October dementia current awareness musgrove 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 5 October 2015

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

Books

Cochrane Systematic Reviews

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: Multimodal imaging in Alzheimer's disease: Validity and usefulness for early detection Citation: The Lancet Neurology, October 2015, vol./is. 14/10(1037-1053), 1474-4422;1474-4465 (01 Oct 2015) Author(s): Teipel S., Drzezga A., Grothe M.J., Barthel H., Chetelat G., Schuff N., Skudlarski P., Cavedo E., Frisoni G.B., Hoffmann W., Thyrian J.R., Fox C., Minoshima S., Sabri O., Fellgiebel A. Abstract: Alzheimer's disease is a progressive neurodegenerative disease that typically manifests clinically as an isolated amnestic deficit that progresses to a characteristic dementia syndrome. Advances in neuroimaging research have enabled mapping of diverse molecular, functional, and structural aspects of Alzheimer's disease pathology in ever increasing temporal and regional detail. Accumulating evidence suggests that distinct types of imaging abnormalities related to Alzheimer's disease follow a consistent trajectory during pathogenesis of the disease, and that the first changes can be detected years before the disease manifests clinically. These findings have fuelled clinical interest in the use of specific imaging markers for Alzheimer's disease to predict future development of dementia in patients who are at risk. The potential clinical usefulness of single or multimodal imaging markers is being investigated in selected patient samples from clinical expert centres, but additional research is needed before these promising imaging markers can be successfully translated from research into clinical practice in routine care. ________________________________________________________________________________ Title: The Brain Connectivity Basis of Semantic Dementia: A Selective Review Citation: CNS Neuroscience and Therapeutics, October 2015, vol./is. 21/10(784-792), 17555930;1755-5949 (01 Oct 2015) Author(s): Yang Q., Guo Q.-H., Bi Y.-C. Abstract: Semantic dementia (SD) is a neurodegenerative disorder characterized by the progressive loss of semantic memory and conceptual knowledge, coupled with asymmetric local brain atrophy concentrated in the anterior temporal lobe. Recent developments in neuroimaging techniques, especially the emergence of the "human connectomics," have made possible the study of the brain's functional and structural connections and the topological properties of the brain networks. Recent studies applying these techniques have shown that SD manifests extensive structural and functional connectivity alterations, providing important insights into the pathogenesis of SD and the neural basis of semantic memory in general. In this review, we present and discuss the existing findings about the brain connectivity changes in SD and how they might be related to the various behavioral deficits associated with this disorder and propose important unanswered questions that warrant further investigation. ________________________________________________________________________________ Title: An analysis of the cognitive items of the movement disorders society checklist for the diagnosis of dementia in patients with Parkinson's disease Citation: Parkinsonism and Related Disorders, October 2015, vol./is. 21/10(1260-1263), 13538020;1873-5126 (01 Oct 2015) Author(s): Oliveira G.N., Souza C.P., Foss M.P., Tumas V.

Abstract: Objective: Some studies about the Movement Disorders Society checklist for the diagnosis of Parkinson's disease (PD) dementia (PDD) suggested that its accuracy was not totally satisfactory. Our study focused to evaluate the two items of the checklist related to the cognitive assessment. Methods: We assessed 95 consecutive patients with a diagnosis of PD using the UPDRS, Hoehn and Yahr, Schwab and England scales, Pfeffer Functional Activities Questionnaire, MMSE, Clinical Dementia Rating, clock drawing test, verbal fluency test (animals), digit span, word list battery of CERAD, Frontal Assessment Battery and the 15-item Geriatric Depression Scale The cognitive diagnosis was based on the MDS diagnostic criteria for PDD. The checklist was completed later by a blinded investigator. The data were evaluated using descriptive analysis and calculation of sensitivity, and specificity of the checklist for the diagnosis of PDD. Results: 33 patients (35%) were diagnosed with PDD. The ROC curve showed that the MMSE cut-off score < 26 had the highest accuracy (sensitivity: 94%, specificity: 55%) for the diagnosis of PDD. Using the checklist with original cut-off scores we found sensitivity of 97% and specificity of 58%. Using an alternative way to interpret the cognitive assessment of the checklist we found sensitivity of 94% and specificity of 89% for the diagnosis of PDD. Conclusions: Our findings suggest that to improve the accuracy of the checklist, it would be necessary to adjust the way we use and interpret the cut-off scores of the MMSE and of the subtests, without the need to eliminate their use. ________________________________________________________________________________ Title: Differentiating between right-lateralised semantic dementia and behavioural-variant frontotemporal dementia: An examination of clinical characteristics and emotion processing Citation: Journal of Neurology, Neurosurgery and Psychiatry, October 2015, vol./is. 86/10(10821088), 0022-3050;1468-330X (01 Oct 2015) Author(s): Kamminga J., Kumfor F., Burrell J.R., Piguet O., Hodges J.R., Irish M. Abstract: Background and purpose: Right-lateralised semantic dementia (right SD) and behaviouralvariant frontotemporal dementia (bvFTD) appear clinically similar, despite different patterns of underlying brain changes. This study aimed to elucidate distinguishing clinical and cognitive features in right SD versus bvFTD, emphasising emotion processing and its associated neural correlates. Methods: 12 patients with right SD and 19 patients with bvFTD were recruited. Clinical features were documented. All patients were assessed on standardised neuropsychological tests and a facial emotion processing battery. Performance was compared to 20 age-matched and education-matched controls. Grey matter intensity was related to emotion processing performance using whole-brain voxel-based morphometry analysis. Results: Patients with right SD exhibited disproportionate language dysfunction, prosopagnosia and a suggestion of increased obsessive personality/behavioural changes versus patients with bvFTD. In contrast, patients with bvFTD demonstrated pronounced deficits in attention/working memory, increased apathy and greater executive dysfunction, compared to patients with right SD. Decreased empathy, disinhibition and diet changes were common to both dementia subtypes. Emotion processing deficits were present in both FTD syndromes but were associated with divergent patterns of brain atrophy. In right SD, emotion processing dysfunction was associated with predominantly right medial and lateral temporal integrity, compared to mainly left temporal, inferior frontal and orbitofrontal and right frontal gyrus integrity in bvFTD. Conclusions: This study demonstrates comparable deficits in facial emotion processing in right SD and bvFTD, in keeping with their similar clinical profiles. These deficits are attributable to divergent neural substrates in each patient group, namely, right lateralised regions in right SD, versus predominantly left lateralised regions in bvFTD. Full text: Available Highwire Press at Journal of neurology, neurosurgery, and psychiatry ________________________________________________________________________________ Title: Prevalence and severity of dementia in nursing home residents Citation: Dementia and Geriatric Cognitive Disorders, September 2015, vol./is. 40/(166-177), 14208008;1421-9824 (02 Sep 2015)

Author(s): Helvik A.-S., Engedal K., Benth J.S., Selbaek G. Abstract: Background/Aims: The aim of this study was to compare the presence and severity of dementia in two large cross-sectional samples of nursing home residents from 2004/2005 and 2010/2011. Methods: Demographic information as well as data on the type of nursing home unit, length of stay before assessment, physical health, regularly used prescribed drugs and Clinical Dementia Rating scale scores were used in the analyses. Logistic and linear regression models for hierarchical data were estimated. Results: The odds of the occurrence and of a greater severity of dementia were higher in 2010/2011 than in 2004/2005. Independent of the time of study, married men had more severe dementia than single men, and single women had more severe dementia than single men. Conclusion: The findings may reflect the increase in the need for more nursing home beds designed for people with dementia between 2004/2005 and 2010/2011. ________________________________________________________________________________ Title: The Association of Specific Executive Functions and falls risk in people with mild cognitive impairment and early-stage dementia Citation: Dementia and Geriatric Cognitive Disorders, September 2015, vol./is. 40/(178-185), 14208008;1421-9824 (02 Sep 2015) Author(s): Van Der Wardt V., Logan P., Hood V., Booth V., Masud T., Harwood R. Abstract: Background/Aims: Impairment in executive function is associated with a heightened risk for falls in people with mild cognitive impairment (MCI) and dementia. The purpose of this study was to determine which aspects of executive function are associated with falls risk. Methods: Forty-two participants with a mean age of 81.6 years and a diagnosis of MCI or mild dementia completed five different executive function tests from the computerised CANTAB test battery and a comprehensive falls risk assessment. Results: A hierarchical regression analysis showed that falls risk was significantly associated with spatial memory abilities and inhibition of a pre-potent response. Conclusion: The concept of executive function may be too general to provide meaningful results in a research or clinical context, which should focus on spatial memory and inhibition of a pre-potent response. ________________________________________________________________________________ Title: Survival in subcortical vascular dementia: Predictors and comparison to probable Alzheimer's disease in a tertiary memory clinic population Citation: Dementia and Geriatric Cognitive Disorders, September 2015, vol./is. 40/(210-221), 14208008;1421-9824 (02 Sep 2015) Author(s): Kim J.H., Go S.M., Seo S.W., Kim S.H., Chin J., Moon S.Y., Lim H., Cheong H.K., Choi S.A., Lee J.H., Na D.L. Abstract: Background: Subcortical vascular dementia (SVaD) is one of the most common dementias, after Alzheimer's disease (AD) dementia. Few survival analyses in SVaD patients have been reported. Methods: The dates and causes of death of 146 SVaD and 725 AD patients were included. We used the Cox proportional hazards model to compare survival between SVaD and AD patients and to explore possible factors related to survival of SVaD patients. Results: The median survival time after the onset of SVaD (109 months) was shorter than that recorded for AD (152 months). The most common cause of death in SVaD was stroke (47.1%). Factors associated with shorter survival in SVaD were late onset, male sex, worse baseline cognition, absence of hypertension and a family history of stroke. Conclusions: Stroke prevention may be important in SVaD treatment because 47.1% of SVaD patients died of stroke. A family history of stroke and absence of hypertension were associated with a shorter survival in SVaD, suggesting the existence of genetic or unknown risk factors. ________________________________________________________________________________

Title: Guidelines for reporting methodological challenges and evaluating potential bias in dementia research Citation: Alzheimer's and Dementia, September 2015, vol./is. 11/9(1098-1109), 1552-5260;15525279 (01 Sep 2015) Author(s): Weuve J., Proust-Lima C., Power M.C., Gross A.L., Hofer S.M., Thiebaut R., Chene G., Glymour M.M., Dufouil C. Abstract: Clinical and population research on dementia and related neurologic conditions, including Alzheimer's disease, faces several unique methodological challenges. Progress to identify preventive and therapeutic strategies rests on valid and rigorous analytic approaches, but the research literature reflects little consensus on "best practices." We present findings from a large scientific working group on research methods for clinical and population studies of dementia, which identified five categories of methodological challenges as follows: (1) attrition/sample selection, including selective survival; (2) measurement, including uncertainty in diagnostic criteria, measurement error in neuropsychological assessments, and practice or retest effects; (3) specification of longitudinal models when participants are followed for months, years, or even decades; (4) time-varying measurements; and (5) highdimensional data. We explain why each challenge is important in dementia research and how it could compromise the translation of research findings into effective prevention or care strategies. We advance a checklist of potential sources of bias that should be routinely addressed when reporting dementia research. ________________________________________________________________________________ Title: Multimorbidity and frailty in people with dementia Citation: Nursing Standard, Sep 2015, vol. 30, no. 01, p. 45-50, 0029-6570 (September 2, 2015) Author(s): Bunn, Frances, Goodman, Claire, Burn, Anne-Marie

Abstract: Dementia series 9: Many people with dementia have other complex health needs, including comorbidity and frailty. Most models of care focus on single diseases and do not take into account the needs of those with comorbidities and dementia. Integration, continuity of care and personalisation are particularly important for this vulnerable group. It is also important to recognise potential barriers to accessing care so that these can be addressed. Issues around providing health care for people with dementia and complex health needs are considered in this article, including management and organisation of care, access to care, models of care, role of the family carer, and prevention of dementia, frailty and long-term conditions. [PUBLICATION] 43 references Full text: Available NURSING STANDARD at Library MPH ________________________________________________________________________________ Title: Euthanasia and physician-assisted suicide in dementia: A qualitative study of the views of former dementia carers Citation: Palliative Medicine, Sep 2015, vol. 29, no. 8, p. 720-726, 0269-2163 (September 2015) Author(s): Tomlinson, Emily, Spector, Aimee, Nurock, Shirley, Stott, Joshua Abstract: Background: Despite media and academic interest on assisted dying in dementia, little is known of the views of those directly affected. Aim: This study explored the views of former carers on assisted dying in dementia. Design: This was a qualitative study using thematic analysis. Setting/participants: A total of 16 former carers of people with dementia were recruited through national dementia charities and participated in semi-structured interviews. Results: While many supported the individual's right to die, the complexity of assisted dying in dementia was emphasized. Existential, physical, psychological and psychosocial aspects of suffering were identified as potential reasons to desire an assisted death. Most believed it would help to talk with a trained health professional if contemplating an assisted death. Conclusion: Health workers should be mindful of the

holistic experience of dementia at the end of life. The psychological and existential aspects of suffering should be addressed, as well as relief of physical pain. Further research is required. [PUBLICATION] 38 references Full text: Available ProQuest at Palliative Medicine ________________________________________________________________________________ Title: A recipe for mealtime resilience for families living with dementia Citation: Scandinavian Journal of Caring Sciences, Sep 2015, vol. 29, no. 3, p. 486-494, 0283-9318 (September 2015) Author(s): Wong, Fiona, Keller, Heather H., Martin, Lori Schindel Abstract: To date, research delving into the narratives of persons living with dementia is limited. Taking part in usual mealtime activities such as preparing food can sustain the identity of persons living with dementia. Yet if capacity for mealtime activities changes, this can put a strain or demand on the family, which must adjust and adapt to these changes. The aim of this study was to develop an in-depth story of resilience in one family living with dementia that was experiencing mealtime changes. Thematic narrative analysis following the elements of Clandinin and Connelly's (2000) 3D narrative inquiry space was used. One family's dementia journey was highlighted using the metaphor of a baking recipe to reflect their story of resilience. Developing positive strategies and continuing to learn and adapt were the two approaches used by this resilient family. Reminiscing, incorporating humour, having hope and optimism, and establishing social support were specific strategies. This family continued to learn and adapt by focusing on their positive gains and personal growth, accumulating life experiences, and balancing past pleasures while adapting to the new normal. Future work needs to further conceptualise resilience and how it can be supported in families living with dementia. [PUBLICATION] 49 references ________________________________________________________________________________ Title: Neurobiology of Alzheimer's disease: Integrated molecular, physiological, anatomical, biomarker, and cognitive dimensions Citation: Current Alzheimer Research, September 2015, vol./is. 12/8(712-722), 1567-2050;18755828 (01 Sep 2015) Author(s): Raskin J., Cummings J., Hardy J., Schuh K., Dean R.A. Abstract: Background: Alzheimer's disease (AD), the most common form of dementia, is a progressive neurodegenerative disorder with interrelated molecular, physiological, anatomical, biomarker, and cognitive dimensions. Methods: This article reviews the biological changes (genetic, molecular, and cellular) underlying AD and their correlation with the clinical syndrome. Results: Dementia associated with AD is related to the aberrant production, processing, and clearance of betaamyloid and tau. Beta-amyloid deposition in brain follows a distinct spatial progression starting in the basal neocortex, spreading throughout the hippocampus, and eventually spreading to the rest of the cortex. The spread of tau pathology through neural networks leads to a distinct and consistent spatial progression of neurofibrillary tangles, beginning in the transentorhinal and hippocampal region and spreading superolaterally to the primary areas of the neocortex. Synaptic dysfunction and cell death is shown by progressive loss of cerebral metabolic rate for glucose and progressive brain atrophy. Decreases in synapse number in the dentate gyrus of the hippocampus correlate with declining cognitive function. Amyloid changes are detectable in cerebrospinal fluid and with amyloid imaging up to 20 years prior to the onset of symptoms. Structural atrophy may be detectable via magnetic resonance imaging up to 10 years before clinical signs appear. Conclusion: This review highlights the progression of biological changes underlying AD and their association with the clinical syndrome. Many changes occur before overt symptoms are evident and biomarkers provide a means to detect AD pathology even in patients without symptoms. ________________________________________________________________________________

Title: Effect of dextromethorphan-quinidine on agitation in patients with Alzheimer disease dementia a randomized clinical trial Citation: JAMA - Journal of the American Medical Association, September 2015, vol./is. 314/12(1242-1254), 0098-7484;1538-3598 (22 Sep 2015) Author(s): Cummings J.L., Lyketsos C.G., Peskind E.R., Porsteinsson A.P., Mintzer J.E., Scharre D.W., De La Gandara J.E., Agronin M., Davis C.S., Nguyen U., Shin P., Tariot P.N., Siffert J. Abstract: IMPORTANCE Agitation is common among patients with Alzheimer disease; safe, effective treatments are lacking. OBJECTIVE To assess the efficacy, safety, and tolerability of dextromethorphan hydrobromide-quinidine sulfate for Alzheimer disease-related agitation. DESIGN, SETTING, AND PARTICIPANTS Phase 2 randomized, multicenter, double-blind, placebo-controlled trial using a sequential parallel comparison design with 2 consecutive 5-week treatment stages conducted August 2012-August 2014. Patients with probable Alzheimer disease, clinically significant agitation (Clinical Global Impressions-Severity agitation score>4), and a Mini-Mental State Examination score of 8 to 28 participated at 42 US study sites. Stable dosages of antidepressants, antipsychotics, hypnotics, and antidementia medications were allowed. INTERVENTIONS In stage 1, 220 patients were randomized in a 3:4 ratio to receive dextromethorphan-quinidine (n = 93) or placebo (n = 127). In stage 2, patients receiving dextromethorphan-quinidine continued; those receiving placebo were stratified by response and rerandomized in a 1:1 ratio to dextromethorphanquinidine (n = 59) or placebo (n = 60). MAIN OUTCOMES AND MEASURES The primary end pointwas change from baseline on the Neuropsychiatric Inventory (NPI) Agitation/Aggression domain (scale range, 0 [absence of symptoms] to 12 [symptoms occur daily and with marked severity]). RESULTS Atotal of 194 patients (88.2%) completed the study. With the sequential parallel comparison design, 152 patients received dextromethorphan-quinidine and 127 received placebo during the study. Analysis combining stages 1 (all patients) and 2 (rerandomized placebo nonresponders)showedsignificantlyreducedNPIAgitation/Aggressionscoresfordextromethorphanquinid inevsplacebo( ordinaryleastsquareszstatistic,-3.95;P < .001).Instage1,meanNPIAgitation/ Aggression scoreswere reduced from 7.1 to 3.8 with dextromethorphan-quinidine and from 7.0to 5.3withplacebo.Between-grouptreatmentdifferencesweresignificantinstage1(leastsquaresmean, -1.5; 95%CI, -2.3 to -0.7; P<.001). In stage 2, NPI Agitation/Aggression scoreswere reduced from 5.8 to 3.8 with dextromethorphan-quinidine and from 6.7 to 5.8 with placebo. Between-group treatmentdifferenceswere also significant in stage2(leastsquaresmean,-1.6;95%CI,-2.9to-0.3; P=.02).Adverseevents included falls (8.6%fordextromethorphan-quinidine vs3.9%for placebo), diarrhea (5.9%vs 3.1%respectively), and urinary tract infection (5.3%vs 3.9%respectively). Serious adverse events occurred in 7.9%with dextromethorphan-quinidine vs 4.7%with placebo. Dextromethorphan-quinidinewas not associated with cognitiveimpairment, sedation, or clinically significantQTc prolongation. CONCLUSIONS AND RELEVANCE In this preliminary 10-week phase 2 randomized clinical trial of patients with probable Alzheimer disease, combination dextromethorphanquinidine demonstrated clinically relevant efficacy for agitation and was generally well tolerated. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01584440 ________________________________________________________________________________ Title: Dextromethorphan and quinidine for treating agitation in patients with Alzheimer disease dementia Citation: JAMA - Journal of the American Medical Association, September 2015, vol./is. 314/12(1233-1235), 0098-7484;1538-3598 (22 Sep 2015) Author(s): Ballard C., Sharp S., Corbett A. ________________________________________________________________________________ Title: Longitudinal cerebrospinal fluid biomarker changes in preclinical Alzheimer disease during middle age Citation: JAMA Neurology, September 2015, vol./is. 72/9(1029-1042), 2168-6149 (01 Sep 2015) Author(s): Sutphen C.L., Jasielec M.S., Shah A.R., Macy E.M., Xiong C., Vlassenko A.G., Benzinger

T.L.S., Stoops E.E.J., Vanderstichele H.M.J., Brix B., Darby H.D., Vandijck M.L.J., Ladenson J.H., Morris J.C., Holtzman D.M., Fagan A.M. Abstract: IMPORTANCE: Individuals in the presymptomatic stage of Alzheimer disease (AD) are increasingly being targeted for AD secondary prevention trials. How early during the normal life span underlying AD pathologies begin to develop, their patterns of change over time, and their relationship with future cognitive decline remain to be determined. OBJECTIVE: To characterize the within-person trajectories of cerebrospinal fluid (CSF) biomarkers of AD over time and their association with changes in brain amyloid deposition and cognitive decline in cognitively normal middle-aged individuals. DESIGN, SETTING, AND PARTICIPANTS: As part of a cohort study, cognitively normal (Clinical Dementia Rating [CDR] of 0) middle-aged research volunteers (n = 169) enrolled in the Adult Children Study at Washington University, St Louis, Missouri, had undergone serial CSF collection and longitudinal clinical assessment (mean, 6 years; range, 0.91-11.3 years) at 3-year intervals at the time of analysis, between January 2003 and November 2013. A subset (n = 74) had also undergone longitudinal amyloid positron emission tomographic imaging with Pittsburgh compound B (PiB) in the same period. Serial CSF samples were analyzed for beta-amyloid 40 (Abeta40), Abeta42, total tau, tau phosphorylated at threonine 181 (P-tau<inf>181</inf>), visinin-like protein 1 (VILIP-1), and chitinase-3-like protein 1 (YKL-40). Within-person measures were plotted according to age and AD risk defined by APOE genotype (epsilon4 carriers vs noncarriers). Linear mixed models were used to compare estimated biomarker slopes among middle-age bins at baseline (early, 45-54 years; mid, 5564 years; late, 65-74 years) and between risk groups. Within-person changes in CSF biomarkers were also compared with changes in cortical PiB binding and progression to a CDR higher than 0 at follow-up. MAIN OUTCOMES AND MEASURES: Changes in Abeta40, Abeta42, total tau, Ptau<inf>181</inf>, VILIP-1, and YKL-40 and, in a subset of participants, changes in cortical PiB binding. RESULTS: While there were no consistent longitudinal patterns in Abeta40 (P = .001-.97), longitudinal reductions in Abeta42 were observed in some individuals as early as early middle age (P < .05) and low Abeta42 levels were associated with the development of cortical PiB-positive amyloid plaques (area under receiver operating characteristic curve = 0.9352; 95% CI, 0.8895-0.9808), especially in mid middle age (P < .001). Markers of neuronal injury (total tau, P-tau<inf>181</inf>, and VILIP-1) dramatically increased in some individuals in mid and late middle age (P < .02), whereas the neuroinflammation marker YKL-40 increased consistently throughout middle age (P < .003). These patterns were more apparent in at-risk epsilon4 carriers (Abeta42 in an allele dose-dependent manner) and appeared to be associated with future cognitive deficits as determined by CDR. CONCLUSIONS AND RELEVANCE: Longitudinal CSF biomarker patterns consistent with AD are first detectable during early middle age and are associated with later amyloid positivity and cognitive decline. Such measures may be useful for targeting middle-aged, asymptomatic individuals for therapeutic trials designed to prevent cognitive decline. ________________________________________________________________________________ Title: Strategies to implement evidence into practice to improve palliative care: Recommendations of a nominal group approach with expert opinion leaders Ethics, organization and policy Citation: BMC Palliative Care, September 2015, vol./is. 14/1, 1472-684X (29 Sep 2015) Author(s): Van Riet Paap J., Vissers K., Iliffe S., Radbruch L., Hjermstad M.J., Chattat R., VernooijDassen M., Engels Y. Abstract: Background: In the past decades, many new insights and best practices in palliative care, a relatively new field in health care, have been published. However, this knowledge is often not implemented. The aim of this study therefore was to identify strategies to implement improvement activities identified in a research project within daily palliative care practice. Methods: A nominal group technique was used with members of the IMPACT consortium, being international researchers and clinicians in cancer care, dementia care and palliative care. Participants identified and prioritized implementation strategies. Data was analyzed qualitatively using inductive coding. Results: Twenty

international clinicians and researchers participated in one of two parallel nominal group sessions. The recommended strategies to implement results from a research project were grouped in five common themes: 1. Dissemination of results e.g. by publishing results tailored to relevant audiences, 2. Identification and dissemination of unique selling points, 3. education e.g. by developing e-learning tools and integrating scientific evidence into core curricula, 4. Stimulation of participation of stakeholders, and 5. consideration of consequences e.g. rewarding services for their implementation successes but not services that fail to implement quality improvement activities. Discussion: The added value of this nominal group study lies in the prioritisation by the experts of strategies to influence the implementation of quality improvement activities in palliative care. Efforts to ensure future use of scientific findings should be built into research projects in order to prevent waste of resources. Full text: Available National Library of Medicine at BMC Palliative Care Full text: Available National Library of Medicine at BMC Palliative Care Full text: Available National Library of Medicine at BMC Palliative Care ________________________________________________________________________________ Title: Exercise and the heart: The good, the bad, and the ugly Citation: European Heart Journal, 2015, vol./is. 36/23(1445-1453), 0195-668X;1522-9645 (2015) Author(s): Sharma S., Merghani A., Mont L. Abstract: The benefits of exercise are irrefutable. Individuals engaging in regular exercise have a favourable cardiovascular risk profile for coronary artery disease and reduce their risk of myocardial infarction by 50%. Exercise promotes longevity of life, reduces the risk of some malignancies, retards the onset of dementia, and is as considered an antidepressant. Most of these benefits are attributable to moderate exercise, whereas athletes perform way beyond the recommended levels of physical activity and constantly push back the frontiers of human endurance. The cardiovascular adaptation for generating a large and sustained increase in cardiac output during prolonged exercise includes a 1020% increase in cardiac dimensions. In rare instances, these physiological increases in cardiac size overlap with morphologically mild expressions of the primary cardiomyopathies and resolving the diagnostic dilemma can be challenging. Intense exercise may infrequently trigger arrhythmogenic sudden cardiac death in an athlete harbouring asymptomatic cardiac disease. In parallel with the extraordinary athletic milieu of physical performances previously considered unachievable, there is emerging data indicating that long-standing vigorous exercise may be associated with adverse electrical and structural remodelling in otherwise normal hearts. Finally, in the current era of celebrity athletes and lucrative sport contracts, several athletes have succumbed to using performance enhancing agents for success which are detrimental to cardiac health. This article discusses the issues abovementioned, which can be broadly classified as the good, bad, and ugly aspects of sports cardiology. Full text: Available Highwire Press at European Heart Journal ________________________________________________________________________________

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. We now have a subscription to EBL Electronic Books and would be interested to know if there are any titles you feel would be of benefit to be added to our collection. The catalogue can be browsed here; you will need your OpenAthens password to access it. You can request books either on the site itself or by emailing us on library@tst.nhs.uk Fiction Books on the topic of Dementia

Elizabeth is Missing

Turn of Mind

About the book:

Meet Maud. Maud is forgetful. She makes a cup of tea and doesn't remember to drink it. She goes to the shops and forgets why she went. Sometimes her home is unrecognizable - or her daughter Helen seems a total stranger. But there's one thing Maud is sure of: her friend Elizabeth is missing. The note in her pocket tells her so.

The police are convinced that Jennifer White killed her best friend. However, Jennifer cannot tell if she really is responsible. Her days are spent in confusion and memories fragmented, thanks to the Alzheimerâ&#x20AC;&#x2122;s that is gradually destroying her once brilliant mind.

COCHRANE SYSTEMATIC REVIEWS BACK TO TOP Reviews from September and October 2015 Revastigmine for Alzheimer’s disease

Protocols from September and October 2015 Dietary interventions for prevention of dementia in people with mild cognitive impairment Vitamin and mineral supplementation for prevention of dementia or delaying cognitive decline in people with mild cognitive impairment Simulated presence therapy for dementia Non-pharmacological interventions for sleep disturbances in people with dementia

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 Behind the Headlines Could an arthritis drug also help treat Alzheimer’s disease? ‘Dementia could strike 1 in 3 born this year’, claims report Alzheimer’s ‘seeds’ found in seven CJD victims’ brains No evidence that Alzheimer’s can be transmitted through surgery Blood test for dementia claims are premature

REPORTS, PUBLICATIONS AND RESOURCES BACK TO TOP NICE Pathway on Dementia SCIE (Social Care Institute for Excellence) Dementia Gateway Estimation of future cases of dementia from those born in 2015 Alzheimer’s research UK Office of Health Economics Report Living positively with dementia: findings from a qualitative systematic review Considering the effects that dementia has on one’s day-to-day life, it is no wonder that most research and media articles talk about dementia in a (very) negative light. Just think about how it can cause memory problems (Belleville et al., 2007), problem behaviours such as changing appetite or aggression (Risco et al, 2015) and increasing reliance on others to complete daily tasks such as cooking (Giebel et al, 2014). More so, these symptoms can be stressful for those people caring for someone with dementia, such as spouses or children (Sutcliffe et al, 2015) Improving hospital discharge and intermediate care for older people Acute hospitals in England are under unbelievable pressure right now and winter is on its way. Even though we have a rapidly ageing population and an increasing number of people living with complex long-term conditions, frailty or dementia, we have lost hospital beds at pace over the past three decades. Yo-yo stories on optimum weight and Alzheimer’s risk — inappropriate language keeps readers’ heads spinning Research into lifestyle factors that may increase the risk for developing Alzheimer’s disease in later life is very important considering the disease’s nasty profile as well as its reach among the elderly. The first of the 74 million “baby boomers” (born between 1946 and 1964) have been reaching 65year-old senior status at the rate of 8,000 a day since 2010. Public health experts have been waving a warning flag to expect a doubling in Alzheimer’s cases by 2050 as the U.S. and global population ages. Words matter in dementia care EBN are excited to share Joanne Agnelli’s latest blog which focuses on the appropriate use of language in dementia care.

Leading models of dementia care highlighted to inspire Three leading models of how to care for people with dementia are being flagged up to the NHS in a bid to improve patient services by sharing learning. Dementia, rights, and the social model of disability This paper describes the social model of disability in relation to dementia, as well as national and international law that is informed by it or that it connects with. It goes on to describe tools that can be used to apply the model through policy, practice, service and community development. Using the social model of disability has implications for the rights of people with dementia under the law, for disability discourse and public policy, and for how dementia is experienced and perceived by people with dementia and their carers, as well as how it is viewed and discussed in public.

Multimillion euro boost to international dementia research Twenty one research projects have won a total of €35 million (£25.7 million) in a transnational scheme to boost research into neurodegenerative diseases, according to an announcement made by the EU Joint Programme – Neurodegenerative Disease Research (JPND) today. Nine of the 21 successful collaboration projects involve UK research teams who will receive MRC funds through the JPND initiative. The winning projects will help researchers to better understand, treat and eventually prevent a wide range of debilitating neurodegenerative diseases.

New clinical study strengthens the possibility that the dissemination of misfolded proteins may contribute to Alzheimer's disease A study published in Nature presents an interesting observational study on a small number of patients who had acquired CJD following treatment with growth hormone derived from human brain tissue human-derived growth hormone has not been used since 1985.

TOPIC ALERTS AND UPDATES BACK TO TOP ABSTRACTS AVAILABLE VIA LINKS BELOW- FOR FULL-TEXT PLEASE ASK LIBRARY STAFF Medscape Topic Alerts Association Between Atrial Fibrillation and Dementia in the General Population JAMA Neurol. Published online September 21, 2015. Metabolic profiling distinguishes three subtypes of Alzheimer's disease AGING, Vol 7, No 8 , pp 595-600 FREE FULL TEXT Effect of Dextromethorphan-Quinidine on Agitation in Patients With Alzheimer Disease Dementia: A Randomized Clinical Trial JAMA. 2015;314(12):1242-1254.

Evidence for human transmission of amyloid-β pathology and cerebral amyloid angiopathy Nature 525, 247-250 (10 September 2015) FREE FULL TEXT Vitamin D Status and Rates of Cognitive Decline in a Multiethnic Cohort of Older Adults JAMA Neurol. Published online September 14, 2015. A randomized, double-blind, placebo-controlled trial of resveratrol for Alzheimer disease Neurology. Published online September 11, 2015. FREE FULL TEXT Multimorbidity and Risk of Mild Cognitive Impairment Journal of the American Geriatrics Society Volume 63, Issue 9, pages 1783–1790, September 2015 FREE FULL TEXT

Elsevier Practice Updates

Type 2 diabetes mellitus and biomarkers of neurodegeneration Neurology September 29, 2015 vol. 85 no. 13 1123-1130

Association Between Atrial Fibrillation and Dementia in the General Population JAMA Neurol. Published online September 21, 2015.

Effect of Dextromethorphan-Quinidine on Agitation in Patients With Alzheimer Disease Dementia- : A Randomized Clinical Trial JAMA. 2015;314(12):1242-1254 Midlife adiposity predicts earlier onset of Alzheimerâ&#x20AC;&#x2122;s dementia, neuropathology and presymptomatic cerebral amyloid accumulation Molecular Psychiatry advance online publication 1 September 2015 TRIP Database Spectrum of cognition short of dementia: Framingham Heart Study and Mayo Clinic Study of Aging. Neurology. 2015 Oct 9. Strategies to support engagement and continuity of activity during mealtimes for families living with dementia; a qualitative study. BMC Geriatr. 2015 Oct 9;15(1):119. FREE FULL TEXT Incidence of antipsychotic use in relation to diagnosis of Alzheimer's disease among communitydwelling persons. Br J Psychiatry. 2015 Oct 8. Strategies for Improving Memory: A Randomized Trial of Memory Groups for Older People, Including those with Mild Cognitive Impairment. J Alzheimers Dis. 2015 Sep 22. Psychological treatment for depression and anxiety associated with dementia and mild cognitive impairment Br J Psychiatry. 2015 Oct;207(4):286-7 Intensity and Types of Physical Exercise in Relation to Dementia Risk Reduction in Community-Living Older Adults. J Am Med Dir Assoc. 2015 Oct 1;16(10):899.e1-7. FRONTIER Executive Screen: a brief executive battery to differentiate frontotemporal dementia and Alzheimer's disease. J Neurol Neurosurg Psychiatry. 2015 Sep 29.

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

The Validation Breakthrough: Naomi Feil, a masterclass- 26 October 2015, Worcester rd

Care and Dementia Show- 3 November 2015, Birmingham th

10 UK Dementia Congress- 3 -5 November 2015, Telford th

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

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.