A less healthy lifestyle increases the risk of dementia

The less healthy your lifestyle, the more you are at risk of developing dementia in later life, a new systematic review has shown. Researchers analysed the results of 18 studies with over 44,000 participants | BMJ Open | via National Institute for Health research

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Having two or more ‘modifiable risk factors’, including smoking, high blood pressure, poor diet, inactivity, obesity and excessive alcohol consumption, puts adults at greater risk of developing dementia.

The included studies followed up people without signs of cognitive decline to see who developed dementia of any cause.

A third of the studies could be combined in a meta analysis and these showed a 20% increase in the risk of dementia for one risk factor, which rose to 65% for two risk factors. The presence of three risk factors doubled the risk of dementia.

There was also a reduction in risk conveyed by having fewer risk factors and this, despite any direct evidence from intervention trials, holds out hope that interventions which either reduce or remove risk will lead to a reduction in the incidence of dementia diagnoses.

These results are consistent with our growing knowledge of the links between unhealthy lifestyles and dementia and are highly relevant to the promotion of healthy ageing behaviours in mid-life and beyond,  providing a compelling call to action in terms of public health and ageing.

Further detail at National Institute for Health Research

Full reference: Peters R, Booth A, Rockwood K et al. Combining modifiable risk factors and risk of dementia: a systematic review and meta-analysis. | BMJ Open | 2019 | 9:e022846.

Sundowning (changes in behaviour at dusk)

As the clocks go back this weekend, and with evenings becoming darker earlier, Helen Green who works on Dementia UK’s Admiral Nurse Dementia Helpline talks about how she united one family troubled by sundowning 

Sundowning is a term used for the changes in behaviour that occur in the evening, around dusk. Some people who have been diagnosed with dementia experience a growing sense of agitation or anxiety at this time.

Sundowning symptoms might include a compelling sense that they are in the wrong place. The person with dementia might say they need to go home, even if they are home; or that they need to pick the children up, even if that is not the case. Other symptoms might include shouting or arguing, pacing, or becoming confused about who people are or what’s going on.

This article at Dementia UK explains how the Dementia Helpline supported one family troubled by sundowning

See also Dementia UK’s leaflet on Good habits for bedtime

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Practical tips on preventing sundowning

  • Follow a routine during the day that contains activities the person enjoys
  • Going outside for a walk or visiting some shops is good exercise
  • Limit the person’s intake of caffeinated drinks. Consider stopping the person from drinking alcohol altogether. Caffeine-free tea, coffee and cola are available, as is alcohol-free beer and wine
  • Try and limit the person’s naps during the day to encourage them to sleep well at night instead
  • Close the curtains and turn the lights on before dusk begins, to ease the transition into nighttime
  • If possible, cover mirrors or glass doors. Reflections can be confusing for someone with dementia
  • Once you are in for the evening, speak in short sentences and give simple instructions to the person, to try and limit their confusion
  • Avoid large meals in the evening as this can disrupt sleep patterns
  • Introduce an evening routine with activities the person enjoys, such as: watching a favourite programme, listening to music, stroking a pet etc. However, try to keep television or radio stations set to something calming and relatively quiet—sudden loud noises or people shouting can be distressing for a person with dementia.

New life-saving treatment and diagnosis technology

Diseases could be detected even before people experience symptoms, thanks to a pioneering new health-data programme as part of the government’s modern Industrial Strategy

Businesses and charities are expected to jointly invest up to £160 million, alongside a £79 million government investment, as part of the Accelerating Detection of Disease programme. The project will support research, early diagnosis, prevention and treatment for diseases including cancer, dementia and heart disease.

The pioneering initiative will recruit up to 5 million healthy people. Volunteered data from the individuals will help UK scientists and researchers invent new ways to detect and prevent the development of diseases.

Full story: UK to innovate new life-saving treatment and diagnosis technology | Department of Health & Social Care

National Audit of Dementia

National Audit of Dementia: care in general hospitals 2018-2019 – Round 4 audit report | The Healthcare Quality Improvement Partnership

This report presents the Round 4 results of the National Audit of Dementia.   Scores from each hospital are derived from key themes and are shown in comparison to the scores from Round 3.

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Image source: http://www.hqip.org.uk

There are several areas where improvement has been made: 96% of hospitals in England and Wales now have a system in place for more flexible family visiting; a large number (88%) of carers (and/or patients) receive a copy of the discharge plan; and more staff report being able to access finger food or snacks for patients with dementia.

Key areas for improvement include striving to ensure that more hospitals assess for delirium and that any member of staff involved in the care of people with dementia must have training relevant to their grade and include identification and management of delirium. This training should be recorded to provide assurance to the public and regulators.

For further detail and to download the report, click here

Hidden no more: Dementia and disability 

All Party Parliamentary Group | June 2019 | Hidden no more: Dementia and
disability 

A new report from the All Party Parliamentary Group aims to shine a spotlight on dementia as a disability, to enable people with dementia to assert their rights to services and for their rights as citizens to be treated fairly and equally. Thousands of people who responded to the All-Party Parliamentary Group (APPG) inquiry agreed that they see dementia as a disability. But they told the APPG that society is lagging behind and failing to uphold the legal rights of people with dementia.  Within the report the All Party Parliamentary Group identify six key areas for action which have a direct impact on people’s daily lives, these are: 

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Image source: alzheimers.org.uk
  1. Employment
  2. Social protection
  3. Social care
  4. Transport
  5. Housing
  6. Community life

Full details from the Alzheimer’s Society