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


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


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


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


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


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...]

Pain causing challenging behaviour in people with dementia is overlooked and under-treated


A new review by Pieper et al 2013 aims to provide a comprehensive overview of the research on treatments for both pain and challenging behaviour in people with dementia. It hinges around the fact that pain is commonly undertreated because it is not easy to recognise unless there is a diagnosed physical cause, and also because [read the full story...]

Dementia and the drive to increase diagnosis rates: the debate goes on


As part of its excellent ‘Too Much Medicine’ series, the British Medical Journal last week published an important analysis of the current direction of travel in the field of dementia care. The article is hard to ignore, written as it is by highly authoritative academics from the UK and Australia, including Professor Carol Brayne, an [read the full story...]

Measuring treatment effects in dementia studies: towards a consistent approach


It is now well accepted across the health and social care communities that the incidence of dementia is rising as people continue to live longer. The projected prevalence of dementia over the next ten to twenty years is causing widespread concern at all levels of policy making and care provision. There is a very real [read the full story...]

Helping patients and carers deal with a diagnosis of dementia: one size doesn’t fit all

Senior couple taking medication

Early diagnosis and intervention for people with dementia is increasingly considered a priority.  But there are still considerable barriers to achieving this, and nervousness from practitioners on the possible negative effect of earlier diagnosis of a condition widely perceived as untreatable and life-changing. A recent systematic review by Bunn et al analysed the qualitative evidence [read the full story...]

Perceived freedom of choice and the experiences of carers of older adults with mental health problems

Freedom of choice

Family and friends often play a very important role in supporting older people with long-term, severe mental health problems. It is estimated that 25% of the 6 million carers in the UK are supporting someone with a mental health problem (Carers Trust, 2007). Stress has been cited as having a major impact on the wellbeing [read the full story...]