December 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 7 December 2015

Contents Click on a section title to navigate contents Page Recent journal articles

Books

Cochrane Systematic Reviews

Guidelines

UpToDate & DynaMed

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) Fax: 01823 34 (2434) Email: library@tst.nhs.uk Blog: http://librarymph.wordpress.com @musgrovesompar

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: Quality of in-home care, long-term care placement, and the survival of persons with dementia. Citation: Aging & Mental Health, 2015, vol./is. 19/12(1093-1102), 13607863 Author(s): McClendon, McKee J., Smyth, Kathleen A. Abstract: Purpose of the study:Caregivers of persons with dementia living at home adopt a variety of caregiving styles that vary in quality. Three styles of high-quality care and poor-quality care have been identified. The outcomes, however, of varying styles of caregiving are unknown. Our purpose was to investigate the linkage of quality of care to long-term care placement and survival. Design and methods:We used a sample of 148 primary caregivers of a relative living at home and needing assistance due to memory or thinking problems. We used items from four existing scales and five new items to construct measures of high-quality and poor-quality care. Long-term care and survival were determined from two follow-ups. Cox proportional hazards regression was used to estimate the relationship of quality of care to long-term care placement and survival. Results:Poor quality of care increased the risk of long-term care placement, as expected, but high-quality care was not related to placement. Surprisingly, high-quality care increased the risk of death while poor-quality care decreased the risk. Secondary results were: wishful/intrapsychic coping (a dysfunctional type of emotion-focused coping) and long-term care placement shortened the survival; and caregiver personality traits of neuroticism and agreeableness lengthened the survival. Implications:It is premature to recommend caregiver interventions based on our unexpected findings. Further studies are vital and should include care-recipient impairments and the quality of life of the person with dementia as additional outcomes. ________________________________________________________________________________ Title: The 'syncope and dementia' study: a prospective, observational, multicenter study of elderly patients with dementia and episodes of 'suspected' transient loss of consciousness. Citation: Aging Clinical & Experimental Research, 2015, vol./is. 27/6(877-882), 15940667 Abstract: Background and aim: Syncope and related falls are one of the main causes and the predominant cause of hospitalization in elderly patients with dementia. However, the diagnostic protocol for syncope is difficult to apply to patients with dementia. Thus, we developed a 'simplified' protocol to be used in a prospective, observational, and multicenter study in elderly patients with

dementia and transient loss of consciousness suspected for syncope or unexplained falls. Here, we describe the protocol, its feasibility and the characteristics of the patients enrolled in the study. Methods: Patients aged ≥65 years with a diagnosis of dementia and one or more episodes of transient loss of consciousness during the previous 3 months, subsequently referred to a Geriatric Department in different regions of Italy, from February 2012 to May 2014, were enrolled. A simplified protocol was applied in all patients. Selected patients underwent a second-level evaluation. Results: Three hundred and three patients were enrolled; 52.6 % presented with episodes suspected to be syncope, 44.5 % for unexplained fall and 2.9 % both. Vascular dementia had been previously diagnosed in 53.6 % of participants, Alzheimer's disease in 23.5 % and mixed forms in 12.6 %. Patients presented with high comorbidity (CIRS score = 3.6 ± 2), severe functional impairment, (BADL lost = 3 ± 2), and polypharmacy (6 ± 3 drugs). Conclusion: Elderly patients with dementia enrolled for suspected syncope and unexplained falls have high comorbidity and disability. The clinical presentation is often atypical and the presence of unexplained falls is particularly frequent. ________________________________________________________________________________ Title: Bilingualism, dementia, cognitive and neural reserve. Citation: Current Opinion in Neurology, 2015, vol./is. 28/6(618-625), 13507540 Abstract: Purpose Of Review: We discuss the role of bilingualism as a source of cognitive reserve and we propose the putative neural mechanisms through which lifelong bilingualism leads to a neural reserve that delays the onset of dementia.Recent Findings: Recent findings highlight that the use of more than one language affects the human brain in terms of anatomo-structural changes. It is noteworthy that recent evidence from different places and cultures throughout the world points to a significant delay of dementia onset in bilingual/multilingual individuals. This delay has been reported not only for Alzheimer's dementia and its prodromal mild cognitive impairment phase, but also for other dementias such as vascular and fronto-temporal dementia, and was found to be independent of literacy, education and immigrant status.Summary: Lifelong bilingualism represents a powerful cognitive reserve delaying the onset of dementia by approximately 4 years. As to the causal mechanism, because speaking more than one language heavily relies upon executive control and attention, brain systems handling these functions are more developed in bilinguals resulting in increases of gray and white matter densities that may help protect from dementia onset. These neurocognitive benefits are even more prominent when second language proficiency and exposure are kept high throughout life. ________________________________________________________________________________ Title: A Survey on Dementia Training Needs Among Staff at Community-Based Outpatient Clinics. Citation: Educational Gerontology, 2015, vol./is. 41/12(903-915), 03601277 Abstract: Dementia is a major public health concern. Educating health-care providers about dementia warning signs, diagnosis, and management is paramount to fostering clinical competence and improving patient outcomes. The objective of this project was to describe and identify educational and training needs of staff at community-based outpatient clinics related to treating and managing veterans with dementia. Health professionals took an online survey consisting of questions related to general knowledge and skills in working with veterans with dementia and their families, staff training, and attitudes toward people with dementia. Most participants considered knowledge of dementia important; however, few reported having received training in dementia care within the past year.

Furthermore, over half of participants considered themselves beginners in terms of knowledge and skills in dementia care. Regarding training needs, topics that could improve the overall care of veterans with dementia and their caregivers were most often cited. Participants reported being most satisfied with in-person training. Physicians rated their dementia knowledge and skill as greater than nurses'/other medical professionals’ and support staff's. Compared with support staff, nurses/other medical professionals held more positive attitudes toward persons with dementia. Survey results suggest that staff are interested in improving knowledge of, and skills for, working with persons with dementia, and that job classification is associated with differences in attitudes. ________________________________________________________________________________ Title: Clinical associations of anosognosia in mild cognitive impairment and Alzheimer's disease. Citation: International Journal of Geriatric Psychiatry, 2015, vol./is. 30/12(1207-1214), 08856230 Abstract: Aims and Objective: While loss of insight of cognitive deficits is a common phenomenon in patients with Alzheimer's disease (AD), there is a lack of consensus regarding the presence of impaired insight among patients with mild cognitive impairment (MCI). We aim to investigate the clinical, cognitive, and behavioral associations of anosognosia in AD and MCI subjects.Methods: A consecutive series of 87 subjects (30 healthy older patients, 21 MCI, and 36 AD) each accompanied by a caregiver, underwent clinical assessment including the evaluation of insight using the Anosognosia Questionnaire for Dementia (AQD). We also separately assessed Intellectual Function (AQD-IF) and Behavior domains of the AQD scale. Regression models were subsequently used to investigate associations of AQD scores with cognitive and other neuropsychiatric symptoms, including depression and apathy.Results: Both AD and MCI groups demonstrated significant anosognosia compared with the healthy control group. In the AD group, 55.6% had "Mild Anosognosia," and 27.8% had "Severe Anosognosia." In the MCI group, 42.9% showed "Mild Anosognosia," and 9.5% had "Severe Anosognosia." Greater levels of AQD-Total and AQD-IF were associated with lower Minimental state examination and higher apathy scores in the AD group. In the MCI group, caregiver burden was significantly associated with AQD-Total (p = 0.016) and AQD-IF (p = 0.039).Conclusion: The results indicated that anosognosia is common in both AD and MCI patients and associated with cognitive dysfunction and apathy in AD. The findings of this study warrant further research to delineate the mechanisms of anosognosia as it poses a challenge to treatment outcomes. Copyright © 2015 John Wiley & Sons, Ltd. ________________________________________________________________________________ Title: Caregiver report versus clinician impression: disagreements in rating neuropsychiatric symptoms in Alzheimer's disease patients. Citation: International Journal of Geriatric Psychiatry, 2015, vol./is. 30/12(1230-1237), 08856230 Abstract: Background: The measurement of neuropsychiatric symptoms (NPS) in dementia is often based on caregiver report. Challenges associated with providing care may bias the caregiver's recognition and reporting of symptoms. Given potential problems associated with caregiver report, clinicians may improve measurement by drawing from a wider array of available data and by applying clinical judgment.Objective: The objective of this study is to evaluate potential disagreements between caregiver report and clinician impression when rating psychopathological manifestations from the same patient with dementia.Methods: Three hundred twelve participants (156 patients with Alzheimer's disease [AD] and 156 caregivers) were studied using the Neuropsychiatric Inventory-

Clinician Rating Scale. We considered disagreement to be present when caregiver ratings were significantly higher or lower (p < 0.05) than NPS ratings by clinicians of the same patient. To evaluate whether disagreements were related to dementia severity, we repeated comparisons across levels defined by the clinical dementia rating.Results: The most common disagreements involved ratings of agitation, depression, anxiety, apathy, irritability, and aberrant motor behavior especially in patients with mild dementia. There were fewer discrepancies in moderate or severe dementia. The most consistent disagreements involved global ratings of depression where caregiver scores ranged from +22.5 higher to -4.5 lower than clinician rating.Conclusions: Caregivers may have incomplete perception of patient NPS mainly in mild dementia. NPS ratings might be confounded by cultural beliefs, sometimes leading caregiver to interpret symptoms as part of "normal" aging. Copyright © 2015 John Wiley & Sons, Ltd. ________________________________________________________________________________ Title: Treatment changes among older patients with dementia treated with antipsychotics. Citation: International Journal of Geriatric Psychiatry, 2015, vol./is. 30/12(1238-1249), 08856230 Abstract: Background: Prescribing practice patterns and factors associated with treatment changes in older patients initiating antipsychotic treatment for the behavioral and psychological symptoms of dementia is not well known.Objectives: The objective of this study is to study 90-day prescribing practice patterns across the three most commonly prescribed antipsychotics.Methods: This is a retrospective study using national data from the US Department of Veterans Affairs (VA). The study included patients older than 65 years diagnosed with dementia who began outpatient treatment with an antipsychotic medication between 2005 and 2008. Patients were followed for 90 days from their antipsychotic start. The primary event of interest was changing to another psychotropic medication. Cumulative incidence of treatment change was determined with antipsychotic discontinuation and death as competing risks. Covariate-adjusted hazard ratios for treatment change were determined using competing risk regression models.Results: During the study period, 15,435 patients initiated an atypical antipsychotic; 14,791 started olanzapine, quetiapine, or risperidone. Over half (55%) of the patients discontinued index treatment within 90 days, 36% continued, 3% died while on index treatment, and 6% changed to another psychotropic medication. Compared with quetiapine, the adjusted hazard of treatment change was higher by 43% (p = 0.005) for olanzapine and by 12% (p = 0.08) for risperidone.Conclusion: The higher hazard of treatment change with olanzapine suggests patients either responded worse to or experienced more adverse events with olanzapine compared with quetiapine. Copyright © 2015 John Wiley & Sons, Ltd. ________________________________________________________________________________ Title: Ongoing challenges responding to behavioural and psychological symptoms of dementia. Citation: International Nursing Review, 2015, vol./is. 62/4(506-516), 00208132 Abstract: The article presents a study for describing the experiences of nurses in caring for people with behavioral and psychological symptoms of dementia in aged care facilities. Topics discussed include findings included behavioral and psychological symptoms of dementia, management of symptoms of dementia and undervalued feeling; and enhancement of the quality of care for individuals with dementia. ________________________________________________________________________________

Title: Sleep and agitation in nursing home residents with and without dementia. Citation: International Psychogeriatrics, 2015, vol./is. 27/12(1945-1955), 10416102 Abstract: Background: The prevalence of dementia in Australian nursing homes is high. A large proportion of residents express themselves through agitated behaviors, with substantial interpersonal and day-to-day variance. One factor that may increase agitation is poor sleep. The current study aimed to determine if sleep influences symptoms of agitation in nursing home residents, and whether this effect differed by dementia status. As benzodiazepines are used widely as hypnotic medication, their impact was also considered.Methods: Actigraph devices worn on residents' non-dominant wrists for three days were used to obtain objective measures of sleep. Symptoms of agitation were assessed using staff responses to two standardized questionnaires - the Cohen-Mansfield Agitation Inventory (CMAI) and the Neuropsychiatric Inventory - nursing home version (NPI-NH). Presence of dementia and benzodiazepine use were obtained from resident medical charts.Results: Forty-nine residents (mean age: 85.57 years) from four nursing homes in Tasmania were included in the study. Results indicated that residents were in bed for an average of 11.04 h and slept for 10.14 h per day. Significant relationships between sleep and verbal as well as non-aggressive agitation were found. No relationships between sleep and aggressive agitation were detected. A significant moderation effect of dementia was found, in which residents without dementia expressed verbal agitation when obtaining less sleep, but not residents with dementia. Benzodiazepine use did not result in significantly more sleep.Conclusions: These results suggest that sleep could play an important role in explaining agitation, but more research is needed to explore the relationship between sleep and benzodiazepines in nursing home residents. ________________________________________________________________________________ Title: The effects of a multi-component dyadic intervention on the psychological distress of family caregivers providing care to people with dementia: a randomized controlled trial. Citation: International Psychogeriatrics, 2015, vol./is. 27/12(2031-2044), 10416102 Abstract: Background: Earlier research showed that multi-component dyadic interventions - including a combination of intervention strategies and addressing both the person with dementia and caregiver - have a beneficial impact on the mental and physical health of people with dementia and their family caregivers. A randomized controlled trial (RCT) of a multi-component dyadic intervention, which is a translated and adapted version of an intervention that has been shown to be effective in the US by Teri et al. (2003), was performed. The effects on caregivers' mood (primary outcome), burden, general health, and salivary cortisol levels (secondary outcomes) were studied.Methods: Communitydwelling people with dementia and their family caregivers (N = 111 dyads) were randomly assigned. The experimental group received eight home visits during three months, combining physical exercise and support (psycho-education, communication skills training, and planning of pleasant activities). Both the physical exercise and support component were directed at both the person with dementia and the caregiver. The comparison group received monthly information bulletins and phone calls. There were three measurements at baseline (prior to the intervention), at three months, and at six months into the intervention. Data were analyzed with Generalized Estimating Equations (GEE) based on an intention-to-treat analysis of all available data.Results: All analyses showed no benefits of the intervention over time on any of the outcomes.Conclusion: The negative results might be explained by the translation and adaptation of the intervention that has been shown to be effective in the US: the intervention was shortened and did not include cognitive reframing. However, only the health effects on people with dementia and not on caregivers were studied in the US. Several other

factors might also have played a role, which are important for future studies to take into account. These are: the usual health care in the country or region of implementation; the wishes and needs of participants for specific intervention components; the room for improvement regarding these components; the inclusion of positive outcome measures, such as pleasure, and the quality of the relationship. ________________________________________________________________________________ Title: Clinical utility and applicability of biomarker-based diagnostic criteria for Alzheimer's disease: a BeDeCo survey. Citation: Acta neurologica Belgica, Dec 2015, vol. 115, no. 4, p. 547-555 (December 2015) Author(s): Bier, Jean-Christophe, Verschraegen, Jurn, Vandenberghe, Rik, Guillaume, Bénédicte, Picard, Gaëtane, Otte, Georges, Mormont, Eric, Gilles, Christian, Segers, Kurt, Sieben, Anne, Thiery, Evert, Ventura, Manfredi, De Deyn, Peter, Deryck, Olivier, Versijpt, Jan, Salmon, Eric, Engelborghs, Sebastiaan, Ivanoiu, Adrian Abstract: We conducted a survey regarding the medical care of patients with dementia in expert settings in Belgium. Open, unrestricted and motivated answers were centralized, blindly interpreted and structured into categories. The report of the results was then submitted to the participants in subsequent plenary meetings and through email. Fourteen experts responded to the questionnaire, confirming that recent propositions to modify Alzheimer's disease (AD) diagnostic criteria and options have stirred up debate among well-informed and dedicated experts in the field. The opinions were not unanimous and illustrate how difficult it is to find a standardized method of diagnosing this disease. The responses to the survey suggest that application of a step-by-step pragmatic method is used in practice. Only when the combination of clinical findings and classical structural neuro-imaging is insufficient for a diagnosis or suggests an atypical presentation, additional biomarkers are considered. Interestingly, few differences, if any, were observed between the use of biomarkers in MCI and in AD. In conclusion, the Belgian experts consulted in this survey were generally in agreement with the new diagnostic criteria for AD, although some concern was expressed about them being too "amyloidocentric". Although the clinical examination, including a full neuropsychological evaluation, is still considered as the basis for diagnosis, most experts also stated that they use biomarkers to help with diagnosis. ________________________________________________________________________________ Title: Hippocampal diffusion tensor imaging microstructural changes in vascular dementia. Citation: Acta neurologica Belgica, Dec 2015, vol. 115, no. 4, p. 557-562 (December 2015) Author(s): Ostojic, Jelena, Kozic, Dusko, Pavlovic, Aleksandra, Semnic, Marija, Todorovic, Aleksandar, Petrovic, Kosta, Covickovic-Sternic, Nadezda Abstract: To explore microstructural integrity of hippocampus in vascular dementia (VD) using DTI. Twenty-five individuals with VD, without magnetic resonance imaging (MRI) evidence of gray matter pathology, and 25 matched healthy control (HC) individuals underwent a 3T MRI protocol including T2, FLAIR, and PD in the axial plane, 3D whole-brain T1-weighted with an isotropic resolution of 1 mm, and DTI acquired using 64 diffusion sensitizing directions, b value of 1,500 s/mm(2), 65 axial slices, isotropic resolution of 1.8 mm. Images were processed to obtain indices of microstructural variations of bilateral hippocampi. Mean diffusivity (MD) in the hippocampus of patients with VD was significantly increased (p < 0.05) bilaterally with respect to that of the group of HC examinees. In VD group left hippocampal MD (10(-6 )× mm(2)/s) was 833.4 ± 92.8; in HC group left MD was 699.8 ± 56.

In VD group, right hippocampal MD was 859.1 Âą 69.8; in HC group right MD was 730.4 Âą 40.2. No group differences were found in hippocampal FA. DTI shows microstructural hippocampal damage in VD in patients with normal appearing gray matter structures on conventional MRI, indicating the need for further research on the link between VD and AD. ________________________________________________________________________________ Title: Galantamine improves sleep quality in patients with dementia. Citation: Acta neurologica Belgica, Dec 2015, vol. 115, no. 4, p. 563-568 (December 2015) Author(s): Naharci, Mehmet Ilkin, Ozturk, Ahmet, Yasar, Halit, Cintosun, Umit, Kocak, Necmettin, Bozoglu, Ergun, Tasci, Ilker, Doruk, Huseyin Abstract: The purpose of the study was to evaluate the influences of cholinesterase inhibitors on sleep pattern and sleep disturbance. A total of 87 mild to moderate stage dementia patients who were not on cholinesterase enzyme inhibitor and memantine treatment were included in the study. The dementia patients were treated with donepezil, galantamine or rivastigmine, depending on the preference of the clinician. Fifty-five dementia patients (63.2 %) completed the study. Twenty-three elderly subjects, who had normal cognitive functions, were included in the study as the control group. The Pittsburgh Sleep Quality Index was used for evaluating the sleep quality at the beginning and at the final assessment. The improvement in sleep quality was better with regard to changes in Pittsburgh Sleep Quality Index scores with galantamine treatment compared to the donepezil and the control groups. A significant decrease in Pittsburgh Sleep Quality Index scores was detected in the galantamine group after treatment. Although statistically not significant, rivastigmine decreased and donepezil increased the Pittsburgh Sleep Quality Index scores after treatment. Dementia patients who had a poor sleep quality (n: 36), the rate of improvement in sleep disturbance was 81.8 % in the galantamine group, 75 % in the rivastigmine, and 50 % in the donepezil group. Galantamine may be the first choice of cholinesterase inhibitor in mild to moderate dementia patients in terms of improving sleep quality. ________________________________________________________________________________ Title: The "syncope and dementia" study: a prospective, observational, multicenter study of elderly patients with dementia and episodes of "suspected" transient loss of consciousness. Citation: Aging clinical and experimental research, Dec 2015, vol. 27, no. 6, p. 877-882 (December 2015) Author(s): Ungar, Andrea, Mussi, Chiara, Nicosia, Franco, Ceccofiglio, Alice, Bellelli, Giuseppe, Bo, Mario, Riccio, Daniela, Landi, Francesco, Martone, Anna Maria, Langellotto, Assunta, Ghidoni, Giulia, Noro, Gabriele, Abete, Pasquale Abstract: Syncope and related falls are one of the main causes and the predominant cause of hospitalization in elderly patients with dementia. However, the diagnostic protocol for syncope is difficult to apply to patients with dementia. Thus, we developed a "simplified" protocol to be used in a prospective, observational, and multicenter study in elderly patients with dementia and transient loss of consciousness suspected for syncope or unexplained falls. Here, we describe the protocol, its feasibility and the characteristics of the patients enrolled in the study. Patients aged â&#x2030;Ľ65 years with a diagnosis of dementia and one or more episodes of transient loss of consciousness during the previous 3 months, subsequently referred to a Geriatric Department in different regions of Italy, from February 2012 to May 2014, were enrolled. A simplified protocol was applied in all patients. Selected patients underwent a second-level evaluation. Three hundred and three patients were enrolled; 52.6

% presented with episodes suspected to be syncope, 44.5 % for unexplained fall and 2.9 % both. Vascular dementia had been previously diagnosed in 53.6 % of participants, Alzheimer's disease in 23.5 % and mixed forms in 12.6 %. Patients presented with high comorbidity (CIRS score = 3.6 ± 2), severe functional impairment, (BADL lost = 3 ± 2), and polypharmacy (6 ± 3 drugs). Elderly patients with dementia enrolled for suspected syncope and unexplained falls have high comorbidity and disability. The clinical presentation is often atypical and the presence of unexplained falls is particularly frequent. ________________________________________________________________________________ Title: The Impact of Enhanced Programming on Aging in Place for People With Dementia in Assisted Living. Citation: American journal of Alzheimer's disease and other dementias, Dec 2015, vol. 30, no. 8, p. 733-737 (December 2015) Author(s): Hyde, Joan, Perez, Rosa, Doyle, Patrick J, Forester, Brent P, Whitfield, Theodore H Abstract: Assisted living (AL) is a growing and operationally diverse option in our nation's long-term care system. Many consumers view AL communities as a viable option to receive needed services and age in place. However, little is known about the factors that influence residents' ability to age in place when experiencing cognitive decline. To estimate the association of resident and site characteristics to length of stay, reason for leaving and destination for residents with dementia in assisted living. In particular, this study sought to assess the impact of an 'Enhanced' Program intended to facilitate aging in place. Data were gathered from a retrospective evaluation of residents' clinical records (N = 312) in five dementia-specific ALs (3 with robust enhanced programs) in the Northeastern United States. The time to 50% survival for the full cohort (N = 312) was 20.2 months. Both age at move-in and gender were statistically significant predictors of length of stay. Sites with robust support for aging in place exhibited a statistically significant longer length of stay compared to sites with limited support. Of the residents who left or died (N = 165) nearly one quarter (24%) were able to stay until the end of their lives, while 52% moved to a nursing home, primarily because of family, financial, or medical concerns. Few residents left these settings because of behavioral problems. AL sites with a more robust commitment to an aging in place model and a willingness to provide palliative care demonstrated a significantly longer length of stay. © The Author(s) 2014. ________________________________________________________________________________ Title: Involvement of inflammation in Alzheimer's disease pathogenesis and therapeutic potential of anti-inflammatory agents. Citation: Archives of pharmacal research, Dec 2015, vol. 38, no. 12, p. 2106-2119, 0253-6269 (December 2015) Author(s): Shadfar, Sina, Hwang, Chul Ju, Lim, Mi-Sun, Choi, Dong-Young, Hong, Jin Tae Abstract: Alzheimer's disease (AD) is the most common form of dementia. It is characterized by beta-amyloid (Aβ) peptide fibrils, which are extracellular depositions of a specific protein, and is accompanied by extensive neuroinflammation. Various studies have demonstrated risk factors that can affect AD pathogenesis, and they include accumulation of Aβ, hyperphosphorylation of tau protein, and neuroinflammation. Among these detrimental factors, neuroinflammation has been highlighted by epidemiologic studies suggesting that use of anti-inflammatory drugs could significantly reduce the incidence of AD. Evidence suggests that astrocytes, microglia, and infiltrating immune cells from periphery might contribute to or modify the process of neuroinflammation and

neurodegeneration in AD brains. In addition, recent data indicate that microRNAs may affect neuroinflammatory responses in the brain. This article focuses on supportive evidence that neuroinflammation plays a critical role in AD development. In addition, we depict putative therapeutic capacity of anti-inflammatory drugs for AD prevention or treatment. We also discuss pathogenic mechanisms by which astrocytes, microglia, T cells and microRNA participate in AD and the neuroprotective mechanisms of anti-inflammatory drugs. ________________________________________________________________________________

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. New books available to borrow. Memory loss, Alzheimerâ&#x20AC;&#x2122;s disease, and dementia: a practical guide for clinicians Budson et al nd 2016, 2 edition

Living better with dementia: good practice and innovation for the future Rahman 2015

From the back of the book: Adopting a broad and inclusive approach, Shibley Rahman presents a thorough critical analysis of existing dementia policy, and tackles head-on current and controversial topics at the forefront of public and political debate. Drawing on a wealth of diverse research, and including voices from all reaches of the globe, he identifies current policy challenges for living well with dementia, and highlights pockets of innovation and good practice to inform practical solutions for living better with dementia in the future. A unique and cohesive account of where dementia care practice and policy needs to head, and why, and how this can be achieved, this is crucial reading for dementia care professionals, service commissioners, public health officials and policy makers, as well as academics and students in these fields.

From the back of the book: A practical guide mirroring clinical workflow intended to be used as a tool for accurately diagnosing dementia for all clinicians. Covers the essentials of physical and cognitive examinations and laboratory and imaging studies, giving you the tools you need to consistently make accurate diagnoses in this rapidly growing area. Access in-depth coverage of clinically useful diagnostic tests and the latest treatment approaches. Case studies have been incorporated into the chapters and facilitate the management of both common and uncommon conditions. Includes new National Institute on AgingAlzheimer's Association and DSM-5 criteria for Alzheimer's Disease and Mild Cognitive Impairment. Brand-new chapters on how to approach the differential diagnosis and on primary progressive aphasia .

Taunton and SomPar NHS staff - Have you visited the EBL eBook 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 Taunton & Somerset eBook catalogue

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COCHRANE SYSTEMATIC REVIEWS BACK TO TOP

Protocols from November 2015 Organisational interventions for promoting person-centred care for people with dementia Cognitive training interventions for dementia and mild cognitive impairment in Parkinsonâ&#x20AC;&#x2122;s Disease

GUIDELINES BACK TO TOP NICE 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

UPTODATE & DYNAMED BACK TO TOP Whatâ&#x20AC;&#x2122;s new from our clinical decision-making tools on the topic of dementia. UpToDate (Access for Musgrove Park Staff only) DynaMed 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 Scientists find gene that ‘delays Alzheimer’s’ No hard evidence that champagne can prevent dementia

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. Models of dementia assessment and diagnosis: indicative cost review FREE PDF DOWNLOAD This report identifies and reviews in detail three models of dementia assessment and diagnosis currently being used in dementia care in the NHS in England. Through semi-structured interviews with each unit it presents indicative costs for each model, benefits for patients and carers, key messages and considerations about developing the service, giving insight into how a local Clinical Commissioning Group (CCG) might approach a review of their local service with an aim to making improvements. Dementia: through the eyes of women The Joseph Rowntree Foundation Dementia disproportionately affects women, but their experiences and voices are missing from research and literature. This project aimed to inspire people to think differently about women and dementia by using stories and reflections from individual women to inform the debate in a unique, inspiring and insightful way. The report shows: · there is often resistance to talking about dementia as a women’s issue;

· research needs to focus on the voices, experiences and perceptions of women affected by dementia; · service provision needs to reflect the needs, skills and attributes of women with dementia, female carers and the female care workforce; · the way women experience dementia is affected by gender, but also by many other factors including education, ethnicity, sexuality, class, age, and disability.

Online brain training improves memory and performance of everyday tasks such as cooking and navigating public transport in older people Playing online games that challenge reasoning and memory skills – brain training - could have significant benefits for older people in their day to day lives. This is according to a new study published on 3 November in JAMDA. Researchers at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London have shown that an online brain training package can not only improve memory and reasoning skills - but also how well older people carry out everyday tasks such as navigating public transport, shopping, cooking and managing personal finances. Changes in humour an early sign of dementia Researchers at University College London have revealed that a change in sense of humour could be an early sign of dementia. The findings could help improve dementia diagnosis, by highlighting changes not commonly thought to be linked to the condition. Dementia: Impact on Nonprofessional Caregivers FREE PDF DOWNLOAD A recent study shows that over a 2-year period almost 60% of the dementia caregivers studied developed an anxiety or depressive disorder. According to the World Health Organization, in 2015 approximately 47.5 million people worldwide are living with the diagnosis of dementia and by 2030 that number is projected to increase by 63% to an astounding 75.6 million. With dementia diagnoses increasing at such a staggering rate, it is important for the social work community to understand the latest evidence on the impact dementia has on the nonprofessional caregivers that they work with regularly. Department of Health response to Raj Long's independent report : Finding a path for the cure for dementia FREE PDF DOWNLOAD In 2013 the UK hosted the G8 Dementia Summit and subsequently co-ordinated global activity around dementia. One strand of work led to Raj Long’s independent report, Finding a path for the cure for dementia. The response outlines a continued commitment to this work, and suggests how the DH might work with partners to take it forward as part of the wider continuity model for global action against dementia. Craft workshops with dementia patients Elderly and dementia patients get creative, thanks to charity workshops A series of artistic workshops have been held at Charing Cross Hospital aimed at elderly patients and those with dementia, run by creative team ‘Paper Birch’ and funded by Imperial College Healthcare Charity.

Make a point about young onset dementia 2015 YouTube video A film about young onset dementia, created by Young Dementia UK UKâ&#x20AC;&#x2122;s first Dementia Research Institute to be led by the Medical Research Council (MRC) The DRI will bring together world-leading expertise in discovery science in the fight against dementia, is set to receive up to ÂŁ150m in funding and will be fully functional by 2020. Reducing antipsychotic use in people with dementia living in nursing homes This blog looks at a recent randomised controlled trial by Clive Ballard and colleagues (2015), which investigated the impact of antipsychotic review and nonpharmacological interventions on:

Antipsychotic use;

Neuropsychiatric symptoms; and

Mortality in people with dementia living in nursing homes.

Can higher educational attainment help lower dementia risk? Previous research shows that low education, hypertension, smoking and diabetes may all have causal associations with dementia. An explorative meta-analysis was conducted in order to find out whether a dose-response relation exists between education and dementia risk (Xu et al, 2015). Decision making among male carers of people with dementia The article highlights how carers defer the more difficult and long term decisions until the person who has dementia cannot make or contribute to them, thus removing some of the autonomy which many of us believe to be important.

TOPIC ALERTS AND UPDATES BACK TO TOP ABSTRACTS AVAILABLE VIA LINKS BELOW- FOR FULL-TEXT PLEASE ASK LIBRARY STAFF Identification of the palliative phase in people with dementia: a variety of opinions between healthcare professionals BMC Palliative Care 2015, 14: 56 FREE FULL TEXT UK quality statements on end of life care in dementia: a systematic review of research evidence BMC Palliative Care (2015) 14:51 FREE FULL TEXT Observational cohort study: deprivation and access to anti-dementia drugs in the UK Age and Ageing Advance Access published November 18, 2015 FREE FULL TEXT NHS Evidence Expressed emotion in relatives of persons with dementia: a systematic review and meta-analysis Aging Ment Health. 2015 Nov 16:1-12. [Epub ahead of print]

The experience of caring for patients with dementia within a general hospital setting: a meta-synthesis of the qualitative literature. Aging Ment Health. 2015 Nov 9:1-11. [Epub ahead of print]

Elsevier Practice Updates Diagnosis of dementias by high-field 1H MRS of cerebrospinal fluid J Neurol Neurosurg Psychiatry2015;86:1286-1290

Nursing home placement in the Donepezil and Memantine in Moderate to Severe Alzheimer's Disease (DOMINO-AD) trial: secondary and post-hoc analyses Lancet Neurology Volume 14, No. 12, p1171â&#x20AC;&#x201C;1181, December 2015 Medscape Topic Alerts Association Between Olfactory Dysfunction and Amnestic Mild Cognitive Impairment and Alzheimer Disease Dementia JAMA Neurol. Published online November 16, 2015.

TRIP Database Long-term effects of a 12 weeks high-intensity functional exercise program on physical function and mental health in nursing home residents with dementia: a single blinded randomized controlled trial BMC Geriatrics (2015) 15:158 FREE FULL TEXT Multisensory Stimulation as an Intervention Strategy for Elderly Patients With Severe Dementia: A Pilot Randomized Controlled Trial American Journal of Alzheimer’s Disease and Other Dementias, Published online before print December 1, 2015 Survival After Suspected Urinary Tract Infection in Individuals with Advanced Dementia Journal of the American Geriatrics Society, Article first published online: 28 NOV 2015

Medline Plus APOE*E2 allele delays age of onset in PSEN1 E280A Alzheimer’s disease Molecular Psychiatry advance online publication 1 December 2015 Relationship of regional brain β-amyloid to gait speed Neurology Published online before print December 7, 2015

TWITTER BACK TO TOP The latest from popular Twitter pages dedicated to dementia: 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

Alzheimer’s Research UK Research Conference- 8 March 2016, Manchester th

Dementia 2020- Transforming Care, Support and Research- 12 April 2016 st

31 International Conference of Alzheimer’s Disease International- 21 -24 April 2016, Budapest

LITERATURE SEARCH SERVICE BACK TO TOP Looking for the latest evidence-based research but haven’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.