What should we prescribe for neuropsychiatric symptoms in Alzheimer’s disease?

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Psychiatrist Andrés Fonseca considers how his clinical practice should change, after reading a systematic review and meta-analysis of drug treatment for neuropsychiatric symptoms in Alzheimer’s disease

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Dementia through the eyes of a carer: What would you want for your relative?

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Josephine Neale summarises a recent review of qualitative evidence that finds carers’ views are mixed and lie on a spectrum of acceptance of their relative as actively dying with dementia.

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Which (if any) drugs should we use for agitated or aggressive behaviour in dementia?

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This is a dilemma I frequently face when I am called out to see someone with dementia on the ward or living in a nursing home. On the one hand I am thinking that anything I use can potentially have serious side-effects and will probably lead to increased health risks and increased mortality. On the [read the full story...]

Cochrane review finds no good quality evidence for common medicines used to treat sleep problems in Alzheimer’s Disease

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People with dementia caused by Alzheimer’s Disease (ADD) (which is estimated to be around three quarters of people with dementia) often suffer from sleep disturbances.  These symptoms cause distress to the person with dementia and to their carers, increase the likelihood of admission to a care home, and are also very difficult for care home [read the full story...]

Are there any effective interventions for preventing falls in older people with mental health problems?

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Falls are estimated to cost the NHS more than £2.3 billion per year (College of Optometrists, 2011) and are associated with significant morbidity and mortality. This fact alone should be giving us the drive to look for ways to prevent falls in healthcare settings. A systematic review recently published in BMC Nursing (Bunn et al, 2014) is [read the full story...]

Psychological treatment may be useful in reducing depression and anxiety in people with dementia, says new Cochrane review

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Depression and anxiety are both common conditions in patients with dementia and mild cognitive impairment (MCI), with some studies finding around 30% of patients show at least some depressive symptoms (Enache et al, 2011). Similarly, a study on vascular dementia found around 70% of participants had two or more symptoms of anxiety (Ballard et al, 2000). [read the full story...]

Dealing with a diagnosis of dementia: putting a systematic review into context

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Last July I wrote a blog (Helping patients and carers deal with a diagnosis of dementia: one size doesn’t fit all) about a systematic review of qualitative evidence (Bunn, 2012) relating to patients and carers experiences of reaching and adapting to a diagnosis of dementia.  That blog was heavily influenced by personal experience of my [read the full story...]

Reality orientation and skills training may improve cognition in dementia, but don’t jump to conclusions

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Well this is an interesting one. The abstract of a recent review by Carrion et al concludes that cognitive psychosocial interventions such as reality orientation and skills training improve cognition (Carrion, 2013). Woohoo, I thought; fantastic!  And then I read the review… Methods The authors searched the usual bibliographic databases for randomised and non-randomised controlled trials, [read the full story...]

Exercise may help older people with dementia, but more research is needed

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Many of our older readers will remember tales of the Great Elf Mother running miles every day, o’er hills and vales, to bring the very latest evidence-based research to us younger elves at the breakfast table. It was she who inspired our National Elf Service, and I’m delighted to say that she’s still going strong [read the full story...]