Book Review: Please tell me…

Liz Charalambous is a nurse and PhD student. She tweets @lizcharalambou and is a regular guest blogger for the BGS. Here she reviews ‘Please tell me…’ by Julia Jones and Claudia Myatt.

Without a doubt, one of the most important documents in older person care is the Alzheimer’s Society This is me support tool. It enables carers to access information with which to provide holistic care and is underpinned by a social model of care rather than a medical model, so important in today’s world of fast paced, pressurised, and increasingly politicised healthcare services. It places the person in the centre of care, ensuring their likes, dislikes, and preferences are recorded for the whole team to access.

Indeed, a favourite teaching strategy when introducing new students to dementia care is to provide them with two copies of ‘this is me’ and ask them to take them home for their partners or significant others to complete in the manner of ‘Mr and Mrs’ style 1970s TV programme. I have heard many stories of students returning the next day reporting back to the group that their other half had failed hopelessly in filling in the form, prompting them to realise the precariousness of ensuring person centred care in such instances.

Antidementia medication may improve survival in Alzheimer’s disease

Dr Christoph Mueller is an Academic Clinical Lecturer at the Department of Old Age Psychiatry at King’s College London. He and his co-authors published a paper on the influence of antidementia medication on survival in Alzheimer’s disease in Age and Ageing. He tweets at @DrChrisMueller

At present Acetylcholinesterase inhibitors, as Donepezil or Rivastigmine, are the only medications available for treatment of the early stages of Alzheimer’s disease. They can slow down the progression of the illness and alleviate distressing symptoms. However, their benefits are modest and they can have side effects, such as a slow heartbeat, indigestion, weight loss or an increased risk of falls. Moreover, dementia and Alzheimer’s disease is the leading cause of death for men and women 80 years or older in England and Wales. We investigated whether being prescribed antidementia medication was associated with survival in patients with Alzheimer’s disease.

Dying with dementia – we need to measure more than the place of death

Katherine Sleeman is an NIHR Clinician Scientist and Honorary Consultant in Palliative Medicine at the Cicely Saunders Institute, King’s College London. In this blog she discusses her paper Predictors of emergency department attendance by people with dementia in their last year of life: Retrospective cohort study using linked clinical and administrative data. She tweets @kesleeman

Over the past decade there has been a strong policy focus in the UK and elsewhere on dying out of hospital as a marker of good quality of end of life care. We have previously shown that, for people with dementia, hospital deaths have fallen over this time period, possibly as a result of these policies.

However, it is increasingly recognised that the place of death is an imperfect proxy for the quality of end of life care, providing little more than a snap shot of where a person was in their last moments.

Always on my mind: Understanding the role of music in dementia

Sally Bowell is a Research Fellow at the International Longevity Centre – UK (ILC-UK). In this blog post she discusses a new Commission on Dementia and Music, set up and run by ILC-UK.

Music is an undeniably significant part of being human. It spans different genres, cultures and eras, and it promotes bonding, communication and wellbeing.

From listening to music in the car, to playing in an orchestra, discussing the charts, to joking about each other’s ‘bad’ music tastes: music is a crucial part of daily life.

Research also suggests that our connection to music stays with us throughout our lives, even whilst living with dementia. This powerful notion underpins the creation of a new Commission on Dementia and Music, being coordinated by the International Longevity Centre – UK (ILC-UK) and funded by the Utley Foundation.

Dementia awareness is not just for one week – it’s for life

Dr Shibley Rahman is currently an academic physician in dementia and frailty. His contribution on the diagnosis of behavioural frontal frontotemporal dementia, published while he was a M.B./Ph.D. student at Cambridge in 1999, is considered widely to be an important contribution to the field even cited in the Oxford Textbook of Medicine. He has published widely on dementia, and his first book ‘Living well with dementia’ won best book for health and social care for the BMJ Awards in 2015. His third book ‘Enhancing health and wellbeing in dementia: a person-centred integrated care approach’ was published earlier this year on aspects of the integrated care pathway, and likewise has been critically acclaimed. He, furthermore, has a passionate interest in rights-based approaches which he accrued as part of his postgraduate legal training. He tweets at @dr_shibley.

This week – in England –  it’s ‘Dementia Awareness Week’ – 14-20 May 2017. But so what?

The problem is – ‘dementia awareness’ means different things to different people. In a nutshell, I hope that the workforce can embrace the notion that people living with dementia are incredibly rewarding to support and look after, and use this week as part of a celebration of this.

If you’re working in health and social care, it can be surprisingly easy to overestimate the knowledge about dementia amongst some members of the general public.

Frequent sauna bathing protects men against dementia

Jari Laukkanen is a professor at the University of Eastern Finland. He and his co-authors have recently published a research paper in Age and Ageing journal on the link between sauna bathing and memory diseases. You can follow him on twitter @LaukkanenJari

Frequent sauna bathing can reduce the risk of dementia, according to a 20-year follow-up study.  Men taking a sauna 4–7 times a week were 66% less likely to be diagnosed with dementia than those taking a sauna once a week. The association between sauna bathing and dementia risk has not been previously investigated.

The effects of sauna bathing on the risk of Alzheimer’s disease and other forms of dementia were studied in the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD), involving more than 2,000 middle-aged men living in the eastern part of Finland.

A circulating marker of bone remodelling is associated with cognition in older age

Steven Bradburn is a PhD student at Manchester Metropolitan University. His research interests focus on age-related cognitive decline and physical functioning in later life. He recently published Association between Osteocalcin and Cognitive Performance in Healthy Older Adults in Age and Ageing journal.

Cognitive decline and reductions in bone health regularly co-manifest during advancing age. Previous studies have shown relationships between bone mineral density and risks of Alzheimer’s disease and cognitive decline, especially in older women. This raises the possibility that factors related to bone regulation and function may also influence cognitive wellbeing.

In our study, using the cross-sectional MyoAge cohort, we evaluated the relationship between bone mineral density and proteins related to bone metabolism in the blood with measures of cognitive functioning in physically and mentally healthy older adults.

Systematic biases in death certification: a job for the Medical Examiner?

Katherine Sleeman is an NIHR Clinician Scientist and Honorary Consultant in Palliative Medicine at the Cicely Saunders Institute, King’s College London. In this blog she discusses her recent Age and Ageing paper on death certification in dementia. @kesleeman

It is frequently said that there are just two universal certainties: death and taxes. While HMRC is responsible for ensuring that taxes are paid, information about who dies, where, and how, is gathered through death certification.

Dementia is a public health priority of increasing importance. In 2014, it was reported that dementia had overtaken cancer and cardiovascular disease as the most common cause of death for women in England. We have previously shown that the proportion of death certificates in England where dementia was mentioned as a cause of death doubled between 2001 and 2010.

But what is unclear is why dementia deaths appear to be increasing. Is it due to an increasing prevalence of dementia in our ageing society? Due to increased detection of dementia, perhaps? Or does this increase simply represent an improvement in death certification practices over time?

What happens to patients with abnormal cognition picked up by in-hospital dementia screening – Results from GP questionnaires

Sarah Pendlebury is Associate Professor in the NIHR Oxford Biomedical Research Centre and the Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, University of Oxford and Consultant Physician and Clinical Lead for Dementia and Delirium at the Oxford University Hospitals NHS Foundation Trust. Research and audit interests include cognitive impairment associated with cerebrovascular disease and the interactions between vascular disease, neurodegeneration, co-morbidity and delirium and in the use of short pragmatic cognitive tests in patients with stroke and acute illness. Here she reports on an audit of the actions undertaken by GPs in response to letters informing them of in-hospital identification of cognitive impairment in their patient, which will be presented at the upcoming BGS Spring Meeting in Liverpool.

Dementia and delirium are prevalent in older patients with unplanned admission to hospital and are associated with death and increased dependency, but many confused patients do not have a dementia diagnosis prior to admission. Routine dementia screening for older people (>75 years) hospitalised as an emergency is mandatory in England with onward referral for specialist assessment in those identified as at-risk (dementia CQUIN).