Dementia as a source of social disadvantage and exclusion

Biggs, Simon; Carr, Ashley; Haapala, Irja

doi:10.1111/ajag.12654

Cited by 38 publications

(31 citation statements)

References 14 publications

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“…Social function may deteriorate due to conversion to dementia; however, the limitation and decrease of social activities may adversely affect the progression of dementia. This has been reported consistently in various studies [14-16, 22, 45-48]. Recently, a meta-analysis [49] concluded that social relationship factors that represent a lack of social interaction are associated with incident dementia.…”

Section: Discussionmentioning

confidence: 63%

Characteristics of Individuals Who Converted to Dementia during a 5-Year Follow-Up

Yun

Jung

et al. 2020

Dement Geriatr Cogn Disord

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Introduction: Early diagnosis of dementia is important; however, the diagnostic criteria for the preclinical stage of dementia, including biomarkers and pathophysiological markers, are not suitable for application in patients in real-world clinical settings. One potential noninvasive method to predict the risk of dementia conversion is the neuropsychological test. Therefore, in this study, we examined the results of various assessments, such as comprehensive neuropsychological tests, and the daily function of participants who were evaluated periodically for 5 years. Methods: All participants were outpatients or inpatients with subjective cognitive complaints, who visited a local university hospital for neuropsychiatric evaluation, between January 2011 and January 2019. Of a total of 1,652 subjects who underwent initial screening during this period, 107 were nondemented individuals. These participants underwent periodic comprehensive cognitive tests for up to 5 years. Survival and factors affecting dementia conversion were analyzed using the time-dependent Cox regression analysis. Assessment items included demographic information, including age, sex, and education; 5 cognitive domains of a comprehensive neuropsychological test including memory, language, attention, visuospatial functions, and frontal (executive) function; Barthel’s activities of daily living; the mini-mental state examination findings; and clinical dementia rating (CDR) scores. Results: This study included 61 participants (21 women and 40 men) who developed dementia during the study period. Verification of the cognitive variables affecting dementia conversion revealed that better memory was associated with a lower risk of conversion (hazard ratio [HR] = 0.614, p = 0.005) and higher attention was associated with a higher risk of conversion (HR = 1.602, p = 0.023). In the analysis of the subscales of the CDR, a higher community affairs score (i.e., less social activities) was associated with a higher risk of conversion (HR = 10.814, p = 0.028). Conclusion: Individuals with prominent memory decline or problems with social activities should be carefully observed for dementia conversion. Cognitive intervention techniques for cognitive stimulation, such as social and leisure activities, as well as cognitive training need to be actively used for patients in whom dementia is a concern.

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Section: Discussionmentioning

confidence: 63%

Characteristics of Individuals Who Converted to Dementia during a 5-Year Follow-Up

Yun

Jung

et al. 2020

Dement Geriatr Cogn Disord

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“…People with dementia face many challenges in maintaining their involvement in the community; for example, their memory difficulties can make it difficult for them to go shopping or use public transport (Alzheimer's Society, 2013). People with dementia may have restricted opportunities for social participation, leading to a loss of social connection in their community (Biggs et al, 2019). Dementia also has an impact on a person's confidence; underlying worries and fears may prevent people from engaging in activities (ADI, 2019;Alzheimer's Society, 2014).…”

Section: Introductionmentioning

confidence: 99%

Developing supportive local communities: Perspectives from people with dementia and caregivers participating in the IDEAL programme

Quinn

Hart

Henderson

et al. 2021

Journal of Aging & Social Policy

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Communities play an important role in supporting people living with dementia. The aim of this study was to explore what could be changed in the local community to enable those with dementia to live well. People with dementia and carers taking part in the IDEAL programme responded to open-ended questions. Responses from 1,172 people with dementia and 702 caregivers were analyzed using thematic analysis. Four themes were identified: raising awareness, improving access to support services, providing social events and activities, and supporting people to engage in the community. These highlight the role of individuals, resources and the environment in supporting those with dementia. Longer-term investment in services is needed to underpin dementia-inclusive communities.

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“…Further searches were conducted within these results using the additional search terms "caregiver," "caregiver burden," "stress," "behavioral and psychological symptoms of dementia," "BPSD," "economic," "financial," "autonomy," "dignity," "identity," "personhood" and "ethics." By this method, a total of 103 citations were retained (Pereira, 2011;Schuurmans et al, 2021;Kemmelmeier et al, 2002;Bradley, 2009;Baeke et al, 2011;Chakraborty et al, 2017;Madadin et al, 2020;Nichols, 2013;Emanuel et al, 2000;Krag, 2014;Trachtenberg and Manns, 2017;Bilchik, 1996;Lazar and Davenport, 2018;Karrer et al, 2020;Stakišaitis et al, 2019;Finucane et al, 2007;Finucane, 1999;Sachs et al, 2004;Dominguez et al, 2021;Meier, 1997;Liu et al, 2020;Gao et al, 2019;Gilhooly et al, 2016;Watson et al, 2019;Cheng, 2017;Biggs et al, 2019;Fam et al, 2019;Dening et al, 2013;Owen et al, 2001;Cohen-Mansfield and Brill, 2020;Anderson et al, 2019;O'Dwyer et al, 2016;Bravo et al, 2018;Wicher and Meeker, 2012;Stolz et al, 2015;Seike et al, 2021;Kashimura et al, 2021;Zwingmann et al, 2018;…”

Section: Pitfalls Inherent In the Practice Of Pas In The Specific Case Of Dementiamentioning

confidence: 99%

Physician-Assisted Suicide in Dementia: Paradoxes, Pitfalls and the Need for Prudence

Rajkumar

2021

Front. Sociol.

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There has been an increasing drive towards the legalization of physician-assisted suicide (PAS) in patients with dementia, particularly in patients with advanced disease and severe cognitive impairment. Advocacy for this position is often based on utilitarian philosophical principles, on appeals to the quality of life of the patient and their caregiver(s), or on economic constraints faced by caregivers as well as healthcare systems. In this paper, two lines of evidence against this position are presented. First, data on attitudes towards euthanasia for twenty-eight countries, obtained from the World Values Survey, is analyzed. An examination of this data shows that, paradoxically, positive attitudes towards this procedure are found in more economically advanced countries, and are strongly associated with specific cultural factors. Second, the literature on existing attitudes towards PAS in cases of dementia, along with ethical arguments for and against the practice, is reviewed and specific hazards for patients, caregivers and healthcare professionals are identified. On the basis of these findings, the author suggests that the practice of PAS in dementia is not one that can be widely or safely endorsed, on both cultural and ethical grounds. Instead, the medical field should work in collaboration with governmental, social welfare and patient advocacy services to ensure optimal physical, emotional and financial support to this group of patients and their caregivers.

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Dementia as a source of social disadvantage and exclusion

Cited by 38 publications

References 14 publications

Characteristics of Individuals Who Converted to Dementia during a 5-Year Follow-Up

Characteristics of Individuals Who Converted to Dementia during a 5-Year Follow-Up

Developing supportive local communities: Perspectives from people with dementia and caregivers participating in the IDEAL programme

Physician-Assisted Suicide in Dementia: Paradoxes, Pitfalls and the Need for Prudence

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