ARTICLES BACK TO TOP This is a list of journal articles on the topic of dementia. Some articles are available in the library or on-line via an OpenAthens password by following the full-text link. If you would like an article which is not available as full-text then please contact library staff. Please note that abstracts are not always available for all articles.

Title: Resistiveness to care during assistance with activities of daily living in noninstitutionalized persons with dementia: associations with informal caregivers’ stress and well-being. Author(s): Fauth, Elizabeth Braungart; Femia, Elia E.; Zarit, Steven H. Source: Aging & Mental Health; Sep 2016; vol. 20 (no. 9); p. 888-898

Title: Spousal Caregiver Perspectives on a Person-Centered Social Program for Partners With Dementia. Author(s): Han, Areum; Radel, Jeff Source: American Journal of Alzheimer's Disease & Other Dementias; Sep 2016; vol. 31 (no. 6); p. 465-473

Title: Predictors of Discrepancy Between Care Recipients With Mild-to-Moderate Dementia and Their Caregivers on Perceptions of the Care Recipients’ Quality of Life. Author(s): Moon, Heehyul; Townsend, Aloen L.; Dilworth-Anderson, Peggye; Whitlatch, Carol J. Source: American Journal of Alzheimer's Disease & Other Dementias; Sep 2016; vol. 31 (no. 6); p. 508-515

Title: Barriers, motivators, and facilitators of physical activity in dementia patients: A systematic review. Author(s): van Alphen, Helena J.M.; Hortobágyi, Tibor; van Heuvelen, Marieke J.G. Source: Archives of Gerontology & Geriatrics; Sep 2016; vol. 66 ; p. 109-118

Title: A co-design process developing heuristics for practitioners providing end of life care for people with dementia Author(s): Davies N.; Mathew R.; Wilcock J.; Lamahewa K.; Iliffe S.; Manthorpe J.; Sampson E.L. Source: BMC Palliative Care; Aug 2016; vol. 15 (no. 1) Abstract:Background: The end of life for someone with dementia can present many challenges for practitioners; such as, providing care if there are swallowing difficulties. This study aimed to develop a toolkit of heuristics (rules-of-thumb) to aid practitioners making end-of-life care decisions for people with dementia. Methods: An iterative co-design approach was adopted using a literature review and

qualitative methods, including; 1) qualitative interviews and focus groups with family carers and 2) focus groups with health and care professionals. Family carers were recruited from a national charity, purposively sampling those with experience of end-of-life care for a person with dementia. Health and care professionals were purposively sampled to include a broad range of expertise including; general practitioners, palliative care specialists, and geriatricians. A co-design group was established consisting of health and social care experts and family carers, to synthesise the findings from the qualitative work and produce a toolkit of heuristics to be tested in practice. Results: Four broad areas were identified as requiring complex decisions at the end of life; 1) eating/swallowing difficulties, 2) agitation/restlessness, 3) ending life-sustaining treatment, and 4) providing "routine care" at the end of life. Each topic became a heuristic consisting of rules arranged into flowcharts. Eating/swallowing difficulties have three rules; ensuring eating/swallowing difficulties do not come as a surprise, considering if the situation is an emergency, and considering 'comfort feeding' only versus time-trialled artificial feeding. Agitation/restlessness encourages a holistic approach, considering the environment, physical causes, and the carer's wellbeing. Ending life-sustaining treatment supports practitioners through a process of considering the benefits of treatment versus quality-of-life and comfort. Finally, a heuristic on providing routine care such as bathing, prompts practitioners to consider adapting the delivery of care, in order to promote comfort and dignity at the end of life. Conclusions: The heuristics are easy to use and remember, offering a novel approach to decision making for dementia end-of-life care. They have the potential to be used alongside existing end-of-life care recommendations, adding more readily available practical assistance. This is the first study to synthesise experience and existing evidence into easy-to-use heuristics for dementia end-of-life care.

Title: The Initial Development of a Checklist for Assessing Thirst in Patients With Advanced Dementia. Author(s): Yang, Ya-Ping; Wang, Chi-Jane; Wang, Jing-Jy Source: The journal of nursing research : JNR; Sep 2016; vol. 24 (no. 3); p. 224-231 Abstract:Patients with advanced dementia (PwAD) often have difficulty expressing their needs verbally because of cognitive impairments. PwAD thus often communicate these needs through behaviors and psychological symptoms. Understanding the behavioral characteristics of certain needs is critical for caregivers and clinicians when caring for PwAD. The purpose of this study was to develop a checklist that may be used to assess the thirst status of PwAD. A mixed method design was used. The checklist was developed using qualitative interviews and surveys. The initial items were developed through interviews with 10 professional nurses who were caring for PwAD. Four experts in dementia assessed the content validity of these items. PwAD caregivers from eight facilities were then invited to complete the checklist based on their current PwAD patient care experience. Data obtained in this study were analyzed with regard to content validity, interrater reliability, internal consistency, and exploratory factor analysis. The content validity of the initial 18 items was .96, interrater reliability was -.33 to 1, and internal consistency reliability was .52. Exploratory factor analysis identified seven checklist items, including repetitive movements, squirming, restlessness or anxiety, persistent or unreasonable demands, pacing back and forth, repeating a sentence or question without purpose, and slow reaction. The factor loadings of these seven items accounted for 49.3% of the total variance. The reassessed internal consistency reliability was .66. Caregivers may use this checklist as an aid to identify the thirst or fluid needs of PwAD who are unable to communicate their needs effectively.

Title: Update on Vascular Dementia. Author(s): Khan, Ayesha; Kalaria, Raj N; Corbett, Anne; Ballard, Clive Source: Journal of geriatric psychiatry and neurology; Sep 2016; vol. 29 (no. 5); p. 281-301 Abstract: Vascular dementia (VaD) is a major contributor to the dementia syndrome and is described as having problems with reasoning, planning, judgment, and memory caused by impaired blood flow

to the brain and damage to the blood vessels resulting from events such as stroke. There are a variety of etiologies that contribute to the development of vascular cognitive impairment and VaD, and these are often associated with other dementia-related pathologies such as Alzheimer disease. The diagnosis of VaD is difficult due to the number and types of lesions and their locations in the brain. Factors that increase the risk of vascular diseases such as stroke, high blood pressure, high cholesterol, and smoking also raise the risk of VaD. Therefore, controlling these risk factors can help lower the chances of developing VaD. This update describes the subtypes of VaD, with details of their complex presentation, associated pathological lesions, and issues with diagnosis, prevention, and treatment.

Title: Frontotemporal Dementia: An Updated Clinician's Guide. Author(s): Rosness, Tor Atle; Engedal, Knut; Chemali, Zeina Source: Journal of geriatric psychiatry and neurology; Sep 2016; vol. 29 (no. 5); p. 271-280 Abstract:Today, frontotemporal dementia (FTD) remains one of the most common forms of earlyonset dementia, that is, before the age of 65, thus posing several diagnostic challenges to clinicians since symptoms are often mistaken for psychiatric or neurological diseases causing a delay in correct diagnosis, and the majority of patients with FTD present with symptoms at ages between 50 and 60. Genetic components are established risk factors for FTD, but the influence of lifestyle, comorbidity, and environmental factors on the risk of FTD is still unclear. Approximately 40% of individuals with FTD have a family history of dementia but less than 10% have a clear autosomal dominant pattern of inheritance. Lack of insight is often an early clue to FTD. A tailored treatment option at an early phase can mitigate suffering and improve patients' and caregivers' quality of life.

Title: Imaging in Dementia With Lewy Bodies: An Overview. Author(s): Watson, Rosie; Colloby, Sean J Source: Journal of geriatric psychiatry and neurology; Sep 2016; vol. 29 (no. 5); p. 254-260 Abstract:Dementia with Lewy bodies (DLB) while common in older age can present a diagnostic challenge to clinicians and is often misdiagnosed as Alzheimer disease (AD). Imaging studies have improved our understanding of the neurobiological changes in DLB during life and how they differ from AD. This has led to significant advances in the development of new techniques, such as dopaminergic imaging, which can aid the clinical diagnosis. Other functional imaging methods also show promise in helping to assess the influence of differing pathologies in DLB, most notably, ADrelated and vascular pathology during life. This article will provide an overview of the main imaging findings in DLB.

Title: The Ongoing Dilemma on the Use of Antipsychotics to Manage the Behavioral Symptoms of Dementia. Author(s): Alafris, Antonia Source: Journal of clinical pharmacology; Sep 2016; vol. 56 (no. 9); p. 1058-1059

Title: Use of Antipsychotics for the Treatment of Behavioral Symptoms of Dementia. Author(s): Greenblatt, H Karl; Greenblatt, David J Source: Journal of clinical pharmacology; Sep 2016; vol. 56 (no. 9); p. 1048-1057 Abstract: Antipsychotic medications are widely used in the management of behavioral and psychological symptoms of dementia. While nonpharmacological interventions should be the first-line

treatment for behavioral symptoms of dementia, these are often unfeasible and/or ineffective. Conventional and atypical antipsychotic agents appear to have modest to moderate clinical efficacy in the treatment of these symptoms, though it is unclear which individual agents are most effective. No conclusive evidence exists that any available alternative medications are safer and more effective than antipsychotics. A number of studies have shown an increased risk of mortality associated with antipsychotics in patients with behavioral symptoms of dementia, though the observed risk increase may be partially confounded by illness severity and/or preexisting health determinants. The mechanisms of increased mortality risk are not fully established, but are likely to involve cardiovascular events. It is probable, though not certain, that conventional antipsychotics are associated with a greater number of poor outcomes than atypical antipsychotics. In certain patients with refractory behavioral symptoms, antipsychotics are a viable treatment option. Key considerations for antipsychotic prescribing for this population are published in regulatory guidelines, and include minimization of dosage and duration of treatment, continuous reevaluation of symptoms, and involvement of caregivers.

BOOKS BACK TO TOP If you are unable to find a book, or require a book that is not on this list, please ask library staff who will be able to locate the book for you using interlibrary loan. Please note that some books detailed below may not be available in your local library and would need to be ordered for you.

Long-term management of dementia Scharre, D 2016

Non-Alzheimerâ&#x20AC;&#x2122;s and Atypical Dementia Racine Belkoura, C et al 2016

From the back of the book: With people living longer, dementia is now at the forefront of medical research. In answer to this changing trend, Long-Term Management of Dementia presents a stand-alone resource for diagnosis, treatment, and management issues for the patient suffering from this debilitating disease. Topics covered include: Social, legal, economic, and ethical dilemmas Functional abilities Driving and the dementia patient Hygiene and nutritional concerns Supervision models Medical complications Neurologists, psychiatrists, geriatricians, nurses, and social workers, along with family members of those suffering will find this book a valuable resource for understanding this disorder.

From the back of the book: Dementia is the most common type of neurodegenerative disorder. Non-Alzheimer's and Atypical Dementia concentrates on each form of dementia individually, considering symptoms, diagnosis and treatment Focuses on non-Atypical Dementia Multidisciplinary approach to diagnosis and management Allows development of management and care plan strategies Practical approach including case studies Written by a world-renowned editorial team.

Taunton and SomPar NHS staff - Have you visited the Proquest Ebook Central catalogue? Follow the links below and login via OpenAthens to read online books free for 5-10 minutes each day, send requests for eBook loans or purchase suggestions eBook catalogue About OpenAthens

COCHRANE LIBRARY BACK TO TOP Protocols from August 2016 Depression rating scales for detection of major depression in people with dementia

*NEW* Cochrane Clinical Answers Cochrane Clinical Answers covers 32 Clinical Specialties and provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care. Each Cochrane Clinical Answer contains a clinical question, a short answer, and an opportunity to â&#x20AC;&#x2DC;drill downâ&#x20AC;&#x2122; to the evidence from the Cochrane Review. The evidence is displayed in a user friendly format, mixing narrative, numbers and graphics. The target audience for Cochrane Clinical Answers is healthcare practitioners and professionals, and other informed health care decision-makers. Cochrane Clinical Answers have been developed by Cochrane Innovations Ltd. and Wiley Online Library. August 2016 How do statins affect cognitive outcomes in people with normal cognitive function but risk factors for Alzheimer's or other cerebrovascular disease?

GUIDELINES BACK TO TOP NICE Guidelines Current Guidelines NG22: Older people with social care needs and multiple long-term conditions- November 2015 NG16: Disability, dementia and frailty in later life- mid-life approaches to prevention- October 2015

Updated Guidelines CG42 Dementia: supporting people with dementia and their carers in health and social care- updated May 2016 TA217: Donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer's disease- updated May 2016

UPTODATE & DYNAMED PLUS BACK TO TOP What’s new from our clinical decision-making tools on the topic of dementia. UpToDate Access for Musgrove Park Staff only DynaMed Plus Access for Somerset Partnership Staff only Please contact library staff for details on how to access these resources; you will need an Athens password.

DEMENTIA IN THE NEWS

BACK TO TOP Behind the Headlines Gene patterns may explain brain’s Alzheimer’s vulnerability Claims that acupuncture ‘staves off dementia’ are missing the point Calcium supplements linked to post-stroke dementia in women BBC News NHS dementia atlas reveals patchy care

REPORTS, PUBLICATIONS AND RESOURCES BACK TO TOP NICE Pathway on Dementia NICE Pathway on Dementia, Disability and Frailty in Later Life: Mid-Life Approaches to Delay or Prevent Onset overview SCIE (Social Care Institute for Excellence) Dementia Gateway th

10 UK Dementia Congress 2015- slides and presentations from this year’s conference

Improving Dementia Education and Awareness (IDEA)- Online resource created by the University of Nottingham, listing online courses, news, events and resources. Age UK- resource and information page on dementia. DEEP- the dementia engagement and empowerment project Dementia Evidence Toolkit The Dementia Evidence Toolkit is for commissioners, care providers, people working in health and social care and people with dementia and their families. The toolkit will help those planning and shaping services and treatments for people with dementia and their carers make informed decisions about which services and treatments to provide and how much they cost. Dementia Atlas- Putting a Focus on Dementia In England, 676,000 people live with dementia, a figure which will soar over the next forty years. This map sets out what we currently know about dementia care and support across the country, based on available national data. The data is grouped in themes based on NHS England’s well dementia pathway which serves as a framework to ensure people with dementia have a better experience of health and social care support from diagnosis through to end of life. Public Health England Dementia Profile Welcome to the dementia profile. This profile has been developed to support the work of the Dementia Intelligence Network (DIN) in providing health intelligence with which to inform the provision of care of people in England who have dementia. Communication and Alzheimer’s Alzheimer's disease and other dementias gradually diminish a person's ability to communicate. Communication with a person with Alzheimer's requires patience, understanding and good listening skills. These strategies can help both you and the person with dementia understand each other better. NIHR Dissemination Centre This highlight summarises some recent NIHR funded research in this area. This is not a definitive review of evidence relating to carers of people with dementia, but brings together NIHR research published in the last two years which will be of particular interest to family carers and those agencies who need to support them. Panorama- Living with Dementia: Chris’ Story PLEASE NOTE THIS IS A BBC IPLAYER LINK A powerful, multi-textured documentary filmed over almost two years following a 55-year-old man and his family as they come to terms with his Alzheimer's diagnosis. Bristol Dementia Conference - Living Well with Dementia Bristol Clinical Commissioning Group (CCG) held its first annual Dementia Conference on 23 June 2016 at Ashton Gate Stadium. The event, chaired by Alison Moon, Transformation and Quality Director and Hilary Doxford, World Dementia Council Member and Vice-Chair of the European Working Group of People with Dementia, welcomed delegates from all over the country. The purpose of the day was to share Bristol CCGs successful approach to delivering dementia services and to celebrate Bristol reporting the highest dementia diagnosis rates in the South West. The event,

attended by over 120 delegates, included a range of speakers from different organisations followed by facilitated workshops in the afternoon. Attendees included GPs, Secondary Care clinicians, commissioners, the voluntary sector, provider services and service users and carers. Speaker presentations from the conference are included. eBook supports dementia carers The Dementia Guide for Carers and Care Providers is a free eBook and app developed by Health Education England’s Thames Valley team in collaboration with healthcare professionals, educators and carers. The guide provides practical information for anyone caring for a person with dementia and is broken down into six sections: ·

Understanding dementia – what it is, its symptoms and treatment

Day-to-day living – looking after the person with dementia, yourself and the family

Support – people and organisations who can help

Legal and money – advice and sources of help

Symptoms and behaviours – a look-up guide

Medical terms – definitions of medical terms and abbreviations which medical professionals may use.

The guide is available for free from iBooks, the Kindle Store and Smashwords or alternatively as an app through the Apple App Store. Quality Outcomes Framework (QOF) Recorded Dementia Diagnoses, July 2016 Recorded dementia prevalence at 31 July 2016 is 0.767 per cent (1 person in 130). When considered alongside monthly data collected in 2014-15, this indicates a progressive increase in recorded prevalence from March 2015 (0.738) to July 2016 (0.767). After adjustments to remove spurious, 'non-GP' practices, shared practices and practices which decided not to participate in this extraction, the extract cohort available for collection was 7,475 practices. Of the extract cohort, data for 7,323 practices were collected, representing 98.0 per cent coverage of cohort practices. New Drugs for Dementia Parliamentary Office of Science and Technology- A POSTnote outlining the challenges in developing new drugs to treat dementia, and an overview of UK and international research activities to accelerate progress.

World’s most in depth study to detect early signs of Alzheimer’s disease A new multimillion pound study, which will see the most thorough and rigorous series of tests to detect Alzheimer’s disease ever performed on volunteers, is announced today. The Deep and Frequent Phenotyping study is funded by the National Institute of Health Research and the MRC and hopes to dramatically improve the success rate of clinical trials for treatments in Alzheimer’s disease.

Cytox launches breakthrough genetic biomarker research assay for Alzheimer’s disease risk assessment Simple blood-based test will help reduce screening failure in clinical trials and assist drug discovery Raising dementia awareness in the African Caribbean community Health Education England has commissioned a film “Finding Patience” for health and social care providers to focuses on the specific needs of dementia patients in the African Caribbean community within the care process. The film seeks to help health and care professionals to discuss cultural sensitivities that may result in a reluctance to come forward and talk about concerns. It aims to encourage health and care professionals to break down barriers in order to reach people who may otherwise go undiagnosed or struggle in isolation to provide care within family units. Person-centered dementia care Health Education England has released a new film highlighting the importance of person-centered care in enabling people in care homes to live well with dementia. “Finding Patience – the later years” continues to follow Patience and her family, who we were introduced to in the film ‘Finding Patience’ as she moves into a care home. The film explores the challenges faced by staff and demonstrating what good quality person-centered care looks like.

TOPIC ALERTS AND UPDATES BACK TO TOP ABSTRACTS AVAILABLE VIA LINKS BELOW- FOR FULL-TEXT PLEASE ASK LIBRARY STAFF Anxiety as A Predictor for Cognitive Decline and Dementia: A Systematic Review and Meta-Analysis Am J Geriatr Psychiatry. Published online July 4, 2016. A Phase II Study of Fornix Deep Brain Stimulation in Mild Alzheimer’s Disease Journal of Alzheimer's Disease, vol. Preprint, no. Preprint, pp. 1-11, 2016 FREE FULL TEXT Evaluation of Tau Imaging in Staging Alzheimer Disease and Revealing Interactions Between βAmyloid and Tauopathy JAMA Neurol. Published online July 25, 2016 Cognitive interventions in Alzheimer's and Parkinson's diseases: emerging mechanisms and role of imaging Curr Opin Neurol. 2016;29(4):405-411 FREE FULL TEXT Calcium supplementation and risk of dementia in women with cerebrovascular disease Neurology, Published online before print August 17, 2016 Negative Aging Stereotypes Impair Performance on Brief Cognitive Tests Used to Screen for Predementia J Gerontol B Psychol Sci Soc Sci (2016) First published online: July 27, 2016

TWITTER BACK TO TOP The latest from popular Twitter pages dedicated to dementia: PLEASE NOTE LINKS WORK BETTER IN CHROME BROWSER Dementia UK @DementiaUK Alzheimer’s Society @alzheimerssoc Dementia Today @DementiaToday Dementia Friends @DementiaFriends

TRAINING & NETWORKING OPPORTUNITIES, CONFERENCES, EVENTS BACK TO TOP

Alzheimer’s Society Training and resources Dementia training for care providers Health Education England Dementia awareness training RCN Ongoing work at the RCN on dementia care Online learning Caring for people with dementia in the general hospital – Communication http://sonet.nottingham.ac.uk/rlos/mentalhealth/communication/ Caring for people with dementia in the general hospital - Dementia and Cognitive Loss http://sonet.nottingham.ac.uk/rlos/mentalhealth/dementia_hospital/ Caring for people with dementia in the general hospital - Person-centred dementia care http://sonet.nottingham.ac.uk/rlos/mentalhealth/dementia_care/

5 International Conference on Alzheimer’s Disease and Dementia - 29 September-1 October 2016, London

26 Alzheimer Europe Conference- 31 October-2

November 2016, Copenhagen th

Alzheimerâ&#x20AC;&#x2122;s Association International Conference 2017- 16 -20 July 2017, London

LITERATURE SEARCH SERVICE BACK TO TOP Looking for the latest evidence-based research but havenâ&#x20AC;&#x2122;t got time to trawl the databases? Do you need a literature search carried out? Do you need to find evidence to support an improvement? Do you want to know how something has been done elsewhere and whether it worked?

Library staff provide a literature search service for busy clinicians who are pressed for time.

To request a search please complete and return the appropriate form, providing as much information as possible. Alternatively if you would like an assisted search training session, where we will sit down with you and go through the steps of a literature search, then please contact the library. Musgrove staff click here to access literature search form Somerset Partnership staff click here to access literature search form

TRAINING AND ATHENS BACK TO TOP Most electronic resources are available via an Athens password. You can register for this via the Library intranet page, or from home at www.swice.nhs.uk and following the link for Athens selfregistration. Please note that registering from home will take longer as it will need to be verified that you are NHS staff/student on placement. The library offers training on how to access and use Athens resources, as well as an introductory course on critical appraisal. You can book a course through the Learning and Development intranet page, or by contacting the library directly.