Dementia

Although vascular dementia is the second most common cause of dementia globally, evidence‐based treatments are still lacking. Cerebrolysin is a porcine brain‐derived preparation that is said to have neurotrophic and neuroprotective activity. In many parts of the world Cerebrolysin, given as a series of daily intravenous infusions, is used as a potential intervention for vascular dementia. A previous Cochrane Review on Cerebrolysin in vascular dementia yielded inconsistent results. We wished to update the review to add new studies from the international literature and employ contemporary methods for appraising the strength of the evidence.

This study suggested that the intervention was both feasible and acceptable to people with dementia and their carers but further research is needed to refine it for a full trial.

This guidance identifies the principles relevant to victims and witnesses with mental health conditions or disorders, namely: A mental disorder, as defined by the 2 External 0 0 0 Mental Health Act 2007 false https://www.legislation.gov.uk/ukpga/2007/12/section/1 true false%> A learning disability A learning difficulty Autism Spectrum Disorder An acquired brain injury Dementia Other mental health, cognitive or neuro-diverse conditions. Further information about such conditions can be found at Annex A. This guidance therefore seeks to address a span of conditions which comprise disorders, disabilities, impairments, injuries and diseases, which relate both to the brain and the mind. The term ";mental health conditions or disorders" will therefore be used as a non-stigmatising, non-technical terms, but terminology which focuses those who use this guidance on recognised conditions.

Depression is a common comorbidity in dementia. Randomised controlled studies of antidepressants do not show a significant improvement in depressive symptoms in patients with comorbid dementia and are known to lead to an increase in side effects. However, there are relatively few studies of depression in dementia, and drawing firm conclusions about the use of antidepressants is limited by the amount of data available. Furthermore, it is unclear whether data can be extrapolated from similar populations (eg, those with late-life depression) to inform pharmacotherapy in this patient group. Given the lack of effectiveness and risk of side effects associated with pharmacological treatments, psychological interventions may offer important therapeutic benefits. There is evidence for the effectiveness of individual psychological therapy, and further research will establish which psychological approach is the most effective. Some studies have shown an improvement in depressive symptoms using structured sleep hygiene programmes, exercise, arts interventions and music therapy. These studies are hampered by small data sets, and the benefits to individuals may not be well captured by standard outcome measures. At present, the best evidence for arts-based approaches is in music therapy. Depression with comorbid dementia responds well to electroconvulsive therapy and this is a useful treatment modality for those with severe or life-threatening depressive symptoms. Alternative neurostimulation techniques such as transcranial magnetic stimulation are not widely used at present and further research is needed before they can be a more widely used treatment modality.

This report calls on the government to invest in six priority research areas, which will help to deliver a life-changing treatment for dementia by doubling research funding and speeding up trials for new treatments.

This review discusses the status of existing therapies for cognitive symptoms of Alzheimer's disease with an emphasis on how to tailor management to the individual patient.

This guidance explains how commissioners and health professionals can use data and analysis for decisions about dementia services and interventions.

Overall findings from this briefing show that patients with dementia are more likely to have multiple health conditions; 22% with >3 comorbidities and 8% with >4 comorbidities vs 11% and 3%, respectively, in all patient group (same list of health conditions, excluding dementia).

This case study report provides examples of extra care schemes and other housing-related community services supporting people with dementia to develop meaningful relationships to reduce social isolation and loneliness.

People living with dementia should be offered activities such as exercise, aromatherapy, art, gardening, baking, reminiscence therapy, music therapy, mindfulness and animal assisted therapy to help promote their wellbeing. The recommendation comes in NICE's updated quality standard on dementia published 28 June 2019. It says people living with dementia and people involved in their care should be given the opportunity to talk about their life experiences, preferences, interests, strengths with a healthcare professional. This can help the person living with dementia to choose activities to promote wellbeing that suit their preferences and needs.