Dementia Awareness Research Articles

Evaluating a Kid’s Dementia Awareness Game with Pre-Licensure Children and Young People’s Nursing (CYP) Students in Northern Ireland – A Pre/Posttest Study

ABSTRACT Dementia not only affects the person living with the condition but also their family and wider social circle. For that reason, it is important to educate family members, the wider public and health professionals. How a child and young people’s (CYP) nurse supports and responds to a CYP whose family member has dementia or acts as a carer is of interest to pre-licensure (pre-registration) CYP nursing programs. With serious games becoming more common as a method to educate a diverse population regardless of age and gender, this study aims to learn if playing a kid’s dementia awareness game improves CYP nursing student’s attitude to dementia using a validated pre-/posttest questionnaire. This study adopted a pretest, posttest design to assess the attitudes of pre-licensure CYP nursing students toward dementia. The Approaches to Dementia Questionnaire (ADQ) was administered before and after playing a serious CYP kid’s dementia game developed by children and people living with dementia for 10- to 11-year-old children. The ADQ measured the total score, Hope subscale, and person-centered approaches. Matched paired t-test was used for analysis conducted with SPSS statistics 29. Seventy-two participants, from one university in Northern Ireland, completed pretest measures, of these, 55 also completed the posttest questionnaire. The participating CYP pre-licensure undergraduate and postgraduate nursing students demonstrated a significant increase in overall dementia attitudes post-gameplay, with an increase from 78.31 to 83.27. Subscales for Hope (27.75 to 30.44) and person-centered approaches also exhibited significant improvement (50.56 to 52.84). Demographic data revealed all participants as female, with 50% knowing a person living with dementia, and limited training experiences. In conclusion, this study has shown a positive response to playing a dementia game relevant to the child population. This adds to the literature building on the use of serious games for health education. Attitudes and hope scales increased with the use of the game.

A Study on the Dementia Attitude, Knowledge and Awareness of Support Policy

A Study on the Dementia Attitude, Knowledge and Awareness of Support Policy

Intervention Development for Tailored Education for Aging and Cognitive Health (TEACH) for Dementia Prevention in Midlife Adults: Protocol for a Randomized Controlled Trial.

A total of 12 modifiable risk factors account for 40% of dementia cases globally, yet population adherence to health behaviors associated with these factors is low. Midlife is a critical window for dementia prevention, as brain pathology often begins to accumulate years or decades before the onset of symptoms. Although multidomain behavioral interventions have been efficacious in reducing the risk of cognitive decline, adherence is low. Intrapersonal factors, such as health beliefs, are known mediators of the relationship between knowledge and health behavior. In keeping with stage I of the National Institutes of Health (NIH) Stage Model for Behavioral Intervention Development, this study will use mixed methods to (1) develop an enhanced health education intervention, including an explanatory method for communicating information about dementia risk and personal health beliefs, and (2) conduct a pilot randomized controlled trial (n=20 per intervention arm) over 8 weeks to assess the feasibility of delivering the enhanced intervention versus basic health education alone. Phase 1 will involve focus groups and individual qualitative interviews. Focus groups will be analyzed using (1) a descriptive framework matrix analysis and (2) interpretive data review by the research team. Individual qualitative interviews will be coded using applied thematic analysis using a phenomenographic approach. Phase 2 will involve a pilot randomized controlled trial. Proximal outcomes (measured at baseline, 4 weeks, and 8 weeks) include the perceived threat of Alzheimer disease, dementia awareness, and self-efficacy. This project was funded in August 2022. Data collection began in 2023 and is projected to be completed in 2025. Study findings will reveal the feasibility of delivering an 8-week multidomain health education intervention for primary prevention of dementia in midlife and will provide preliminary evidence of mechanisms of change. ClinicalTrials.gov NCT05599425; https://clinicaltrials.gov/study/NCT05599425. DERR1-10.2196/60395.

Evaluation of an Occupational Therapy led Cognitive Stimulation Therapy Programme in an Integrated Care Programme for Older Persons

Abstract Background Cognitive Stimulation Therapy (CST) is a non-pharmacological, evidence-based approach specifically designed to support people with dementia to maintain their cognitive functions e.g. reminiscence, higher executive skills, sensory integration, orientation, memory strategies and day-to-day activities. Methods Participants referred to a community specialist ICPOP team were identified for CST following Comprehensive Geriatric Assessment (CGA), where cognitive impairment or dementia was identified. Inclusion criteria: Rockwood Clinical Frailty Scale ≤5, Barthel Index of Activities of Daily Living ≥11, Lawton Brody Instrumental Activities of Daily Living Scale (IADL) ≥4, Montreal Cognitive Assessment (MoCA) ≥10, and ability to consent to participate. Addenbrooks Cognitive Examination (ACE-III) scores were obtained pre and post CST, alongside post CST feedback questionnaires. Results 5 CST programmes of seven weeks duration were conducted over a ten-month period. 31 (male=16, female=15) participants completed the programme. 3 participants dropped out due to lack of transport/interest. The average ACE-III score pre-CST was 68.3 +/- 14.31; post-CST was 76.1 +/- 11.4. 28 participants completed feedback questionnaires. Positive feedback included “Got a great sense of achievement with each session, and eagerly looked forward to the coming weeks”, “Each session topped the previous session” “Gave me a reason to get out, a routine to my week”. 45 % commented that they felt safe sharing difficulties/problems with the group. 71% reflected that CST provided an opportunity to meet others in a similar situation. 100% would recommend CST to others. Conclusion Experience of CST was overwhelmingly positive demonstrating benefit not only from a cognitive perspective but from informal peer support and connections made in group settings. Participants commented on lack of follow-on programmes, identifying the need to develop maintenance CST programmes led by trained community stakeholders which would sustain these benefits long-term as well as increasing awareness and knowledge of dementia within communities.

Dementia awareness raising forum: Improving attitudes towards people living with dementia.

Stigma surrounding dementia is a significant issue affecting individuals and communities leading to discrimination towards those living with the condition. However, the changing paradigm in dementia support to living well with dementia can reduce this stigma and improve community attitudes. A community initiative aimed to address this evaluated the impact of a two-hour education forum involving 92 community members. Presentations from experts, including a person with dementia, addressed dementia-related human rights issues and initiatives to live well with dementia. Attendees completed the new Dementia Community Attitudes Questionnaire (DCAQ) aligned with the evolving paradigm of living well with dementia before and after the forum. Participants with prior dementia education had higher initial scores while those without education showed more significant improvements. Almost all DCAQ items showed post-forum score improvements. This community Dementia Awareness Raising Forum provided an opportunity for people to come together and initiate conversations around dementia resulting in more positive community attitudes.

Prevalence and general characteristics of dementia: a nationwide population-based study of electronic health records in Türkiye.

Türkiye is a country with an increasing life expectancy and an older adult population in parallel with the rest of the world. Several national small-scale studies were performed regarding the prevalence and characteristics of dementia in Türkiye, and the results of these studies differ from each other. We aimed to determine the prevalence of dementia in Türkiye to present the demographic characteristics, the frequency of use of health services, and the management of dementia. Patients aged 65 years and over with a diagnosis of any type of dementia between January 1, 2019, and December 31, 2020, were retrospectively screened from the electronic health records of the Ministry of Health using ICD-10 codes. In 2019, the total number of dementia cases identified in individuals aged 65 years and older was 247,727, of whom 150,529 (60.8%) were women. In 2020, the total number of dementia cases identified in this age group was 233,949, with 142,878 (61.1%) of these cases being women. The rate of patients admitted to the emergency department was 72.3% and 66.2% of all dementia patients in 2019 and 2020, respectively. In terms of the use of outpatient clinics, most patients with dementia were admitted to neurology (71.0% in 2019 and 62.4% in 2020). The geriatric medicine outpatient clinic was the least used by patients with dementia both in 2019 and 2020. The prevalence of patients living with dementia in Türkiye is lower than the global average. This suggests that most dementia cases are overlooked, highlighting the need to raise dementia awareness both in the community and among primary health care providers who frequently encounter older individuals. The study is significant in that it is the first to show the nationwide frequency of dementia in Türkiye.

Mild Cognitive Impairment and Dementia Awareness in Commoners

Mild Cognitive Impairment and Dementia Awareness in Commoners

A Dementia-Friendly Educational Program Using Virtual Reality for the General Public in Japan: A Randomized Controlled Trial for DRIVE.

Raising dementia awareness is essential for building a dementia-friendly community. However, existing studies have underexplored the effects of virtual reality (VR) dementia educational programs for the general public on enhancing positive attitude toward dementia. This study aimed to examine the effectiveness of a VR dementia-friendly educational program called the Drive for Dementia Readiness Inside Virtual Reality (DRIVE) program to improve attitude toward dementia of the general public. A two-arm randomized controlled trial was conducted. Eligibility criteria for participants included being 16 years and older in Japan and having no professional license in healthcare and social care. We randomized individuals to attend a multielement VR dementia-friendly educational program (intervention), including simulation, VR films, short films, lectures, and discussions or a lecture-based program (control). Data were collected 3 times, including at baseline, postintervention, and 3-month follow-up. The primary outcome was attitude toward dementia. The secondary outcomes were intention of helping behavior for people living with dementia and knowledge of dementia. We recruited 157 community residents, among whom 130 were included in the analysis. Although the mean changes in attitude score were not significantly different between the groups (Hedge's g = 0.26), the intention of helping behavior score was significantly higher in the intervention group (g = 0.49). The DRIVE, a VR-based multielement dementia-friendly educational intervention, was shown as a promising tool for significantly affecting the intention of helping behavior for people living with dementia to establish dementia-friendly communities. UMIN000044901.

Perceptions of Dementia among Nursing Students in South Korea: A Phenomenological Study.

This study aimed to determine nursing students' perceptions of dementia and patients with dementia. Specifically, this study sought to illuminate the essential meaning of dementia among nursing students to uncover insights useful for developing patient-centered care rooted in empathy for patients with dementia. This study used a descriptive phenomenological research method. Between August and September 2023, semi-structured interviews were conducted with 15 nursing students. Colaizzi's method was used for the manual analysis. After analyzing the interview data on nursing students' awareness of dementia, four categories, nine theme clusters, and 28 formulated meanings were derived. The four categories were "View of dementia", "Feelings about dementia", "Efforts made regarding dementia", and "Dementia as a nursing student". Although nursing students' perceptions of dementia resulted in negative perspectives and emotions, by looking into coping methods and wishes for dementia, this study also confirmed that nursing students had an awareness of caring for patients with dementia.

Dementia awareness in Egypt: what do people really know?

BackgroundDementia is a pressing problem for families and society. In 2019, a total of 57.4 million people worldwide were estimated to be living with dementia, and this number will almost double every 20 years, especially in Africa and the Middle East. This study aimed to investigate knowledge about dementia among the Egyptian population. A cross-sectional online survey was conducted among a sample of adult Egyptians using a socio-demographics data sheet and a designed dementia knowledge questionnaire.ResultsNearly one-third (33.4%) had a poor knowledge score. The items most often answered incorrectly were the sudden onset of cognitive problems as characteristic of dementia (59.3%). The highest percentage of good knowledge was in the manifestations and prevention domains (62.20% and 67.18%, respectively). On the other hand, the lowest rate of good knowledge was in the treatment and life impact domains (35.23% and 25.70%, respectively). Not working in the medical field (OR 2.656, 95% CI: 1.504–4.688, p < 0.001), had no contact with dementia patients (OR 1.910, 95% CI: 1.229–2.970, p = 0.004), no previous knowledge on dementia (OR 3.184, 95% CI: 1.797–5.642, p < 0.001), or never heard about dementia "Marad Alkharaf" (OR 6.385, 95% CI: 4.127–9.878, p < 0.001) were significantly associated with poorer dementia knowledge.ConclusionThe findings of our study indicated variable levels of knowledge of dementia among Egyptians. Our recommendation is to encourage conducting campaigns for raising public awareness about dementia and through media that has an important and widespread effect in reaching the Egyptian population.

Awareness and knowledge of dementia and its communication disorders amongst Brazilian speech and language therapists.

Speech and language therapists (SLTs) play an important role in assessing and rehabilitating communication disorders in people with dementia, but there is evidence to suggest that they do not receive appropriate training to provide management and support during their training. To investigate the level of awareness and knowledge that practising SLTs from Brazil have about dementia and their role in the care of dementia through an online survey. An online survey tool was developed to collect information from practising Brazilian SLTs regarding their knowledge about dementia, awareness about their role in the care of people with dementia, and opinions on how SLTs may be better prepared to work in the dementia field. The survey was disseminated via social media, websites, and e-mail lists of researchers and stakeholders. A total of 227 SLTs completed the survey. Participants showed good knowledge of dementia in general, while their answers were less accurate on primary progressive aphasia. Regarding the awareness by SLTs of their role in the care of people with dementia, most agreed or strongly agreed that SLTs could help people in the diagnosis, treatment and prevention of dementia (> 80%). However, fewer participants agreed or strongly agreed that they felt confident in contributing to the treatment and diagnosis process of dementia (about 50%). To improve the training of SLTs in Brazil, most participants believed that it would be necessary to improve the teaching of dementia at the undergraduate speech and language therapy curriculum level and to develop recommendations or guidelines about speech and language therapy practice in dementia. The results of this survey point to a need for improvement in the knowledge and confidence of Brazilian SLTs about dementia. To reach this goal, targeted training courses and applied practice opportunities should be embedded within university curricula and training programmes. What is already known on the subject Many studies confirm the importance of speech and language therapy in the non-pharmacological treatment of people with dementia. However, other evidence suggests to a possible lack of training for Brazilian SLTs, especially in the curriculum of undergraduate courses. What this paper adds to existing knowledge This study reveals that Brazilian SLTs have substantial knowledge of dementia and recognize the significance of their role in treating people with dementia. However, a minority expressed confidence in their ability to assess and treat people with dementia. What are the potential or actual clinical implications of this work? The findings of this research demonstrate that Brazilian SLTs have good knowledge of dementia and endorse their professional role in dementia care; however, they lack confidence in their own skills and expertise in diagnostic assessment and treatment of dementia. Interventions aimed at boosting the SLT's confidence level could lead to improved patients outcomes and overall quality of care within clinical settings.

Evaluation of a dementia awareness game for health professions students in Northern Ireland: a pre-/post-test study

BackgroundDementia is a prevalent global health issue, necessitating comprehensive education for healthcare practitioners and students. Nursing and pharmacy students, provide support across healthcare settings often working as frontline caregivers. Therefore, it is imperative to equip these students with a profound understanding of dementia. The aim of this study was to evaluate whether a serious dementia game co-designed with stakeholders, students, and people living with dementia improved the attitudes of nursing and pharmacy students.MethodsA pretest-posttest design was used to assess the attitudes of health professions students (nursing and pharmacy) towards dementia. The Approaches to Dementia Questionnaire (ADQ) was administered before and after playing a serious Dementia Game. The ADQ measured the total score, Hope subscale, and Recognition of Personhood subscale. Matched pairs t-test was used for analysis conducted with IBM SPSS statistics 27.ResultsA diverse cohort of 505 participants from one university in Northern Ireland participated, with 461 matched pairs used for analysis. Both nursing and pharmacy students demonstrated a significant increase in overall dementia attitudes post-gameplay, with nursing students showing an increase from 79.69 to 83.59 and pharmacy students from 75.55 to 79.86. Subscales for Hope (Nursing = 28.77 to 31.22, Pharmacy = 26.65 to 29.20). and Recognition of Personhood also exhibited significant improvement (Nursing = 50.93 to 52.38, Pharmacy = 48.89 to 50.67). Demographic data revealed predominantly female participants, a lack of personal connections to dementia, and varied training experiences.DiscussionThe study highlights the efficacy of the serious Dementia Game in enhancing attitudes to dementia amongst health professions students, indicating its potential as an educational tool. The study contributes to the growing body of evidence supporting serious games and gamification in healthcare education.

A Pilot Study of BRAIN BOOTCAMP, a Low-Intensity Intervention on Diet, Exercise, Cognitive Activity, and Social Interaction to Improve Older Adults’ Dementia Risk Scores

BackgroundLittle is known about the impact of short, low-intensity multidomain dementia risk reduction interventions in older adults.ObjectivesTo examine the effectiveness and feasibility of a low-intensity multidomain lifestyle intervention on dementia risk and dementia literacy in Australian older adults.DesignSingle-group pre-post design.SettingCommunity-dwelling.ParticipantsA total of 853 older Australians (Mean age=73.3 years, SD=6.1) recruited from the community.InterventionA 3-month dementia risk reduction program, BRAIN BOOTCAMP, including education, personalised risk information, physical cues for healthier choices and goal setting and planning to target four modifiable risk factors of diet, exercise, cognitive activity and social interaction in older adults.MeasurementsThe ‘LIfestyle for BRAin health’ (LIBRA) index was used to assess participants’ modifiable dementia risk based on 12 factors, with higher scores indicating greater risk. Dementia literacy was measured using a modified questionnaire derived from Dutch and British surveys, encompassing knowledge, risk reduction, and awareness aspects. Paired t-tests were used to compare dementia risk scores and dementia literacy before and after the program. Multivariate regressions were performed to identify sociodemographic and psychological factors associated with change in the LIBRA index.ResultsProgram attrition was high (58.3%). Participants who completed the program had decreased dementia risk scores (Cohen’s d=0.59, p<0.001), increased dementia literacy and awareness (Cohen’s d=0.64, p<0.001) and increased motivation to change lifestyle behaviors (Cohen’s d=0.25–0.52, p<0.016). Participants with higher motivational beliefs had greater dementia risk reduction.ConclusionsImproving older adults’ motivation and knowledge may help modify lifestyle behaviors to reduce dementia risk. However, program attrition remains a challenge, suggesting the need for strategies to enhance participant engagement and retention in such interventions.

Understanding engagement in diet and dementia prevention research among British South Asians: a short report of findings from a patient and public involvement group.

Dementia is a global public health challenge. Evidence suggests that individuals from South Asian communities are an at-risk group for dementia, partly as a result of early and cumulative exposure to known dementia risk factors, such as obesity and type 2 diabetes. There needs to be more culturally appropriate community engagement to increase awareness of dementia and identify better strategies to encourage participation in dementia-related research. We aimed to better understand the barriers and facilitators towards engaging with, and participating in, diet and dementia related research among British South Asians. This was achieved using a public and patient involvement (PPI) approach. A community-based, engagement event involving information sharing from experts and roundtable discussions with South Asian communities (n = 26 contributors) was held in June 2023 in Newcastle-upon-Tyne, UK. Collaboration from preidentified PPI representatives (n = 3) informed the content and structure of PPI activities, as well as recruitment. Data were synthesised using template analysis, a form of codebook thematic analysis. This involved deductively analysing data using relevant a priori themes, which were expanded upon, or modified, via inductive analysis. The findings highlighted the importance of trust, representation and appreciation of cultural barriers as facilitators to engagement in diet and dementia risk reduction research. Consideration of language barriers, time constraints, social influences and how to embed community outreach activities were reported as driving factors to maximise participation. This PPI work will inform the design and co-creation of a culturally adapted dietary intervention for brain health in accordance with the Medical Research Council and National Institute for Health and Care Research guidance for developing complex interventions.

Cultural Perceptions and Awareness of Dementia Amongst the People of Ibiaku Issiet Community: A Qualitative Study

This study investigates the perceptions and interpretations of dementia within the Ibiaku Issiet community, focusing on individuals&amp;#39; understanding of dementia, its symptoms, and its impact on affected individuals and their families. A qualitative approach was employed, utilizing semi-structured interviews with open-ended questions. Fifteen participants, comprising men and women aged 34 to 76, were selected from the community, with inclusion criteria limited to those who have a family member with dementia. Analysis of the data revealed various themes, including spiritual influences, punishment beliefs, limited awareness, stigmatization, spiritual beliefs, lack of accessibility to support services, frustration, helplessness, and a call for educational awareness and support initiatives. These findings highlight the importance of cultural interpretations in understanding dementia and underscore the need for increased awareness and support, particularly in communities lacking awareness. Recommendations include government intervention to provide educational programs and allocate resources for tailored support programs for caregivers within diverse cultural contexts.

“I know now that it's something that you can do something about”: Deductive thematic analysis of experiences at an arts-based dementia risk reduction exhibit

Dementia is one of the leading global health crises. Despite the devastating impacts of the illness, general population knowledge pertaining to risk reduction is still limited. Previous research on the impact of dementia risk reduction campaigns has largely focused on awareness rather than behaviour change. Our research introduced an arts-based exhibit to address dementia modifiability, aiming to enhance effectiveness by providing an immersive experience for altering adults’ perceptions of risk reduction and lifestyle behaviours. Interviews were conducted with adults (n = 38 [13 male, 25 female]) who attended an interactive dementia awareness and risk reduction exhibit. Data was analysed using deductive thematic analysis within the Health Belief Model framework to determine key mechanisms of behaviour change. Four key themes encompassing exhibit significance and factors underlying behaviour change were identified. Participants recounted positive experiences, particularly being engaged by the artistic aspects of the exhibit, and recorded heightened engagement in behaviours supporting dementia risk reduction post-exhibit. Areas for improvement included the need for a take-home summary and variation in formats. Participants described prior encounters with dementia and their age as factors which influenced their engagement with dementia risk reduction behaviour, with younger participants reporting lesser engagement with risk reduction information. Our research found that arts-based educational initiatives have the potential to advance public understanding and promote behavioural changes for dementia risk reduction. Our study recommends enhancing the impact of future interventions by employing innovative formats and tailoring them to varied audiences, with a specific emphasis on engaging younger individuals.

Assessing the impact of an online dementia awareness initiative co-created with and for English, Arabicand Vietnamesespeaking communities: A case study.

Awareness and understanding of dementia remain limited in ethnically diverse populations in multicultural societies due to culturally inappropriate and inaccessible information. To establish the impact, helpersand hinderers of an online multilingual dementia awareness initiative co-created with and for English, Arabicand Vietnamese speaking people. A case study using mixed methods to assess the impact and implementation of an information session on dementia knowledge. The study was conducted with English, Arabicand Vietnamese speaking individuals in Canterbury-Bankstown, Australia. A dementia alliance co-created an online multilingual dementia information session, which was delivered synchronously in English, Arabicand Vietnamese by trained facilitators. In-session group discussions, quizzesand a postsession survey assessed the impact on dementia knowledge. A postimplementation focus group explored the factors that helped and hindered the initiative. The online dementia information session successfully supported participants understanding of dementia causes, impactsand care strategies. The initiative was hindered by competing priorities and limited accessibility to target audiences, while it was helped by the support of an established organisation and feedback mechanisms. Ongoing dementia education and awareness-raising campaigns that are culturally sensitive are needed in communities to promote dementia literacy and help-seeking. An online multilingual dementia information session can be an effective way to improve dementia literacy and advocate for change in multicultural communities. English, Arabicand Vietnamese speaking members of the Canterbury Bankstown Dementia Alliance participated in the co-creation and evaluation of this initiative.

Awareness, attitudes, and beliefs of dementia in Indonesia.

Tackling dementia stigma is a policy priority. In Indonesia, we have little insight into the general public's knowledge and attitudes about dementia. Cross-sectional study of 4430 Indonesian adults recruited from Jakarta and North Sumatra, Indonesia. Measures included dementia knowledge and attitudes. A total of 86.3% (n=3,803) of adults had not heard of the terms dementia or Alzheimer's disease, and commonly viewed dementia as a normal part of aging. Being older, incorrect knowledge about etiology, not having heard of the terms dementia and/or Alzheimer's disease, having less than primary education, and being from North Sumatra were associated with more negative attitudes (p-values<0.05). Misconceptions and lack of awareness about dementia are common in Indonesia. Attitudes tended not to be negative, but our research highlights factors associated with dementia attitudes. Future research should use this information to better tailor and target potential anti-stigma strategies. Most Indonesians had not heard of the terms dementia and/or Alzheimer's disease and thought it was caused by normal aging.The majority of participants held mixed or positive attitudes towards dementia.A series of demographic factors alongside poor awareness were associated with negative attitudes towards dementia.

Exploring the contribution of Japan's experience in addressing rapid aging in Asia: Focus on dementia care.

This review article explores the potential contribution of Japan's experience in addressing rapid aging in Asia with a specific focus on dementia care. As Japan is a frontrunner in terms of aging society, we consider valuable insights and lessons from Japanese policy history and reflect on its contribution. The World Health Organization, Regional Office for the Western Pacific Regional Action Plan on Healthy Ageing for the Western Pacific was compared with the Japanese "Outline for Promotion of Dementia Policies". The following five issues were discussed: i) improving awareness of dementia and community engagement in Japan from a mutual aid perspective; ii) social activities for prevention of dementia at the local level; iii) human resources for medical and long-term care; iv) local coordinators for old people care at home to evaluate the needs for care and tailor the care-plan on an individual basis; v) research and development of long-term care products. Given these factors, it is important to address the aging society through a combined cross-sectoral approach, including policy, research, development of care products, community, and education of care workers. Aging population measures in Japan do not provide a definitive answer, which prompts the consideration of better solutions derived from Japan's trial and error. The aging rate of 7%, 14%, and 21% are commonly used in international comparisons as indicators of the speed of the aging process, but before this 7% is reached, policies tailored to each country should be considered.

Identifying longitudinal healthcare pathways and subsequent mortality for people living with dementia in England: an observational group-based trajectory analysis

BackgroundThe number of people living with dementia (PLWD) continues to increase, particularly those with severe symptomatology. Severe symptoms and greater ill-health result in more acute care need. Early healthcare interventions can prove beneficial. Healthcare use has not been analysed as a holistic set of interlinked events. This study explores different healthcare pathways among PLWD, social or spatial inequalities in healthcare pathways and subsequent mortality risk.MethodsGroup-based trajectory models (GBTM) were applied to electronic healthcare records. We generated clusters of PLWD with similar five-year, post-diagnosis trajectories in rates of primary and secondary healthcare use. Potential social and spatial variations in healthcare use clusters were examined. Cox Proportional Hazards used to explore variation in subsequent mortality risk between healthcare use clusters.ResultsFour healthcare use clusters were identified in both early- (n = 3732) and late-onset (n = 6224) dementia populations. Healthcare use variations were noted; consistent or diminishing healthcare use was associated with lower subsequent mortality risk. Increasing healthcare use was associated with increased mortality risk. Descriptive analyses indicated social and spatial variation in healthcare use cluster membership.ConclusionHealthcare pathways can help indicate changing need and variation in need, with differential patterns in initial healthcare use post-diagnosis, producing similar subsequent mortality risk. Care in dementia needs to be more accessible and appropriate, with care catered to specific and changing needs. Better continuity of care and greater awareness of dementia in primary can enhance prospects for PLWD. Research needs to further illuminate holistic care need for PLWD, including health and social care use, inequalities in care, health and outcomes.