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Farina N, Hassan E, Theresia I, Fitri FI, Suswanti I, Sani TP, Evans‐Lacko S, Banerjee S, Turana Y. Awareness, attitudes, and beliefs of dementia in Indonesia. Alzheimers Dement (Amst) 2024; 16:e12570. [PMID: 38617185 PMCID: PMC11010264 DOI: 10.1002/dad2.12570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 04/16/2024]
Abstract
INTRODUCTION Tackling dementia stigma is a policy priority. In Indonesia, we have little insight into the general public's knowledge and attitudes about dementia. METHODS Cross-sectional study of 4430 Indonesian adults recruited from Jakarta and North Sumatra, Indonesia. Measures included dementia knowledge and attitudes. RESULTS A total of 86.3% (n = 3,803) of adults had not heard of the terms dementia or Alzheimer's disease, and commonly viewed dementia as a normal part of aging. Being older, incorrect knowledge about etiology, not having heard of the terms dementia and/or Alzheimer's disease, having less than primary education, and being from North Sumatra were associated with more negative attitudes (p-values < 0.05). DISCUSSION Misconceptions and lack of awareness about dementia are common in Indonesia. Attitudes tended not to be negative, but our research highlights factors associated with dementia attitudes. Future research should use this information to better tailor and target potential anti-stigma strategies. Highlights Most Indonesians had not heard of the terms dementia and/or Alzheimer's disease and thought it was caused by normal aging.The majority of participants held mixed or positive attitudes towards dementia.A series of demographic factors alongside poor awareness were associated with negative attitudes towards dementia.
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Affiliation(s)
| | - Esra Hassan
- Centre for Dementia Studies, Brighton and Sussex Medical SchoolEast SussexUK
| | | | - Fasihah Irfani Fitri
- Department of Neurology, Faculty of MedicineUniversitas Sumatera UtaraMedanIndonesia
| | - Ika Suswanti
- Department of NeurologySchool of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | | | - Sara Evans‐Lacko
- Care Policy and Evaluation CentreLondon School of Economics and Political ScienceLondonUK
| | - Sube Banerjee
- Faculty of Medicine and Health SciencesUniversity of NottinghamNottinghamUK
| | - Yuda Turana
- School of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
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Turana Y, Farina N, Theresia I, Fitri FI, Suswanti I, Jacobs R, Schneider M, Sani TP, Comas-Herrera A, Albanese E, Govia I, Ferri CP, Knapp M, Banerjee S. The dementia severity rating scale: A potential community screening tool for dementia in low- and middle-income countries. Dementia (London) 2024; 23:476-492. [PMID: 38096489 DOI: 10.1177/14713012231186837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
BACKGROUND The Dementia Severity Rating Scale (DSRS) is an informant report, dementia staging tool that is quick to administer and has previous been shown to differentiate between people with dementia and healthy controls. However, it is not clear how accurate the tool is screening against diagnostic criteria in middle-income settings. METHODS Embedded within the STRiDE programme, older adults (aged ≥65 years) and their informants were randomly recruited from four sites across Indonesia and South Africa. All informants were asked to complete DSRS. We report the tool's psychometric properties and accuracy against the 10/66 short diagnostic algorithm. RESULTS Between September and December 2021, data was collected from 2110 older adults in Indonesia and 408 in South Africa. Overall, the DSRS scores significantly differed between those with and without dementia, as identified on the 10/66 short algorithm (p < .05). The difference between groups remained significant after controlling for key factors related to older adult and informant demographics. A score >2 on the DSRS had the greatest agreement with the 10/66 short algorithm and had excellent discriminative properties in both Indonesia (Area Under Curve (AUC) = .75, 95% CIs = .72-.77) and South Africa (AUC = .82, 95% CIs = .76-.88). CONCLUSIONS The DSRS has potential as a screening tool for dementia in middle-income countries, with high sensitivity and specificity against a standardized diagnostic algorithm.
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Affiliation(s)
- Yuda Turana
- School of Medicine and Health Sciences, Atma Jaya Hospital, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Nicolas Farina
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
- Faculty of Health, University of Plymouth, Plymouth, UK
| | | | - Fasihah Irfani Fitri
- Department of Neurology, Adam Malik General Hospital, Universitas Sumatera Utara, Medan Indonesia, Indonesia
| | - Ika Suswanti
- School of Medicine and Health Sciences, Atma Jaya Hospital, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Roxanne Jacobs
- Alan J. Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa
| | | | | | | | | | - Ishtar Govia
- Caribbean Institute for Health Research (CAIHR)-Epidemiology Research Unit, The University of the West Indies, Kingston, Jamaica
| | - Cleusa P Ferri
- Department of Psychiatry, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Martin Knapp
- London School of Economics and Political Science, London, UK
| | - Sube Banerjee
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
- Faculty of Health, University of Plymouth, Plymouth, UK
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Ayu AP, Rahadi A, Kristian K, Sani TP, Putra A, Halim G, Mangkuliguna G, Kusumoputri TP, Turana Y. Mode of HIV exposure and excess burden of neurocognitive impairment in people living with HIV: a protocol for systematic review and meta-analysis of controlled studies. Syst Rev 2023; 12:214. [PMID: 37968747 PMCID: PMC10652586 DOI: 10.1186/s13643-023-02371-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 10/24/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND Chronic HIV infection significantly elevates the risk of brain pathology, precipitating neurocognitive impairment (NCI) among people living with HIV (PLWH). The diagnosis of NCI in PLWH hinges on evaluating deviations in neuropsychological test performance in comparison to HIV-seronegative normative controls. However, the adverse psychosocial conditions experienced by PLWH can also result in reduced test performance, potentially confounding the accurate NCI attribution to HIV infection. This planned systematic review aims to investigate potential disparities in the excess burden of NCI among PLWH in two groups of studies: (a) studies enrolling controls who shared a similar mode of HIV exposure (MoHE) with the PLWH participants (MoHE-adjusted) and (b) studies enrolling normative controls or controls without undefined MoHE (MoHE-naive). METHODS We will systematically search five electronic databases (MEDLINE, Embase, PsycINFO, Web of Science, ProQuest) and registries (OpenGrey, ClinicalTrials.gov, ISRCTN registry). Studies reporting NCI in PLWH and HIV-seronegative controls with cross-sectional or baseline measurements, published from January 2007 to September 2023, will be included. To be classified as MoHE adjusted, a study must evidence ≥ 90% enrolment of both PLWH and their seronegative controls from the same MoHE group (e.g. men who have sex with men, people who use drugs or alcohol). Reports of test performance scores will be transformed into NCI proportions using simulated score distributions, applying a global deficit score cut-off ≥ 0.5 to estimate NCI cases. The Newcastle-Ottawa scale adapted to the purpose of the review will be used to appraise study quality. Random-effects meta-analysis will be used to pool the excess burden of NCI in prevalence ratios and test the difference between MoHE-adjusted and MoHE-naive studies. Furthermore, subgroup analyses and meta-regression will be undertaken across categorical study-level covariates (e.g. study locations, NCI diagnostic criteria) and continuous/ordinal covariates (nadir CD4, number of neurocognitive domains assessed), respectively. DISCUSSION This systematic review will contribute towards a greater appreciation of the unique psychosocial conditions of PLWH that are missing from the current case definition of HIV-associated neurocognitive disorder. The findings will additionally highlight possible disparities in the distribution of the excess burden of NCI by MoHE groups, thereby guiding the prioritization of mitigation efforts. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021271358.
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Affiliation(s)
- Astri Parawita Ayu
- Department of Psychiatry and Behavioural Sciences, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, North Jakarta, 14440, Indonesia
- HIV AIDS Research Center (ARC) - University Center of Excellence in Health Policy and Social Innovation, Atma Jaya Catholic University of Indonesia, South Jakarta, 12930, Indonesia
| | - Arie Rahadi
- HIV AIDS Research Center (ARC) - University Center of Excellence in Health Policy and Social Innovation, Atma Jaya Catholic University of Indonesia, South Jakarta, 12930, Indonesia
| | - Kevin Kristian
- Department of Public Health and Nutrition, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, North Jakarta, 14440, Indonesia.
| | | | - Aditya Putra
- HIV AIDS Research Center (ARC) - University Center of Excellence in Health Policy and Social Innovation, Atma Jaya Catholic University of Indonesia, South Jakarta, 12930, Indonesia
| | - Glenardi Halim
- HIV AIDS Research Center (ARC) - University Center of Excellence in Health Policy and Social Innovation, Atma Jaya Catholic University of Indonesia, South Jakarta, 12930, Indonesia
| | - Ghea Mangkuliguna
- HIV AIDS Research Center (ARC) - University Center of Excellence in Health Policy and Social Innovation, Atma Jaya Catholic University of Indonesia, South Jakarta, 12930, Indonesia
| | - Theresia Puspoarum Kusumoputri
- HIV AIDS Research Center (ARC) - University Center of Excellence in Health Policy and Social Innovation, Atma Jaya Catholic University of Indonesia, South Jakarta, 12930, Indonesia
| | - Yuda Turana
- Alzheimer Indonesia, South Jakarta, 12930, Indonesia
- Department of Neurology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, North Jakarta, 14440, Indonesia
- Atma Jaya Neuroscience and Cognitive Centre, Atma Jaya Hospital, North Jakarta, 14440, Indonesia
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Farina N, Jacobs R, Turana Y, Fitri FI, Schneider M, Theresia I, Docrat S, Sani TP, Augustina L, Albanese E, Comas-Herrera A, Du Toit P, Ferri CP, Govia I, Ibnidris A, Knapp M, Banerjee S. Comprehensive measurement of the prevalence of dementia in low- and middle-income countries: STRiDE methodology and its application in Indonesia and South Africa. BJPsych Open 2023; 9:e102. [PMID: 37278200 DOI: 10.1192/bjo.2023.76] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND A core element of the Strengthening Responses to Dementia in Developing Countries (STRiDE) programme was to generate novel data on the prevalence, cost and impact of dementia in low- and middle-income countries, to build better health policy. Indonesia and South Africa are two middle-income countries in need of such data. AIMS To present the STRiDE methodology and generate estimates of dementia prevalence in Indonesia and South Africa. METHOD We conducted community-based, single-phase, cross-sectional studies in Indonesia and South Africa, randomly sampling participants aged 65 years or older in each country. Dementia prevalence rates for each country were generated by using the 10/66 short schedule and applying its diagnostic algorithm. Weighted estimates were calculated with national sociodemographic data. RESULTS Data were collected between September and December 2021 in 2110 people in Indonesia and 408 people in South Africa. The adjusted weighted dementia prevalence was 27.9% (95% CI 25.2-28.9) in Indonesia and 12.5% (95% CI 9.5-16.0) in South Africa. Our results indicate that there could be >4.2 million people in Indonesia and >450 000 people in South Africa who have dementia. Only five participants (0.2%) in Indonesia and two (0.5%) in South Africa had been previously diagnosed with dementia. CONCLUSIONS Despite prevalence estimates being high, formal diagnosis rates of dementia were very low across both countries (<1%). Further STRiDE investigations will provide indications of the impact and costs of dementia in these countries, but our results provide evidence that dementia needs to be prioritised within national health and social care policy agendas.
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Affiliation(s)
- Nicolas Farina
- Centre for Dementia Studies, Brighton and Sussex Medical School, UK; and Community and Primary Care Research Group, University of Plymouth, UK
| | - Roxanne Jacobs
- Alan J Flisher Centre for Public Mental Health, University of Cape Town, South Africa
| | - Yuda Turana
- Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Indonesia
| | | | - Marguerite Schneider
- Alan J Flisher Centre for Public Mental Health, University of Cape Town, South Africa
| | | | - Sumaiyah Docrat
- Alan J Flisher Centre for Public Mental Health, University of Cape Town, South Africa
| | | | | | - Emiliano Albanese
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Switzerland
| | - Adelina Comas-Herrera
- Care Policy and Evaluation Centre, London School of Economics and Political Science, UK
| | | | - Cleusa P Ferri
- Psychogeriatric Unit, Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
| | - Ishtar Govia
- Epidemiology Research Unit, Caribbean Institute for Health Research (CAIHR), The University of the West Indies, Jamaica
| | - Aliaa Ibnidris
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Switzerland
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, UK
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Turana Y, Kristian K, Suswanti I, Sani TP, Handajani YS, Tran K, Nguyen TA. Adapting the World Health Organization iSupport Dementia program to the Indonesian socio-cultural context. Front Public Health 2023; 11:1050760. [PMID: 36875360 PMCID: PMC9978708 DOI: 10.3389/fpubh.2023.1050760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 01/23/2023] [Indexed: 02/18/2023] Open
Abstract
Background Providing care for people with dementia (PwD) without sufficient understanding of the condition might negatively affect the wellbeing of the caregivers, given the lengthy care and progressive nature of the disease. The iSupport for dementia developed by World Health Organization (WHO) is a self-administered training manual for caregivers of PwD, adaptable to local cultures and contexts. This manual needs translation and adaptation to produce a culturally appropriate version for use in Indonesia. This study reports the outcomes and lessons learnt from our translation and adaptation of iSupport content into Bahasa Indonesia. Methods The original iSupport content was translated and adapted using the WHO iSupport Adaptation and Implementation Guidelines. The process included forward translation, expert panel review, backward translation, and harmonization. The adaptation process included Focus Group Discussions (FGD), involving family caregivers, professional care workers, professional psychological health experts, and Alzheimer's Indonesia representatives. The respondents were asked to express their opinions about the WHO iSupport program, which comprises five modules and 23 lessons covering well-established topics on dementia. They were also asked to suggest improvements and their personal experiences compared to the adaptations applied in the iSupport. Results Two experts, 10 professional care workers, and eight family caregivers participated in the FGD. Overall, all participants had positive views of the iSupport material. The expert panel identified the need to reformulate definitions, recommendations, and local case studies to fine-tune the original contents to local knowledge and practices. Based on the feedback in the qualitative appraisal, several improvements regarding the language and diction, additional relevant and concrete examples, personal names and cultural habits, and customs and traditions were addressed. Conclusions The translation and adaptation of the iSupport into the Indonesian context have shown some changes needed to make the iSupport content culturally and linguistically appropriate for Indonesian end users. In addition, given the broad spectrum of dementia, various case illustrations have been added to improve the understanding of care in particular situations. Future studies are needed to evaluate the efficacy of the adapted iSupport in improving the quality of life of PwD and their caregivers.
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Affiliation(s)
- Yuda Turana
- School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Kevin Kristian
- School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Ika Suswanti
- School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Tara Puspitarini Sani
- School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Yvonne Suzy Handajani
- Center of Health Research, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Kham Tran
- Social Gerontology Division, National Ageing Research Institute, Melbourne, VIC, Australia
| | - Tuan Anh Nguyen
- Social Gerontology Division, National Ageing Research Institute, Melbourne, VIC, Australia.,School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia.,UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia.,Health Strategy and Policy Institute, Ministry of Health, Hanoi, Vietnam
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Farina N, Jacobs R, Sani TP, Schneider M, Theresia I, Turana Y, Fitri FI, Albanese E, Lorenz‐Dant K, Docrat S, Toit PD, Ferri CP, Govia I, Comas‐Herrera A, Ibnidris A, Knapp M, Banerjee S. Description of the cross-cultural process adopted in the STRiDE (STrengthening Responses to dementia in DEveloping countries) program: A methodological overview. Alzheimers Dement (Amst) 2022; 14:e12293. [PMID: 35317433 PMCID: PMC8923343 DOI: 10.1002/dad2.12293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 01/05/2022] [Accepted: 01/18/2022] [Indexed: 06/14/2023]
Abstract
Cross-cultural adaptation is an important part of using validated questionnaires across countries and settings. Here we describe the cross-cultural process adopted in the STRiDE (STrengthening Responses to dementia in DEveloping countries) program. We adopted a cross-cultural adaptation process including forward translation, back translations, and cognitive interviews of the STRiDE toolkit. In total, 50 older adults and 41 carers across sites in Indonesia and South Africa participated in cognitive interviews; field notes and verbatim quotes are reported. We describe the cross-cultural adaptation process of the STRiDE toolkit. During the process, issues were identified with the translated toolkit, including aspects related to cultural appropriateness, terminology equivalence, and timings. The data demonstrate that a rigorous, yet pragmatic, cross-cultural adaptation process can be achieved even with limited resources. Our process should help the design and conduct of future dementia research in various contexts.
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Affiliation(s)
| | | | | | | | | | - Yuda Turana
- Atma Jaya Catholic University of IndonesiaJakartaIndonesia
| | | | | | | | | | | | | | - Ishtar Govia
- Caribbean Institute for Health Research (CAIHR)—Epidemiology Research UnitThe University of the West IndiesJamaica
| | | | | | - Martin Knapp
- The London School of Economics and Political ScienceUK
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Breuer E, Freeman E, Alladi S, Breedt M, Govia I, López-Ortega M, Musyimi C, Oliveira D, Pattabiraman M, Sani TP, Schneider M, Swaffer K, Taylor D, Taylor E, Comas-Herrera A. Active inclusion of people living with dementia in planning for dementia care and services in low- and middle-income countries. Dementia (London) 2021; 21:380-395. [PMID: 34468232 DOI: 10.1177/14713012211041426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Involving people living with dementia in service design and planning has become more common in high-income countries. It remains rare in low- and middle-income countries where two-thirds of the world's people with dementia live. In this commentary article, we explore the barriers to inclusion of people living with dementia in planning in low- and middle-income countries and make a case for the inclusion of people living with dementia in care and service planning. We suggest how this can be done at individual, community or national and state level using the following principles: 1) respecting the rights of people living with dementia to self-determination; 2) valuing people living with dementia's unique understanding of dementia; 3) creating a culture of active inclusion which creates a space for people living with dementia to participate and 4) ensuring appropriate accommodations are in place to maximise participation.
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Affiliation(s)
- Erica Breuer
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Emily Freeman
- Care Policy and Evaluation Centre, 4905London School of Economics and Political Science, London, UK
| | - Suvarna Alladi
- Department of Neurology, 29148National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Marinda Breedt
- STRiDE South Africa National Advisory Group, Cape Town, South Africa
| | - Ishtar Govia
- Epidemiology Research Unit, Caribbean Institute for Health Research, 54657The University of the West Indies, Kingston, Jamaica
| | | | - Christine Musyimi
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - Déborah Oliveira
- Department of Psychiatry, 28105Universidade Federal de São Paulo, Sao Paulo, Brazil
| | | | - Tara Puspitarini Sani
- 64732Alzheimer Indonesia and Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Marguerite Schneider
- Alan J. Flisher Centre for Public Mental Health, 37716University of Cape Town, Rondebosch, South Africa
| | - Kate Swaffer
- Dementia Alliance International and Faculty of Science, Medicine and Health, 8691University of Wollongong, Wollongong, NSW, Australia
| | - Dubhglas Taylor
- Dementia Alliance International and Dementia Awareness Advocacy Team, Capalaba, QLD, Australia
| | - Eileen Taylor
- Dementia Alliance International and Dementia Awareness Advocacy Team, Brisbane, QLD, Australia
| | - Adelina Comas-Herrera
- Care Policy and Evaluation Centre, 4905London School of Economics and Political Science, London, UK
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Breuer E, Comas-Herrera A, Freeman E, Albanese E, Alladi S, Amour R, Evans-Lacko S, Ferri CP, Govia I, Iveth Astudillo García C, Knapp M, Lefevre M, López-Ortega M, Lund C, Musyimi C, Ndetei D, Oliveira D, Palmer T, Pattabiraman M, Sani TP, Taylor D, Taylor E, Theresia I, Thomas PT, Turana Y, Weidner W, Schneider M. Beyond the project: Building a strategic theory of change to address dementia care, treatment and support gaps across seven middle-income countries. Dementia (London) 2021; 21:114-135. [PMID: 34196585 DOI: 10.1177/14713012211029105] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Evidence from middle-income countries indicates high and increasing prevalence of dementia and need for services. However, there has been little investment in care, treatment or support for people living with dementia and their carers. The Strengthening Responses to Dementia in Developing Countries (STRiDE) project aims to build both research capacity and evidence on dementia care and services in Brazil, Indonesia, India, Jamaica, Kenya, Mexico and South Africa. This article presents the Theory of Change (ToC) approach we used to co-design our research project and to develop a strategic direction for dementia care, treatment and support, with stakeholders. ToC makes explicit the process underlying how a programme will achieve its impact. We developed ToCs in each country and across the STRiDE project with researchers, practitioners, people living with dementia, carers and policymakers at different levels of government. This involved (1) an initial ToC workshop with all project partners (43 participants); (2) ToC workshops in each STRiDE country (22-49 participants in each); (3) comparison between country-specific and overall project ToCs; (4) review of ToCs in light of WHO dementia guidelines and action plan and (5) a final review. Our experiences suggest ToC is an effective way to generate a shared vision for dementia care, treatment and support among diverse stakeholders. However, the project contribution should be clearly delineated and use additional strategies to ensure appropriate participation from people living with dementia and their carers in the ToC process.
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Affiliation(s)
- Erica Breuer
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia; Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Rondebosch, South Africa
| | - Adelina Comas-Herrera
- Care Policy and Evaluation Centre, 4905London School of Economics and Political Science, London, UK
| | - Emily Freeman
- Care Policy and Evaluation Centre, 4905London School of Economics and Political Science, London, UK
| | - Emiliano Albanese
- Universià della Svizzerra Italiana, Lugano; Faculty of Medicine, University of Geneva, Switzerland
| | - Suvarna Alladi
- 29148National institute of Mental Health and Neuro Sciences, India
| | - Rochelle Amour
- Caribbean Institute for Health Research, 54657The University of the West Indies, Jamaica
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre, 4905London School of Economics and Political Science, UK
| | - Cleusa P Ferri
- Department of Psychiatry, 28105Universidade Federal de São Paulo, Brazil
| | - Ishtar Govia
- Caribbean Institute for Health Research, The University of the West Indies, Jamaica
| | | | - Martin Knapp
- Care Policy and Evaluation Centre, 4905London School of Economics and Political Science, UK
| | | | | | - Crick Lund
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | | | - David Ndetei
- Department of Psychiatry; 107854University of Nairobi; Africa Mental Health Research and Training Foundation, Kenya
| | - Deborah Oliveira
- Department of Psychiatry, 28105Universidade Federal de São Paulo, Brazil
| | - Tiffany Palmer
- Caribbean Institute for Health Research, 54657The University of the West Indies, Jamaica
| | | | - Tara Puspitarini Sani
- Alzheimer Indonesia and Department of Neurology, School of Medicine and Health Sciences, 64732Atma Jaya Catholic University of Indonesia, Indonesia
| | | | | | | | | | - Yuda Turana
- Alzheimer Indonesia; Department of Neurology, School of Medicine and Health Sciences, 64732Atma Jaya Catholic University of Indonesia, Indonesia
| | | | - Marguerite Schneider
- Alan J. Flisher Centre for Public Mental Health, 37716University of Cape Town, South Africa
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Handajani YS, Turana Y, Yogiara Y, Widjaja NT, Sani TP, Christianto GAM, Suwanto A. Tempeh Consumption and Cognitive Improvement in Mild Cognitive Impairment. Dement Geriatr Cogn Disord 2021; 49:497-502. [PMID: 33080604 DOI: 10.1159/000510563] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/28/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Tempeh consumption has been linked to the improvement of cognitive function in older people. However, to what extent the amount of microorganism or the size of tempeh serving consumed per day influences the benefit to cognitive functions has not yet been studied. METHODS This experimental study involved a total of 90 respondents, who were divided into 3 groups: group A (consuming 100 g of Tempeh A/day), group B (consuming 100 g of Tempeh B/day), and group C (control). Intervention was given for 6 months. Cognitive assessments were done before and after the intervention. Blood uric acid level was checked at the end of intervention to examine the effect of tempeh consumption on this. The inclusion criteria were respondents aged 60 years or over with mild cognitive impairment (MCI) who agreed not to consume other fermented food during the study period. Respondents with diabetes were excluded. RESULTS There were 84 subjects at the end of the study, majority being female (71.4%) and aged over 65 years (72.6%). An increase in global cognitive scores was found in both groups A and B. The increase in language domain scores was found only in group A. CONCLUSION Both Tempeh A or Tempeh B consumption for 6 months appeared to be beneficial in improving global cognitive function of older people with MCI. Consuming Tempeh A, which had a lower number of microorganisms, was also associated with an improvement in the language domain.
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Affiliation(s)
- Yvonne Suzy Handajani
- Center of Health Research, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Yuda Turana
- Department of Neurology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia,
| | - Yogiara Yogiara
- Faculty of Biotechnology, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Nelly Tina Widjaja
- Center of Health Research, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Tara Puspitarini Sani
- Department of Neurology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | | | - Antonius Suwanto
- Faculty of Biotechnology, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
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Rai HK, Prasetya VGH, Sani TP, Theresia I, Tumbelaka P, Turana Y, Schneider J, Orrell M. Exploring the feasibility of an individual cognitive stimulation therapy application and related technology for use by people with dementia and carers in Indonesia: A mixed-method study. Dementia (London) 2021; 20:2820-2837. [PMID: 33993771 DOI: 10.1177/14713012211018003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cognitive stimulation therapy (CST) is a psychosocial intervention for people with dementia and can benefit cognition and quality of life. A touch-screen individualised CST (iCST) application has been developed to improve on accessibility and provide increased interactivity. This study aimed to explore the attitudes of people with dementia, carers and healthcare professionals in Indonesia towards the iCST application and related technology. METHODS Four focus groups were organised: one comprising family carers (n = 3), two comprising people with dementia and family carers (n = 12) and one made up of family carers and home care workers (n = 3). Participants discussed the uses of technology, tried out the iCST application and completed a usability and acceptability questionnaire. Furthermore, 21 healthcare professionals attended an expert meeting to discuss the potential of implementing the iCST application in the community. RESULTS Attitudes towards technology were positive but lack of experience, difficulties with operating devices and a limited infrastructure to support technology were described as barriers. The iCST application was seen as an interesting tool to support mental stimulation. Compared with people with dementia, carers were more willing to use the application and rated its usability higher. Healthcare professionals were positive about the interactive features of the application and judged that it could be useful within the family context. DISCUSSION Low-cost and low-infrastructure technology like iCST can meet the needs for stimulation of people with dementia in Indonesia and other countries. By understanding the attitudes of people with dementia and carers towards IT and their willingness to adopt technology like the iCST application, we are better placed to overcome potential obstacles to its implementation. It appears that systemic changes are needed to facilitate wider use of IT particularly in dementia care. These include needs to empower end users, strengthen access and connectivity to technology, and improve diagnostic support.
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Affiliation(s)
- Harleen Kaur Rai
- Institute of Mental Health, 6123University of Nottingham, Nottingham, UK
| | | | - Tara Puspitarini Sani
- 64732Atma Jaya Catholic University of Indonesia and Alzheimer Indonesia, Jakarta, Indonesia
| | | | | | - Yuda Turana
- 6123Atma Jaya Catholic University of Indonesia and Alzheimer Indonesia, Jakarta, Indonesia
| | - Justine Schneider
- School of Sociology & Social Policy, Law & Social Sciences Building, 6123University of Nottingham, University Park, Nottingham, UK
| | - Martin Orrell
- Institute of Mental Health, 6123University of Nottingham, Nottingham, UK
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Farina N, Ibnidris A, Alladi S, Comas-Herrera A, Albanese E, Docrat S, Ferri CP, Freeman E, Govia I, Jacobs R, Astudillo-Garcia CI, Musyimi C, Sani TP, Schneider M, Theresia I, Turana Y, Knapp M, Banerjee S. A systematic review and meta-analysis of dementia prevalence in seven developing countries: A STRiDE project. Glob Public Health 2020; 15:1878-1893. [PMID: 32658604 DOI: 10.1080/17441692.2020.1792527] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The STRiDE project sets out to support the development of effective dementia policy in middle-income countries (Brazil, India, Indonesia, Jamaica, Kenya, Mexico, and South Africa). As part of this it will generate new data about the prevalence of dementia for a subset of these countries. This study aims to identify the current estimates of dementia prevalence in these countries and where the gaps lie in the current literature. A systematic review was completed on 30th April 2019 across electronic databases, identifying dementia prevalence literature originating from any of the seven countries. Four hundred and twenty-nine records were identified following de-duplication; 28 studies met the inclusion criteria and were included in the systematic review. Pooled estimates of dementia prevalence ranged from 2% to 9% based on DSM-IV criteria; these figures were generally higher in studies using other diagnostic criteria (e.g. the 10/66 algorithm). Available prevalence data varied between countries. Only Brazil, Mexico and India had data derived from studies judged as having a low risk of bias. Irrespective of country, studies often were not explicit in detailing the representativeness of their sample, or whether there was non-response bias. Further transparent and externally valid dementia prevalence research is needed across the STRiDE countries.
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Affiliation(s)
- N Farina
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - A Ibnidris
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - S Alladi
- National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - A Comas-Herrera
- London School of Economics and Political Science, London, UK
| | - E Albanese
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - S Docrat
- Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa
| | - C P Ferri
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - E Freeman
- London School of Economics and Political Science, London, UK
| | - I Govia
- Caribbean Institute for Health Research (CAIHR) - Epidemiology Research Unit, The University of the West Indies, Kingston, Jamaica
| | - R Jacobs
- Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - C Musyimi
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - T P Sani
- Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - M Schneider
- Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa
| | - I Theresia
- Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Y Turana
- Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - M Knapp
- London School of Economics and Political Science, London, UK
| | - S Banerjee
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK.,Faculty of Health, University of Plymouth, Plymouth, UK
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- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
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