Dementia causes loss of memory, judgement, and normal walking pattern. People with memory problems struggle with everyday activities. They are more prone to accidents, especially falls — 60 to 80 per cent of people with dementia fall each year and these falls accelerate decline in physical and mental health.
Now a team at The University of Nottingham and Nottingham University Hospitals NHS Trust has been awarded a £2.8 million grant from the National Institute for Health Research (NIHR) to develop and evaluate a new therapeutic approach. The study is being carried out in collaboration with Nottinghamshire Healthcare NHS Foundation Trust, Nottingham Citycare Partnership and Bangor University.
Public health issue
Leading the study, Professor Rowan Harwood said: “The number of people living with dementia is increasing rapidly as the population continues to age, and problems associated with dementia have become a major public health issue. Nearly half of broken hips occur in a person with dementia and attempts to prevent these falls to date have been largely ineffective so our new study aims to rectify that.
“We started by looking at ways of preventing falls, but interviews with patients, carers and professionals suggested that we should focus on promoting activity, independence and well-being rather than emphasising the falls themselves. We have been developing a programme over the past 4 years that combines balance exercises, advice on undertaking daily activities confidently and safely, and a grown-up attitude towards what risks are worth taking and what are not.”
One target of the study is all about ‘dual-task’ activities – doing two things at once – which is a particular problem from the earliest stages of dementia, and which may respond to training. The team will carefully focus on individual’s abilities, interests and goals, to make taking part worthwhile for them. They will work with people with mild dementia who are at risk of deterioration and will look for benefits and impact on disability, rate of falling, activity levels, memory and quality of life. The aim is to try to set back the impact of the disease by a year or two, to help people live well with dementia for longer.
East Midlands based trial
The next step will be to test the programme in Nottingham and Derby by comparing the outcomes of groups of people with early dementia who are given usual care and advice with the outcomes of those given the new therapy programme. The team will study how the programme works in practice, including the role and impact on families, and how it can be incorporated into existing services and facilities. An economic appraisal will decide whether it is value for money.
The researchers hope that the PrAISED (Promoting Activity Independence and Stability in Early Dementia) trial will help reduce the number of falls and fractures among people with dementia. This could reduce and delay disability, distress and the cost of disease progression with a real prospect of financial savings to the NHS. The intervention could form an important addition to the treatments offered to patients and families after a diagnosis of dementia.
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Notes to editors: The University of Nottingham has 43,000 students and is ‘the nearest Britain has to a truly global university, with a “distinct” approach to internationalisation, which rests on those full-scale campuses in China and Malaysia, as well as a large presence in its home city.’ (Times Good University Guide 2016). It is also one of the most popular universities in the UK among graduate employers and the winner of ‘Research Project of the Year’ at the Times Higher Education Awards 2014. It is ranked in the world’s top 75 by the QS World University Rankings 2015/16, and 8th in the UK by research power according to the Research Excellence Framework 2014. It has been voted the world’s greenest campus for three years running, according to Greenmetrics Ranking of World Universities.
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