BackgroundCommunity health professionals play a significant role in dementia care. However, little is known about community health professionals’ capacity in dementia care, especially in low and middle-income countries. The aim of the present study was to assess community health professionals’ dementia knowledge, attitudes and care approach in China, a country with the largest population of people with dementia in the world and where community based dementia care services are much needed.MethodsA cross-sectional survey was conducted. 450 health professionals were recruited into the study using random sampling from community health service centres in Changsha, China. Their knowledge, attitudes and care approach were assessed utilising the Chinese version of the Alzheimer’s Disease Knowledge Scale, Dementia Care Attitude Scale and Approach to Advanced Dementia Care Questionnaire respectively.ResultsA total of 390 participants returned the questionnaire (response rate 87%). Age, education, professional group and care experience were associated with knowledge scores, and overall dementia knowledge was poor. Attitudes were generally positive and influenced by age, professional group, gender and care experience. The experience of caring for people with dementia was positively associated with a person-centred care approach, although the participants tended not to use a person-centred care approach. A statistically significant association was found between knowledge and attitudes (r = 0.379, P < 0.001), and between attitudes and care approach (r = 0.143, P < 0.001). However, dementia knowledge has no relationship with a person-centred approach.ConclusionsCommunity health professionals showed generally positive attitudes towards people with dementia. However, they demonstrated poor dementia knowledge and tended not to use a person-centred care approach. The results suggest that a multifaceted approach consisting of educational interventions for community health professionals, and policy and resource development to meet the demand for community dementia care services, is urgently needed in China.

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Background Clinicians, older adults and caregivers frequently meet to make decisions around treatment and lifestyle during an acute hospital admission. Patient age, psychological status and health locus of control (HLC) influence patient preference for consultation involvement and information but overall, a shared-decisionmaking (SDM) approach is favoured. However, it is not known whether these characteristics and the presence of cognitive impairment influence SDM competency during family meetings.

Running head: quality of life of frail older people in residential aged care Results: There was a large divergence in mean (SD) utility scores at baseline for the EQ-5D-5Land DEMQOL-U [EQ-5D-5L mean 0.21 (0.19); DEMQOL-U mean 0.79 (0.14)]. However, at 4 weeks a stronger degree of convergence was evident [EQ-5D-5L mean 0.45(0.38); DEMQOL-U mean 0.58 (0.38). The EQ-5D was more responsive to the physical recovery trajectory experienced by frail older people following surgery to repair a fractured hip, whereas the DEMQOL-U and DEMQOL-Proxy-U instruments were more responsive to the changes in cognitive functioning often experienced by frail older people in this period. Conclusions

Objective to determine whether a 4-week postoperative rehabilitation program delivered in Nursing Care Facilities (NCFs) would improve quality of life and mobility compared with receiving usual care. Design parallel randomised controlled trial with integrated health economic study. Setting NCFs, in Adelaide South Australia. Subjects people aged 70 years and older who were recovering from hip fracture surgery and were walking prior to hip fracture. Measurements primary outcomes: mobility (Nursing Home Life-Space Diameter (NHLSD)) and quality of life (DEMQOL) at 4 weeks and 12 months. Results participants were randomised to treatment ( n = 121) or control ( n = 119) groups. At 4 weeks, the treatment group had better mobility (NHLSD mean difference −1.9; 95% CI: −3.3, −0.57; P = 0.0055) and were more likely to be alive (log rank test P = 0.048) but there were no differences in quality of life. At 12 months, the treatment group had better quality of life (DEMQOL sum score mean difference = −7.4; 95% CI: −12.5 to −2.3; P = 0.0051), but there were no other differences between treatment and control groups. Quality adjusted life years (QALYs) gained over 12 months were 0.0063 higher per participant (95% CI: −0.0547 to 0.0686). The resulting incremental cost effectiveness ratios (ICERs) were $5,545 Australian dollars per unit increase in the NHLSD (95% CI: $244 to $15,159) and $328,685 per QALY gained (95% CI: $82,654 to $75,007,056). Conclusions the benefits did not persist once the rehabilitation program ended but quality of life at 12 months in survivors was slightly higher. The case for funding outreach home rehabilitation in NCFs is weak from a traditional health economic perspective. Trial registration ACTRN12612000112864 registered on the Australian and New Zealand Clinical Trials Registry. Trial protocol available at

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