Dementia is a group of brain disorders that affect a person’s memory, thinking and ability to interact socially. It is caused by damaged nerve cells that may occur in several areas of the brain. As a result, people experience dementia differently, depending on which area of their brain is affected. The dementia types are classified in a variety of ways, often according to what they have in common or whether they worsen over time (progressive dementias).
Some dementias, such as those caused by a reaction to medications or an infection, are reversible with treatment.
Types of dementias that are not reversible and worsen over time include:
Each year the number of older people undergoing surgery increases. Although evidence is well established that older age and frailty are associated with greater risk of poorer postoperative outcomes, there is little evidence to date to establish whether outcomes can be improved through geriatric intervention.
This research program explores the influence of dementia on the pattern of hospital admissions, clinical care, health outcomes and economic costs of older people with an injury-related hospitalisation. It provides data on the impact of injury on a person with dementia and the health system more generally.
The IFOCIS study aims to determine the ability of an individualised exercise and home hazard reduction program to reduce the rates of falls in older people living in the community with cognitive impairment or dementia. To do this, we have two groups– an ‘intervention’ group and a ‘control’ group. The Intervention program involves: an exercise program and a home hazard reduction program delivered by experienced therapists tailored to the participant’s cognitive and physical abilities. Carers are an integral part of the intervention team, as some participants require supervision for exercise sessions. We work with carers to help them understand how to get the best from the participant they are caring for, in terms of their ‘functional cognition’, completing the exercises and preventing falls.
Taking this individual approach means that participants can have very different cognitive abilities and still be included in our study. No other study has done this to date.
All participants will undergo an assessment at baseline with re tests at 6 and 12 months to compare each of these groups on things like strength & balance. The primary outcome is the rate of falls during the 12 month study period which is collected using falls diaries on a monthly basis.
Recruitment for the project is now in the 2nd year. We have enrolled 184 participants and their carers into the trial from the Prince of Wales hospital / NeuRA site and the Hornsby hospital site. We hope to have 360 participants enrolled by the end of 2017. We continue to recruit from Prince of Wales and Hornsby hospital wards and outpatient clinics and other Sydney metropolitan hospital dementia day clinics.
Falls and functional decline are common in people with dementia. Falls are more likely to result in injury, death and institutionalisation when compared to older people without dementia. There is limited evidence that falls can be prevented in people with dementia. Strategies aimed at maintaining independence and preventing decline and falls are urgently needed. This research will a) further our understanding of fall risk and functional decline and b) explore novel fall and decline prevention programs, including the use of technology in older people with dementia.
Dennis Frost was diagnosed with frontotemporal dementia at age 59. In honour of Frontotemporal Awareness Week, he has shared with us some of the impacts the diagnosis has had on his life. Here, he shares how the music of his youth holds even greater relevance to him now and offers him a pathway to the past once again. It is well […]