Why discuss dementia risk reduction with middle-aged patients in general practice?

2020 ◽  
Vol 37 (5) ◽  
pp. 727-729
Author(s):  
Kali Godbee
Keyword(s):  
General Practice ◽  
Risk Reduction ◽  
Middle Aged ◽  
Aged Patients ◽  
Dementia Risk

scholarly journals Middle-aged Australians’ perceptions of support to reduce lifestyle risk factors: a qualitative study

2020 ◽  
Vol 26 (4) ◽  
pp. 313
Author(s):  
Christine Ashley ◽  
Elizabeth Halcomb ◽  
Susan McInnes ◽  
Karin Robinson ◽  
Elizabeth Lucas ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Practice ◽  
Risk Reduction ◽  
Structured Interview ◽  
Middle Aged ◽  
Aged People ◽  
Lifestyle Risk Factors ◽  
Prevention And Health Promotion ◽  
Lifestyle Risk ◽  
Lifestyle Risk Reduction

Increasingly, middle-aged people are demonstrating lifestyle risk factors that increase their risk of developing chronic disease. Reducing lifestyle risk in middle age can significantly reduce future morbidity and mortality and improve quality of life. Understanding peoples’ perceptions of health support is important to inform health professionals and policymakers regarding strategies to support lifestyle risk reduction. This paper seeks to explore middle-aged Australians’ perceptions of support for lifestyle risk reduction. Thirty-four middle-aged Australians were interviewed using a semi-structured interview schedule. Interviews were audio-recorded, transcribed and analysed using thematic analysis. The overarching theme ‘support for healthy lifestyles’ comprised three subthemes. ‘Engagement with general practice’ highlighted gender differences in why people attend and what impacts their access to general practice. ‘Providing information’ emphasised participants’ experiences of lifestyle risk communication in general practice. Finally, ‘Sources of support’ revealed participants’ current health advice-seeking behaviours. Findings highlight a need for general practices to better engage middle-aged people in behaviour change and educate them about the role of general practice in prevention and health promotion. Consistent messaging across the community and strategies that focus on gender-specific concerns are likely to ensure that middle-aged people are able to make informed choices about seeking support for lifestyle risk reduction.

scholarly journals Autoimmune rheumatic diseases increase dementia risk in middle-aged patients: A nationwide cohort study

PLoS ONE ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. e0186475 ◽  
Author(s):  
Tzu-Min Lin ◽  
Wei-Sheng Chen ◽  
Jau-Jiuan Sheu ◽  
Yi-Hsuan Chen ◽  
Jin-Hua Chen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Rheumatic Diseases ◽  
Middle Aged ◽  
Aged Patients ◽  
Autoimmune Rheumatic Diseases ◽  
Dementia Risk

scholarly journals An Internet-Based Intervention Augmented With a Diet and Physical Activity Consultation to Decrease the Risk of Dementia in At-Risk Adults in a Primary Care Setting: Pragmatic Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Kaarin J Anstey ◽  
Nicolas Cherbuin ◽  
Sarang Kim ◽  
Mitchell McMaster ◽  
Catherine D'Este ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
At Risk ◽  
General Practice ◽  
Risk Reduction ◽  
Primary Outcome ◽  
Control Group ◽  
Web Based ◽  
Dementia Risk ◽  
Diet And Physical Activity

BACKGROUND There is a need to develop interventions to reduce the risk of dementia in the community by addressing lifestyle factors and chronic diseases over the adult life course. OBJECTIVE This study aims to evaluate a multidomain dementia risk reduction intervention, Body Brain Life in General Practice (BBL-GP), targeting at-risk adults in primary care. METHODS A pragmatic, parallel, three-arm randomized trial involving 125 adults aged 18 years or older (86/125, 68.8% female) with a BMI of ≥25 kg/m<sup>2</sup> or a chronic health condition recruited from general practices was conducted. The arms included (1) BBL-GP, a web-based intervention augmented with an in-person diet and physical activity consultation; (2) a single clinician–led group, Lifestyle Modification Program (LMP); and (3) a web-based control. The primary outcome was the Australian National University Alzheimer Disease Risk Index Short Form (ANU-ADRI-SF). RESULTS Baseline assessments were conducted on 128 participants. A total of 125 participants were randomized to 3 groups (BBL-GP=42, LMP=41, and control=42). At immediate, week 18, week 36, and week 62 follow-ups, the completion rates were 43% (18/42), 57% (24/42), 48% (20/42), and 48% (20/42), respectively, for the BBL-GP group; 71% (29/41), 68% (28/41), 68% (28/41), and 51% (21/41), respectively, for the LMP group; and 62% (26/42), 69% (29/42), 60% (25/42), and 60% (25/42), respectively, for the control group. The primary outcome of the ANU-ADRI-SF score was lower for the BBL-GP group than the control group at all follow-ups. These comparisons were all significant at the 5% level for estimates adjusted for baseline differences (immediate: difference in means −3.86, 95% CI −6.81 to −0.90, <i>P</i>=.01; week 18: difference in means −4.05, 95% CI −6.81 to −1.28, <i>P</i>&lt;.001; week 36: difference in means −4.99, 95% CI −8.04 to −1.94, <i>P</i>&lt;.001; and week 62: difference in means −4.62, 95% CI −7.62 to −1.62, <i>P</i>&lt;.001). CONCLUSIONS A web-based multidomain dementia risk reduction program augmented with allied health consultations administered within the general practice context can reduce dementia risk exposure for at least 15 months. This study was limited by a small sample size, and replication on a larger sample with longer follow-up will strengthen the results. CLINICALTRIAL Australian clinical trials registration number (ACTRN): 12616000868482; https://anzctr.org.au/ACTRN12616000868482.aspx.

scholarly journals An Internet-Based Intervention Augmented With a Diet and Physical Activity Consultation to Decrease the Risk of Dementia in At-Risk Adults in a Primary Care Setting: Pragmatic Randomized Controlled Trial

10.2196/19431 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e19431
Author(s):  
Kaarin J Anstey ◽  
Nicolas Cherbuin ◽  
Sarang Kim ◽  
Mitchell McMaster ◽  
Catherine D'Este ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
At Risk ◽  
General Practice ◽  
Risk Reduction ◽  
Primary Outcome ◽  
Control Group ◽  
Web Based ◽  
Dementia Risk ◽  
Diet And Physical Activity

Background There is a need to develop interventions to reduce the risk of dementia in the community by addressing lifestyle factors and chronic diseases over the adult life course. Objective This study aims to evaluate a multidomain dementia risk reduction intervention, Body Brain Life in General Practice (BBL-GP), targeting at-risk adults in primary care. Methods A pragmatic, parallel, three-arm randomized trial involving 125 adults aged 18 years or older (86/125, 68.8% female) with a BMI of ≥25 kg/m2 or a chronic health condition recruited from general practices was conducted. The arms included (1) BBL-GP, a web-based intervention augmented with an in-person diet and physical activity consultation; (2) a single clinician–led group, Lifestyle Modification Program (LMP); and (3) a web-based control. The primary outcome was the Australian National University Alzheimer Disease Risk Index Short Form (ANU-ADRI-SF). Results Baseline assessments were conducted on 128 participants. A total of 125 participants were randomized to 3 groups (BBL-GP=42, LMP=41, and control=42). At immediate, week 18, week 36, and week 62 follow-ups, the completion rates were 43% (18/42), 57% (24/42), 48% (20/42), and 48% (20/42), respectively, for the BBL-GP group; 71% (29/41), 68% (28/41), 68% (28/41), and 51% (21/41), respectively, for the LMP group; and 62% (26/42), 69% (29/42), 60% (25/42), and 60% (25/42), respectively, for the control group. The primary outcome of the ANU-ADRI-SF score was lower for the BBL-GP group than the control group at all follow-ups. These comparisons were all significant at the 5% level for estimates adjusted for baseline differences (immediate: difference in means −3.86, 95% CI −6.81 to −0.90, P=.01; week 18: difference in means −4.05, 95% CI −6.81 to −1.28, P<.001; week 36: difference in means −4.99, 95% CI −8.04 to −1.94, P<.001; and week 62: difference in means −4.62, 95% CI −7.62 to −1.62, P<.001). Conclusions A web-based multidomain dementia risk reduction program augmented with allied health consultations administered within the general practice context can reduce dementia risk exposure for at least 15 months. This study was limited by a small sample size, and replication on a larger sample with longer follow-up will strengthen the results. Trial Registration Australian clinical trials registration number (ACTRN): 12616000868482; https://anzctr.org.au/ACTRN12616000868482.aspx.

Refined conceptual model for implementing dementia risk reduction: incorporating perspectives from Australian general practice

2020 ◽  
Vol 26 (3) ◽  
pp. 247
Author(s):  
Kali Godbee ◽  
Jane Gunn ◽  
Nicola T. Lautenschlager ◽  
Victoria J. Palmer
Keyword(s):  
General Practice ◽  
Risk Reduction ◽  
Conceptual Model ◽  
Implementation Strategies ◽  
Lessons Learned ◽  
Routine Practice ◽  
Practice Nurses ◽  
Implementing Change ◽  
Dementia Risk ◽  
Australian General Practice

Dementia is now a global health priority. With no known cure, the best way to reduce the number of people who will be living with dementia is by promoting dementia risk reduction (DRR). However, despite evidence-based guidelines, DRR is not yet routinely promoted in Australian general practice. Previously, we proposed a preliminary conceptual model for implementing DRR in primary care based on our scoping review of practitioners’ views. The present study aimed to refine this model for the Australian context by incorporating the current perspectives of Australian general practitioners (GPs) and general practice nurses (GPNs) about DRR. Interviews with 17 GPs and GPNs were analysed using the framework method, underpinned by the Consolidated Framework for Implementation Research (CFIR). We identified 12 barriers to promoting DRR in Australian general practice, along with five facilitators. Using the CFIR–Expert Recommendations for Implementing Change (ERIC) Matching Tool to select prioritised implementation strategies from the ERIC project, the findings were incorporated into a refined conceptual model. The refined model points to an implementation intervention that uses educational materials and meetings to reach consensus with GPs and GPNs on the importance of promoting DRR and an appropriate approach. Champion GPs and GPNs should be prepared to drive the agreed implementation forward, and general practices should share successes and lessons learned. This model is a crucial step in bridging the gap between DRR guidelines and routine practice.

A qualitative study of older and middle-aged adults' perception and attitudes towards dementia and dementia risk reduction

2015 ◽  
Vol 71 (7) ◽  
pp. 1694-1703 ◽  
Author(s):  
Sarang Kim ◽  
Kerry A. Sargent-Cox ◽  
Kaarin J. Anstey
Keyword(s):  
Qualitative Study ◽  
Risk Reduction ◽  
Middle Aged ◽  
Dementia Risk ◽  
Middle Aged Adults

scholarly journals F1-01-02: THE BODY-BRAIN-LIFE PROJECT: PRELIMINARY RESULTS FROM AN ONLINE TRIAL OF DEMENTIA RISK REDUCTION IN MIDDLE-AGED ADULTS

2014 ◽  
Vol 10 ◽  
pp. P124-P124
Author(s):  
Kaarin Jane Anstey ◽  
Alex Bahar-Fuchs ◽  
George Rebok ◽  
Nicolas Cherbuin ◽  
Pushpani Herath ◽  
...  
Keyword(s):  
Risk Reduction ◽  
The Body ◽  
Middle Aged ◽  
Life Project ◽  
Preliminary Results ◽  
Dementia Risk ◽  
Middle Aged Adults
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