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Older People's Health Evidence Update

27/01/2016

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Older people: independence and mental wellbeing
 
New and Updated Cochrane Systematic Reviews

Mini-Mental State Examination (MMSE) for the detection of dementia in clinically unevaluated people aged 65 and over in community and primary care populations
Authors' conclusions: The MMSE contributes to a diagnosis of dementia in low prevalence settings, but should not be used in isolation to confirm or exclude disease. We recommend that future work evaluates the diagnostic accuracy of tests in the context of the diagnostic pathway experienced by the patient and that investigators report how undergoing the MMSE changes patient-relevant outcomes.

Statins for the prevention of dementia
Authors' conclusions: There is good evidence that statins given in late life to people at risk of vascular disease do not prevent cognitive decline or dementia. Biologically, it seems feasible that statins could prevent dementia due to their role in cholesterol reduction and initial evidence from observational studies was very promising. However, indication bias may have been a factor in these studies and the evidence from subsequent RCTs has been negative. There were limitations in the included studies involving the cognitive assessments used and the inclusion of participants at moderate to high vascular risk only.
Other Good Quality Systematic Reviews

Telephone communication between practice nurses and older patients with long term conditions - a systematic review

Association between frailty and quality of life among community-dwelling older people: a systematic review and meta-analysis

Effect of Vascular Risk Factors and Diseases on Mortality in Individuals with Dementia: A Systematic Review and Meta-Analysis

A systematic review of diagnostic accuracy of vertebral fracture assessment (VFA) in postmenopausal women and elderly men

Meta-analysis of synaptic pathology in Alzheimer's disease reveals selective molecular vesicular machinery vulnerability

Fall prevention intervention technologies: A conceptual framework and survey of the state of the art

Telomere length in Parkinson's disease: A meta-analysis

A systematic review and meta-analysis of plasma amyloid 1-42 and tau as biomarkers for Alzheimer's disease

Comparative safety and effectiveness of cognitive enhancers for Alzheimer's dementia: protocol for a systematic review and individual patient data network meta-analysis

The risk of overweight/obesity in mid-life and late life for the development of dementia: a systematic review and meta-analysis of longitudinal studies
Reports

Dementia profiling
Public Health England has published a new Dementia Profile, providing access to local authority and CCG level data across the whole dementia care pathway. For the first time, the profile will enable comparison between local authorities and CCG’s in England in one, interactive online platform.  The profile shares key information, such as how many people have dementia broken down by area and age; the number of people who have received an NHS health check; the number of people who have depression; emergency hospital admission numbers; and where people with dementia die.

Guidance for people with dementia and carers
Last month the London dementia strategic clinical network launched its guidance for carers and people with dementia to explain what good quality services should look like. 
https://www.networks.nhs.uk/networks/news/guidance-for-people-with-dementia-and-carers

Dementia: immediate post diagnosis support guidelines
The London dementia strategic clinical network has created guidance for professionals to support people with dementia and carers immediately following diagnosis.
https://www.networks.nhs.uk/networks/news/dementia-immediate-post-diagnosis-support-guidelines

Policy paper: Developing dementia treatments: response to Raj Long’s report 
Department of Health response to Raj Long’s independent report on the challenges faced when developing treatments for dementia.
https://www.gov.uk/government/publications/developing-dementia-treatments-response-to-raj-longs-report

Press release: PM announces funding for UK’s first Dementia Research Institute 
The UK’s first Dementia Research Institute will receive up to £150 million to drive forward research and innovation in fighting dementia.
https://www.gov.uk/government/news/pm-announces-funding-for-uks-first-dementia-research-institute

Hearing loss and dementia
The Joseph Rowntree Foundation has published Dementia friendly communities: supporting learning and outreach with the deaf community. This report aims to inform the development of policy and practice in relation to dementia awareness and information models in the Deaf community and with people with hearing loss. These approaches challenge misconceptions and provide signposting for appropriate information and support. The report considers and provides next steps on best practice models based on a pilot project with Alzheimer’s Society and BDA. 

Frailty fulcrum model
NHS England has published an animated model for frailty. This model aims to provide a ‘common language’ for frailty that can be shared between individuals, carers and professionals.  It offers an interpretation of frailty that is meaningful, relevant and sustainable for people living with the condition, throughout their journeys of care. 

Policy paper: Dementia: post-diagnostic care and support 
Joint declaration across government, health, social care and the third sector to deliver better quality services to people with dementia.
https://www.gov.uk/government/publications/dementia-post-diagnostic-care-and-support

Challenges for families of older patients
A report from the King's Fund and the Royal Voluntary Service explores the experiences of families of older patients during hospital discharge and transition.
https://www.networks.nhs.uk/networks/news/challenges-for-families-of-older-patients

Press release: Using data to improve dementia care in England 
PHE has published a new Dementia Profile, providing access to local authority and CCG level data across the whole dementia care pathway.
https://www.gov.uk/government/news/using-data-to-improve-dementia-care-in-england

Dementia care in hospitals
The Alzheimer’s Society has published Fix dementia care: hospitals.  This report marks the start of a new Alzheimer’s Society campaign looking at the experiences of people affected by dementia in a range of health and care settings. It contains the results of freedom of information requests from hospital trusts across England; a survey completed by self-selecting sample of carers of people affected by dementia; and analysis of government and NHS data.  The report sets out recommendations for the NHS and health regulators to improve the experiences of people affected by dementia in hospitals.
Additional link: BBC News report

Dementia in the Family
Alzheimer’s Research UK has published Dementia in the Family: the impact on carers. The report explores the experiences of people who are caring for family members with dementia, highlighting the heavy toll the condition can take on family carers.  The report includes case studies purposely chosen to include different types of relationships between the person with dementia and their carer. They were also chosen to include people at different stages of the condition.  

Older people more reluctant to complain about NHS services
The Parliamentary Ombudsman Service has published Breaking down barriers.  This report highlights that older people are often more reluctant to speak up, or simply don’t know how to complain when they receive poor care. The report makes a number of recommendations to improve older people’s experience of the complaints system these include: wanting all NHS providers to make older people aware of how to complain, pointing them to the support that is available to them, and make it clear that their future care will not be compromised if they complain. 
Additional link: BBC news report
NHS Behind the Headlines - Older People's Health media stories explained

Targeting inflammation 'could help treat Alzheimer's disease'

Do high doses of vitamin D increase falls risk in the elderly?

Molecule removes Alzheimer's plaques from brains of mice

Scientists find 'gene that delays Alzheimer's'
Table of Contents

Age and Ageing
Alzheimer's & dementia : the journal of the Alzheimer's Association
Alzheimer disease and associated disorders
Alzheimer's Research and Therapy
American Journal of Geriatric Psychiatry
Clinics in Geriatric Medicine
Current Alzheimer research
Dementia
Dementia & Geriatric Cognitive Disorders
European Geriatric Medicine
Geriatric Nursing
GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry
International Journal of Geriatric Psychiatry
International journal of older people nursing
Journal of Geriatric Oncology
Journal of Geriatric Psychiatry and Neurology
Old Age Psychiatrist
Quality in Ageing and Older Adults
Topics in Geriatric Rehabilitation
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