Literature Review

[UK] Efficacy of music-based intervention for people living with dementia in an inpatient setting: A pilot studyJournal of Alzheimer's Disease; Neha Abeywickrama, Mel N Ellul Miraval, Hari Subramaniam, Qadeer Arshad, Stephanie Pollard, Geeta Chauhan, Shifa Jussab, Elizabeta B Mukaetova-Ladinska; 1/25Pharmacological treatment of behavioral and psychological symptoms of dementia is of limited benefit. The addition of non-pharmacological interventions is often essential for optimal symptom control. Clinical professionals can successfully deliver music-based intervention to inpatients with advanced dementia to help manage their behavioral symptoms in the short term. Music-based interventions' use for inpatient wards must be further investigated as an economical and personalized non-pharmacological therapeutic tool for patients with dementia.

Palliative care program for community-dwelling individuals with dementia and caregivers: The IN-PEACE randomized clinical trialJAMA Network; by Greg A. Sachs, Nina M. Johnson, Sujuan Gao, Alexia M. Torke, Susan E. Hickman, Amy Pemberton, Andrea Vrobel, Minmin Pan, Jennifer West, Kurt Kroenke; 1/25Among community-dwelling individuals with moderate to severe dementia, does a dementia care management program with integrated palliative care reduce patients’ neuropsychiatric symptoms? In this randomized clinical trial, a dementia care management program with integrated palliative care did not significantly improve patients’ neuropsychiatric symptoms.

[UK] Identifying challenges related to the management of comorbidities in people with dementia in residential care: Expert delphi consensus exerciseJournal of Applied Gerontology; Serena Sabatini, Frances Hawes, Kelechi Eluigwe, Eugene Y. H. Tang; 1/25Improving early detection, management, and treatment of comorbid conditions to dementia in residential care could slow down cognitive and functional decline, and increase residents’ quality of life. ... Mental illnesses, delirium, and sensory impairments were identified as the most difficult comorbidities to dementia to deal with. Medication management, symptom management, shortage of staff, lack of training among staff, and limited resources from the broader healthcare system were identified as the most difficult issues when dealing with dementia comorbidities. To address disparities between different residential care homes there is the need of mandatory standards of care across UK residential care homes, and of clear guidelines on topics such as pathways of care for residents’ medical problems, staff to resident ratios, and minimum wages.

[Sweden] The process of pain assessment in people with dementia living in nursing homes: A scoping reviewPalliative Care and Social Practice; Caroline Kreppen Overen, Maria Larsson, Adelheid Hummelvoll Hillestad, Ingela Karlsson, Siren Eriksen; 1/25Studies have documented a pain prevalence in people with dementia living in nursing homes of 35%–43%, but a possible prevalence of 60%–80%. This scoping review provides a comprehensive description of pain assessment in people with dementia living in nursing homes as a process in three steps. Self-reported information is the most appropriate when assessing pain, as symptom experience is subjective and highly personal. However, for people with dementia living in nursing homes, self-reporting represents a challenge due to cognitive impairment, including difficulties with language and communication. People with dementia might express pain with different behavioural expressions or signs, such as agitation, apathy, restlessness or wandering. Numerous observational assessment tools targeting pain in people with dementia have been developed and evaluated and systematic use of standardized observational tools has been recommended.

US dementia cases projected to double within 40 years Medscape Medical News; by Pauline Anderson; 1/13/25 The number of US adults who will develop dementia each year is projected to increase from approximately 514,000 in 2020 to about 1 million in 2060, new research shows. In addition, the lifetime risk of developing dementia after age 55 is estimated at 42%. The research showed that the relative growth in dementia cases is particularly pronounced for Black adults. These new findings researchers say, “highlight the urgent need for policies that enhance healthy aging, with a focus on health equity.”

Effective solutions for caregivers of older adults: A review of systematic reviewsJournal of Applied Gerontology; Molly McHugh, Ellen Munsterman, Hannah Cho; 1/25This umbrella review aims to describe caregiver interventions tested across populations of informal caregivers of older adults and to examine the effect of caregiver interventions on depression, burden, and quality of life across intervention types and care-recipient populations. Most commonly, interventions focused on improving outcomes for caregivers of older adults with dementia. Among the included reviews, caregiver depression was most likely to be reduced by caregiver interventions, and cognitive behavioral therapy (CBT) and mindfulness-based interventions (MBI) were most effective. The use of information and communication technologies to deliver caregiver interventions is increasingly common. Standardization of intervention classifications and transparent reports of intervention delivery details will strengthen research in this field.

Transition to hospice: how it impacts the mental health of caregivers of persons with dementiaAlzheimer's & Dementia; by Oonjee Oh, Debra Parker Oliver, Karla Washington, George Demiris; 2024In this study, we aimed to examine caregivers’ mental health indicators and their correlation structure based on the timing of hospice transition... In the context of dementia care, our results highlight that caregivers who just entered hospice are undergoing a challenging transition that often finds them in a mentally vulnerable position. To develop and implement effective strategies for caregivers of persons with dementia, we need to understand the needs and vulnerabilities of caregivers during hospice transition and identify the best timing for the delivery of supportive tools.

[London] The problem of value change: Should advance directives hold moral authority for persons living with dementia?Bioethics; by Anand Sergeant1; 12/24As the prevalence of dementia rises, it is increasingly important to determine how to best respect incapable individuals' autonomy during end‐of‐life decisions. Many philosophers advocate for the use of advance directives in these situations to allow capable individuals to outline preferences for their future incapable selves. In this paper, however, I consider whether advance directives lack moral authority in in-stances of dementia.

Health disparities in hospice - home health transitions in Hispanic older adults with co-occurring dementia and cardiovascular diseaseAmerican Journal of Hospice and Palliative Care; by Sharon E Bigger, Kathy Howard Grubbs, Yan Cao, Gail L Towsley; 12/24We aimed to determine if there were demographic and/or diagnostic variables associated with the frequency of transitions between skilled HH and hospice... Hispanic older adult beneficiaries with Alzheimer's disease and related dementias (ADRD) and co-occurring cardiovascular disease (CVD) had significantly higher rates of care transitions from hospice to skilled HH than other racial and ethnic groups with both diagnoses... Our findings provide evidence of disparities in care transitions from hospice to skilled HH for Hispanic older adults living with ADRD and CVD.

Developing evidence-based health policy for dementia careJAMA Health Forum; Katherine Baicker, PhD; Kosali Simon, PhD; 12/24The rising prevalence of Alzheimer disease and related dementias (ADRD) represents a profound challenge to health care and long-term care systems. Promising diagnostic tools, medicines, and interventions for ADRD are on the horizon, but these medical advances will come with substantial costs. By 2050, the annual cost of care for patients with ADRD is projected to reach $1.5 trillion in the US, with 75% covered by Medicaid and Medicare. In addition to payment policy, the decision-making environment (what, when, and how information is presented and the way that different choices are framed) for both patients and clinicians will determine the quality and value of care delivered and how that varies across patient populations. With a rapidly aging population and rising prevalence of ADRD, the need for these efforts is urgent.

New NIH-funded program will train ASU students for the future of AI-powered medicine Arizona State University - ASU News; by Richard Harth; 11/26/24 The medical sector is increasingly exploring the use of artificial intelligence, or AI, to make health care more affordable and to improve patient outcomes, but new programs are needed to train engineers and biomedical researchers for this future. A team at Arizona State University has received a $2.35 million award from the National Institutes of Health (NIH) to establish just such a pioneering program to train doctoral students to meet these needs. The program will welcome its first cohort of PhD students in the spring of 2025.

How to support loved ones experiencing cognitive decline while securing their financial well-being Nasdaq, Peronsal Finance; by Deanna Ritchie; 12/6/24 Supporting a loved one with cognitive decline can be one of life’s most challenging challenges. Those with cognitive impairments, such as dementia or Alzheimer’s, often need to be emotionally resilient and make practical adjustments. However, proactive financial planning to secure their well-being is frequently overlooked. The reason? The Wall Street Journal reported that those with undiagnosed memory loss are prone to significant financial declines. Researchers at the University of Michigan found that people without knowledge of their memory problems lost an average of $31,000 in net worth, while people with knowledge lost $5,400. Keeping this in mind, here’s a guide for providing compassionate care while protecting their savings and financial stability. [Click on the title's link for more.]

Hospice of the Valley and CLS bridge the generation gap Arcadia News, Phoenix, AZ; by Cliff Summerhill; 12/1/24 Hospice of the Valley (HOV) and Christ Lutheran School (CLS) are entering the second year of a partnership that connects students with individuals at the Dementia Care and Education Campus. As part of HOV’s Adult Day Club, fifth-grade students visit individuals living with dementia to bridge intergenerational divides and spread enrichment, support, and joy that lasts long after the day’s activities have ended. ... Students partake in various meaningful activities with club members, including painting, coloring, gardening, and activities like cornhole, catch, and shuffleboard. The most important activity, however, is conversation. “Even though there is an age gap, both the Adult Day Club members and the students have the opportunity to learn from each other as they share stories and various interests,” CLS Service Learning Coordinator Mandi Schnepf said.