scholarly journals Dementia Risk Scores and Their Role in the Implementation of Risk Reduction Guidelines

2022 ◽  
Vol 12 ◽  
Author(s):  
Kaarin J. Anstey ◽  
Lidan Zheng ◽  
Ruth Peters ◽  
Scherazad Kootar ◽  
Mariagnese Barbera ◽  
...  
Keyword(s):  
Risk Reduction ◽  
World Health Organisation ◽  
World Health ◽  
Risk Scores ◽  
Policy And Practice ◽  
Targeted Interventions ◽  
Dementia Risk ◽  
Dementia Prevention ◽  
Wide Range ◽  
Evidence Based Guidelines

Dementia prevention is a global health priority. In 2019, the World Health Organisation published its first evidence-based guidelines on dementia risk reduction. We are now at the stage where we need effective tools and resources to assess dementia risk and implement these guidelines into policy and practice. In this paper we review dementia risk scores as a means to facilitate this process. Specifically, we (a) discuss the rationale for dementia risk assessment, (b) outline some conceptual and methodological issues to consider when reviewing risk scores, (c) evaluate some dementia risk scores that are currently in use, and (d) provide some comments about future directions. A dementia risk score is a weighted composite of risk factors that reflects the likelihood of an individual developing dementia. In general, dementia risks scores have a wide range of implementations and benefits including providing early identification of individuals at high risk, improving risk perception for patients and physicians, and helping health professionals recommend targeted interventions to improve lifestyle habits to decrease dementia risk. A number of risk scores for dementia have been published, and some are widely used in research and clinical trials e.g., CAIDE, ANU-ADRI, and LIBRA. However, there are some methodological concerns and limitations associated with the use of these risk scores and more research is needed to increase their effectiveness and applicability. Overall, we conclude that, while further refinement of risk scores is underway, there is adequate evidence to use these assessments to implement guidelines on dementia risk reduction.

scholarly journals Multidomain interventions: state-of-the-art and future directions for protocols to implement precision dementia risk reduction. A user manual for Brain Health Services—part 4 of 6

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Alina Solomon ◽  
Ruth Stephen ◽  
Daniele Altomare ◽  
Emmanuel Carrera ◽  
Giovanni B. Frisoni ◽  
...  
Keyword(s):  
Health Services ◽  
Risk Reduction ◽  
Risk Groups ◽  
Risk Scores ◽  
Current Evidence ◽  
Brain Health ◽  
Dementia Risk ◽  
Dementia Prevention ◽  
Multidomain Intervention ◽  
Prevention Trials

AbstractAlthough prevention of dementia and late-life cognitive decline is a major public health priority, there are currently no generally established prevention strategies or operational models for implementing such strategies into practice. This article is a narrative review of available evidence from multidomain dementia prevention trials targeting several risk factors and disease mechanisms simultaneously, in individuals without dementia at baseline. Based on the findings, we formulate recommendations for implementing precision risk reduction strategies into new services called Brain Health Services. A literature search was conducted using medical databases (MEDLINE via PubMed and SCOPUS) to select relevant studies: non-pharmacological multidomain interventions (i.e., combining two or more intervention domains), target population including individuals without dementia, and primary outcomes including cognitive/functional performance changes and/or incident cognitive impairment or dementia. Further literature searches covered the following topics: sub-group analyses assessing potential modifiers for the intervention effect on cognition in the multidomain prevention trials, dementia risk scores used as surrogate outcomes in multidomain prevention trials, dementia risk scores in relation to brain pathology markers, and cardiovascular risk scores in relation to dementia. Multidomain intervention studies conducted so far appear to have mixed results and substantial variability in target populations, format and intensity of interventions, choice of control conditions, and outcome measures. Most trials were conducted in high-income countries. The differences in design between the larger, longer-term trials that met vs. did not meet their primary outcomes suggest that multidomain intervention effectiveness may be dependent on a precision prevention approach, i.e., successfully identifying the at-risk groups who are most likely to benefit. One such successful trial has already developed an operational model for implementing the intervention into practice. Evidence on the efficacy of risk reduction interventions is promising, but not yet conclusive. More long-term multidomain randomized controlled trials are needed to fill the current evidence gaps, especially concerning low- and middle-income countries and integration of dementia prevention with existing cerebrovascular prevention programs. A precision risk reduction approach may be most effective for dementia prevention. Such an approach could be implemented in Brain Health Services.

scholarly journals Reducing the Risk of Cognitive Decline and Dementia: WHO Recommendations

2022 ◽  
Vol 12 ◽  
Author(s):  
Neerja Chowdhary ◽  
Corrado Barbui ◽  
Kaarin J. Anstey ◽  
Miia Kivipelto ◽  
Mariagnese Barbera ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Risk Reduction ◽  
Social Care ◽  
Guideline Development ◽  
Action Plan ◽  
World Health Organisation ◽  
World Health ◽  
Public Health Response ◽  
Health And Social Care ◽  
The World

With population ageing worldwide, dementia poses one of the greatest global challenges for health and social care in the 21st century. In 2019, around 55 million people were affected by dementia, with the majority living in low- and middle-income countries. Dementia leads to increased costs for governments, communities, families and individuals. Dementia is overwhelming for the family and caregivers of the person with dementia, who are the cornerstone of care and support systems throughout the world. To assist countries in addressing the global burden of dementia, the World Health Organisation (WHO) developed the Global Action Plan on the Public Health Response to Dementia 2017–2025. It proposes actions to be taken by governments, civil society, and other global and regional partners across seven action areas, one of which is dementia risk reduction. This paper is based on WHO Guidelines on risk reduction of cognitive decline and dementia and presents recommendations on evidence-based, multisectoral interventions for reducing dementia risks, considerations for their implementation and policy actions. These global evidence-informed recommendations were developed by WHO, following a rigorous guideline development methodology and involved a panel of academicians and clinicians with multidisciplinary expertise and representing geographical diversity. The recommendations are considered under three broad headings: lifestyle and behaviour interventions, interventions for physical health conditions and specific interventions. By supporting health and social care professionals, particularly by improving their capacity to provide gender and culturally appropriate interventions to the general population, the risk of developing dementia can be potentially reduced, or its progression delayed.

scholarly journals Development of the First WHO Guidelines for Risk Reduction of Cognitive Decline and Dementia: Lessons Learned and Future Directions

2021 ◽  
Vol 12 ◽  
Author(s):  
Ruth Stephen ◽  
Mariagnese Barbera ◽  
Ruth Peters ◽  
Nicole Ee ◽  
Lidan Zheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Decline ◽  
Risk Reduction ◽  
Individual Risk ◽  
Who Guidelines ◽  
Dementia Risk ◽  
Dementia Prevention ◽  
Multidomain Intervention ◽  
Intervention Trials ◽  
Individual Risk Factors

The first WHO guidelines for risk reduction of cognitive decline and dementia marked an important milestone in the field of dementia prevention. In this paper, we discuss the evidence reviewed as part of the guidelines development and present the main themes emerged from its synthesis, to inform future research and policies on dementia risk reduction. The role of intervention effect-size; the mismatch between observational and intervention-based evidence; the heterogeneity of evidence among intervention trials; the importance of intervention duration; the role of timing of exposure to a certain risk factor and interventions; the relationship between intervention intensity and response; the link between individual risk factors and specific dementia pathologies; and the need for tailored interventions emerged as the main themes. The interaction and clustering of individual risk factors, including genetics, was identified as the overarching theme. The evidence collected indicates that multidomain approaches targeting simultaneously multiple risk factors and tailored at both individual and population level, are likely to be most effective and feasible in dementia risk reduction. The current status of multidomain intervention trials aimed to cognitive impairment/dementia prevention was also briefly reviewed. Primary results were presented focusing on methodological differences and the potential of design harmonization for improving evidence quality. Since multidomain intervention trials address a condition with slow clinical manifestation—like dementia—in a relatively short time frame, the need for surrogate outcomes was also discussed, with a specific focus on the potential utility of dementia risk scores. Finally, we considered how multidomain intervention could be most effectively implemented in a public health context and the implications world-wide for other non-communicable diseases targeting common risk factors, taking into account the limited evidence in low-middle income countries. In conclusion, the evidence from the first WHO guidelines for risk reduction of cognitive decline and dementia indicated that “one size does not fit all,” and multidomain approaches adaptable to different populations and individuals are likely to be the most effective. Harmonization in trial design, the use of appropriate outcome measures, and sustainability in large at-risk populations in the context of other chronic disorders also emerged as key elements.

scholarly journals Future Directions for Dementia Risk Reduction and Prevention Research: An International Research Network on Dementia Prevention Consensus

2020 ◽  
Vol 78 (1) ◽  
pp. 3-12
Author(s):  
Kaarin J. Anstey ◽  
Ruth Peters ◽  
Lidan Zheng ◽  
Deborah E. Barnes ◽  
Carol Brayne ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Reduction ◽  
International Research ◽  
Large Body ◽  
Geographical Location ◽  
Evidence Base ◽  
Research Network ◽  
Future Research ◽  
Dementia Risk ◽  
Dementia Prevention

In the past decade a large body of evidence has accumulated on risk factors for dementia, primarily from Europe and North America. Drawing on recent integrative reviews and a consensus workshop, the International Research Network on Dementia Prevention developed a consensus statement on priorities for future research. Significant gaps in geographical location, representativeness, diversity, duration, mechanisms, and research on combinations of risk factors were identified. Future research to inform dementia risk reduction should fill gaps in the evidence base, take a life-course, multi-domain approach, and inform population health approaches that improve the brain-health of whole communities.

scholarly journals Teaching clinical handover with ISBAR

2020 ◽  
Vol 20 (S2) ◽  
Author(s):  
Annette Burgess ◽  
Christie van Diggele ◽  
Chris Roberts ◽  
Craig Mellis
Keyword(s):  
Health Professional ◽  
Community Setting ◽  
World Health Organisation ◽  
World Health ◽  
Clinical Environment ◽  
Clinical Handover ◽  
Professional Students ◽  
Wide Range ◽  
Health Professional Students ◽  
Patient Care Errors

AbstractClinical handover is one of the most critical steps in a patient’s journey and is a core skill that needs to be taught to health professional students and junior clinicians. Performed well, clinical handover should ensure that lapses in continuity of patient care, errors and harm are reduced in the hospital or community setting. Handover, however, is often poorly performed, with critical detail being omitted and irrelevant detail included. Evidence suggests that the use of a structured, standardised framework for handover, such as ISBAR, improves patient outcomes. The ISBAR (Introduction, Situation, Background, Assessment, Recommendation) framework, endorsed by the World Health Organisation, provides a standardised approach to communication which can be used in any situation. In the complex clinical environment of healthcare today, ISBAR is suited to a wide range of clinical contexts, and works best when all parties are trained in using the same framework. It is essential that healthcare leaders and professionals from across the health disciplines work together to ensure good clinical handover practices are developed and maintained. Organisations, including universities and hospitals, need to invest in the education and training of health professional students and health professionals to ensure good quality handover practice. Using ISBAR as a framework, the purpose of this paper is to highlight key elements of effective clinical handover, and to explore teaching techniques that aim to ensure the framework is embedded in practice effectively.

scholarly journals Sociodemographic factors associated with Public knowledge of dementia in a Cuban population

2021 ◽  
Author(s):  
Zoylen Fernandez-Fleites ◽  
Yunier Broche-Perez ◽  
Claire Eccleston ◽  
Elizabeth Jimenez-Puig ◽  
Evelyn Fernandez-Castillo
Keyword(s):  
Risk Reduction ◽  
Sociodemographic Factors ◽  
Demographic Variables ◽  
Cognitive Stimulation ◽  
University Education ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Dementia Risk ◽  
Dementia Prevention ◽  
Cuban Population

population with regard to dementia risk factors and to determine the demographic variables related with it. Study design: A cross-sectional survey was carried out on 1004 Cubans. Methods: The survey measured the importance placed on dementia, risk reduction knowledge and the actions to prevent it. Logistic regression was undertaken to identify variables associated with knowledge. Results: Most respondents (47.5%) believe that dementia risk reduction should start before age of 40. Cognitive stimulation and physical activities were selected with major frequency. Being older than 48 years, having previous contact with dementia and university education increases the probability of having healthy lifestyles. Conclusions: The exploration of demographic variables allows the prediction of likelihood to know about or have positive beliefs in relation to dementia. They should be contemplated into strategies for dementia prevention in Cuban population.

scholarly journals Creation and Worldwide Utilisation of New COVID-19 Online Information Hub for Genetics Health Professionals, Patients and Families

2021 ◽  
Vol 12 ◽  
Author(s):  
Adam P. Tobias ◽  
Jonathan Berg ◽  
Roseanne Cetnarskyj ◽  
Zosia Miedzybrodzka ◽  
Mary E. Porteous ◽  
...  
Keyword(s):  
Human Genetics ◽  
Genetic Disorders ◽  
Protein Structures ◽  
World Health Organisation ◽  
Relevant Information ◽  
Steering Committee ◽  
World Health ◽  
Online Information ◽  
The Public ◽  
Wide Range

The current COVID-19 pandemic has unfortunately resulted in many significant concerns for individuals with genetic disorders and their relatives, regarding the viral infection and, particularly, its specific implications and additional advisable precautions for individuals affected by genetic disorders. To address this, the resulting requirement for guidance and information for the public and for genetics professionals was discussed among colleagues nationally, on the ScotGEN Steering Committee, and internationally on the Education Committee of the European Society of Human Genetics (ESHG). It was agreed that the creation of an online hub of genetics-related COVID-19 information resources would be particularly helpful. The proposed content, divided into a web page for professionals and a page for patients, was discussed with, and approved by, genetics professionals. The hub was created and provided online at www.scotgen.org.uk and linked from the ESHG’s educational website for genetics and genomics, at www.eurogems.org. The new hub provides links, summary information and representative illustrations for a wide range of selected international resources. The resources for professionals include: COVID-19 research related hubs provided by Nature, Science, Frontiers, and PubMed; clinical guidelines; the European Centre for Disease Prevention and Control; the World Health Organisation; and molecular data sources including coronavirus 3D protein structures. The resources for patients and families include links to many accessible sources of support and relevant information. Since the launch of the pages, the website has received visits from over 50 countries worldwide. Several genetics consultants have commented on usefulness, clarity, readability, and ease of navigation. Visits have originated most frequently in the United Kingdom, Kuwait, Hong Kong, Moldova, United States, Philippines, France, and Qatar. More links have been added since the launch of the hub to include additional international public health and academic resources. In conclusion, an up-to-date online hub has been created and made freely available for healthcare professionals, patients, relatives and the public, providing categorised easily navigated links to a range of worldwide resources related to COVID-19. These pages are receiving a rapidly growing number of return visits and the authors continue to maintain and update the pages’ content, incorporating new developments in this field of enormous worldwide importance.

Role of Chyavanprashas a Rasayana in combating an outbreak of COVID-19

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 165-170
Author(s):  
Rajni Kamlakar Gurmule
Keyword(s):  
Causative Factor ◽  
World Health Organisation ◽  
Viral Disease ◽  
World Health ◽  
Human Beings ◽  
Healthy Life ◽  
Wide Range ◽  
High Incidence ◽  
Better Than

Today the whole world is suffering from the most dreadful disease that is Covid 19. The Causative factor for COVID 19 is SARS-COV2. It was ϑirst noticed in Wuhan city of China. World Health Organisation declared the fatality of this disease as a pandemic. This disease has become a problem of great concern globally. This virus targets the respiratory system of human beings. There is a high incidence of person to person transmission of this disease through contact. However, there is also a signiϑicant role in innate immunity in pathogenesis and management of this disease. The whole world is seeking for ϑlawless control of this viral disease. Ayurveda is a holistic science. Its aim is not only on the cure of diseases but also on its prevention. It emphasises mainly on healthy life of an individual. There is a wide range of principles described in Ayurveda which are used to combat disease from its root. Rasayana Chikista is a useful principle of Ayurveda, beneϑicial for management and prevention of many diseases. It is always said that “prevention is better than cure”. Chyavanprash is one of the well known Rasayana. Contents of Chyavanprash shows a wide range of actions on respiratory diseases as well as on boosting immunity. These properties of it provoke us to review the role of Chyavanprash in the prevention of Covid 19, thereby increasing one’s immune response. This Chyavanaprash can be a boon in the prevention of Covid 19 by improving immunity against it.

scholarly journals OVERSIMPLIFICATION OF DEMENTIA RISK REDUCTION MESSAGING IS A THREAT TO KNOWLEDGE TRANSLATION IN DEMENTIA PREVENTION RESEARCH

2017 ◽  
pp. 1-3
Author(s):  
K.J. Anstey ◽  
R. Peters
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Risk Factor ◽  
Knowledge Translation ◽  
Risk Reduction ◽  
Assessment Tools ◽  
Prevention Research ◽  
Dementia Risk ◽  
Dementia Prevention

The evidence for specific risk factors for Alzheimer’s disease, vascular dementia and all cause dementia is increasing rapidly in quantity and quality. This has enabled the compilation of risk assessment tools for Alzheimer’s disease (1), and their validation (2). It has also supported the promulgation of public health messaging about dementia risk reduction or dementia prevention. In general these developments are strong advances in the field of dementia prevention. However, the oversimplification of the findings and possible over-or mis-interpretation of their meaning, poses risks to accurate and effective knowledge translation in this field. Lack of balance in the interpretation of evidence on risk factors for dementia may lead to trials of interventions for dementia prevention that are ineffective. This will waste resources and create pessimism about dementia prevention research. Two potential problems that may occur when translating evidence from observational research into prescriptions for prevention are identified here. The first is the generalisation of specific findings about risk factors either to multiple types of dementia or to multiple populations, when the evidence is in fact relevant to specific populations or outcomes. The second is the inference that reversal of a risk factor will lead to prevention, without knowledge of the threshold at which a factor becomes a ‘risk’, or evidence that reversal of the risk factor also reverses neuropathological processes instigated or caused by the risk factor.

scholarly journals Age-Friendly Built Environment

Encyclopedia ◽  
2021 ◽  
Vol 1 (3) ◽  
pp. 781-791
Author(s):  
Hing-Wah Chau ◽  
Elmira Jamei
Keyword(s):  
Older Adults ◽  
Built Environment ◽  
Independent Living ◽  
Holistic Approach ◽  
World Health Organisation ◽  
Living Environment ◽  
World Health ◽  
Active Ageing ◽  
Outdoor Spaces ◽  
Wide Range

Age-friendly built environments have been promoted by the World Health Organisation (WHO, Geneva, Switzerland) under the Global Age-friendly Cities (AFC) movement in which three domains are related to the built environment. These are: housing, transportation, outdoor spaces and public buildings. The aim is to foster active ageing by optimising opportunities for older adults to maximise their independent living ability and participate in their communities to enhance their quality of life and wellbeing. An age-friendly built environment is inclusive, accessible, respects individual needs and addresses the wide range of capacities across the course of life. Age-friendly housing promotes ageing in familiar surroundings and maintains social connections at the neighbourhood and community levels. Both age-friendly housing and buildings provide barrier-free provisions to minimise the needs for subsequent adaptations. Age-friendly public and outdoor spaces encourage older adults to spend time outside and engage with others against isolation and loneliness. Age-friendly public transport enables older adults to get around and enhances their mobility. For achieving an age-friendly living environment, a holistic approach is required to enable independent living, inclusion and active participation of older adults in society. The eight domains of the AFC movement are not mutually exclusive but overlap and support with one another.

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