Dementia in older age: barriers to primary prevention and factors

Evidence review showing that changing some behaviours in midlife can reduce the chances of getting dementia in older age | PHE

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These documents help commissioners and researchers make decisions about prioritisation of primary prevention measures relevant to dementia.

This review, by the Personal Social Services Research Unit (PSSRU) at the London School of Economics and Political Science (2016), shows that there is evidence that the risk of dementia is increased by:

  • physical inactivity
  • current smoking
  • diabetes
  • hypertension in mid-life
  • obesity in mid-life and depression

It also shows that mental activity can reduce the risk of dementia.

To promote primary prevention of dementia, it is important to understand both the barriers to primary prevention and factors which facilitate primary prevention.

Read the full overview here

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Monthly announcement of national dementia diagnosis rate

Alistair Burns, NHS England’s clinical director for dementia has written to CCGs with an update on national priorities and the latest dementia diagnosis figures, for April 2017 | NHS England

The monthly CCG letters can be found below with the national dementia diagnosis rates alongside general updates on national priorities. Commissioners are asked to cascade this information to member practices.

General practitioners’ practices when suspecting cognitive impairment

General practitioners (GPs) play a major role in the assessment of dementia but it is still unrecognized in primary care and its management is heterogeneous | Aging & Mental Health

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Objective: Our objective is to describe the usual practices, and their determinants, of French GPs in this field.

Results: Hundred two GPs completed the study. GPs were in majority men, working in urban areas. Mean age was 54.4 years old. GPs’ feeling of confidence and self-perception of follow-up of national recommendations is linked with their practices. Performing a clinical interview to assess cognitive impairment is linked with good communication skills. GPs feel less confident to give information about resources for dementia. The main reason alleged for underdiagnosis is the limited effectiveness of drug therapy.

Conclusions: This study underlines the importance of GPs’ feeling of confidence when managing cognitively impaired patients with dementia, and the need of increasing training in the field of dementia, which could improve the awareness of GPs about diagnosis and available resources.

Full reference: Harmand, M.G-C. et al. (2017) Description of general practitioners’ practices when suspecting cognitive impairment. Recourse to care in dementia (Recaredem) study. Aging & Mental Health. Published online: 8 June 2017

Dementia: Best practice repository for clinical commissioning

NHS England has developed a repository of examples and case studies of best practice, which is available via the online Learning Environment.

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In March 2016, NHS England introduced a new CCG Improvement and Assessment Framework (CCG IAF). This framework brings together a range of key indicators, enabling NHS England and CCGs to work together to drive improvement for patients.
The CCG IAF framework has indicators for six national clinical priority areas, including dementia. The dementia indicators are:

  • Estimated diagnosis rate for people with dementia.
  • Dementia care planning and post-diagnostic support.

NHS England recognises that CCGs will have varying levels of need for support based on their performance against the indicators, and in October 2016 published a support offer to help with this.

To substantiate the support offer, the NHS England Dementia Team has developed the Best Practice Repository on the NHS England Learning Environment website. This repository is currently being developed and case studies will be added to the NHS England Learning Environment website along with links to other resources.

View an overview of the resource here

Search for case studies here

NHS England Dementia: Good Care Planning

Care planning is crucial in delivering improved care for people living with dementia, and supporting their families and carers | NHS England

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Image source: NHS England

he importance of having a high quality care plan that is reviewed regularly is reiterated through its inclusion in the CCG IAF as one of the dementia indicators. It also forms a key part of the forthcoming evidence-based treatment pathway for dementia.

Simply having a care plan, whilst being a good start, is not enough. Any care plan needs to be personalised to the specific needs of each person with dementia and reflect changes in their care needs over time. To support the adoption of high-quality care plans NHS England has developed a guide Dementia: Good Care Planning, with input from people living with dementia, their carers and health and social care professionals.

View the full range of resources here

Commissioning for Value mental health and dementia packs

NHS RightCare has published new data packs for a range of mental health and dementia services for each CCG.

NHS RightCare has published new Commissioning for Value mental health and dementia packs for each CCG. The packs contain data across a range of mental health and dementia services, and include a number of new indicators not included in previous packs. The information is intended to support discussions about mental health care in local health economies to improve the value and utilisation of resources.

 Rotherham CCG Commissioning for Value Mental health and dementia pack:

National dementia diagnosis rates and monthly workbook published

The National Clinical Director for Dementia, Professor Alistair Burns has been writing to CCGs with the national dementia diagnosis rate in order to achieve and maintain the national ambition of diagnosing 2/3rd of the estimated population living with dementia.

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The monthly CCG letters can be found below with the national dementia diagnosis rates alongside general updates on national priorities. Commissioners are asked to cascade this information to member practices.

CCG Letter – Dementia Diagnosis Rates – November 2016
CCG Letter – Dementia Diagnosis Rates – October 2016

Read the full overview here