Culturally tailored therapeutic interventions for people affected by dementia: a systematic review and new conceptual model

James, Tiffeny; Mukadam, Naaheed; Sommerlad, Andrew; Ceballos, Stefanny Guerra; Livingston, Gill

doi:10.1016/s2666-7568(21)00001-5

Cited by 14 publications

(20 citation statements)

References 44 publications

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“…PLWD also have high comorbidities, particularly older PLWD, emphasising how vital treating dementia and comorbidities is to maintaining health and quality of life [60,61]. Furthermore, holistic care, involving non-medicative treatments can be beneficial [62,63].…”

Section: Implications For Policy Practice and Researchmentioning

confidence: 99%

The Impact of Demographic, Socio-Economic and Geographic Factors on Mortality Risk among People Living with Dementia in England (2002–2016)

Watson

Darlington‐Pollock

Green

et al. 2021

IJERPH

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Increasing numbers of people living with dementia (PLWD), and a pressured health and social care system, will exacerbate inequalities in mortality for PLWD. There is a dearth of research examining multiple factors in mortality risk among PLWD, including application of large administrative datasets to investigate these issues. This study explored variation mortality risk variation among people diagnosed with dementia between 2002–2016, based on: age, sex, ethnicity, deprivation, geography and general practice (GP) contacts. Data were derived from electronic health records from a cohort of Clinical Practice Research Datalink GP patients in England (n = 142,340). Cox proportional hazards regression modelled mortality risk separately for people with early- and later- onset dementia. Few social inequalities were observed in early-onset dementia; men had greater risk of mortality. For early- and later-onset, higher rates of GP observations—and for later-onset only dementia medications—are associated with increased mortality risk. Social inequalities were evident in later-onset dementia. Accounting for other explanatory factors, Black and Mixed/Other ethnicity groups had lower mortality risk, more deprived areas had greater mortality risk, and higher mortality was observed in North East, South Central and South West GP regions. This study provides novel evidence of the extent of mortality risk inequalities among PLWD. Variance in mortality risk was observed by social, demographic and geographic factors, and frequency of GP contact. Findings illustrate need for greater person-centred care discussions, prioritising tackling inequalities among PLWD. Future research should explore more outcomes for PLWD, and more explanatory factors of health outcomes.

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Section: Implications For Policy Practice and Researchmentioning

confidence: 99%

The Impact of Demographic, Socio-Economic and Geographic Factors on Mortality Risk among People Living with Dementia in England (2002–2016)

Watson

Darlington‐Pollock

Green

et al. 2021

IJERPH

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“…We had no control group in this trial, unlike the original RCT where the control group's mental health deteriorated, thus accentuating the between‐group difference. Nevertheless, it is appropriate to use an acceptability and feasibility trial rather than a full controlled trial is not necessary to test an intervention that has not modified its therapeutic components 15 …”

Section: Discussionmentioning

confidence: 99%

Tailoring STrAtegies for RelaTives for Black and South Asian dementia family carers in the United Kingdom: A mixed methods study

Webster

Amador²,

Rapaport

et al. 2023

Int J Geriat Psychiatry

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Objectives We culturally adapted STrAtegies for RelaTives (START), a clinically and cost‐effective intervention for dementia family carers, for Black and South Asian families. It had previously been delivered to family carers around the time of diagnosis, when most people with dementia had very mild, mild or moderate dementia. Methods We interviewed a maximum variation sample of family carers (phase one; n = 15 South Asian; n = 11 Black) about what aspect of START, required cultural adaptation, then analysed it thematically using the Cultural Treatment Adaptation Framework then adapted it in English and into Urdu. Facilitators then delivered START individually to carers (phase two; n = 13 South Asian; n = 8 Black). We assessed acceptability and feasibility through the number of sessions attended, score for fidelity to the intervention and interviewing family carers about their experiences. We used the Hospital Anxiety and Depression Scale. to examine whether immediate changes in family carers' mental health were in line with previous studies. Results In phase one we made adaptations to peripheral elements of START, clarifying language, increasing illustrative vignettes numbers, emphasising privacy and the facilitator's cultural competence and making images ethnically diverse. In phase two 21 family carers consented to receive the adapted intervention; 12 completed ≥5/8 sessions; four completed fewer sessions and five never started. Baseline HADS score (n = 21) was 14.4 (SD = 9.8) but for those who we were able to follow up was 12.3 (SD 8.1) and immediately post‐intervention was 11.3 (n = 10; SD = 6.1). Family carers were positive about the adapted START and continued to use elements after the intervention. Conclusions Culturally adapted START was acceptable and feasible in South Asian and Black UK‐based family carers and changes in mental health were in line with those in the original clinical trial. Our study shows that culturally inclusive START was also acceptable. Changes made in adaptations were relevant to all populations. We now use the adapted version for all family carers irrespective of ethnicity.

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“…First, by estimating dementia prevalence by migrant heterogeneity, mechanisms to culturally adapt existing evidence on dementia prevention can be established. 29 Better targeting of specific communities is also possible. To date, risk reduction messaging targeted at older migrants has been inadequate.…”

Section: Discussionmentioning

confidence: 99%

The role of demographic change in explaining the growth of Australia's older migrant population living with dementia, 2016–2051

Temple

Wilson

Brijnath

et al. 2022

Australian and New Zealand Journal of Public Health

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Objective: To examine the demographic drivers contributing to the future growth in the population of older migrants in Australia living with dementia. Methods: Using birthplace‐specific cohort‐component projection models, we projected the number of older migrants living with dementia. ABS data on births, deaths, migration and birthplace were used, alongside Australian Institute of Health and Welfare (AIHW) estimates of dementia prevalence with birthplace dementia weights calculated from administrative data. Results: The number of older migrants living with dementia is projected to increase from about 134,423 in 2016 to 378,724 by 2051. Increases in populations with dementia varied considerably, from a slight decrease for those born in Southern & Eastern Europe to over 600% increases amongst the South‐East Asia, Southern & Central Asia, and Sub‐Saharan Africa‐born populations. Conclusions: Cohort flow is the primary driver increasing the number of older migrants living with dementia. This growth is largely inevitable because the cohorts are already living in Australia as part of the migrant population, but currently at ages below 60 years. Implications for public health: High relative growth and shifting birthplace composition in the number of migrants living with dementia poses implications for culturally appropriate care, health care access and workforce needs to support migrant families, carers and their communities.

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Culturally tailored therapeutic interventions for people affected by dementia: a systematic review and new conceptual model

Cited by 14 publications

References 44 publications

The Impact of Demographic, Socio-Economic and Geographic Factors on Mortality Risk among People Living with Dementia in England (2002–2016)

The Impact of Demographic, Socio-Economic and Geographic Factors on Mortality Risk among People Living with Dementia in England (2002–2016)

Tailoring STrAtegies for RelaTives for Black and South Asian dementia family carers in the United Kingdom: A mixed methods study

The role of demographic change in explaining the growth of Australia's older migrant population living with dementia, 2016–2051

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