The development of quality indicators to improve psychosocial care in dementia.

Background: The evidence for the effectiveness of psychosocial interventions in dementia care is growing but the implementation of available evidence is not automatic. Our objective was to develop valid quality indicators (QIs) for psychosocial dementia care that facilitate the implementation process in various countries and settings.

Methods: A RAND-modified Delphi technique was used to develop a potential set of QIs.

The world of dementia beyond 2020.

Counterpoised against dire projections of the tripling of the prevalence of dementia over the next 40 years are major developments in diagnostic biomarkers, neuroimaging, the molecular biology of Alzheimer's disease (AD), epidemiology of risk and protective factors, and drug treatments-mainly targeting the amyloid pathway, tau protein, and immunotherapy-that may have the potential to modify the progression of AD. Drug combinations and presymptomatic treatments are also being investigated. Previous trials of dementia-modifying drugs have not shown benefit, and even if current Phase III trials prove successful, these drugs will not eradicate other dementias, could (if not curative) increase dementia duration and prevalence, and are unlikely to come onto the market before 2020.

Impact of hip fracture, heart failure and weight loss on the risk of institutionalization of community-dwelling patients with dementia.

Objectives: This study sought to identify the influence of medical symptoms and diseases on the risk of nursing home placement in a prospective cohort of newly diagnosed community-dwelling patients with dementia.

Study Design And Setting: This study included 348 patients with dementia, consecutively diagnosed, recruited and followed at a geriatric outpatient center (mean age: 81 years, 65.5% with Alzheimer's disease, mean baseline MMSE score: 20.

[Non pharmacological interventions in dementia: a review and prospect].

Non pharmacological interventions in Alzheimer's disease and related disorders are a growing area of research. If, to date, the limited number of randomized controlled trials, the small size of the samples, the variable degree of precision of the interventions provide limited evidence of the efficacy of such interventions, some appear most promising: among cognitive interventions, individualized cognitive rehabilitation strategies, among emotion-oriented interventions, reminiscence therapy, and among interventions designed for carers, those who include interventions with the patients present, to date, the most reliable data. Among the environmental and behavioral interventions, the very promising results of behavioral therapies for carers in the treatment of depression, as well as of behavioral techniques in improving the relationship between staff members and residents in challenging care situations (bathing) are emphasized.

Major depression as a risk factor for early institutionalization of dementia patients living in the community.

Objective: Although depression is known to be frequently associated with dementia, it is nonetheless under-diagnosed and under-treated among this patient population. Its effect on outcome for dementia patients is thought to be substantial, because depression appears to induce higher than normal rates of disability as well as supplementary cognitive decline. The aim of this study was to measure the impact of major depression on the institutionalization rate of community-dwelling dementia patients.