Dementia Policy Flashcards
What are some of the major problems associated with living with dementia?
▪️Loneliness
▪️Community isolation
▪️Comorbid medical conditions or disabilities
▪️Lack of autonomy
▪️Lack of goverent support
What are the 5 “We” statements of the Dementia Action Alliance?
- Right to be recognised for who they are, not a diagnosis
- Right to live without discrimination or social isolation
- Right to early diagnosis and treatment
- Right to plan and make decisions about their future
- Right to know about and participate in current research
What is the National Dementia Strategy (2009)?
A strategic framework with 17 objectives that aim to improve:
▪️Awareness of dementia
▪️Earlier diagnosis and intervention and research
▪️Quality of dementia care and support
What is NOT covered by the National Dementia Strategy?
Prevention
What were the three goals of the Prime Minister’s challenge on Dementia (2012)?
▪️Improve health and care
▪️Raise awareness
▪️Better research
(by 2020)
What positive changes came out of the Prime Minister’s challenge on Dementia?
▪️The UKDRI
▪️Dementia Friends (education of people without healthcare background)
▪️Named GP coordinating care
▪️Faster access to diagnosis and post-diagnosis support
What were the main problems to David Cameron’s dementia initiatives?
The 2010 coelition and his resignation in 2016
Is national dementia screening recommended and why?
No!
▪️No current accurate tests
▪️No current confident treatments
What are the five main parts of the Well Pathway for Dementia?
- Preventing well
- Diagnosing well
- Supporting well
- Living well
- Dying well
What are the five secondary parts of the Well Pathway for Dementia?
▪️Researching
▪️Integrating
▪️Commissioning
▪️Training
▪️Monitoring
What is the dementia diagnosis rate?
The ratio between those with a diagnosis and those without.
No. with diagnosis in GP records /total estimated to have dementia
What is the national aim for dementia diagnosis?
Two thirds of the estimated number of people with dementia should be diagnosed with appropriate post-diagnostic support
What happens if the dementia diagnosis rate becomes too low in an area?
The Clinical commissioning groups are offered intensive support
Why did DDR improve massively in early 2015?
Introduction of better GP coding
Why has the DDR decreased recently?
Covid-19
What trend has been seen regarding the prescription of antipsychotics in dementia?
A reduction of almost half (now ~10%)
(although with a slight postpandemic increase)
Why have antipsychotic prescriptions for dementia decreased?
Concerns over necessity and adverse side effects.
There has been an important recent initiative to ensure they are used only as a last resort, at a minimal dose and for a minimal duration.
What trend has been seen regarding the prescription of antidementia medication?
An increase, now over half of patients
What are the main aims of the NHS Operational Planning and Contracting Guidance (2017-18)?
▪️Increase no. diagnosed with dementia and starting treatment withing 6 weeks from referral
▪️Improve quality of post-diagnostic treatment and support
What aspects of the NICE guideline were investigated by the National Memory Service Audit in 2019?
▪️Wait from referral to diagnosis
▪️% diagnosed within 6 weeks
▪️% offered CST
▪️% who refused CST
▪️% offered a dementia advisor
▪️% offered carer education
▪️Access to research
What were the main findings of the National Memory Service Audit (2019)?
▪️Performance is highly variable across services
▪️30% are diagnosed within 6 weeks and 75% within 18 weeks
▪️CST is not offered as much as it should be
▪️Lots of people are offered dementia advisors
What percentage of dementia worldwide is accounted for by modifiable risk factors?
40%
What are the two main routes to dementia prevention?
▪️Reducing neuropathological damage
▪️Increasing and maintaining cognitive reserve
What can we do to increase and maintain cognitive reserve, thus reducing likelihood of dementia?
▪️Treat hearing impairment
▪️Frequent social contact
▪️Attain high education levels
▪️Frequent exercise
▪️Reduce occurrence of depression
▪️Avoid excessive alcohol
What modifiable risk factors may contribute to the neuropathological damage seen in dementia?
▪️Diabetes
▪️Hypertension
▪️Head injury
▪️Smoking
▪️Air pollution
▪️Midlife obesity
Is the risk of dementia in the UK currently increasing or decreasing?
Decreasing
Why, if risk for dementia is decreasing, is the prevalence still increasing?
People are living longer
Age is the biggest non-modifiable risk factor
What are the current major challenges to dementia care?
▪️Memory service practice is variable
▪️Covid-19
▪️Diagnostic and treatment pathways are very non-medical
▪️No proper public health strategy for prevention
What have been the major advances of dementia care in recent years?
▪️Raised awareness
▪️Better clinical guidance
▪️Increased diagnostic rate
▪️Reduced use of antipsychotics
▪️Post-diagnostic support commission
▪️Research infrastructure
