July dementia current awareness draft by Musgrove Park Hospital Library

Library Service Musgrove Park Academy

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 2 July 2015

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

New books

Cochrane Systematic Reviews/guidelines

UpToDate & DynaMed

Dementia in the News

Reports, publications and resources

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 Athens 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.

Title: The effects of treatment adherence and treatment-specific therapeutic competencies on outcome and goal attainment in telephone-based therapy with caregivers of people with dementia. Citation: Aging & Mental Health, 01 September 2015, vol./is. 19/9(808-817), 13607863 Author(s): Schink��, Denise, Altmann, Uwe, Wilz, Gabriele Abstract: Objectives:Contradictory results have been found for the impact of therapist's adherence and competence on intervention outcomes. Most studies focus on generic aspects of competence and adherence, rather than taking into account treatment-specific aspects or specific challenges of the clientele. Appropriate analyses are lacking for cognitive behavioral therapy (CBT) with caregivers of people with dementia. Method:In a sample of 43 caregivers, we examined adherence and different competence ratings of 80 complete sessions, as predictors of symptom change and goal attainment. Therapist's competence was evaluated by four raters, using an adapted version of the cognitive therapy scale (CTS) on three subscales of competence: General therapeutic (GT), session-structuring (SS), and treatment-specific CBT technique (CT). Therapist's adherence to the manual was also assessed. Results:The results show that GT competencies were associated with lower post-test depression scores and that CT competencies predicted a decrease in caregiver burden and higher goal attainment, while SS competencies predicted higher post-test burden. Therapist's adherence had no relationship to outcome, but the higher application of modifying dysfunctional thoughts was associated with higher goal attainment. Conclusion:The results suggest the importance of treatmentspecific competencies for outcome. Future research should identify empirically what kind of therapeutic behavior is appropriate to the challenges of a specific clientele such as caregivers of people with dementia. Title: An RCT to evaluate the utility of a clinical protocol for staff in the management of behavioral and psychological symptoms of dementia in residential aged-care settings. Citation: Aging & Mental Health, 01 September 2015, vol./is. 19/9(799-807), 13607863 Author(s): McCabe, Marita P., Bird, Michael, Davison, Tanya E., Mellor, David, MacPherson, Sarah, Hallford, David, Seedy, Melissa Title: Psychosis associated behavioral and psychological signs and symptoms in mild cognitive impairment and Alzheimer's dementia. Citation: Aging & Mental Health, 01 September 2015, vol./is. 19/9(818-828), 13607863 Author(s): Van der Mussele, Stefan, Mari 뮬 Peter, Saerens, Jos, Somers, Nore, Goeman, Johan, De Deyn, Peter P., Engelborghs, Sebastiaan Title: A qualitative study of older and middle-aged adults' perception and attitudes towards dementia and dementia risk reduction. Citation: Journal of Advanced Nursing, 01 July 2015, vol./is. 71/7(1694-1703), 03092402 Author(s): Kim, Sarang, Sargent-Cox, Kerry A., Anstey, Kaarin J.

Title: Discovering what works well: exploring quality dementia care in hospital wards using an appreciative inquiry approach. Citation: Journal of Clinical Nursing, 01 July 2015, vol./is. 24/13/14(1916-1925), 09621067 Author(s): Scerri, Anthony, Innes, Anthea, Scerri, Charles Title: Barriers to Qualitative Dementia Research: The Elephant in the Room. Citation: Qualitative Health Research, 01 July 2015, vol./is. 25/7(1013-1019), 10497323 Author(s): Carmody, John, Traynor, Victoria, Marchetti, Elena Title: The development of Music in Dementia Assessment Scales (MiDAS). Citation: Nordic Journal of Music Therapy, 01 July 2015, vol./is. 24/3(232-251), 08039828 Author(s): McDermott, Orii, Orrell, Martin, Ridder, Hanne Mette Abstract: There is a need to develop an outcome measure specific to music therapy in dementia that reflects a holistic picture of the therapy process and outcome. This study aimed to develop a clinically relevant and scientifically robust music therapy outcome measure incorporating the values and views of people with dementia. Focus groups and interviews were conducted to obtain qualitative data on what music meant to people with dementia and the observed effects of music. Expert and peer consultations were conducted at each stage of the measure development to maximise its content validity. The new measure was field-tested by clinicians in a care home. Feedback from the clinicians and music therapy experts were incorporated during the review and refinement process of the measure. A review of the existing literature, the experiential results and the consensus process enabled the development of the new outcome measure Music in Dementia Assessment Scales (MiDAS). Analysis of the qualitative data identified five key areas of the impact of music on people with dementia and they were transformed as the five Visual Analogue Scale (VAS) items: levels ofInterest, Response, Initiation, InvolvementandEnjoyment.MiDAS comprises the five VAS items and a supplementary checklist of notable positive and negative reactions from the individual. This study demonstrates that it is possible to design and develop an easy to apply and rigorous quantitative outcome measure which has a high level of clinical relevance for people with dementia, care home staff and music therapists. Title: INFORMING A PATIENT THEY HAVE DEMENTIA IS A CLINICAL JUDGEMENT. Citation: Nursing Standard, 17 June 2015, vol./is. 29/42(33-), 00296570 Author(s): Owen, Michael Full Text: Available from NURSING STANDARD in Library MPH Title: Signs and symptoms of dementia. Citation: Nursing Standard, 10 June 2015, vol./is. 29/41(42-51), 00296570 Author(s): Sandilyan, Malarvizhi Babu, Dening, Tom Full Text: Available from NURSING STANDARD in Library MPH Title: Falls prevention interventions in older adults with cognitive impairment: A systematic review of reviews. Citation: International Journal of Therapy & Rehabilitation, 01 June 2015, vol./is. 22/6(289-296), 17411645 Author(s): Booth, Vicky, Logan, Pip, Harwood, Rowan, Hood, Victoria Abstract: Aim: This critical review explores the review material on falls prevention interventions in older adults with cognitive impairment, such as dementia. Method: A systematic review of reviews

was conducted using the following bibliographic databases: PubMed/Medline, EMBASE, AMED, CINAHL and the Cochrane electronic library. The search terms used were: 'falls'; 'rehabilitation'; 'falls prevention'; 'interventions'; 'cognitive impairment'; 'dementia'; and 'Alzheimer's disease'. All available studies were marked against predetermined inclusion and exclusion criteria. Results: Of the seven review articles that met the inclusion criteria, only one had a homogenous population of adults with a cognitive impairment. The most reported intervention was exercise, which was included in all seven reviews of 91 studies. Multifactorial and multicomponent falls prevention programmes were also frequently reported. Reports of efficacy were inconsistent for all the interventions reported. Conclusion: Evidence for falls prevention interventions for adults with cognitive impairment is varied and inconclusive. When compared with the literature on falls interventions in healthy older adult populations, both primary and synthesis studies in older adults with cognitive impairment are lacking in number, quality and homogeneity of sample population and interventions. Promising results are emerging but clinical recommendations cannot be made at this time. Full Text: Available from EBSCOhost in International Journal of Therapy & Rehabilitation Title: Comfort goal of care and end-of-life outcomes in dementia: A prospective study. Citation: Palliative Medicine, 01 June 2015, vol./is. 29/6(538-546), 02692163 Author(s): van Soest-Poortvliet, Mirjam C, van der Steen, Jenny T, de Vet, Henrica CW, Hertogh, Cees MPM, Deliens, Luc, Onwuteaka-Philipsen, Bregje D Title: Pulmonary function as a risk factor for dementia death: an individual participant meta-analysis of six UK general population cohort studies. Citation: Journal of Epidemiology & Community Health, 01 June 2015, vol./is. 69/6(550-556), 0143005X Author(s): Russ, Tom C., Starr, John M., Stamatakis, Emmanuel, KivimäŤŠ, Mika, Batty, G. David Abstract: Background In addition to being associated with all-cause mortality and cardiovascular disease mortality, lung function has been linked with dementia. However, existing studies typically provide imprecise estimates due to small numbers of outcome events and are based on unrepresentative samples of the general population. Methods Individual participant meta-analysis of six cohort studies from the Health Survey for England and the Scottish Health Survey (total N=54 671). Dementiarelated mortality was identified by mention of dementia on any part of the death certificate (mean follow-up 11.7 years). Study-specific Cox proportional hazard models of the association between lung function and dementia-related death were pooled using random effect meta-analysis to produce overall results. Results There was a doseresponse association between poorer lung function and a higher risk of dementia-related death (age- and sex-adjusted HR compared to highest quartile of forced expiratory volume in 1 s (FEV1), 95% CI: second quartile 1.32, 0.99 to 1.76; third quartile 1.78, 1.30 to 2.43; fourth (lowest) quartile 2.74, 1.73 to 4.32). There was no significant heterogeneity in study-specific estimates (I2=0%). Controlling for height, socioeconomic status, smoking and general health attenuated but did not remove the association (second quartile 1.15, 0.82 to 1.62; third quartile 1.37, 0.96 to 1.94; fourth quartile 2.09, 1.17 to 3.71). Results for forced vital capacity and peak flow were similar. Conclusions In these general population samples, the relation between three measures of lung function and dementia death followed a doseresponse gradient. Being in the bottom quartile of lung function was associated with a doubling of the risk. Full Text: Available from Highwire Press in Journal of Epidemiology and Community Health

Title: Cultural competence: part of good personalised dementia care. Citation: Nursing & Residential Care, 01 June 2015, vol./is. 17/6(338-341), 14659301 Author(s): Mendes, Aysha Full Text: Available from EBSCOhost in Nursing & residential care : the monthly journal for care assistants, nurses and managers working in health and social care Title: Development of an exercise intervention to improve cognition in people with mild to moderate dementia: Dementia And Physical Activity (DAPA) Trial, registration ISRCTN32612072. Citation: Physiotherapy, 01 June 2015, vol./is. 101/2(126-134), 00319406 Author(s): Brown, Deborah, Spanjers, Katie, Atherton, Nicky, Lowe, Janet, Stonehewer, Louisa, Bridle, Chris, Sheehan, Bart, Lamb, Sarah E. Abstract: More than 800 000 people in the UK have dementia, and it is a government priority to improve dementia care. Drug treatment options are relatively limited. The Dementia And Physical Activity (DAPA) study is a randomised trial which targets cognition in people with dementia, using an exercise programme. There is evidence to suggest that both aerobic and resistance exercise may be useful in improving cognition. Hence the intervention comprises a supervised part of twice-weekly exercise classes of one hour duration for 4 months, including aerobic exercise at moderate intensity on static bicycles, and resistance (weight training) exercise using weight vests, weight belts and dumbbells. Thereafter participants progress to unsupervised, independent exercise. Aids to behaviour modification have been incorporated into the intervention. The DAPA intervention has been designed to maximise likelihood of effectiveness and cost-effectiveness, and for delivery in the UK National Health Service. Title: The Impact of Living Arrangements on Dementia Caregivers Sleep Quality. Citation: American Journal of Alzheimer's Disease & Other Dementias, 01 June 2015, vol./is. 30/4(352-359), 15333175 Author(s): Simpson, Cherie, Carter, Patricia Title: Cognitive Fluctuations as a Challenge for the Assessment of Decision-Making Capacity in Patients With Dementia. Citation: American Journal of Alzheimer's Disease & Other Dementias, 01 June 2015, vol./is. 30/4(360-363), 15333175 Author(s): Trachsel, Manuel, Hermann, Helena, Biller-Andorno, Nikola Title: Gait and Apathy as Relevant Symptoms of Subcortical Vascular Dementia. Citation: American Journal of Alzheimer's Disease & Other Dementias, 01 June 2015, vol./is. 30/4(390-399), 15333175 Author(s): Moretti, Rita, Cavressi, Monica, Tomietto, Paola Title: The Peripheral Sympathetic Neuron is Intact in Alzheimers Disease and Behavioral Variant of Frontotemporal Dementia. Citation: American Journal of Alzheimer's Disease & Other Dementias, 01 June 2015, vol./is. 30/4(400-404), 15333175 Author(s): Struhal, Walter, Javor, Andrija, Benesch, Thomas, Vosko, Milan R., Ransmayr, Gerhard Title: A Risk-Benefit Assessment of Dementia Medications: Systematic Review of the Evidence. Citation: Drugs & Aging, 01 June 2015, vol./is. 32/6(453-467), 1170229X Author(s): Buckley, Jacob, Salpeter, Shelley

Title: From Admission to Death: Prevalence and Course of Pain, Agitation, and Shortness of Breath, and Treatment of These Symptoms in Nursing Home Residents With Dementia. Citation: Journal of the American Medical Directors Association, 01 June 2015, vol./is. 16/6(475481), 15258610 Author(s): Hendriks, Simone A., Smalbrugge, Martin, Galindo-Garre, Francisca, Hertogh, Cees M.P.M., van der Steen, Jenny T. Abstract: Objectives Burdensome symptoms frequently develop as part of the dementia trajectory and influence quality of life. We explore the course of symptoms and their treatment during nursing home stay to help target adequate symptom management. Design Data were collected as part of the Dutch End of Life in Dementia study, a longitudinal observational study with up to 3.5 years of followup. Physicians performed assessments at baseline, semiannually, and shortly after death of pain, agitation, shortness of breath, and treatment provided for these symptoms. Setting Long-term care facilities (28) in the Netherlands. Participants Newly admitted nursing home residents (372) in variable stages of dementia. Measurements We described prevalence and course of symptoms, and treatment provided for these symptoms. We used generalized estimating equations to evaluate the longitudinal change in symptoms and their treatment, and the associations between the symptoms of pain and agitation, as well as between stage of dementia and symptoms. Results Pain was common (varying from 47% to 68% across the semiannual assessments) and frequently persistent (36%41% of all residents); it increased to 78% in the last week of life. Agitation was the most common symptom (57%71%), and also frequently persistent (39%53%), yet it decreased to 35% in the last week of life. Shortness of breath was less common (16%26%), but it increased to 52% at the end of life. Pain was not significantly associated with agitation. Advanced dementia was associated with more pain only. Treatment changed in particular at the end of life. Pain was treated mostly with acetaminophen (34%52%), and at the end of life with parenteral opioids (44%). Agitation was mostly treated nonpharmacologically (78%92%), and at the end of life anxiolytics were the most frequently prescribed treatment (62%). Overall, aerosolized bronchodilators were the most frequently prescribed treatment for shortness of breath (29%67%), but at the end of life, this was morphine (69%). Conclusion Pain and agitation were common and frequently persisted in residents with dementia during nursing home stay, but symptom management intensified only at the end of life. Symptom control may be suboptimal from admission, and a stronger focus on symptom control is needed at an earlier stage than the end of life. Title: Critical Decisions for Older People With Advanced Dementia: A Prospective Study in LongTerm Institutions and District Home Care. Citation: Journal of the American Medical Directors Association, 01 June 2015, vol./is. 16/6(0-), 15258610 Author(s): Toscani, Franco, van der Steen, Jenny T., Finetti, Silvia, Giunco, Fabrizio, Pettenati, Francesca, Villani, Daniele, Monti, Massimo, Gentile, Simona, Charrier, Lorena, Di Giulio, Paola Abstract: Objective To describe and compare the decisions critical for survival or quality of life [critical decisions (CDs)] made for patients with advanced dementia in nursing homes (NHs) and home care (HC) services. Design Prospective cohort study with a follow-up of 6 months. Setting Lombardy Region (NHs) and Reggio-Emilia and Modena Districts (HC), Italy. Participants Patients (496 total; 315 in NHs and 181 in HC) with advanced dementia (Functional Assessment Staging Tool score =7) and expected survival =2 weeks. Measurements At baseline, the patients' demographic data, date of admission and of dementia diagnosis, type of dementia, main comorbidities, presence of pressure sores, ongoing treatments, and current prescriptions were abstracted from clinical records. At baseline and every 15 days thereafter, information regarding the patients' general condition and CDs (deemed critical by the doctor or team) was collected by an interview with the doctor. For each CD, the physician reported the problem that led to the decision, that was eventually made, the purpose of the decision, whether the decision had been discussed with and/or communicated to the family, who made the final decision, whether the decision was maintained after 1 week, whether it corresponded to what the doctor would have judged appropriate, and the expected survival of the patient (=15 days). Results For 267 of the 496 patients (53.8%; 60.3% in NHs and 42.5% at home), 644 CDs were made; for 95 patients, more than 1 CD was made. The problems that led to a CD were mainly infections (respiratory tract and other infections; 46.6%, 300/644 CDs); nutritional/hydration problems (20.6%; 133 CDs); and the worsening of a pre-existing disease (9.3%; 60 CDs). The most

frequent type of decision concerned the prescription of antibiotics (overall 41.1%, 265/644; among NH patients 44.6%, 218/488; among HC patients, 30.2%, 47/156). The decision to hospitalize the patient was more frequently reported for HC than NH patients (25.5% vs 3.1%). The most frequent purposes of the CDs in both settings were reducing symptoms or suffering (more so in NHs; 81.1% vs 57.0% in HC) and prolonging survival (NH 27.5%; HC 23.1%; multiple purposes were possible). For 26 decisions (3.8%), the purpose was to ease death or not to prolong life. Conclusions Decisions critical for the survival or quality of life of patients with advanced dementia were made for approximately onehalf of the patients during a 6-month time frame, and such decisions were made more frequently in NHs than in HC. HC patients were more frequently hospitalized, and a sizeable minority of these patients were treated with the goal of prolonging survival. Italian patients with advanced dementia may benefit from the implementation of palliative care principles, and HC patients may benefit from the implementation of measures to avoid hospitalizing patients near the end of life. Title: Implementing person centred dementia care: a musical intervention. Citation: Working with Older People: Community Care Policy & Practice, 01 June 2015, vol./is. 19/2(77-84), 13663666 Author(s): Argyle, Elaine, Kelly, Tony Abstract: Purpose Recent years have seen the advocacy of person-centred approaches to dementia care. An important component of this approach has been the use of arts in the promotion of health and well-being. However, relatively little attention has been given to the barriers and facilitators experienced in trying to implement these types of interventions in a dementia care setting. It is therefore, the purpose of this paper is to help to redress this neglect by examining the process of implementing a personalised musical intervention for the clients of a specialist dementia home care service. Design/methodology/approach Drawing on interviews with five project stakeholders, the paper examines, not only the potential benefits to be gained from the musical intervention but also identifies the barriers experienced in its implementation and ways in which they could be overcome. Findings It was found that although the musical intervention had a potentially positive impact, there were multi-levelled barriers to its implementation including issues of training, leadership as well as contextual issues such as commissioning and resourcing more generally. Originality/value The key role played by these issues in the process of implementation suggests that practice should transcend its focus on individual wellbeing and address the wider factors that can facilitate or prevent its fulfilment. While the multi-levelled nature of the obstacles identified suggest that the implementation of innovative interventions within health and social care settings should adopt a similarly eclectic approach. Full Text: Available from Emerald Group Publishing Limited in Working with Older People

NEW 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. New books recently added to stock

Excellence in Dementia Care: Research into Practice 2 edition 2014 Murna Downs et al Maidenhead: Open University Press A comprehensive text on dementia care, drawn from research evidence, practice and the experience of people with dementia. From the back of the book: This scholarly yet accessible textbook is the most comprehensive single text in the field of dementia care. Drawn from research evidence, international expertise and good practice guidelines, the book has been crafted alongside people with dementia and their families. Case studies and quotes in every chapter illustrate the realities of living with dementia and bring the theory to life.

10 helpful hints for carers: practical solutions for carers living with people with dementia 2015 University of Stirling/University of Leeds Stirling: Dementia Services Development Cente From the back of the book: 10 helpful hints for carers is an easy-to-read guide for carers living with people with dementia. It provides simple, practical solutions to the everyday problems family carers can face when looking after a person with dementia. Covering areas like how to cope with aggression, creating relaxing environments, â&#x20AC;&#x2DC;wanderingâ&#x20AC;&#x2122;, sleeplessness and how to cope with dementia and depression, it is a mine of information and good advice.

COCHRANE SYSTEMATIC REVIEWS BACK TO TOP Full-text evidence-based systematic reviews prepared by the Cochrane collection Reviews from June 2015 Regional Cerebral Blood Flow Single Photon Emission Computed Tomography for detection of Frontotemporal dementia in people with suspected dementia Enhanced rehabilitation and care models for adults with dementia following hip fracture surgery

UPTODATE & DYNAMED BACK TO TOP What’s new from our clinical decision-making tools on the topic of dementia. UpToDate DynaMed Please contact library staff for details on how to access these resources; you will need an Athens password if accessing from home.

DEMENTIA IN THE NEWS BACK TO TOP BBC News Drivers with early dementia are a ‘risk to the public’

REPORTS, PUBLICATIONS AND RESOURCES BACK TO TOP Dementia from the inside- a video created by The Social Care Institute for Excellence (SCIE), highlighting what it might feel like to live with dementia, from the point of view of a person with dementia. Based on true experiences of people living with dementia. How can and should UK society adjust to dementia? The Joseph Rowntree Foundation has published this paper discussing new ways of understanding dementia, and ways to meet the needs of the growing number of people living with dementia, including the application of the social model of disability. The Mental Elf- smoking is associated with an increased risk of dementia

Guidance for NHS continuing healthcare assessors: Evaluating emotional and psychological needs of people in the later stages of dementia- Publication from the Alzheimer’s Society Dementia festival of ideas- a year-long celebration of the most stimulating thinking, writing and discussion on what dementia means in 2015. Women and dementia: a global research overview Full report Summary Butterfly Scheme- reaching out to people with dementia and to anyone needing memory support

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 th

10 UK Dementia Congress

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 attached 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.

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.