Unmet needs, quality of life and support networks of people with dementia living at home.

Background: There is lack of evidence about the unmet needs of people with dementia (PWD) living at home and the predictors of high levels of unmet needs. The main aim of this study was to identify the relationship between unmet needs, social networks and quality of life of PWD living at home.

Methods: One hundred and fifty two community dwelling PWD and 128 carers were interviewed about PWD's needs, social networks, quality of life and other functional and psychological factors.

GPs' attitudes, awareness, and practice regarding early diagnosis of dementia.

Background: In primary care, the diagnosis of dementia is often delayed and the 2007 National Audit Office Report concluded action was needed to improve patient care and value for money.

Aim: To investigate the attitudes, awareness, and practice of GPs in England regarding early diagnosis and management of patients with dementia, and perceptions of local specialist services, to identify training or support needs.

Design Of Study: Secondary analysis of survey data that capture the above attitudes, awareness, and practice.

Nonpharmacological therapies in Alzheimer's disease: a systematic review of efficacy.

Introduction: Nonpharmacological therapies (NPTs) can improve the quality of life (QoL) of people with Alzheimer's disease (AD) and their carers. The objective of this study was to evaluate the best evidence on the effects of NPTs in AD and related disorders (ADRD) by performing a systematic review and meta-analysis of the entire field.

Methods: Existing reviews and major electronic databases were searched for randomized controlled trials (RCTs).

Using a biopsychosocial model of dementia as a tool to guide clinical practice.

Background: Over the years, a number of non-medical and psychosocial explanations and models of dementia have been proposed, due to the complex nature of the illness. However, there is a need for a more pragmatic, user-friendly model which takes into account the biological, psychological and social processes.

Methods: Existing models of dementia were amalgamated into a revised, pragmatic model which aims to increase our understanding of the factors that may lead to improvement or deterioration in dementia and to illustrate the role of psychosocial factors in the context of biological processes.

Maintenance Cognitive Stimulation Therapy (CST) for dementia: a single-blind, multi-centre, randomized controlled trial of Maintenance CST vs. CST for dementia.

Background: Psychological treatments for dementia are widely used in the UK and internationally, but only rarely have they been standardised, adequately evaluated or systematically implemented. There is increasing recognition that psychosocial interventions may have similar levels of effectiveness to medication, and both can be used in combination. Cognitive Stimulation Therapy (CST) is a 7-week cognitive-based approach for dementia that has been shown to be beneficial for cognition and quality of life and is cost-effective, but there is less conclusive evidence for the effects of CST over an extended period.

People with dementia living alone: what are their needs and what kind of support are they receiving?

Background: In the U.K. about 141,460 people with dementia (PWD) live alone.

Empowerment in older psychiatric inpatients: development of the empowerment questionnaire for inpatients (EQuIP).

Objective: To develop a questionnaire that measures levels of empowerment experienced by older adults admitted to a psychiatric ward.

Design: Diverse views were sought to inform the questionnaire through a triangulation method; opinions of researchers were collected through a Delphi survey, clinical staff from different disciplines completed questionnaires, and patients participated in two focus group sessions. Once the questionnaire was developed, the authors asked patients to complete it alongside other instruments.

User, carer and staff perspectives on anxiety in dementia: a qualitative study.

Background: Anxiety is extremely common in dementia and can lead to social exclusion, excess disability and associated problems including high physical dependency, problems in the patient/carer relationship, and increased cognitive and behavioural difficulties. Despite this, there is little research on the detection or management of anxiety in dementia, and nothing from the perspective of people with dementia or their carers.

Methods: This study aimed to conceptualize users', carers' and staff views on the causes and management of anxiety in dementia.

Cognitive Stimulation Therapy (CST): effects on different areas of cognitive function for people with dementia.

Background: There is good evidence indicating that group Cognitive Stimulation Therapy (CST) leads to generalised cognitive benefits for people with dementia. However, little is known about whether some aspects of cognition might change more than others and why.

Methods: Cognitive Stimulation Therapy, a 14-session group treatment, has been evaluated in a multi-centre, single-blind, randomised controlled trial.

Changes in the quality of life of people with dementia living in care homes.

Quality of Life (QoL) is now an established outcome measure for people with dementia. There is a need to understand if measures are sensitive to change and what factors are associated with change in QoL in dementia to develop interventions to improve QoL and identify who may be most likely to benefit. This study aimed to assess change in QoL in people living in 24-hour care homes using the Quality of Life-Alzheimer's Disease (QOL-AD) scale and investigated which clinical factors predicted changes in QoL in dementia.

Reminiscence groups for people with dementia and their family carers: pragmatic eight-centre randomised trial of joint reminiscence and maintenance versus usual treatment: a protocol.

Background: The growing number of people with dementia, and the increasing cost of care, provides a major incentive to develop and test methods of supporting them in the community for longer. Most attention has been given to pharmacological interventions, but there is increasing recognition that psychosocial interventions may be equally effective, even preferable where medication has negative side-effects. Reminiscence groups, run by professionals and volunteers, which use photographs, recordings and other objects to trigger personal memories are probably the most popular therapeutic approach to working with people with dementia, but there is little evidence for their effectiveness and cost-effectiveness.

Identifying need in care homes for people with dementia: the relationship between two standard assessment tools.

Considerable effort has been invested in improving assessment processes for older people, some of the most vulnerable of whom live in care homes. The paper compares two well-known assessment tools used in care homes, the CANE and the Minimum Data Set/Resident Assessment Instrument. There was poor agreement between the tools in terms of domains of need covered.

Validation study of the Camberwell Assessment of Need for the Elderly (CANE) in Portugal.

Background: The Camberwell Assessment of Need for the Elderly (CANE) is widely used for multidimensional evaluation of older people with mental health problems. The aim of this study was to evaluate reliability and validity of a Portuguese version of CANE.

Method: A cross-sectional multicenter study was designed using a convenience sample of elderly mental health services' users.

What is meaningful activity for people with dementia living in care homes? A comparison of the views of older people with dementia, staff and family carers.

Background: Older people with dementia living in care homes often lack appropriate activities. Although homes are expected to offer a range of activities to meet residents' needs, little is known about what makes activities meaningful for people with dementia. This study explores concepts of meaningful activity, as defined by older people with dementia living in care homes, staff and family carers.

Cognitive stimulation for the treatment of Alzheimer's disease.

In recent years, there has been an increase in the recognition and use of psychosocial interventions for dementia. This has coincided with an increase in high-quality research in the area, and restrictions in the use of drug therapies for Alzheimer's disease in the UK. Cognitive stimulation therapy (CST) is a brief group treatment for people with mild-to-moderate dementia, based on the theoretical concepts of reality orientation and cognitive stimulation.

The needs of people with dementia in care homes: the perspectives of users, staff and family caregivers.

Background: People with dementia in care homes are at risk of having their views ignored and decisions are often made on their behalf by care home staff and family carers. The aim of this study was to compare the ratings of needs of older people with dementia living in care homes, as assessed by the older person themselves, a family caregiver, and the staff of the care home.

Method: The Camberwell Assessment of Need for the Elderly (CANE) was completed for 238 residents with dementia by care staff.

Assessing the validity and reliability of the Pool Activity Level (PAL) Checklist for use with older people with dementia.

Activity is key to maintaining physical and mental health and well-being. However, as dementia affects the ability to engage in activity, care-givers can find it difficult to provide appropriate activities. The Pool Activity Level (PAL) Checklist guides the selection of appropriate, personally meaningful activities.

Coping strategies, anxiety and depression in caregivers of people with Alzheimer's disease.

Objectives: There have been few longitudinal studies investigating the impact of coping on psychological morbidity in caregivers of people with dementia. Findings have been inconsistent and little attention has been paid to anxiety in caregivers. We explored the hypothesis that the relationship between caregiver burden and anxiety and depression is mediated by coping style.

A European consensus on outcome measures for psychosocial intervention research in dementia care.

Psychosocial intervention makes a vital contribution to dementia care. However, the lack of consensus about which outcome measures to use to evaluate effectiveness prevents meaningful comparisons between different studies and interventions. This study used an iterative collaborative, evidence-based approach to identify the best of currently available outcome measures for European psychosocial intervention research.

Does the patient-centred approach help identify the needs of older people attending primary care?

Objectives: To investigate the effect of a general practitioner's 'patient centredness' on identification of unmet needs in older adults.

Design: Correlational questionnaire based study with a descriptive element.

Setting: Two south London general practice surgeries.

WITHDRAWN: Reality orientation for dementia.

Background: Reality Orientation (RO) was first described as a technique to improve the quality of life of confused elderly people, although its origins lie in an attempt to rehabilitate severely disturbed war veterans, not in geriatric work. It operates through the presentation of orientation information (eg time, place and person-related) which is thought to provide the person with a greater understanding of their surroundings, possibly resulting in an improved sense of control and self-esteem. There has been criticism of RO in clinical practice, with some fear that it has been applied in a mechanical fashion and has been insensitive to the needs of the individual.

A cluster randomised controlled trial to reduce the unmet needs of people with dementia living in residential care.

Background: Older people with dementia living in residential care have complex unmet needs and decreased quality of life.

Aim: To reduce unmet needs in older people with dementia in residential care compared to a 'care as usual' control group.

Method: A single blind, multicentre, cluster randomised controlled trial recruited 238 people aged 60+ with dementia living in 24 residential homes from three areas.

Quality of life in dementia: care recipient and caregiver perceptions of quality of life in dementia: the LASER-AD study.

Background: Quality of Life (QoL) is a key outcome in dementia.

Aim: To compare care recipients' (CR) and caregivers' (CG) views on CRs' QoL and identify determinants.

Methods: CRs and CGs completed the Quality of Life - Alzheimer's Disease (QOL-AD) scale.

Quality of life (QoL) in dementia: a comparison of the perceptions of people with dementia and care staff in residential homes.

Evaluating quality of life (QoL) in people with dementia has become increasingly valued, for example in assessing the effectiveness of interventions or making treatment decisions. This study compared the QoL of people with dementia as assessed by the individuals and their care staff, and possible factors associated with the discrepancy between ratings. Seventy-six dyads of people with dementia and care staff in 9 residential homes were recruited.