Creating dementia-friendly and inclusive communities for social inclusion: a scoping review protocol

Understandings and Perceived Benefits of Outdoor-Based Support for People Living with Dementia

The importance of the outdoors for supporting well-being is recognized, but less is known about the role of the outdoors in supporting people living with dementia. The aim of this study was to examine three stakeholder groups' understandings about outdoor-based support and care for people living with dementia to help understand what might be done to maximize the outdoors as a source of support for people living with dementia. Data were collected in Southern Ontario, Canada, between January and June 2023 via 1-1 interviews (n = 12); four focus groups (n = 17) with staff from organizations providing outdoor recreation or social programming; six in-person focus groups (n = 37); and 2 outdoor-based walking focus groups (n = 17) conducted with people living with dementia, care partners, and older adults. All interviews and focus groups, other than the walking focus groups where the field notes were used, were audio recorded and fully transcribed verbatim. Within and across data sets, thematic analysis was conducted. We report findings relating to the challenges of achieving full participation in outdoor-based activities; perceived physical, social, and mental health benefits of outdoor activities; stigma; and overcoming perceived risks. The importance of the outdoors for people living with dementia and their care partners is evident. There are implications for care policy and practice relating to the promotion of (social) health and well-being for people living with dementia.

A multi-stakeholder collaboration model of dementia-friendly communities: Experiences from Nanjing, China

The care for people with dementia (PwD) in low- and middle-income countries (LMICs) is dominated by home care and supplemented sporadically by public care provided using public resources. In the context of community resources cannot meet the demand for high-quality services for PwD, dementia-friendly communities (DFCs) provide ideas for alleviating this situation by integrating resources from multiple stakeholders. However, there is still a considerable gap between the capacity of services and the demand of PwD. Based on the experience of elderly services and DFCs construction in Nanjing, China, this study developed a stakeholder collaboration model and clarified the collaborative relationship among stakeholders such as the government, communities, and medical institutions in meeting the needs of PwD. This work summarizes the partnerships and specific actions of stakeholders and highlights the importance of facilitating resource integration to provide comprehensive services.

Facilitators of and barriers to patient and public involvement in building learning health systems in community health services settings: a scoping review protocol

INTRODUCTION

The development of learning health systems (LHSs) has often focused on optimally leveraging data. More attention should be paid to patient and public involvement or community engagement in forming learning communities that work together to build LHS. This scoping review aims to identify facilitators of and barriers to involving patients and the public in building LHSs in community health services settings.

METHODS AND ANALYSIS

We will use the Joanna Briggs Institute's scoping review methodology. We will review literature in English published from 1 January 2007 to 31 December 2022. The databases that will be searched are MEDLINE, CINAHL, Embase, Web of Science, Scopus, AgeLine, PsycINFO and Web of Science. Key inclusion and exclusion criteria include the following: we will only consider a learning community in a community health services context (eg, home care, long-term care, primary care); we will exclude literature on acute care settings; and we will consider any research designs apart from big data analytics. We will review all sources, including university student theses and dissertations. The review will proceed in three steps: (1) we will identify keywords and index terms from the MEDLINE and CINAHL databases; (2) using the keywords and index terms identified in step (1), we will search other databases and (3) we will handsearch the reference lists of the selected literature and will search for grey literature using Google. Two research assistants will screen the titles and abstracts separately, with reference to the inclusion criteria. Two researchers will then assess the full text of selected studies, also in reference to the inclusion criteria. We will present the findings in a charting table and provide a narrative summary.

ETHICS AND DISSEMINATION

This work does not require ethics approval because the data for this scoping review are publicly available. The findings will be presented in a journal article and at conferences.

Creating a Dementia Friendly Community in an African American Neighborhood: Perspectives of People Living with Dementia, Care Partners, Stakeholders, and Community Residents

A dementia friendly community allows people with dementia and their care partners to remain engaged in their community well into the disease. This study presents the results of primary research aimed at exploring perceptions regarding building a dementia friendly community in an African American neighborhood in northeast Florida. Twelve focus groups and five interviews were conducted with people living with dementia, informal and formal care partners, community stakeholders and neighborhood residents, and analyzed using a grounded theory approach. Three main themes emerged from the analyses, including (1) perceived needs, (2) facilitators and barriers to being dementia friendly, and (3) opportunities for the community to become more dementia friendly. Study findings highlight the unique needs of a single African American neighborhood and the importance of culturally tailoring the dementia friendly model to diverse communities.

Facilitators and barriers to using smart TV among older adults in care settings: a scoping review protocol

INTRODUCTION

The objective of the scoping review is to understand what has been reported in the literature regarding facilitators and barriers to using smart television (smart TV) among older adults in care settings.

METHODS AND ANALYSIS

The scoping review will adopt the Joanna Briggs Institute scoping review methodology. It will occur between March and August 2022. It will consider literature on using smart TV with older adults in care settings. A three-step search strategy will be applied: (1) to identify keywords and index terms from MEDLINE and CINAHL; (2) to do a search using identified keywords and index terms across chosen databases (MEDLINE, CINAHL, Embase, Web of Science, Scopus, AgeLine, PsycINFO, Web of Science, ProQuest and Google) and (3) to hand search the reference lists of all selected literature for additional literature. Further, we will search using Google for grey literature. Two research assistants will independently screen the titles and abstracts by referring to the inclusion criteria. After that, two researchers will independently assess the full text of selected literature by referring to the inclusion criteria. We will present the data in a table with narratives that answer the questions of the scoping review.

ETHICS AND DISSEMINATION

The scoping review does not require ethics approval because it collects data from the publicly available literature. The findings will offer insights to inform the use of smart TV among older adults in care settings for education, practice, policy and future research. The scoping review results will also be disseminated through conference presentations and an open-access publication in a peer-reviewed journal.

Five-Year Community Management Rate for Dementia Patients: A Proposed Indicator for Dementia Policies

Background and Purpose

There is no specific indicator for monitoring dementia management. We propose an auxiliary indicator called the community management rate, defined as the proportion of dementia patients who receive informal care from close caregivers or themselves within their community population. The 5-year community management rate is the percentage of dementia patients who are receiving community management at 5 years after they were diagnosed. The aim of this study was to identify how the community management rate has changed over time and how the 5-year community management rate differs according to age, sex, income, residence area, and comorbidities.

Methods

We analyzed customized research database of the Korean National Health Insurance Services from 2003 to 2018. The 5-year community management rate was calculated annually with newly diagnosed dementia patients, and compared among subgroups according to age, sex, income, residence area, and comorbidities.

Results

This study analyzed 549,297 patients. Among those newly diagnosed with dementia in 2003, the mean duration of community management during the 15-year follow-up was 5.98 years. The community management rate decreased rapidly from 2003 to 2006, after which it increased. A low 5-year community management rate was associated with older age, higher comorbidity burden, nonmetropolitan residence, and low income.

Conclusions

The community management rate seems to reflect diverse patient factors. Efforts are needed to reduce the comorbidity burden and differences in the 5-year community management rate according to residence area and income. This study indicates the need for further investigations into the use of this indicator to monitor the management of dementia patients.

Ziziphus jujuba (Rhamnaceae) Alleviates Working Memory Impairment and Restores Neurochemical Alterations in the Prefrontal Cortex of D-Galactose-Treated Rats

Alzheimer's disease is a progressive cognitive dysfunction. However, pharmacological treatments are symptomatic and have many side effects, opening the opportunity to alternative medicine. This study investigated the antiamnesic effect of the aqueous extract of Ziziphus jujuba on D-galactose-induced working memory impairment in rats. Impairment of working memory was induced by subcutaneous (s.c.) injection of D-galactose (350 mg/kg/day) to rats for 21 days. These animals were then subjected to object recognition and Y-maze tests. Rats with confirmed memory impairment were treated per os (p.o.) with tacrine (10 mg/kg), aspirin (20 mg/kg, p.o.), extract (41.5, 83, and 166 mg/kg, p.o.), and distilled water (10 mL/kg, p.o.) daily for 14 days. At the end of the treatments, alteration in working memory was assessed using the above paradigms. Afterward, these animals were euthanized, and cholinergic, proinflammatory, and neuronal damage markers were analyzed in the prefrontal cortex. Rats administered D-galactose and treated with distilled water had impaired working memory (evidenced by decreased time spent on the novel object and discrimination index) and decreased spontaneous alternation in the Y-maze. D-galactose also decreased the levels of acetylcholinesterase and acetylcholine and increased the level of glial fibrillary acidic protein, ionized calcium-binding adapter molecule 1, tumor necrosis factor-alpha (TNF-α), interleukin 1 beta (IL-1β), interleukin 6 (IL-6), and interferon-gamma (IFN-γ). Treatment with the extract (166 mg/kg) reversed the time spent on the novel object and the discrimination index. It equally increased the percentage of spontaneous alternation. Neurochemical analysis revealed that the extract markedly alleviated acetylcholinesterase activity and neuroinflammation. These observations were corroborated by the reduction in neuronal loss. Taken together, these results suggest that Ziziphus jujuba aqueous extract possesses an antiamnesic effect. This effect seems to involve cholinergic and anti-inflammatory modulations. This, therefore, claims using this plant in the treatment of dementia in Cameroon subject to further studies and trials.