Summary

Health Secretary Jeremy Hunt has announced that Government spending on dementia research will be boosted by two-thirds, with a £22 million cash injection. This money, allocated to the National Institute for Health Research’s “themed dementia call”, will be used on projects in various areas, including improving hospital care for people with dementia and exploring the use of diabetes drugs to treat dementia.

Almost £14 million of this funding will go into projects delivered jointly with the Alzheimer’s Society, including:

• A £2 million study at the University of East Anglia to further improve hospital care for people with dementia.
• £1.4 million for University of Bristol research into using a widely available drug for high blood pressure for the treatment for Alzheimer’s Disease.
• £2.4 million for research into early diagnosis and rehabilitation of people with Alzheimer’s Disease at Bangor University.
• £900,000 funding for research into improving the management of pain for people with dementia.

Read more: Government announces £22 million to boost dementia research. Alzheimer’s Society.

Reference

Government announces £22 million to boost dementia research. London: Alzheimer’s Society, December 21^st 2012. (Online Webpage).

Full Text Link

Reference

Pioneering dementia research projects receive £22 million government boost. London: Department of Health, December 21^st 2012. (Online Webpage).

There are 21 projects in five NIHR programmes.

Efficacy and Mechanism Evaluation (EME) Programme

1. Minocycline in Alzheimer’s disease Efficacy Trial: The MADE Trial. (EME 11/47/01).
2. Reducing pathology in Alzheimer’s disease through Angiotensin TaRgeting – The RADAR Trial. (EME 11/47/03).

Health Services and Delivery Research (HS&DR) Programme

1. Comorbidity and dementia: improving healthcare for people with dementia (CoDem). (HS&DR 11/1017/07).
2. The detection and management of pain in patients with dementia in acute care settings: development of a decision tool. (HS&DR 11/2000/05).
3. Improving care for people with dementia: development and initial feasibility study for evaluation of Life Story work in dementia care. (HS&DR 11/2000/11).
4. A multi-site evaluation of the Person, Interactions & Environment (PIE) tool to improve person-centred care for people with dementia admitted to acute hospital wards. (HS&DR 11/1017/18).
5. The prevalence of visual impairment in people with dementia. (HS&DR 11/2000/13).
6. Service provision for older people who are homeless and have memory problems. (HS&DR 11/1017/04).

Health Technology Assessment (HTA) Programme

1. Assistive Technology and Telecare to maintain Independent Living At home for people with dementia: The ATTILA Trial. (HTA 10/50/02).
2. Goal-oriented cognitive rehabilitation in early-stage Alzheimer’s disease: multi-centre single-blind randomised controlled trial (GREAT). (HTA 11/15/04).
3. Evaluating the effectiveness and cost effectiveness of Dementia Care Mapping (DCM) to enable person-centred Care for people with dementia and their carers: A UK cluster randomised controlled trial in care homes (DCM EPIC trial). (HTA 11/15/13).

Programme Grants for Applied Research (PGfAR)

1. Effective home support in dementia care. Components, impact and costs of tertiary prevention. (DTC-RP-PG-0311-12003).
2. Improving the diagnosis and management of dementias of Lewy body type in the NHS (DIAMAND-Lewy). (DTC-RP-PG-0311-12001).
3. Peri-operative Enhanced Recovery hip Fracture Care of patients with Dementia: “PERFECTED” project. (DTC-RP-PG-0311-12004).
4. Supporting Excellence in End of life care in Dementia via an integrated care pathway (SEED programme). Northumbria Healthcare NHS Foundation Trust. (DTC-RP-PG-0611-20005).

Research for Patient Benefit (RfPB) Programme

1. Hydroxymethylglutaryl-CoA reductase inhibition with simvastatin in mechanically ventilated patients at high risk of delirium. (PB-PG-0211-24123).
2. Investigation of screening tools for amnestic mild cognitive impairment (a-MCI). (PB-PG-0211-24044).
3. Prevention of falls in cognitively impaired older adults living in residential care (PROF-COG). (PB-PG-0211-24140).
4. Shared decision making in mild to moderate dementia. (PB-PG-1111-26063).
5. Strategies for managing Behavioural and Psychological Symptoms in Dementia (BPSD) for community dwelling older people: evidence into practice. (PB-PG-0211-24078).
6. Using Conversation Analysis in the differential diagnosis of memory problems: a pilot study. (PB-PG-0211-24079).

Full Text Link (Master Projects List)

Reference

NHS National Institute for Health Research (2012). Summary of funded Dementia Research Projects: Health Services and Delivery Research (HS&DR) Programme. London: Dementia and Neurodegenerative Diseases Research Network (DeNDRoN); National Institute for Health Research, December 21^st 2012.

Follow this link for abstract

Date of publication: November 2012

Publication type: Journal article

In a nutshell: Exercise is part of the management of patients with osteoporosis and is associated with better quality of life and lower risk of future fracture. An exercise programme needs to address flexibility, muscle strength, core stability and gait steadiness, which also need to be individualised. To address falls and fractures, an exercise programme should include balance and lower extremity training. The SPEED programme can also improve extensor strength, the level of physical activity and locomotion, and reduce back pain and the fear and risk of falls.

Length of publication: 6 pages

Some important notes: Please contact your local NHS Library for full text of the article. Follow this link to find your local NHS Library.

Follow this link for abstract

Date of publication: September 2012

Publication type: Journal article

In a nutshell: This trial studied the effect of a supervised Tai Chi intervention compared to a physiotherapy programme on fall-related clinical outcomes.

Length of publication: 2 pages

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Follow this link for abstract

Date of publication: August 2012

Publication type: Journal article

In a nutshell: Researchers explored the following interventions: group-based exercise, home hazard management and vision improvement, with a control of no intervention. Group-based exercise was found to be the most effective intervention, but falls were also reduced by combining one or both of the other two.

Length of publication: 2 pages

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Follow this link for information

Date of publication: October 2012

Publication type: Website

In a nutshell: This event is part of the Age UK falls prevention webinar series, previously held as part of the falls prevention week. Professionals are given the chance to find out more about the latest research and good practice in falls prevention. It is aimed at anyone working with older people with dementia.

Length of publication: 1 page

Follow this link for the abstract

Date of publication: October 2012

Publication type: Journal article

In a nutshell: Three audits were carried out over four years looking into falls services across the UK, and showed that falls management and bone health is sub-optimal in emergency departments and minor injury units, and there is an urgent need for more effective assessment and management to prevent further injury.

Length of publication: 3 pages

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

The Dementia Action Alliance (DAA), in partnership with the NHS Institute for Innovation and Improvement has distributed this letter inviting leaders of NHS acute trusts to sign up to “The Right Care: a call to action to improve the experience of people with dementia receiving hospital care”.

Full Text Link

Reference

Dementia Action Alliance (2012). The right care: creating dementia-friendly hospitals. Invitation letter to Hospital Trust Chief Executives. Re:  Becoming a dementia-friendly hospital. London: Dementia Action Alliance (DAA), November 12^th 2012.

[A brief reference to this item features in Dementia and Elderly Care: the Latest Evidence Newsletter (RWNHST), Volume 3 Issue 5, January 2013].

While falls can be of real concern to many people of any age, there are three simple things you can do to limit the risks:

A good example of poor choice of footwear

Tip 1: Wear suitable footwear- supportive shoes with a back are best. Nothing too flimsy, and slips-on may be easy to put on, but are easy to trip over in

Tip 2:  Remove trip hazards - rugs may be lovely to look at but they can easily ruck up and catch your foot

Tip 3: Take your time – Not rushing around might be obvious, but getting out of bed quickly can cause a sudden drop in blood pressure and unsteadiness in some people. This is often more common in older people. It can also happen when going from sitting to standing; so just take your time.

These are just a few reasons why people may fall, and can be easily avoided. There are times when these steps may not be enough and a balance programme can help you gain confidence to get back to normal. A balance programme is a simple series of exercises that a Physiotherapist can prescribe to reduce your risk of falls.

Picture credit

Report: http://www.wrvs.org.uk/Uploads/Documents/Reports%20and%20Reviews/Falls%20report_web_v2.pdf

Press release:  http://www.wrvs.org.uk/news-and-events/news/psychological-impact-of-falls-devastating-for-older-people

BBC News report:  http://www.bbc.co.uk/news/health-20138731

Follow this link for abstract

Date of publication: September 2012

Publication type: Journal article

In a nutshell: This study explored the associations between spatiotemporal gait and falls in older people who had a cognitive impairment, as well as investigating sensorimotor and neuropsychological factors to see if these mediate gait performance and falls. According to the study, slow and variable gait patterns increase the risk of falls in those studied, and the association between gait and falls appears to be mediated by reduced sensorimotor function.

Length of publication: 4 pages

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Follow this link for abstract

Date of publication: September 2012

Publication type: Journal article

In a nutshell: This study investigated whether depression can predict falls in community-dwelling older people in Taiwan, in addition to problems with vision, strength and balance. Depressive symptoms were found to be significantly more prevalent in those who experienced one or more falls compared to those who didn’t fall. The findings suggest that interventions to treat depression should be built into falls prevention strategies.

Length of publication: 6 pages

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Follow this link for abstract

Date of publication: November 2012

Publication type: Journal article

In a nutshell: Problems with sensorimotor control have been documented in the young and middle-aged, though whether this affects older people with neck pains is unknown. This study aimed to see if this extrapolation is valid, as problems with sensorimotor functions in older people can inform falls prevention and management programmes.

Length of publication: 5 pages

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Follow this link for abstract

Date of publication: November-December 2012

Publication type: Journal article

In a nutshell: This study investigated the interrelationships between physical function, pain, impaired mobility and falls in older American adults. Balance and mobility testing are suggested as a priority in fall screening and prevention programmes.

Length of publication: 7 pages

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Follow this link for abstract

Date of publication: January 2013

Publication type: Journal article

In a nutshell: It is known that slip resistance performance improves with floor surface roughness. However, the question remains as to whether this correlates in a linear way with surface topographies, and what roughness levels are required for effective slip resistance, including in wet or dry conditions. Findings from this study may impact on floor designs for reducing fall hazards.

Length of publication: 6 pages

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Summary

This guide from the Royal College of Nursing (RCN) has been produced to help nursing staff care for people with dementia in hospital. As a synopsis of the entire field this overview of the main themes is an absolute masterpiece of clarity and concision.  It supports implementation of the RCN’s five principles for improving the quality of care for people with dementia; “Make SPACE for good dementia care”. These principles are used as the overall key for organising topics and resources.

1. Staff who are skilled and have time to care.
2. Partnership working with carers.
3. Assessment and early identification of dementia.
4. Care plans which are person centred and individualised.
5. Environments that are dementia friendly.

This “how to” guide also emphasises the importance of support for carers. There are sections on the use of mental capacity assessments, advance care planning, nutritional tools, pain assessments and safety tools.

The guide links to a range of resources, many of which are available from, or mapped by, the dementia pages on the RCN’s website: www.rcn.org.uk/dementia.

There is also an RCN video, similarly entitled “Dementia: Commitment to the care of people with dementia in hospital settings”. Additionally, the RCN provides a “gallery” of those dementia-friendly hospitals throughout the UK which exemplify best practice in the care for people with dementia.

Full Text Link

Reference

Thompson, R. Mills, N. [and] Heath, H. (2012). Dementia guide: commitment to the care of people with dementia in hospital settings. London: Royal College of Nursing, October 2012.

Introduction

Each month a large number of journal articles, including systematic reviews and meta-analyses, are examined. Here are selected citations for the more notable of these to be published, or to have come to our attention, in recent weeks. Thanks should go to Medline / PubMed as the source of these bibliographic citations and abstracts.

The Bibliographic Citations

1. Simek, EM. McPhate, L. Haines, TP, Adherence to and efficacy of home exercise programs to prevent falls: a systematic review and meta-analysis of the impact of exercise program characteristics. Preventive Medicine. July 17^th 2012. [Epub ahead of print].
2. Billington, J. Fahey, T. Galvin, R. Diagnostic accuracy of the STRATIFY clinical prediction rule for falls: A systematic review and meta-analysis. BMC Family Practice. August 7^th 2012; 13: 76. Full Text Link.
3. Hsu, CL. Nagamatsu, LS. Davis, JC. [et al]. Examining the relationship between specific cognitive processes and falls risk in older adults: a systematic review. Osteoporosis International. October 2012; 23(10): 2409-24. Full Text Link.
4. Child, S. Goodwin, V. Garside, R. [et al]. Factors influencing the implementation of fall prevention programmes: a systematic review and synthesis of qualitative studies. Implementation Science: IS. 2012 Sep 14;7(1):91. [Epub ahead of print]. Full Text Link.
5. Smith, ML. Jiang, L. Ory, MG. Falls efficacy among older adults enrolled in an evidence-based program to reduce fall-related risk: sustainability of individual benefits over time. Family & Community Health. July – September 2012; 35(3): 256-63.
6. Aranda-Gallardo, M. Asencio, JM. Canca-Sanchez, JC. [et al]. Instruments for assessing the risk of falls in acute hospitalized patients: a systematic review protocol. Journal of Advanced Nursing. August 9^th 2012. [Epub ahead of print].
7. Gillespie, LD. Robertson, MC. Gillespie, WJ. [et al]. Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews (Online). September 12^th 2012; Issue 9: No. CD007146. Full Text Link.
8. He, J. Dunton, N. Staggs, V. Unit-level time trends in inpatient fall rates of us hospitals. Medical Care. September 2012; 50(9):801-7.

- Prevent Blindness Georgia Will Provide More Information  at the Georgia Division of Aging Services and Department of Community Health

Each year, one in three Americans aged 65 and over falls. Falls are the most common cause of nonfatal injuries and hospital admissions for trauma. In fact, every 15 seconds an older adult is treated in an emergency room for a fall-related injury, according to the National Council on Aging.

The state Division of Aging Services and Department of Community Health are partnering to host a Falls Prevention Awareness event on Friday, September 21^st from 10:00 am to 2:00 pm at 2 Peachtree Street, Atlanta. Prevent Blindness Georgia will man an exhibit booth which provides information about aging eye diseases and falls prevention. The public is invited to attend the event to be held in the lobby of the building which has easy access to the MARTA Five Points Station.

Prevent Blindness Georgia  joins with the Falls Free™ Coalition to declare Sept. 22, 2012 National Falls Prevention Awareness Day.  The goal of the national campaign is to educate the public on the risks and dangers of falls and the best ways to prevent them from happening.  Visual impairment, which can include decreased visual acuity, contrast sensitivity, depth perception, and/or visual field, has been found to influence the risk of fall.s

The Falls Free Coalition consists of 34 states and 70 national organizations, professional associations, and federal agencies dedicated to reducing fall-related injury and death among older adults.

One way to help reduce the risk of falls and serious injuries is to take steps to improve eye health. In fact, a recent study published in the Journal of the American Medical Association, “Risk of Fractures Following Cataract Surgery in Medicare Beneficiaries,” found compelling evidence that improved vision from cataract surgery helped to significantly decrease the number of hip fractures from people ages 80-84 by 28 percent.  All patients who had severe cataracts removed had 23 percent fewer hip fractures than those who had not received the surgery.

“What is most exciting about this new research is how clearly it demonstrates the positive impact that taking care of the eyes can have on our overall health, including the prevention of serious injuries from falls,” said Jenny Pomeroy, CEO of Prevent Blindness Georgia.  “By making an appointment with an eye health professional today, you can help avoid debilitating falls in the future.”

To help prevent falls, The Centers for Disease Control and Prevention recommends maintaining an exercise program, reviewing medications with a doctor and getting vision checked regularly.  In addition, because half of all falls occur in the home, the CDC also recommends making the home safer by:

·         Removing items such as papers, books, and shoes from stairs and walkways.

·         Removing small rugs or using double-sided tape to keep the rugs from slipping.

·         Keeping items that are used often in cabinets that are easily accessed without using a step stool or ladder.

·         Installing grab bars next to the toilet and in the tub or shower and using non-slip mats in the bathtub and on shower floors.

·         Improving the lighting in your home.

·         Having handrails and lights installed near all staircases.

·         Wearing shoes both inside and outside the house and avoiding going barefoot or wearing slippers.

For more information about National Falls Prevention Awareness Day or general eye health, please contact Prevent Blindness Georgia at 404-266-2020 or visit http://www.pbga.org

Follow this link for summary 

Date of publication: June 2012

Publication type: Journal article

In a nutshell: This is a systematic review of ten years’ worth of intervention programs to find out which were most effective and to recommend further research to identify the best components of them. Further RCTs of at least six months follow-up were recommended.

Length of publication: 1 page

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Date of publication: 2011

Publication type: website

In a nutshell: This is a website providing information about falls prevention services in the UK and Ireland.

Length of publication: 1 page

Follow this link for article

Date of publication: August 2012

Publication type: website

In a nutshell: The Chartered Society of Physiotherapy originally launched guidelines for preventing falls in older people back in 1998, the first to be released with a sole focus on physiotherapy.  These have now been updated due to the evidence and guidelines published in the meantime. The new guidelines emphasise steps that can be taken to prevent falls, including specific recommendations on exercise programmes.

Length of publication: 1 page