Don’t forget to plan for dementia care – and prevention

Healthy Ageing

Poor public understanding of dementia care, treatment and prevention have emerged in new Flinders research.

Recent reports from from the Rehabilitation, Aged and Extended Care research group at Flinders University highlight the urgent need for more dementia education.

The research indicates the general public still tends to believe dementia is a normal and non-preventable part of ageing, despite decades of public awareness campaigns about the potential for dementia prevention.

In particular, the general public underestimate the importance of cardiovascular health and regular exercise to prevent the advance of dementia, even though it has been proven as the single most powerful influence on brain health.

The Australian Bureau of Statistics estimates more than 425,000 Australians are living with dementia (55% females, 45% males), with dementia the second leading cause of death of Australians, contributing to 10.6% of all female deaths and 5.4% of all male deaths each year – with numbers rising as the population ages.

The public also tends to endorse poorly supported risk reduction strategies such as taking vitamin supplements, ahead of more effective but time consuming and energetic strategies, such as exercise regimes.

These problems are among those outlined in the paper, ‘What does the general public understand about prevention and treatment of dementia? A systematic review of population-based surveys’, recently published by PLoS One.

“We were surprised to find that dementia literacy is still so poor, given how much effort has been put into improving understanding,” says lead researcher Monica Cations, from the College of Medicine and Public Health.

“The view that dementia is a normal part of ageing with few treatment options is a demonstrated barrier to both preventive health behaviours and to help-seeking and diagnosis in the event that symptoms emerge.”

A second paper, ‘Economic evaluations of occupational therapy approaches for people with cognitive and/or functional decline: A systematic review‘, published in Health and Social Care in the Community journal (DOI 10.1111/hsc.12553), shows how non-pharmacological therapy programs can improve outcomes for older people (including people with dementia and their families) and can also be cost effective.

Photo: iStock.

The review covered the findings from 13 papers which evaluated the effectiveness of home-based occupational therapy.

Most programs consisted of several consultations, for example eight sessions over a period of up to four months, or had a specific focus on preventing falls at home.

The review found that approaches that addressed individual needs delivered better economic outcomes.

Therapy involved strategies such as improving the home environment such as removing clutter or adjusting lighting, finding ways for people to remain independent and working with families on strategies.

“The benefits of these interventions were evident for supporting people with dementia and their caregivers, as well as the caregivers of people with other neuro-degenerative diseases and older people living in the community with different functional limitations or decline,” says co-author and Flinders Occupational Therapy (Honours) researcher Miia Rahja.

These types of programs work to prevent decline and hospitalisation and so fit with current priorities.

While it is difficult to report a single amount for the cost saving from the review, due to the variety of methods for evaluating and reporting costs across different papers, the authors believe that better functional and economic outcomes for different stakeholders are possible and should be implemented into practice.

Other authors of the PLoS One Professor Maria Crotty, Gorjana Radisic and Dr Kate Laver, from the Rehabilitation, Aged and Extended Care research group at Flinders University collaborate with the national NHMRC Cognitive Decline Partnership Centre.

Professor Crotty, Dr Laver, Tracy Comans and Lindy Clemson were co-authors of the study of occupational therapy benefits.

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