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Frailty is the most problematic expression of population ageing. It is a state of vulnerability to poor resolution of homoeostasis after a stressor event and is a consequence of cumulative decline in many physiological systems during a lifetime. This cumulative decline depletes homoeostatic reserves until minor stressor events trigger disproportionate(More)
PURPOSE There is a need for valid and reliable short scales that can be used to assess social networks and social supports and to screen for social isolation in older persons. DESIGN AND METHODS The present study is a cross-national and cross-cultural evaluation of the performance of an abbreviated version of the Lubben Social Network Scale (LSNS-6),(More)
Acknowledgements Alzheimer's Association (US) for support with reviewing and launching this Report. The members of ADI's Medical and Scientific Advisory Panel who answered a survey to help define the questions for this Report. The people with dementia and carers whose words are featured in this report. Cover photo: Facunda and Esther arrived early for the(More)
OBJECTIVE To measure general practitioners' knowledge of, confidence with and attitudes to the diagnosis and management of dementia in primary care. SETTING 20 general practices of varying size and prior research experience in Central Scotland, and 16 similarly varied practices in north London. PARTICIPANTS 127 general practitioners who had volunteered(More)
OBJECTIVE To test the effectiveness of educational interventions in improving detection rates and management of dementia in primary care. DESIGN Unblinded, cluster randomised, before and after controlled study. SETTING General practices in the United Kingdom (central Scotland and London) between 1999 and 2002. INTERVENTIONS Three educational(More)
OBJECTIVES To estimate survival after a diagnosis of dementia in primary care, compared with people without dementia, and to determine incidence of dementia. DESIGN Cohort study using data from The Health Improvement Network (THIN), a primary care database. SETTING 353 general practices in the United Kingdom providing data to THIN. PARTICIPANTS All(More)
OBJECTIVES Doubt over the cost-effectiveness of the cholinesterase inhibitors in dementia has renewed interest in alternative treatments such as Ginkgo biloba. We aimed to determine the effectiveness and the safety profile of Ginkgo biloba for treating early stage dementia in a community setting. METHODS We conducted a community-based, pragmatic,(More)
BACKGROUND The 'Hawthorne Effect' may be an important factor affecting the generalisability of clinical research to routine practice, but has been little studied. Hawthorne Effects have been reported in previous clinical trials in dementia but to our knowledge, no attempt has been made to quantify them. Our aim was to compare minimal follow-up to intensive(More)
BACKGROUND The diagnosis of dementia in primary care is perceived as a problem across countries and systems, resulting in delayed recognition and adverse outcomes for patients and their carers. Improving its early detection is an area identified for development in the English National Dementia Strategy 2009; there are thought to be multiple benefits to the(More)
BACKGROUND Admission avoidance hospital at home is a service that provides active treatment by health care professionals in the patient's home for a condition that otherwise would require acute hospital in-patient care, and always for a limited time period. In particular, hospital at home has to offer a specific service to patients in their home requiring(More)