Alzheimer's Australia NSW Library News

"Planning Ahead Tools" For my future legal, health and asset decisions - NSW Government

noreply@blogger.com (Michelle) — Wed, 25 Jan 2012 02:25:00 +0000

Planning Ahead Tools

We all expect that we will be able to make our own decisions about our lives. However, illness or accidents may mean that we need to rely on other people to make decisions about our health, welfare, finances or medical treatment. This website contains information, tools and resources to make sure your wishes are known and you have a plan for the future.
http://www.planningaheadtools.com.au/

for information see the website

Resources for designing care homes

noreply@blogger.com (Janet de Bres) — Wed, 25 Jan 2012 01:13:00 +0000

These resources are available for loan to members of AANSW - if you would like to reserve them please email the Library on lis@alznsw.asn.au

Design for people with dementia : audit tool
DSDC Iris Murdoch Building, University of Stirling
This folder contains a series of resources for assessing environments that are used by people with dementia. The information they contain is evidence-based and reflects international best practice. The aim of the design audit tool is to provide consistent guidance on designing environments for people with dementia. It can be used for refurbishments projects or new buildings, and is relevant across a range of settings, including day centres, wards, care homes and medical centres.

Design for dementia : improving dining and bedroom environments in care homes
by Gregor Timlin and Nic Rysenbry
This guide explores how better product and environment design can improve quality of life for care home residents with dementia. The design ideas developed are a practical response to the challenge of cognitive decline and can be retrofitted to existing care homes as well as applied to new developments.

DVD review

noreply@blogger.com (Michelle) — Wed, 25 Jan 2012 00:37:00 +0000

Review by Madeleine Hayes Alzheimer's NSW

Life with Two Hats

Viviana Fain-Binda
For Carers of People with Dementia
An insightful account of the caring voyage associated with Alzheimer’s Disease, Life with two Hats finds the carer in a constant juggle of two hats; one being the compassionate ‘Florence Nightingale’ contrasting with the other, battling ‘Warrior Helmet’.
Viviana Fain-Binda takes us on an inspiring and poignant journey of the carer’s experience, reminding one that ‘it is not a sign of weakness to ask for help, it is actually good caring’. Issues of transition to care, respite, and carer stress and support are touched upon in a realistic and candid manner illustrating the various concerns the carer is faced with when looking after a loved one with dementia.
An emotionally honest snapshot of the carers experience based on the lives of Marie and Lonnie Smith and Kitty and Geoff Hermges, Life with Two Hats offers and captures invaluable experiential information from the carer and service provider’s perspectives, bestowing reassurance and encouragement for the carers benefit when tending to a loved one.
It is the perfect companion for those new to the caring experience, essentially reminding the carer to remain ‘flexible and pragmatic’ in their daily approach, as well as being proactive in their search for available services which would best suit the needs of their loved one.

To borrow the DVD email lis@alznsw.asn.au

Resources on activities and lifestyle for people with dementia

noreply@blogger.com (Janet de Bres) — Tue, 24 Jan 2012 22:49:00 +0000

These resources are available for loan to members of AANSW - if you would like to reserve them please email the Library on lis@alznsw.asn.au

Adding life to your years
Australian Nutrition Foundation
An easy to understand book of guidelines for older people. Includes quick references to fat, calcium, salt, alcohol and fibre; eating a varied diet, daily meal plans, a food habit check list and shopping tips. There are mini recipes to try, guidelines for eating out, managing weight, being active and managing specific health related issues.
Adding life to your years : the cookbook
This concise, 63 page colour book contains a range of easy to prepare recipes, meal and snack ideas when catering for one or two people. The book also contains valuable information about choosing a balanced diet, food hygiene and economical shopping for a well stocked, healthy pantry. Additional information is provided about maintaining general good health with advice on physical activity, alcohol consumption and diabetes.

Dementia : walking not wandering : fresh approaches to understanding practice
Edited by Mary Marshall and Kate Allan
Contents: A normal, enjoyable activity -- 2. Reasons for walking -- 3. Medical aspects -- 4. Settings -- 5. Confinement -- 6. Focus on the past -- 7. Movement -- 8. Staying safe and healthy -- 9. Therapy -- 10. Walking with.
Walking is normal and healthy yet, when people with dementia do it, it becomes wandering with all sorts of associated problems. This book is designed for those working with people with dementia in care homes, hospitals, day care centres and the community. It argues passionately that for people with dementia walking should neither be feared nor discouraged by professional carers, and especially not classified as challenging behaviour. Instead, walking should be viewed as an activity, fully understood, with significant potential and benefits. With the aging of the population, increasing numbers of people will need some type of assistance to maintain their independence. One of the fastest-growing options in long-term care is assisted living, a residential model of living arrangements that strives to combine housing and supportive services in a less-institutional facility. Assisted living arrangements usually offer individuals or couples private units that consist of a bedroom with bathing facilities and small cooking area. Residents also have access to a full-service dining room, a health clinic, and a variety of other spaces for recreational and social activities.

Involving people living with dementia making involvement count
People and organisations wanting to engage and consult with people with dementia will benefit from a this ‘what works’ resource. People with dementia may experience memory loss, confusion, and struggle in unfamiliar surroundings or have problems with speech and understanding. The resource aimed to give specific information, advice and top tips on a range of topics that will help overcome or prevent this, and support people with dementia to get involved in activities whilst recognising their current abilities.

Dementia: Things to do. Activity Ideas for Carers
Developed by the The Northern Territory Dementia Behaviour Management Advisory Service
Dementia: Things to do. Activity Ideas for Carers was created for those people from an indigenous background and who live in remote areas of the NT.
The resource was developed in consultation with people in the field and during the development and draft process feedback was sought from cultural advisors to ensure that the content of the resource was sound and culturally safe.

Support people with dementia who are going into hospital

noreply@blogger.com (Michelle) — Tue, 24 Jan 2012 00:40:00 +0000

Jo Brand - discussing dementia

Jo Brand discusses a new scheme to help tackle poor dementia care in hospitals (a leaflet called 'This Is Me') so the patient's details are known to hospital staff and then discusses her autobiography.

This is me should be completed by the person or persons who know the patient best and wherever possible with the person themselves.
A photo
My name: full name and the name I prefer to be known by…………
I currently live……………..
Carer/the person who knows me best……………
I would like you to know…………….
My home and family, things that are important to me…………
My life so far………..
My hobbies and interests…………
Things which may worry or upset me………..
I like to relax by……………
My hearing and eyesight…………..
My communication……………
My mobility…………..
My sleep…………….
My personal care…………..
My eating and drinking………….
My medication…………….
Your relationship to patient:……………..

*see the booklet

for resources on people with dementia in hospital you can borrow the following from the library lis@alznsw.asn.au

*Caring for people with dementia in acute hospital wards DVD
*People with dementia in acute hospitals : a practice guide for clinical support workers by Archibald, Carole

*What can I do? by Bennett, Lydia
*Improving care for hospitalized elders with dementia by Silverstein, Nina M

*People with dementia in acute hospital settings by Archibald, Carole

*The Alzheimer's health care handbook : how to get the best medical care for your relative with Alzheimer's disease, in and out of the hospital by Mittelman, Mary S

* Hospitalization happens : a guide to hospital visits for individuals with memory loss

*When someone in your care has memory loss and needs to go to hospital : tips worth considering

Staying Connected While Letting Go and Letting go without giving up

noreply@blogger.com (Michelle) — Fri, 20 Jan 2012 03:37:00 +0000

Staying connected while letting go : the paradox of Alzheimer's caregiving

by Sandy Braff and Mary Rose Olenik
Caregivers have been known to put their own lives on hold and become entirely devoted to caregiving—making this difficult role even harder, and often compromising their own health. This needn’t happen.

The caregivers you will meet in this book, with whom you have much in common, have learned how to deal with the frustration, anger, and grief that come naturally to any person in this role. Through their poignant stories and personal experiences you will find the strength that you need to care for your loved one while remaining emotionally committed as the mutuality of your partnership fades. Loving and nurturing while letting go is the paradox of Alzheimer’s caregiving.

You can learn from the caregivers in this book what you need to do to create a satisfying life that meshes with your role as caregiver. You will ultimately be able to make the right decisions and minimize the chaos that can overwhelm you.

During their many years working with caregivers in both counseling and research settings, Sandy Braff and Mary Rose Olenik have been profoundly impressed with their courage, compassion, and resilience in living with this paradox of staying connected while letting go. They thought that there was no better way to help others than through sharing these inspiring stories accompanied by strategies for understanding and coping with the emotional conundrums of Alzheimer’s.

Letting go without giving up : continuing to care for the person with dementia

by Jenny Henderson and Maureen Thom

The idea for Letting go without giving up grew from concerns expressed by carers who felt they were no longer allowed to have a role in caring for the person they had looked after at home after the person entered long-stay care. This booklet is aimed at carers who want to continue their involvement in the lives of the people they have cared for, even if they are no longer responsible for their day-to-day physical care needs.

to borrow these email lis@alznsw.asn.au

Fast steps to beating the Grim Reaper - Australian Ageing Agenda: Aged Care and Retirement Industry News and Issues

noreply@blogger.com (Michelle) — Fri, 20 Jan 2012 00:32:00 +0000

Fast steps to beating the Grim Reaper - Australian Ageing Agenda: Aged Care and Retirement Industry News and Issues

Books for carers

noreply@blogger.com (Janet de Bres) — Thu, 19 Jan 2012 04:18:00 +0000

These resources are available for loan to members of AANSW - if you would like to reserve them please email the Library on lis@alznsw.asn.au

The selfish pig's guide to caring

by Hugh Marriott
Six million people in the UK, often unnoticed by the rest of us, provide unpaid care for disabled or elderly relatives, friends or neighbours. Their job is long, lonely and hard, yet there is limited support and no formal training. As a result, carers suffer frequent damage to physical and mental health. Oddly, though carers by definition are anything but selfish pigs, they are liable to feelings of guilt, probably brought on by fatigue and isolation. So Hugh Marriott has written this book for them - and also for the rest of us who don’t know what being a carer is all about. His aim is bring into the open everything he wishes he'd been told when he first became a carer. And he does. The book airs such topics as sex, thoughts of murder, and dealing with the responses of friends and officials who fail to understand.

Hold my hand : a practical guide for carers of dementia sufferers
by Bill Gomatos

Drawing on personal experiences, author Bill Gomatos shares his story of caring for his wife Chrisoula, who was diagnosed with dementia in 2004. Aspiring to help others in his situation, Hold My Hand offers comfort and insight to carers and provides invaluable, practical advice and suggestions for overcoming the many obstacles of looking after someone in the home. Bill also shares with the reader his simple inventions that have made his life immeasurably easier.As well, the book sheds light on the plethora of support organisations and programs which are available in Australia, and provides relevant contact information for readers. Most importantly, Hold My Hand is a testimony to the power of loving care; it is a much-needed inspiration to those who are faced with the daunting task of looking after their loved ones in their home.

This book can be purchased online http://www.holdmyhand.net.au/buy_online.html

Read an excerpt http://www.louisadent.com/pdf/HMH_excerpt.pdf

Forgetting but not forgotten

by Noel C. Schultz
The author gives us the opportunity to be more confident to travel along beside the person on the journey with dementia by sharing in providing physical, psychological, spiritual, social and emotional support. Each of us should seek to reduce the dread of this disease by a new confidence that much can be done through support and medications.
The cognitively impaired person whose brain cells are under attack remains a person, a body-mind-spirit-soul entity. It is up to all of us to modify our reactions and behaviours to prevent people with dementia becoming excluded from the social groups that have previously shaped and supported their lives.
Faith and social communities, as well as aged-care staff, will find this book a great asset in understanding the world of someone who has dementia and in supporting them and their families. Forgetting But Not Forgotten encourages us in attitudinal change so that we are enabled to ensure that people with dementia remain valued and loved members of our communities.

Hazel : my mother's story
by Sue Pieters-Hawke
Hazel Hawke is one of our most loved and respected Australians. As the wife of a prime minister she brought a down-to-earth warmth to Canberra that influenced everyone she came into contact with. Whether it was working to improve life for the disadvantaged, supporting the arts community or passionately advocating her belief in equality and social inclusion, we all felt her energy, her practicality and her immense capacity for humour and enjoyment. From the age of eighteen Bob Hawke was the love of her life, yet their journey from youthful idealism to the political realities of Canberra was at times far from easy. The very strengths that made Hawke one of Australia's longest-serving and most successful leaders – his passion and commitment, his gregariousness and his drive – created their own tensions and issues within the family. After leaving the Lodge, their marriage famously fell apart. But Hazel's life was undiminished, as she continued to build her role as an advocate for tolerance and fairness in the broader community and as a mother and a grandmother within her own family. Public love and support for Hazel reached a new peak eight years ago when she publicly announced she'd been diagnosed with Alzheimer's disease. This intimate, beautiful biography of an extraordinary woman is written by Hazel's eldest daughter, Sue Pieters-Hawke. Candid, revealing and fascinating it explores Hazel's life as she navigated personal challenges and profound social changes, and celebrates her value as a mother, wife, role model and tireless worker for the rights and welfare of others.

New books on interpersonal relations

noreply@blogger.com (Janet de Bres) — Thu, 19 Jan 2012 03:29:00 +0000

These resources are available for loan to members of AANSW - if you would like to reserve them please email the Library on lis@alznsw.asn.au

Boundaries : where you end and I begin
by Anne Katherine
Boundaries can bring order to your life, strengthen your relationships with yourself and others, and are essential to your mental and physical health. Real-life stories illustrate the ill effects of not setting limits and the benefits you can gain by protecting your own personal boundaries and respecting those of others.

Power games : confronting hurtful behaviour and transforming our own
by Kay Douglas and Kim McGregor
This work has been written for women who feel caught in power struggles. These include those who feel powerless, who worry that they are misusing their power, and those wanting to claim and express power with integrity. It has the specific aim of showing women how to tackle these issues successfully, and stopping them from either being caught in a power game or playing one themselves.

Controlling people : how to recognize, understand, and deal with people who try to control you
by Patricia Evans
Does this sound like someone you know?
•Always needs to be right
•Tells you who you are and what you think
•Implies that you're wrong or inadequate when you don't agree
•Is threatened by people different from him- or herself
•Feels attacked when questioned
•Doesn't seem to really hear or see you
In Controlling People, the autho tackles the "controlling personality," and reveals why and how these people try to run other people's lives. She also explains the compulsion that makes them continue this behavior-even as they alienate others and often lose those they love.

New books in the library on brain fitness

noreply@blogger.com (Janet de Bres) — Thu, 19 Jan 2012 00:57:00 +0000

These resources are available for loan to members of AANSW - if you would like to reserve them please email the Library on lis@alznsw.asn.au

The mature mind : the positive power of the aging brain
by Gene Cohen
Never mind those "senior moments" in which a word slips away just as it’s about to leave the lips. Cohen has good news for the over-40 set: older brains can learn new things, and they are actually better than younger brains at many types of intellectual tasks. Recent studies show that the brain and mental capacity continue to grow throughout life. This development takes advantage of a lifetime of experiences as well as the emotional mellowing that occurs with advancing age and eventuates in the older brain processing information in a manner quite different from and in no way inferior to the way a young brain performs. Cohen’s own research establishes that both hemispheres of the brain are used more efficiently and that the brain becomes vastly more creative as life goes on. Contrary to the previous belief that new brain cells stop forming after adolescence, the former chief of the Center on Aging at the National Institutes of Health says that growing new brain cells is a lifelong phenomenon.

Save your brain : 5 things you must do to keep your mind young and sharp
by Paul David Nussbaum
Delay potential memory loss and dementia with a brain health lifestyle! Maybe you find yourself forgetting names or searching for the right words. Or you see your elderly mother struggling with dementia and worry that you're witnessing your future. You take supplements and do the New York Times crossword puzzles to keep your mind active, but is that enough? What can you do to achieve a lifestyle that champions your brain health? In Save your Brain, clinical neuropsychologist Paul David Nussbaum proescribes a proactive brain health lifestyle that incorporates socialization, physical activity, mental stimulation, spirituality, and nutrition to keep your brain in great shape. After completing a survey that will determine your overall brain health, you can follow Dr Nussbaum's brain healthy lifestyle program that includes "Healthy Brain Tips" and tasty meal plans and recipes - ensuring that your brain will be fit for life!

Enhancing cognitive fitness in adults : a guide to the use and development of community-based programs
edited by Paula E. Hartman-Stein and Asenath La Rue
One of the major milestones of aging research is the concept that dementia is not a one-cause, one-effect disorder. From this realization, scores of research-based cognitive wellness programs have been established alongside traditional medical interventions to help older adults deal with memory decline, cognitive deficits, and other signs of brain aging. Enhancing Cognitive Fitness in Adults takes a wellness-support rather than a disease-based approach to its subject, presenting a wide range of promising interventions among the diversity that is currently being offered, from intergenerational volunteer programs, writing workshops, and multimedia strategies to meditation, biofeedback, nutrition, and exercise. Areas of coverage include:•Research bases for cognitive wellness interventions.•Social programs designed to improve and sustain cognitive function.•Enhancing cognition through the arts and cultural activities.•Cognitive wellness interventions for adults with memory impairment.•Community-based programs with positive societal impact.

American Journal of Alzheimer's Disease and Other Dementias - September 2011, Vol 26, No 6

noreply@blogger.com (Janet de Bres) — Tue, 17 Jan 2012 23:07:00 +0000

Full text articles are available to fee paying members of Alzheimer’s Australia NSW by emailing lis@alznsw.asn.au

Review of issue
Brain Donation and the Dementia Family: What Factors Impact Participation?
p. 435-436

Current Topics in Care
Keeping up Health Promotion Practices in Specialized Day Care Units for People With Dementia
Background: Health promotion practices hold promises for elderly individuals' quality of life. This article shows that such practices can be promoted in specialized day care units for individuals with dementia. Method: Group interviews with 8 groups of staff (comprising 24 staff members) in 3 day care units. Results: Rather than referring directly to health promotion practices, the staff-members talked about the importance of regular drinks and meals, as well as exercise such as gym programs, walking, and swimming sessions for the wellbeing of their clients. They also maintained that the pursuit of different individual interests reduced stress both for the individual client and for the respective family. Conclusion: Day care for elderly individuals with dementia can promote individual health practices, in as much as it is based on knowledgeable monitoring of health and well-being. Such health practices strengthen the daycare client's optimal independent function which the staff members regard as a prerequisite for living at home.
p. 437-442

Rivastigmine in Alzheimer’s Disease and Parkinson’s Disease Dementia
An ADAS-Cog Factor Analysis
Rivastigmine treatment is associated with significant improvements on the cognitive subscale of the Alzheimer’s Disease Assessment Scale (ADAS-cog) in patients with mild-to-moderate Alzheimer’s disease (AD) and Parkinson’s disease dementia (PDD). Both AD and PDD are purported to have different profiles of cognitive impairment, which may respond differentially to rivastigmine treatment. This was a retrospective analysis of 3 randomized, double-blind, rivastigmine trial databases (Investigation of transDermal Exelon in ALzheimer's disease [IDEAL; AD], EXelon in PaRkinson's disEaSe dementia Study [EXPRESS; PDD], and Alzheimer's Disease with ENA 713 [ADENA; AD]). Factor analyses of the 11 baseline ADAS-cog items derived the same factors in the 2 diseases, that is, “memory” and “language”. Rivastigmine-treated AD and PDD patients showed significant improvements (P < .0001 versus placebo) on both factors. For both AD and PDD, rivastigmine had a numerically greater effect on memory than language. Treatment effect sizes were numerically greater in PDD compared with AD. Rivastigmine treatment is associated with improvement in memory and language in AD and PDD. The numerically greater response in PDD is consistent with greater cholinergic deficits in this disease state. p. 443-449

Current Topics in Research
Brain Glutamate Levels Are Decreased in Alzheimer’s Disease
A Magnetic Resonance Spectroscopy Study
Glutamate (Glu) is the most abundant excitatory neurotransmitter in the central nervous system (CNS) and is involved in the pathophysiology of Alzheimer’s disease (AD) in which there is an increased excitotoxicity. Biochemical composition of living tissues including the levels of Glu was analyzed by magnetic resonance spectroscopy (MRS). Previous reports point to decreased levels of Glu in AD. As Glu plays an important role in memory, we hypothesize that Glu levels are decreased in patients with AD when compared with controls. A consecutive sample of 30 patients with mild-to-moderate AD underwent H-MRS with the voxel placed in the bilateral posterior cingulate gyrus. For comparison purposes, we carried out the same technique in 68 patients with mild cognitive impairment (MCI) and in 26 controls. The healthy controls had higher metabolite levels of N-acetyl-aspartate (NAA) than patients with MCI and AD. In turn, patients with MCI and the controls had higher levels of Glu than in patients with AD. The differences were significant in the analysis of variance (ANOVA) test model corrected for age. In the post hoc analysis, the most remarkable differences were seen between patients with AD and the rest (patients with MCI and the controls). In AD, the levels of Glu and NAA are decreased in comparison with MCI and normality, which reflects loss of neurons.
p. 450-456

Relationship Between Late-Life Hypertension, Blood Pressure, and Alzheimer’s Disease
Relationship between late-life hypertension and Alzheimer’s disease (AD) remains less clear. Both cross-sectional and longitudinal methods were used to examine whether systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean arterial pressure (MAP), and self-reported hypertension (S-HTN) in late life were associated with having and developing AD. The cross-sectional examination included 1768 individuals with AD and 818 nondemented individuals, and AD was not significantly associated with S-HTN or any of blood pressure measures (S-HTN: P = .236; SBP: P = .095; DBP: P = .429; PP: P = .145; MAP: P = .162). In the longitudinal examination, 594 nondemented individuals, 171 with and 423 without S-HTN at entry, were included. Diastolic blood pressure was significantly related to the development of AD (P = .030) but not S-HTN (P = .251), SBP (P = .294) PP (P = .919), and MAP (P = .060). The association underscores the necessity of further investigation to outline the detailed mechanisms and biological relevance, if any, of late-life DBP to later AD.
p. 457-462

Apolipoprotein E-e4, Processing Speed, and White Matter Volume in a Genetically Enriched Sample of Midlife Adults
Healthy midlife children of a parent with Alzheimer’s disease ([AD] N = 23; 9 male) participated in neuropsychological testing, and magnetic resonance imaging (MRI) of brain volumetrics were obtained. In all, 35% of the sample were apolipoprotein E (ApoE)-e4 positive (n = 8; 5 male). The ApoE-e4 group exhibited significantly slower performances on an executive function and processing speed measure and had less white matter volume than the non-ApoE-e4 group. Lesser white matter volume was significantly correlated with slower processing speed. Processing speed and changes in white matter volume might be indicators of preclinical decline in AD.
p. 463-468

African American Participation in Alzheimer’s Disease Research That Includes Brain Donation
Historically, minority groups have been underrepresented in research and clinical trials. The lack of participation by minorities has been attributed to a variety of factors including a mistrust of the predominately white research establishments and a lack of education about the purpose of research. The current study was designed to determine African American interest in Alzheimer’s disease (AD) research and to recruit African Americans as normal controls in current AD studies with the goal of eventually gaining consent for brain donation upon death. Participants were 46 African Americans aged 65 or older, who were interviewed about the knowledge of medical procedures and experience with research. After initial recruitment interviews, 31.7% of participants agreed to yearly testing with eventual brain donation. Study findings suggest a moderate relationship between participants' knowledge of medical procedures used to prolong life and willingness to donate one’s brain.
p. 469-476

Frontotemporal Dementia Caregivers and Researchers Partnering for Brain Donation
This study utilized a community-based, participatory research model between the Association for Frontotemporal Degeneration (AFTD) and the Education Core of the Indiana Alzheimer Disease Center. A total of 30 caregivers of persons with frontotemporal dementia (FTD) participated in 6 focus groups in 3 cities. The majority of participants were spouses of the person with FTD and had been providing care for an average of 6 years. Transcript analysis revealed 7 prominent themes: willingness to participate, when/how the issue of brain donation is raised, who initiates discussion about brain donation, who is involved in decisions about brain donation, motivation for participating in brain donation, lack of effective communication, and barriers to research participation. Caregivers demonstrated a strong desire to participate in research and contribute to advancing knowledge. The lack of effective communication between the clinicians and caregivers was a barrier to developing positive rapport, detrimentally impacting research participation.
p. 477-483

A Novel Technology to Screen for Cognitive Impairment in the Elderly
Background: Traditional evaluation of mild cognitive impairment (MCI) can be costly, time consuming, and impractical for widespread screening. DETECT is a portable device developed to rapidly perform cognitive testing in diverse settings. This study compares DETECT with formal clinical assessment. Methods: A prospective cross-sectional comparison of the DETECT device versus an expert neuropsychologist’s assessment (NPA). A total of 405 participants ≥65 years old, recruited from geriatric clinics and retirement facilities, completed both DETECT and NPA. Multivariable logistic regression methods were used to evaluate the degree of correlation between DETECT testing and the NPA diagnosis. Results: Predictive modeling demonstrated very good ability to discriminate between normal, MCI, and dementia per the NPA reference standard using DETECT subtests (c = 0.85 for any impairment; c = 0.99 for dementia). Conclusion: DETECT scores closely correlate with NPA. DETECT can identify and discriminate between normal, MCI, and dementia and could be incorporated as a screener for MCI.
p. 484-491

Characteristics of Generalized Anxiety Disorder in Patients With Dementia
Background: Overlap of cognitive and anxiety symptoms (i.e., difficulty concentrating, fatigue, restlessness) contributes to inconsistent, complicated assessment of generalized anxiety disorder (GAD) in persons with dementia. Methods: Anxious dementia patients completed a psychiatric interview, the Penn State Worry Questionnaire-Abbreviated, and the Rating for Anxiety in Dementia scale. Analyses to describe the 43 patients with and without GAD included the Wilcoxon Mann-Whitney two-sample test, Fisher’s exact test. Predictors of GAD diagnosis were identified using logistic regression. Results: Those with GAD were more likely to be male, have less severe dementia and endorsed more worry, and anxiety compared to patients without GAD. Gender, muscle tension and fatigue differentiated those with GAD from those without GAD. Conclusions: Although this study is limited by a small sample, it describes clinical characteristics of GAD in dementia, highlighting the importance of muscle tension and fatigue in recognizing GAD in persons with dementia.
p. 492-497

News Briefs
Mystery Ingredient in Coffee Boosts Protection Against Alzheimer’s Disease
A yet unidentified component of coffee interacts with the beverage’s caffeine, which could be a surprising reason why daily coffee intake protects against
Alzheimer’s disease. A new Alzheimer’s mouse study by researchers at the University of South Florida (USF) found that this interaction boosts blood levels of a critical growth factor that seems to fight off the Alzheimer’s disease process.

Falls May be Early Sign of Alzheimer’s Disease
Falls and balance problems may be early indicators of Alzheimer’s disease, researchers at Washington University School of Medicine in St Louis report on July 17, 2011, at the Alzheimer’s Association International Conference on
Alzheimer’s Disease in Paris.

Study: Alzheimer’s Disease Symptoms More Subtle in People Older Than 80
A new study suggests that the relationship between brain shrinkage and memory loss in Alzheimer’s disease changes across the age spectrum. The research is published in the August 10, 2011, online issue of Neurology, the
medical journal of the American Academy of Neurology.

Rhode Island Hospital Study Identifies Fish Oil’s Impact on Cognition and Brain Structure
Researchers at Rhode Island Hospital’s Alzheimer’s Disease and Memory Disorders Center have found positive associations between fish oil supplements and cognitive functioning as well as differences in brain structure
between users and nonusers of fish oil supplements. The findings suggest possible benefits of fish oil supplements on brain health and aging. The results were reported at the recent International Conference on Alzheimer’s Disease in Paris, France.

Even Mild Cognitive Impairment Appears to Substantially Increase Risk of Death
Cognitive impairment, even when detected at an early, mild stage is a significant predictor of decreased life expectancy. According to a new, long-term study from Regenstrief Institute and Indiana University researchers, cognitive impairment, especially at the moderate-to-severe stages has an impact on life expectancy similar to chronic conditions such as diabetes
or chronic heart failure. Their findings, ‘‘Cognitive Impairment: An Independent Predictor of Excess Mortality. A Cohort Study’’ appears in the September 6, 2011 issue of Annals of Internal Medicine.

Study Reveals Link Between High Cholesterol and Alzheimer’s Disease
People with high cholesterol may have a higher risk of developing Alzheimer’s disease, according to a study published in the September 13, 2011 issue of Neurology, the medical journal of the American Academy of Neurology.

Safeguards Needed to Prevent Discrimination of Patients With Early Alzheimer’s in the Workplace
Policies Needed to Prepare Individuals, Society for Earlier Diagnosis and High Risk of Alzheimer’s Philadelphia, PA—The changing tide of Alzheimer’s diagnosis presents new challenges to the public, physicians, and lawmakers:
if you could find out your Alzheimer’s risk, would you want to know? How should doctors tell you your risk? And what does it mean for the many newly diagnosed Americans still in the workplace?
p.498-502

Tests for Your Memory for Alzheimer's Dementia

noreply@blogger.com (Michelle) — Mon, 09 Jan 2012 02:08:00 +0000

If you decide to try any test and, you find the results of the test suspicious Please don't jump to any conclusion until;
You consult with your personal care physician
And, schedule a test with a memory specialist. Test Your Memory for Alzheimer's Dementia in 15 Minutes (SAGE)

This 15 question written exam that could have a dramatic impact on a major problem -- the early detection of Alzheimer's disease.

This handwritten self-assessment test can be taken in less than 15 minutes. SAGE is a reliable tool for evaluating memory and cognitive ability. Findings confirming the validity of the tool were reported in the journal Alzheimer Disease and Associated Disorders.

SAGE Test Download Page

The following four SAGE forms are interchangeable. Click on link - Only one test form should be taken

Explanation of SAGE Scoring

Please note that SAGE screening is not a diagnostic test of any condition. Our research has shown that SAGE can often, but not always, indicate whether individuals fall into the normal range, have mild memory or thinking impairments, or have a more severe memory or thinking condition. Please see link

Alzheimer's Clock Draw Test -- Detect the Signs of Alzheimer's Early

Drawing a clock by hand is one of several useful screening tools that can help to detect mild cognitive impairment, dementia, or Alzheimer.

This test can help you, or your doctor, differentiate between normal aging and possible dementia.

If you administer the test on your own and find the results either disconcerting or suspicious, schedule an appointment with your personal care physician. Take the copy of the clock test with you to the doctor appointment, and show the test to the doctor.

The Clock Drawing Test

Have the person draw a clock by hand on a large piece of paper.
Draw the face of a clock and put the numbers in the correct positions.

Then draw the hands to indicate 3:40 (time).

Clock Drawing Test Scoring

To score, assign the following points for each part of the drawing:

1 point for a closed circle

1 point for properly placed numbers

1 point for including all twelve numbers

1 point for properly placed hands

Journal of Gerontological Nursing - Vol. 37 No. 12 December 2011

noreply@blogger.com (Janet de Bres) — Thu, 22 Dec 2011 04:16:00 +0000

Full text articles are available to fee paying members of Alzheimer’s Australia NSW by emailing lis@alznsw.asn.au

Clinical Concepts
Aging and Living with HIV/AIDS
With individuals either living longer with the disease or contracting it at a later stage in life, HIV/AIDS can no longer be regarded as just a young person’s disease. In fact, people older than 50 will represent 50% of HIV/AIDS cases by 2015. The intersection of aging and HIV/AIDS is explored in this article through the use of an individual example highlighting typical age-related issues encountered in living with a chronic HIV infection and two of the more common comorbid conditions. Nursing implications for managing these conditions—depression and dyslipidemia—as well as other considerations for providing care to older adults with HIV/AIDS are addressed.
p. 4-7

PUBLIC POLICY
Substance Abuse in Older Adults: Policy Issues
By 2020, it is projected that the number of older adults needing treatment for drug and alcohol addictions will increase dramatically. Although Medicare covers treatment for mental health issues, copayments can be prohibitive for those with lower incomes. The Positive Aging Act, an amendment to the Public Health Service Act, is a policy alternative that could address substance abuse in the older adult population by (a) demonstrating ways of integrating mental health services for older adults into primary care settings, and (b) supporting the establishment and maintenance of interdisciplinary geriatric mental health outreach teams in community settings where older adults reside or receive social services. Increasing funding to states to emphasize primary care provider education on the detection, evaluation, and treatment of substance abuse problems of older adults has the potential to better meet the substance abuse needs of this population. Educating primary care providers, including gerontological nurses, to recognize signs of substance abuse in this population and providing age-appropriate treatment options is critically important but will require funding beyond what is currently available.
p. 8-11

Guest Editorial
The Hartford Impact on the Care of Older Adults in Transition
p.12

Transitions Experienced by Older Survivors of Critical Care
The transition from hospital to home is complicated for older adults who experience a serious or life-threatening illness. The specific aims of this prospective, observational cohort study were to determine the number of older adults who experience a change in their functional ability and residence after an intensive care unit (ICU) stay and to explore risk factors for functional decline and new institutionalization at hospital discharge. We found high rates of unrecognized preexisting cognitive impairment, delirium, complications, functional decline, and new institutionalization in this sample (N = 43). A number of variables were associated with functional decline or new institutionalization, including narcotic agent use (p = 0.03), ICU complications (p = 0.05), comorbidities (p = 0.01), depression (p = 0.05), and severity of illness (p = 0.05). We identified device self-removal, admission type, and ICU delirium as also potentially associated with these outcomes (p ≤ 0.25). There are a number of important and potentially modifiable factors that influence an older adult’s ability to recover after a critical illness.
p. 14-25

Chronic Grief Management for Dementia Caregivers in Transition: Intervention Development and Implementation
Research reveals that Alzheimer’s disease (AD) caregivers do not relinquish their role after placing a family member in long-term care. Caregivers report increased emotional upset around the time of placement, with sustained losses over time leading to chronic grief. Chronic grief increases caregivers’ risk for depression and suicide. There are no documented interventions designed to decrease caregivers’ chronic grief post placement. The Chronic Grief Management Intervention (CGMI) builds on existing evidence to target caregivers’ chronic grief in the transition of a family member into long-term care. The intervention is structured into three major components: (a) knowledge, (b) communication and conflict resolution skills, and (c) chronic grief management skills. The 12-week intervention was pilot tested with 34 caregivers for feasibility and preliminary effects on caregiver skill, knowledge, chronic grief, and depression. This article presents a general study description while focusing on the development and implementation of the CGMI.
p. 28-35

Initial Efficacy of a Cardiac Rehabilitation Transition Program: Cardiac TRUST
The purpose of this pilot study was to test the initial efficacy, feasibility, and safety of a specially designed postacute care transitional rehabilitation intervention for cardiac patients. Cardiac Transitional Rehabilitation Using Self-Management Techniques (Cardiac TRUST) is a family-focused intervention that includes progressive low-intensity walking and education in self-management skills to facilitate recovery following a cardiac event. Using a randomized two-group design, exercise self-efficacy, steps walked, and participation in an outpatient cardiac rehabilitation (CR) program were compared in a sample of 38 older adults (17 Cardiac TRUST, 21 usual care). At discharge from postacute care, the intervention group trended toward higher levels of self-efficacy for exercise outcomes than the usual care group. During the 6 weeks following discharge, the intervention group had greater attendance in outpatient CR and a trend toward more steps walked during the first week. The feasibility of the intervention was better for the home health care participants than for those in the skilled nursing facility. The provision of CR during postacute care has the potential to bridge the gap in transitional services from hospitalization to outpatient CR for these patients at high risk for future cardiac events. Further evidence of the efficacy of Cardiac TRUST is warranted.
p. 36-44

Medication Regimens in Older Home Care Patients
Medication regimens in older patients have been strongly associated with adverse events leading to hospitalization in ambulatory care settings. Despite a 29% hospitalization rate, to date, no research regarding medication regimens and readmission to the hospital has been completed in the home care setting. As part of a larger study evaluating predictors of readmission to the hospital from home care, descriptive analyses, chi-square tests, and t tests for independent samples were used in this secondary analysis to evaluate the Outcome and Assessment Information Set and medication records from 911 older patients admitted from the hospital to 15 home care agencies. Patients readmitted back to the hospital were older, sicker, and more cognitively impaired, and had complex medication regimens that included significant polypharmacy and inappropriate medication use. Nurses working with older adults need to be especially vigilant in monitoring medication regimens of patients to reduce opportunities for adverse drug events and subsequent hospitalization.
p. 45-55

Medication Reconciliation in Nursing Homes: Thematic Differences Between RN and LPN Staff
The purpose of this qualitative descriptive study was to describe medication reconciliation practices in nursing homes with a specific focus on nursing staff involvement in the process. The study was conducted in eight Midwestern nursing homes and included 46 onsite observations of resident transfers to the nursing home. Informal interviews of nursing staff performing medication reconciliation were conducted during each observation. Findings suggest nursing home nursing staff, including both RN and licensed practical nurse (LPN) staff, were primarily responsible for performing medication reconciliation; however, these staff often varied in how they processed resident transfer information to identify medication order discrepancies. Patterns of differences were found related to their perceptions about medication reconciliation, as well as their actions when performing the process. RN staff were more often focused on resident safety and putting the “big picture” together, whereas LPN staff were more often focused on the administrative assignment and “completing the task.”
p. 56-63

Aged Care Insite - December-January 2012 Issue 68

noreply@blogger.com (Janet de Bres) — Thu, 22 Dec 2011 02:45:00 +0000

Full text articles are available to fee paying members of Alzheimer’s Australia NSW by emailing lis@alznsw.asn.au

News
Turning criticism into a positive
Collaboration between the government, consumers and industry seems to have been successful in setting up a new complaints system.
p. 3

State of play
Since the release of the Productivity Commission’s report, the minister has been consulting with both industry and consumers. This article looks the progress so far.
p. 8

Lessons learnt the hard way
Planning for a better response to emergencies is continuing in many states hit hard by bushfires, floods or storms.
p. 12

Help can be a quick phone call away
With a shortage of community care workers expected, an internet system has been developed to assist workers.
p. 14

Making cents with no-for-profit
Management of the aged care sector has improved, say directors, but it takes time and effort.
p.16

Operator tries to ease roster pressures
An innovative provider is finding success by meeting the work needs of staff, residents and management.
p. 17

The generation gap
To entice young workers into aged care, you first have to understand them.
p. 18

Industry calls for a special bank
No-for-profit leaders want to copy a British idea of using dormant accounts to provide more stable finance for the sector.
p. 19

Clever connections
Just as a round of government funding gets underway new research looks
At the growth of teaching nursing homes in Australia and highlights the role they can play in improving quality of care and countering workforce issues.
p. 20

Advanced in-home monitoring a success
The expansion of the national broadband network will be of great benefit to those using in-home health monitoring systems.
p. 23

Getting wise to the smart home
Many studies have demonstrated the economic and health benefits of telehealth in aged care, yet the take-up remains patchy. This article looks at why , and what’s needed to change it.
p. 24

Green thumbs in the pink
Gardening has many physical and mental benefits, including helping older people to relax and even recover from surgery.
p. 26

More than a lick of paint
The institutional look has been left behind as architects and interior designers create warm, homely buildings
p. 28

Shedding light on the dark hours
Night staff get a poor deal in training and support , and the riisk is this might affect the standard of care.
p. 29

Understanding the final journey
Better communication about the symptoms and palliative care of terminal dementia is helping carers and families.
p. 30

Hand design goes high-tech
Hand-held devices are helping to create better environments at aged care facilities.
p. 31

More than just brown rice
A vegetarian diet is healthy and the large range of products available can make it very interesting
p. 32

The best protection
Urinary/Faecal Incontinence : absorbent products
What is the effectiveness of the different types of absorbent products designed for moderate-heavy incontinence?
p. 33

When things go bump in the night
There are simple steps staff can take to improve dementia care at night
p. 35

If you are having difficulty accessing Library News: http://alzheimersnswlibrary.blogspot.com/
because of restricted access by your IT department or spyware try the following alternative web address: http://digbig.com/4sdps )

Journal of Gerontological Nursing - Vol. 37 No. 11 November 2011

noreply@blogger.com (Janet de Bres) — Thu, 08 Dec 2011 03:01:00 +0000

Full text articles are available to fee paying members of Alzheimer’s Australia NSW by emailing lis@alznsw.asn.au

Guest Editorial
Focus on Elder Mistreatment and Abuse
This issue of the Journal of Gerontological Nursing includes several interesting and informative articles related to elder mistreatment and abuse. This focus is relevant to gerontological nursing education, practice, and policy and is timely in terms of passage of the Elder Justice Act in 2010 (see Alford, 2011). It is important in that early identification and intervention has the potential to reduce and/or prevent elder mistreatment—a harsh reality for many older adults in both community and institutional settings.
p.3

Evidence-Based Practice Guideline
Elder Abuse Prevention
The purpose of this evidence-based practice guideline is to facilitate health care professionals’ assessment of older adults in domestic and institutional settings who are at risk for elder abuse, and to recommend interventions to reduce the incidence of mistreatment.
p. 11-17

Clinical Concepts
The Nursing Role in Reporting Elder Abuse: Specific Examples and Interventions
Elder abuse is a serious national problem with potential for significant physical, emotional, and financial harm. In some situations, elder abuse may lead to death. Nurses are mandated reporters for suspected elder abuse to help prevent and curtail these serious outcomes and thus are responsible for recognizing the types of elder abuse and ways it can manifest. However, the variety of settings, perpetrators, and types of elder abuse may make it difficult for nurses to recognize when elder abuse is present and to understand the proper course of action. In addition, it is necessary for nurses to be aware that elder abuse is not just a public problem but can occur in clinical settings and everyday practice. The purpose of this article is to provide several brief clinical scenarios that exemplify specific aspects of potential elder abuse and to identify appropriate nursing interventions.
p. 19-23

Diagnosis: Dementia
Psychiatric Referral Versus Federal Regulations: A Balancing Act for Long-Term Care Nurses
After reviewing an all-too-common scenario that occurs in long-term care facilities specific to residents with problematic behaviors, we will examine the nurse’s role in facilitating appropriate care and treatment of residents with problematic behaviors stemming from dementia while protecting the organization from deficient practices.
p. 24-27

CNE Article
The Role of Health Care Providers in Recognizing and Reporting Elder Abuse
The incidence of abuse cases in older adults is on the rise. Health care providers play an important role in recognizing and reporting abuse, the first step of which is to prepare themselves with knowledge regarding abuse. This consists of knowing the risk factors and signs and symptoms of abuse and how to report it. Of equal importance is knowledge of ethical implications, legalities, and ways to prevent elder abuse. Health care providers must take advantage of their unique roles to assess for mistreatment as well as to spread knowledge on recognizing, reporting, and preventing elder abuse.
p. 28-33

Feature Articles

Home Telehealth: Patient Satisfaction, Program Functions, and Challenges for the Care Coordinator
Home telehealth programs can enhance older adults’ access to care, but eliciting accurate information regarding program effectiveness is challenging because patients are reluctant to criticize. This study sought accurate patient perspectives about both benefits and challenges of the Veterans Health Administration’s rapidly expanding care coordination/home telehealth program. Patients who completed the standard 8-item satisfaction survey were subsequently interviewed, and the transcripts were content analyzed to identify program functions most salient to patients and program components most challenging for patients. Interviews generally supported patients’ high survey ratings but also revealed some challenges that the survey did not capture. Program functions most salient to patients were providing access, educating or instructing, and monitoring or tracking. However, patients were frustrated by equipment problems as well as care coordinator inaccessibility and slow response. Gathering detailed information about patient perceptions of health care delivery is important so challenges can be addressed to meet patients’ expectations.
p. 38-46

Pictograph-Based Discharge Instructions for Low-Literate Older Adults After Hip Replacement Surgery: Development and Validation
Current forms of written text-based discharge instructions are not suitable for presenting lengthy, complex discharge home care actions, and are difficult for low-literate patients to follow precisely at home. The aims of this study were to develop and validate pictograph-based discharge instructions for older adults after hip replacement surgery. Once low-literacy text and pictographs were created, their appropriateness, accuracy, and relevance were reviewed and validated by five experts. The findings show that pictographs (i.e., simple line drawings showing explicit discharge care actions) using stick figures are well suited for presenting action-based discharge instructions. The experts perceived the pictographs as engaging and easy to understand. The pictograph-based approach can be an effective tool in developing health care instructions not only for patients with low-literate skills in acute health care settings, but also for immigrants and refugees who speak English as a second language and present significant communication challenges for health care providers.
p. 47-56

Dementia November 2011, Volume 10, No. 4

noreply@blogger.com (Janet de Bres) — Wed, 07 Dec 2011 04:04:00 +0000

Full text articles are available to fee paying members of Alzheimer’s Australia NSW by emailing lis@alznsw.asn.au

Table of Contents

Editorial
Visitor or care manager? Reflections on my mother, me and living well with dementia in a care home
p.457-458

Service users’ involvement in the development of a maintenance cognitive stimulation therapy (CST) programme: A comparison of the views of people with dementia, staff and family carers
This study reports on the process of developing a maintenance programme manual following the Medical Research Council guidelines representing the ‘phase I’ or modelling. This study uses an inductive thematic analysis approach to examine user perceptions on the maintenance cognitive stimulation therapy (CST) programme. Three focus groups were carried out with people with dementia, three with staff, and three with family carers of people with dementia. In total 17 people with dementia, 13 staff and 18 family carers took part in separate focus groups. The main findings from the user focus clearly supports the recent draft NICE guidelines on dementia (NICE‐SCIE, 2006) that states that all people with mild/moderate dementia should be ‘given the opportunity to participate in a structured group of cognitive stimulation programme’. People with dementia highly valued the opportunity to take part in a mental stimulating group programme and found it vital in keeping them healthy and active. Most family carers and staff were very positive but expressed concerns about the effectiveness of this type of programme and gave real life examples where the idea of ‘use it or lose it’ did not apply. Results from the focus groups will be used in order to produce a new version of the maintenance CST draft manual and this will be evaluated in a large randomized controlled trial (RCT).
p. 459-473

Government, professional and public efforts in Japan to change the designation of dementia (chihō)
In 2004, the label for dementia was officially changed in Japan as part of a publicity campaign to raise public awareness about dementia and replace the previously stigmatizing word ‘chihō’, which translates as a ‘disease of cognition associated with idiocy’. The aim of this study is to examine the name-changing process and to explore its implications for Japan and the field of dementia studies in general. First, this article explains the process through which the new name for ‘dementia’, ‘ninchishō’, was selected and why. It then addresses Alzheimer’s Association Japan (AAJ), describing the influence of this organization on the name-changing process. Finally, the article delineates how an educational initiative was developed in response to the decision to advance a new terminology, ninchishō, and evaluates the initial impact of the name-changing project.
P.475-486

Implementing the National Dementia Strategy in England: Evaluating innovative practices using a case study methodology
With dementia ever-increasing in prevalence and cost on society, and with recent reports emphasizing the need for improved and standardized diagnosis and care for patients with dementia, the National Dementia Strategy (NDS) has been published by the English Department of Health. The NDS encourages the identification of successful innovations to implement on a wider scale. This paper uses case studies to describe some examples of innovative practice in the diagnosis and management of patients with dementia in primary care. It goes on to discuss methodological problems in the evaluation and comparison of innovations in practice, focusing on the potential to compare complex with simple interventions, and recognizing the role that commissioners play in making decisions about the choice and implementation of innovation.
p. 487-498

Coping and its relationship to quality of life in dementia caregivers
Coping and Quality of Life (QoL) of dementia caregivers has not been studied in the Indian context. Thirty two patients with dementia of Alzheimer’s type were assessed for level of cognitive functioning using Hindi mental state examination and for severity of dementia using Clinical dementia rating. Their key caregivers were assessed using the Coping checklist and WHO-QoL (BREF) Hindi version. Education was positively correlated to total coping score (p = 0.02), problem-solving (p < 0.01), positive distraction (p = 0.04) and acceptance (p = 0.02) and negatively correlated with religion (p = 0.01) and denial (p = 0.01). Use of social support as coping was found to be positively correlated with domains of QoL. Problem-solving was seen to have a significant positive correlation with psychological QoL (p = 0.0471) while denial/blame (p = 0.0068) had significant negative correlation with both physical and psychological QoL. Both coping strategies and QoL has been shown to depend on caregiver characteristics rather than the severity of the patient’s dementia. p. 499-508

Self and embodiment: A bio-phenomenological approach to dementia
Loss of self is widely regarded to be a consequence of dementia, and this perceived loss presents a variety of problems – not least because a clear understanding of the concept of self is elusive. This paper suggests a way to cut through problems that arise because we rely on conceptions of self in our understanding of the effects of dementia. It is proposed that we can avoid reliance on the concept of self through an approach based in bio-phenomenology. Such an approach would help us better understand the inner life of those with dementia and assist us to recognize that even in late stage dementia they are semiotic subjects with unique value. p. 509-522

Sliding interactions: An ethnography about how persons with dementia interact in housing with care for the elderly
This ethnography describes how persons with dementia interact with cognitively intact persons in housing with care for the elderly. The results, drawing upon 31 observation sessions and nine interviews, are described under the following themes, which were interpreted from the standpoint of social interaction theory: interaction with expression of satisfaction, disorientation, and dissociation. Interaction provided satisfaction, but did not always reflect a positive experience. Awareness in persons with dementia seemed to be greater than others perceived and, as a result, interaction was adversely affected by frequent well-intentioned corrections and comments. Participation in interaction can be encouraged and feelings of indignation avoided by assuming that persons with dementia are aware of their situation and how others behave toward them. Sensitivity is required to interpret individuals' expressions of desire not to participate, while simultaneously it is important to try to interpret why they want to refrain. p. 523-538

Interaction in community-based aged healthcare: Perceptions of people with dementia
This research sought to understand how people with dementia perceive interaction in the context of their service experience. Using the client data from a qualitative study that was conducted over three years and employed both inductive and deductive techniques, the data from 22 client interviews were consolidated and then analysed. Seven themes related to service experience were identified: Awareness; Communication; Dependency; Expectations; Experience; Position; and Relationship. These themes provide insights that could assist service providers to better understand and facilitate interaction with their clients. The study highlights that clients with dementia wish to be given the opportunity to have input to the creation of their service. Itpoints out that service organizations need to develop tailored mechanisms that will allow this to occur; and the study provides information that could be used to facilitate the achievement of a responsive, client-centred community-based aged healthcare service. p. 539-554

Dementia timeline: Journeys, delays and decisions on the pathway to an early diagnosis
Here we present the timeline for those who reach a memory assessment service based on research conducted with 31 people living with dementia and 49 carers in one area of the UK. The study develops the findings of earlier timeline work by illuminating other stages on the journey as events and decision points. Two key stages of delay are exposed. Firstly, the period from first thinking something may be amiss to the point of first talking to someone about it. Secondly, the period from first talking to someone, to first contact with a healthcare professional (HCP). A third period emerged where delays may occur once contact with the healthcare system is made. The mean journey time from thinking that something may be amiss to beginning the formal process of diagnosis was around three years. On average there is a gap of about a year between thinking something may be amiss and first talking to a friend or family member about the problem. Further, it typically takes just under two and a half years for a person to move from thinking something may be amiss to first contact with a healthcare professional. The mean time from first contact with a healthcare professional to arrival at a memory assessment service was around 35 weeks; however, for 90% of people it was eight weeks or less. Implications for policies that aim to bring forward diagnosis are that the largest potential for achieving earlier diagnosis will be from encouraging people to contact healthcare professionals earlier. p. 555-570

Dementia in the family: Two Norwegian case studies
With increasing longevity the numbers of people suffering from dementia are rising. This development creates problems and dilemmas for public health care agencies as well as close relatives who are expected to provide care. This article is based on two Norwegian case studies of spouses and adult children who give care to elderly people – both males and females – with dementia. Nine families were included in these studies, and a total of 27 persons were interviewed (husbands, wives, sons and daughters). Central topics discussed in this article are the initial phases of the illness, the heavy demands of home care, and dilemmas associated with multiple caregiving roles. The analyses demonstrate the many challenges encountered by people with family members who suffer from dementia. p. 571-585

Accessibility in public space as perceived by people with Alzheimer’s disease
Most people with dementia remain living at home as long as possible after being diagnosed, and hence their lives also include activities in the public space. The aim of this study was to illuminate experiences of accessibility in public space in people with Alzheimer’s disease. A qualitative grounded theory approach with repeated in-depth interviews was used. The core category, accessibility as a constantly changing experience, was characterized by changes in the relationship between informants and public space. Changes in the relationship took place in activities and use of place and related to familiarity and comfort, individual motives and interests, and planning and protecting. Other changes occurred in places and problematic situations related to everyday technologies, crowded places with high tempo and noise, and change of landmarks. These changes reduced feelings of accessibility and increased difficulties in carrying out activities in public space. These findings may be helpful when providing support, and supporting community living. p. 587-602

Proverbs and formulaic sequences in the language of elderly people with dementia Some types of formulaic (routine and familiar) language seem to remain fairly intact in people with language and memory disturbances, making it a useful tool for both testing language skills and supporting language retention and use. Proverbs can reasonably be considered a subset of formulaic language, and while it is known that the ability to understand proverbs is compromised in dementia, completing them ought to be relatively easy, if proverbs are stored holistically like other kinds of formulaic language. However, this study reports how three people with dementia often struggled to complete proverbs in a game used in a day-care centre to stimulate the memory and language skills. By examining their responses and relating them to the causes of formulaic language patterns, it is argued that these games are not as appropriate a tool for stimulating memory and language skills as might be first thought. Although they do provide a much-needed opportunity for sustained patient-carer interaction that transcends the basic delivery of physical care needs, the games contravene some of the guidelines offered by Orange (2001) regarding the best way to support people with Alzheimer’s Disease in constructive interaction. p. 603-623

Use of the MMSE to screen for dementia in Delhi
Screening tools are created and administered within specific political, cultural and clinical contexts that problematize their supposed universality. This paper, drawing on interviews and participant observation undertaken in 2008 in New Delhi in India, examines how clinical environments influence the interpretations and use of the Mini Mental State Examination (MMSE), a popular screening instrument for dementia. Findings indicate that while doctors recognize the limitations of the MMSE in theory, its continued use in practice is because of time shortages and competing work demands. Yet misdiagnosis or even false-positive screening has implications for service delivery and quality of care. Further research is necessary into how diagnoses are made, which account for cultural and structural variance. p.625-635

Activities 2 Go Magazine

noreply@blogger.com (Janet de Bres) — Tue, 06 Dec 2011 04:36:00 +0000

The Library has a sample copy of this magazine which can be borrowed or you can check out a sample copy at http://www.weboflife.biz/freecopy.php
We are thinking of subscribing and we'd like your feedback.

Activities 2 Go is a resource magazine for Leisure and Lifestyle Staff, Diversional Therapists, Activities Coordinators and Occupational Therapists working in aged care facilities, hospitals and day centres. Each issue has an activity suggestion for every day of the month. Many of the activities are written to coincide with Australian National or International occasions including Easter, Mother’s Day and Remembrance Day, as well as internationally observed days like the International Day of the Older Person. In this way, the activities connect the clients with what’s happening in the broader community, and stimulate in them a continued interest in current affairs and events.

Regular segments include:
• List of Special Days
• Crosswords
• Wordsearches
• Quizzes
• Jokes and Riddles
• Puzzles for mental stimulation
• Brainteasers
• Word Games
• Movie Recommendations
• Craft
• Poetry / Short Stories
• Cooking
• Reminiscence
• Competitions
• Theme Days
• Forward Planning
• Multicultural Days
• Armchair Travel

If you are having difficulty accessing Library News: http://alzheimersnswlibrary.blogspot.com/
because of restricted access by your IT department or spyware try the following alternative web address: http://digbig.com/4sdps )

Journal of Dementia Care - Volume 19 Number 6 November/December 2011

noreply@blogger.com (Janet de Bres) — Thu, 01 Dec 2011 04:04:00 +0000

Full text articles are available to fee paying members of Alzheimer’s Australia NSW by emailing lis@alznsw.asn.au

Cinema: a sensory experience recognized by everyone
How a bit of research and creativity turned a small dark room into a cinema
p. 13

What works, and what we need to do to improve acute hospital care
The author reports on the RCN Dementia Project: Developing a commitment to care for people with dementia in general hospitals
p. 14-15

Collected short stories
Description of how life story work helped build relationships in a care home
p. 16-17

Nurse-led support improves dementia care at end of life
The authors report on the benefits of a nurse facilitation good end of life care for people with dementia in the community, including those in care homes
p. 18-19

Why creativity and dementia go together
Impairment of intellectual capacity in dementia can lead to the exploration of new growth pathways in the brain, forcing a re-evaluation of the way a person sees the world. In this journey ‘from the mind to the heart’, creativity has a chance to re-assert itself
p. 20-22

Making animated films with people with dementia
An introduction to Frames of Mind® an innovative method of using animation to work with people with dementia
p. 23-25

A discharge protocol: can it make a difference?
The authors explain how an NHS inpatient unit for people with dementia has improved its ways of working by having a discharge policy and protocol
p. 26-29

Raising awareness and mutual support: using the internet
The author has dementia with Lewy bodies, and is an active campaigner trying to raise awareness of dementia. One of the ways he does this is via the internet. In this article he talks about his experiences of using various websites and internet services
p. 30-32

Appetite for life: what can help improve the mealtime experience?
The author describes her review of studies on the mealtime experience for people with dementia in formal care settings. She focuses especially on what can help mealtimes to provide ‘food for the soul’ as much as they provide fuel for the body, and the importance of guidance and emotional support for the care staff.
p. 35-38

If you are having difficulty accessing Library News: http://alzheimersnswlibrary.blogspot.com/ because of restricted access by your IT department or spyware try the following alternative web address: http://digbig.com/4sdps )

Resources for activties staff

noreply@blogger.com (Janet de Bres) — Thu, 24 Nov 2011 02:51:00 +0000

Music, movement, mind & body : exercises for people suffering from Alzheimer's disease and related disorders [kit - CD and booklet]
written by Bridget Watson, illustrated by Victoria Peters
Music and exercise program designed specially for the person with dementia. In the book, the author describes a series of exercises which were developed with a group of approximately eight people suffering from dementia at a day care center. Each exercise is clearly described and illustrated and its benefit is outlined. Exercises are performed to the rhythm of the music on the accompanying CD. Suitable for use by caregiver and patient at home or with groups in care facilities. Many exercises can be done sitting in a chair.

Dementia things to do : activity ideas for carers
This resource outlines activities to use with people living with dementia from Aboriginal and Torres Strait Islander backgrounds. It aims to improve quality of life and reduce the impact of Behavioural and Psychological Symptoms of Dementia on carers. This resource has been developed by the Northern Territory Dementia Behaviour Management Advisory Service.

These resources are available for loan to members of AANSW - if you would like to reserve them please email the Library on lis@alznsw.asn.au

Books for carers

noreply@blogger.com (Janet de Bres) — Thu, 24 Nov 2011 01:30:00 +0000

Letting go without giving up : continuing to care for the person with dementia
by Jenny Henderson and Maureen Thom
The idea for Letting go without giving up grew from concerns expressed by carers who felt they were no longer allowed to have a role in caring for the person they had looked after at home after the person entered long-stay care. This booklet is aimed at carers who want to continue their involvement in the lives of the people they have cared for, even if they are no longer responsible for their day-to-day physical care needs.

My mother is my daughter
by Claire Laishley
A poignant and often humorous look at how their relationship changed when the author’s mother was diagnosed with Alzheimer’s.
Early one morning, I had a phone call from my mother's neighbour.
"We have your mother here - she says someone is going to kill her." Overnight, I lost the mother I knew and a stranger had taken her place. Dealing with her journey into dementia became more and more difficult for me - it was like a death but I was unable to mourn. While I could not change the situation, however, I could alter the way I viewed it. By reversing our roles, I could still maintain the family link, but not go through the futile exercise of looking for the mother I lost.

Losing my marbles
by Marian Penman
This is the fictional story of a woman's slow descent into Alzheimer's Disease. Susan Webster is a vibrant fifty-one-year-old, married to twenty-odd years to chauvinistic Nick. She has a family, a career and a lover. Then one Christmas she forgets to buy the turkey and sends everyone on a wild goose chase around the house looking for the present she thought she had bought for Nick.
From that moment, things go from bad to worse for Susan. her family's attempts at helping only cause further upsets and confusion compounding Susan's nightmare. As she faces her inner demons the other members of the family have their own personal dilemmas to try to resolve.

These resources are available for loan to members of AANSW - if you would like to reserve them please email the Library on lis@alznsw.asn.au

Information for healthcare workers

noreply@blogger.com (Janet de Bres) — Thu, 24 Nov 2011 00:55:00 +0000

Dementia : changes in the ability to live independently [poster]
This chart describes the stages through which dementia progresses, the corresponding mini-mental scores, and the accompanying changes in the ways a person with dementia will think, act, and move around.

Building belonging : celebrating inclusive communities [kit DVD and booklet]
UnitingCare Ageing
Building Belonging: Celebrating Inclusive Communities is a series of workshops delivered across Australia in Asset Based Community Development (ABCD) during 2009 to provide additional skills in how to practically begin engaging local communities to prevent isolation and promote community inclusion for older people
The 2 day workshops were presented by Ted Smeaton of Inspiring Communities. Ted has written, developed and implemented ABCD projects throughout Australia and Asia and is a member of Jody Kretzmann and John McKnight's Asset Based Community Development (ABCD) Institute, North Western University, USA.
ABCD defines assets as the wisdom, strengths, passions and gifts that each person has to contribute to community life.
WA representative for the project, Sharon James, says that "The concept behind them (the workshops) is about having a look at the assets we have in our communities. We can break it down smaller than suburbs and look in our own streets. There can be assets in terms of businesses or buildings or individuals."

Talking the talk but not walking the walk : barriers to person centred care in dementia
by Heather Hill
While the concept of person-centred care in dementia has been around for 15 years or more and has attracted much interest and enthusiasm, aged care facilities continue to have difficulty in actually implementing and maintaining person-centred practices. In this study I explore the experience of one aged care facility in order to identify the barriers to changing care practice. The research took place in an ethno-specific (Jewish) aged care facility, Star of David, which was in the process of setting up a program for its residents with dementia based on person-centred principles. The methodology used in the research study was ethnographic, involving participant observation and interview, with a particular focus on a limited number of participants: four residents and their families, four senior staff, four personal care attendants and the executive director. Interviews were also conducted with staff members from three other aged care facilities. The findings showed that Star of David was unable to bring about substantial change in its care practices, while the external interviews and the literature suggest that other facilities have similar difficulties. I identify three major types of barrier: procedural barriers within the institution itself; (government) policy; and barriers relating to hegemonic values and beliefs which underpin established health care practice. These three types of barrier interact with and reinforce one another. I conclude that if we are to change care practice in institutions, we must address all of these barriers at the same time. Finally, I suggest that person-centred care itself, which continues to place emphasis on professional service provision, may only be the beginning of necessary change. In order to be truly person-centred, we need to move towards a more community based or public health approach which recognizes the need of all persons to be treated both as significant individuals and accepted as part of a community.

Capacity and the Law
by Nick O’Neill and Carmelle Peisah
With the ageing of society and the associated onslaught of neurodegenerative diseases such as dementia, and the increasing awareness of the needs and human rights of those with intellectual disability, head injury and mental illness, there has been an emerging recognition of the importance of decision-making capacity. The need for capacity to be understood and for the parliaments and the judges to respond appropriately and justly to the needs of those who have lost capacity became apparent last century. In Australia, the parliaments created new institutions including guardianship tribunals, offices of public guardians. They also broadened the role of public trustees. The judges began to develop the common law to respond to the newly developing circumstances. Those institutions, the statute law and the common law (judge-made law) continue to develop in the 21st century. This is the first book to deal comprehensively with the issue of capacity and the common law and statute law in Australia over a wide range of the situations in which questions of capacity arise.

Principles of neurology [CD-ROM kit]
by Raymond D Adams
Includes full text, tables, illustrations, and index of the texbook Principles of Neurology, by Raymond D. Adams, Maurice Victor, Allan H. Ropper, plus over 230 questions and answers from Joseph H. Friedman and James D. Duffy's Psychiatry/neurology PreTest, referenced to the text. Also includes over 90 additional illustrations, Medline abstracts of selected references, and hot links within the text

These resources are available for loan to members of AANSW - if you would like to reserve them please email the Library on lis@alznsw.asn.au

Reports related to aged care and dementia

noreply@blogger.com (Janet de Bres) — Wed, 23 Nov 2011 23:39:00 +0000

These resources are available for loan to members of AANSW - if you would like to reserve them please email the Library on lis@alznsw.asn.au

Metro North Region NSW Department of Ageing, Disability and Home Care planning framework
New South Wales. Dept of Ageing, Disability and Home Care
Frameworks for : Section 1: Northern Sydney local planning area -- Section 2: Manly, Warringah and Pittwater local government areas -- Section 3: Hornsby and Ku-ring-gai local government areas -- Section 4: Lower North Shore local government areas -- Section 5: Ryde and Hunters Hill local government areas.
Contents include for each area: Planning framework; 1. Area profile -- 1.1 Geography -- 1.2 Population; 2. Service mapping -- 2.1. Home and Community Care (HACC) Services -- 2.2 Commonwealth State Territory Disability Agreement (CSTDA) Services; 3. Service outputs; 4. Funding 4.1 Recent HACC funding -- 4.2 Recent CSTDA/Stronger Together Funding -- 5. Local and state government information -- 6. Appendices.

Australia's health 2010 : the twelfth biennial health report of the Australian Institute of Health and Welfare
Introduction· The health of Australians: an overview· Determinants: keys to prevention· Diseases and injury· Whose health? How population groups vary· Health across the life stages· Health services· Expenditure and workforce· Australia's health performance· Methods and conventions.

Residential aged care in Australia 2009-10: a statistical overview
Australian Institute of Health and Welfare
Residential aged care in Australia 2009-10 provides comprehensive statistical information on residential aged care facilities, their residents, admissions and separations, and residents' dependency levels. At 30 June 2010, there were nearly 183,000 residential aged care places, an increase of almost 3% compared with 30 June 2009. Over 83,500 permanent residents (52%) had a recorded diagnosis of dementia at 30 June 2010. Other recorded health conditions included circulatory diseases (40,000 residents) and diseases of the musculoskeletal and connective tissue (27,500 residents).

The hospital dementia services project : a study description
Australian Institute of Health and Welfare
People with dementia have comparatively high rates of hospitalisation. Their relatively high case mix complexity contributes to longer hospital stays, which has an impact on their physical and mental state. Research shows that well-designed and targeted services have improved the quality of care for people with dementia. However, few studies have investigated patient outcomes using integrated information about health services and aged care provision at the regional level.
The Hospital Dementia Services Project aims to inform health practitioners, health and aged care policy makers and planners, and consumers of how system factors influence care outcomes for patients with dementia. It will achieve this by investigating the extent to which different types, mixes and levels of hospital-based aged care and dementia services are associated with patient outcomes (e.g. death, admission to residential aged care) while accounting for provision levels of community-based (i.e. non-hospital) aged care services.

Caring places : planning for aged care and dementia 2010-2050 : Volume 1
by Access Economics for Alzheimer's Australia
One consequence of an ageing Australian population is the need for an aged care system that can respond to the needs of the older person, their families and carers. However, the current aged care system needs fundamental reform if the supply of community and residential care are to keep pace with the projected demand for care, while at the same time providing increased choice. Alzheimer’s Australia commissioned Access Economics to model different scenarios for the supply of aged care, to identify strategies to increase consumer choice and to promote service
flexibility, and to identify funding options for a sustainable aged care system into the future.

Caring places : planning for aged care and dementia 2010-2050 : Volume 2
by Access Economics for Alzheimer's Australia
The purpose of Volume 2 of Caring Places: Planning for aged care and dementia 2010-2050 is to project the future requirements for aged care places and packages at the jurisdictional level, Aged Care Planning Regions (ACPRs), and Commonwealth Electoral Divisions (CEDs). It detailed projections of aged care supply according to current aged care planning policy (which is based on the proportion of the population aged 70 and over), and compares these with projections based on the supply of aged care services under two growth scenarios. The first growth scenario estimates the supply of aged care if planning were driven by increases in the population aged 85 and over (the highest users of aged care). This coincides with demographic planning recommended by the National Health and Hospital Reform Commission (NHHRC, 2009). The growth second scenario estimates the supply of aged care if planning were based on the projected growth in the prevalence of dementia in Australia over the next 40 years.
Both supply scenarios are expected to strongly correlate with the future increase in demand for aged care services. Consequently, ‘deficits’ between the projected supply of aged care services under the current aged care planning ratio and the two growth scenarios represent potential gaps in the demand for aged care services in the future. To summarise findings, current aged care planning policy will result in a substantial increase in the number of aged care places and packages between 2010 and 2050. However, the projected supply of aged care under both scenarios indicates that this increase in aged care supply will fall well short of demand.

If you are having difficulty accessing Library News: http://alzheimersnswlibrary.blogspot.com/ because of restricted access by your IT department or spyware try the following alternative web address: http://digbig.com/4sdps )

Nutrition and Alzheimer's disease - increasing appetite using aquariums!

noreply@blogger.com (Michelle) — Fri, 18 Nov 2011 02:07:00 +0000

If you would like the full text article or the DVD email lis@alznsw.asn.au
Animal-Assisted Therapy and Nutrition in Alzheimer’s Disease

by Nancy E. Edwards andAlan M. Beck

This studye xamined the influence of animal-assisted therapy, specificallyf ish aquariums, on nutritional intake in individuals with Alzheimer’s disease (AD). Sixty-two individuals with AD who lived in specialized units were studied. Baseline nutritional data were obtained followed by a 2-week treatment period when the aquariums were introduced. The treatment data were collected dailyfor 2 weeks then weeklyfor 6 weeks. Nutritional intake increased significantly (21.1%; p < .001) when the aquariums were introduced and continued to increase during the 6- week weeklyfollow-up. Weight increased significantly(1.65 lbs; p < .001) over the 16-week period. In addition, participants required less nutritional supplementation, resulting in health care cost savings.

American Journal of Alzheimer's Disease and Other Dementias - August 2011

noreply@blogger.com (Janet de Bres) — Thu, 17 Nov 2011 01:34:00 +0000

Full text articles are available to fee paying members of Alzheimer’s Australia NSW by emailing lis@alznsw.asn.au

CONTENTS
Review of issue
Diagnosing and Managing Alzheimer’s Disease, Distinguishing Posterior Variants of Dementia and the Usefulness of Exercise
p. 355-356

Validity, Reliability, and Feasibility of Clinical Staging Scales in Dementia A Systematic Review
New staging systems of dementia require adaptation of disease management programs and adequate staging instruments. Therefore, we systematically reviewed the literature on validity and reliability of clinically applicable, multidomain, and dementia staging instruments. A total of 23 articles describing 12 staging instruments were identified (N = 6109 participants, age 65-87). Reliability was studied in most (91%) of the articles and was judged moderate to good. Approximately 78% of the articles evaluated concurrent validity, which was good to very good, while discriminant validity was assessed in only 25%. The scales can be applied in ±15 minutes. Clinical Dementia Rating (CDR), Global Deterioration scale (GDS), and Functional Assessment Staging (FAST) have been monitored on reliability and validity, and the CDR currently is the best-evidenced scale, also studied in international perspective, and is available in 14 languages. Taking into account the increasing differentiation of Alzheimer’s disease in preclinical and predementia stages, there is an urgent need for global rating scales to be refined as well.
p. 357-365

Treating Sleep Problems in Dementia Caregivers Based on Parent-Child Interventions
Background: Interventions developed for improving sleep in parents of young children or in developmentally delayed children might also prove effective for persons with dementia and their caregivers. Methods: We selectively reviewed the literature for interventions effective in improving sleep in parents of young children or in developmentally delayed children. Results: Graduated extinction and adult fading have been minimally explored in dementia populations. They are fairly brief and could be administered during primary care or dementia clinic visits. Combination strategies such as extinction and sleep-enhancing medication are very effective and may be applicable for persons with dementia and their caregivers. Physical capabilities and degree of cognitive decline of patients with dementia must be considered, and medical staff and caregivers should adjust behavioral strategies to maximize the use of patients' intact cognitive abilities. Conclusions: Interventions for divergent populations prone to similar problems as those of patients with dementia might be effective and advance existing research.
p. 366-372

Psychometric Evaluation of a Proposed Alzheimer’s Aggression Scale
The purpose of this study was to evaluate a popular measure of Alzheimer’s disease (AD) memory and behavior problems and to determine whether its aggressive behavior items coalesced empirically as a subscale to form a psychometrically viable AD aggression measure for clinicians. Data from self-report questionnaires were examined from 419 informal AD caregivers in the southern United States. Principal axis factoring revealed a unidimensional solution with robust item loadings on the single factor. Three forms of reliability analysis indicated moderately strong internal consistency on this proposed measure. Evidence of convergent validity analysis was suggested via the measure’s significant correlations to theoretically linked constructs. The proposed measure emerged as a reliable and valid tool for health care practitioners for the appraisal of problematic AD aggression behaviors from the caregiver perspective.
p. 373-380

Six-Month Walking Program Changes Cognitive and ADL Performance in Patients With Alzheimer
Motor inactivity is typical in the later stages of Alzheimer’s disease although there is evidence that physical exercise can reduce depression and enhance performance of daily activities. The aim of this study was to determine whether a walking program could reduce the functional and cognitive decline of elderly nursing home residents in the later stages of Alzheimer’s disease. A total of 21 patients (84 ± 5 years) were randomly assigned to a walking program (WG) or to a control group (CG). A 6-minute walking test (6WT), the Barthel index of activities of daily living (ADLs), and Mini-Mental State Examination (MMSE) tests were performed before and after 24 weeks of the program. The WG showed significant improvement in the 6WT (20%) and ADLs (23%), while the CG decreased in MMSE (−47%), the WG had a slower decline (−13%). This study indicates that it is possible to stabilize the progressive cognitive dysfunctions in nursing home residents with Alzheimer’s disease through a specific walking program.
p. 381-388

Mattis Dementia Rating Scale 2
Screening for MCI and Dementia
Identifying patients at higher risk of developing dementia is important. The usefulness of the Mattis Dementia Rating scale-Second Edition (MDRS-2) to detect and differentiate between patients with amnestic mild cognitive impairment (A-MCI), Parkinson’s disease and MCI (PD-MCI), PD with dementia (PDD), and Alzheimer’s disease (AD) was investigated. In all, 22 healthy controls (HC), 22 A-MCI, 22 PD-MCI, 16 PDD, and 22 AD patients were evaluated using an extensive neuropsychological battery, including the MDRS-2. The MDRS-2 total standardized score detected all groups of patients. The dementia groups performed worse than HC on the 5 MDRS-2 subscales. Alzheimer’s disease patients scored higher than PDD on MDRS-2 conceptualization and lower on memory. Healthy controls were better than PD-MCI on MDRS-2 initiation/perseveration and memory and better than A-MCI on memory. No difference was found between the MCI groups. The MDRS-2 is a suitable short scale for MCI and dementia screening but is not specific enough to differentiate between A-MCI and PD-MCI.
p. 389- 398

Mild Hypercholesterolemia, Normal Plasma Triglycerides, and Normal Glucose Levels Across Dementia Staging in Alzheimer’s Disease
A Clinical Setting-Based Retrospective Study
We examined retrospectively the concurrent relationships between fasting plasma total cholesterol, triglycerides, and glucose levels, and Alzheimer’s disease (AD), in a clinical setting-based study. Total cholesterol level was higher in patients with AD compared to elderly controls; triglycerides or glucose levels did not significantly differ between the 2 groups. Respective plotted trajectories of change in cholesterol level across age were fairly parallel. No significant difference in total cholesterol levels was recorded between patients with AD classified by the Clinical Dementia Rating (CDR) score subgroups. These results suggest that patients with AD have relative mild total hypercholesterolemia, normal triglyceridemia, and normal fasting plasma glucose level. Mild total hypercholesterolemia seems to be permanent across age, and across dementia severity staging, and fairly parallels the trajectory of age-related change in total cholesterolemia of healthy controls. We speculate that these biochemical parameters pattern may be present long before—a decade at least—the symptomatic onset of the disease.
p. 399-405

Maintaining Physical Fitness and Function in Alzheimer’s Disease
A Pilot Study
Background: Little is known about how aerobic exercise affects physical functioning in persons with Alzheimer’s disease (AD). Methods: This pilot study used a 1-group repeated measures design to examine the feasibility and impact of a 6-month individualized moderate intensity cycling intervention on cardiorespiratory fitness and lower extremity function in 8 participants aged 81.4 ± 3.58. Cardiorespiratory fitness was measured using the shuttle walk and modified YMCA cycle ergometer tests, and lower extremity function was measured using the Short Physical Performance Battery (SPPB) at baseline, 3 months and 6 months. Results: The YMCA test showed a significant reduction in heart rate at stage 2 (103.4 vs 90.9 vs 91.6; P = .01), while no significant changes were observed in the shuttle walk and SPPB tests. Conclusions: Persons with AD are able to improve cardiorespiratory conditioning from aerobic exercise. Randomized, controlled trials are needed to confirm these findings. Implications for future research are detailed.
p. 406-412

Posterior Cortical Atrophy
Evidence for Discrete Syndromes of Early-Onset Alzheimer’s Disease
Background: Posterior cortical atrophy (PCA) may represent a discrete syndrome of Alzheimer’s disease (AD) rather than amnestic AD with visual deficits. Methods: We separated 30 patients with PCA based on ventral and dorsal visual symptoms using cluster analysis and analyzed the demographic, cognitive, and functional imaging features. Results: This analysis revealed subgroups of 26 dorsal and 4 ventral patients. The ventral subgroup had greater confrontational naming impairment, and the dorsal subgroup had greater hypofunction in the parietal regions. The PCA cohort had memory retrieval rather than encoding deficits, and clinical follow-up showed relative isolation of dorsal and ventral visual manifestations. Conclusion: These results support 2, mostly nonoverlapping syndromes in patients with PCA, with the commonest affecting the dorsal visual pathway; moreover, the memory retrieval difficulty in the patients with PCA was dissimilar to the amnestic pattern in typical AD. These results suggest that, in most cases, PCA syndromes are discrete clinical variants of AD.
p. 413-418

News Briefs
Inherited Alzheimer’s detectable 20 years
before dementia

Keeping up your overall health may keep
dementia away

Study demonstrates how memory can be
preserved – and forgetting prevented

Advances in research into Alzheimer’s disease
Transporter proteins at the blood CSF barrier and vitamin
D may help prevent amyloid beta build-up in the brain

Study helps explain ‘sundowning,’ an anxiety
syndrome in elderly dementia patients

Alzheimer’s prevention in your pantry
Tel Aviv University researcher discovers a cinnamon
extract to inhibit progression of Alzheimer’s disease

Natural Alzheimer’s weapon suggests better
Treatment

Dietary changes appear to affect levels of
biomarkers associated with Alzheimer’s
disease

p. 419-424

If you are having difficulty accessing Library News: http://alzheimersnswlibrary.blogspot.com/ because of restricted access by your IT department or spyware try the following alternative web address: http://digbig.com/4sdps )

More Positive Research on Nutrition Intervention for Alzheimer's Disease

noreply@blogger.com (Michelle) — Wed, 16 Nov 2011 21:24:00 +0000

...a patented combination of vitamins and other nutrients (Fortasyn Connect, NV Nutricia) designed to promote the synthesis of new brain synapses....

The results of a clinical trial called Souvenir II, released here at the 4th International Conference on Clinical Trials in Alzheimer's Disease (CTAD), suggest that daily intake of Souvenaid improves memory in drug-naive patients with mild Alzheimer's disease (AD) up to 24 weeks.

However, the study only included results related to memory function, with no electroencephalogram (EEG) confirmation of brain changes. Further, other research released at the meeting seemed to indicate that the medical food does not work in patients with more severe AD who are already taking medications.
"I would be cautious at this point," said lead researcher Philip Scheltens, MD, PhD, professor of cognitive neurology and director, Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands. "I think we need some further studies. We need to see the effects in the brain."
for the full text article email lis@alznsw.asn.au