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PRESS RELEASE
New course will help people with dementia

The first nationally accredited training course aimed at improving the lives of people with dementia is being launched at the University of Sunderland.

The distance learning course for professionals will help further raise the level of care offered to thousands of people across the country living with dementia.

Sunderland has teamed up with the Alzheimer'™s society, BUPA care homes and the Joseph Rowntree Foundation to provide the new course, '˜an introduction to Dementia care'™.

Through open learning, the use of videos, group discussion and working with people with dementia, the course will encourage staff to view dementia care as a career choice and help in the understanding of the illness.

Vicki Lawson-Brown, senior lecturer in health studies at the university said: 'ÂœThis course recognises the attitude, expertise and knowledge needed to deliver successful dementia care.

'œIt'™s an exciting new development to provide a better quality of care for people who have dementia, treating them with the respect and dignity they deserve. We welcome the opportunity to recognise the work of care staff in this field.'

The new course is part of a range of Joseph Rowntree programmes awarded to the University of Sunderland by the trust two years ago.

Studies have shown that up to 75 per cent of people living in nursing and residential care homes have Alzheimer'™s or another form of dementia.

The Alzheimer'™s society hopes that all care providers will eventually use the course to help improve training for those working with people with dementia.

Daren Felgate, the Alzheimer'™s society'™s training and development manager, said: 'œWe hope this course will become the key introductory course for care workers helping people with dementia.

'œWorking with people with dementia is often seen as difficult and challenging, but with the right support many care staff will see it is the most rewarding work they have ever done.'

The course has already been piloted through four BUPA care homes and the Joseph Rowntree Foundation in York. It will be launched at the Royal Society in London on April 22, where speakers from BUPA and the Alzheimer'™s Society will be highlighting the importance of effective dementia care training.

More info is at http://www.sunderland.ac.uk/

The British Medical Journal (BMJ) published several articles about using exercise programs to prevent falls in older people. One half of those aged 80 years and older will fall in any one year, often with serious health and social consequences, so fall prevention is a topic worth investigating. The BMJ research found that an exercise program delivered by a physiotherapist or trained nurses had some success in reducing falls and moderate injuries in elderly people, but were not always cost-effective.

The British Department of Health announced that a new National Service Framework (NSF) for Older People has been launched with the aim of improving care for older people and rooting out age discrimination. The NSF is being backed by 120 million over the next three years to refurbish old-style Nightingale wards, which have fallen below acceptable standards of care. Health secretary Alan Milburn said that the new investment, on top of the 1.4 billion unveiled for older people's services under The NHS Plan, will ensure that old people are treated with dignity and privacy. Professor Ian Philp has been appointed the National Director for Older People?s Services to drive forward these new standards.

The plan includes provisions for champions in each health and social care setting to ensure staff are properly able to care for older people; a process for monitoring access to health and social care services to make sure there is no age discrimination; additional services particularly important for older people, including 70,000 more cataract operations, 16,000 more hip and knee replacements; 3,000 more coronary revascularisations; new services to provide for expert treatment and care at home or in other residential settings; and a new emphasis on healthy living for older people.

A recent issue of the British Medical Journal (BMJ) included an interesting history of the theories about longevity. The Journal, in an article which is easily understandable by both professionals and consumers, discusses the way that theories on "how to live forever" have changed over time. For instance, BMJ points out that people have known for years that eating roasted meats is unhealthy. Now we avoid roasted meats because of the artery clogging effects of cholesterol and the carcinogenic qualities of nitrosamines in the charred parts, but the theory some time back was that consuming roasted food used up too much body energy in the way that a gas burner uses up gas more quickly when the flame is turned up high. The article talks about ways that "fountain of youth" qualities have been attributed to a wide variety of food, drink, and lifestyle issues, like maintaining body heat and moisture, avoiding wine, sleeping on your right side, and taking rhubarb pills.

The British Medical Journal reports that a majority exists within the Scottish parliament in favor of providing free personal care for older Scots. This action came in response to a report from the Royal Commission on Long Term Care for the Elderly which recommended making personal services free to all. It has been estimated that it will cost ?110m ($165m) a year to pay for the improved package of care in Scotland. The personal services the Commission recommended covering include:

Personal toilet (washing, bathing, skin care, personal presentation, dressing and undressing and skin care)

Eating and drinking (as opposed to obtaining and preparing food and drink)

Managing urinary and bowel functions (including maintaining continence and managing incontinence)

Managing problems associated with immobility

Management of prescribed treatment (e.g. administration and monitoring medication)

Behavior management and ensuring personal safety (for example, for those with cognitive impairment - minimizing stress and risk)

The British Medical Journal (BMJ) reports on a promising treatment for macular degeneration. They report that clinical trials showed that photodynamic therapy with verteporfin could reduce the risk of moderate and severe vision loss from 61% to 33% at one year and from 69% to 41% at two years in patients with neovascularisation extending under the centre of the retina and predominantly classic appearances on fluorescein angiography -- an appearance that has a high likelihood of growth and vision loss within months if left untreated.

They state that approximately 20% to 30% of the 200,000 cases of neovascular macular degeneration that present to ophthalmologists in the United States each year are candidates for prompt photodynamic therapy. Once extensive vision loss has occurred the treatment is no longer beneficial. It is important therefore to teach older patients with drusen who are at risk of developing neovascular macular degeneration to screen for the possible development of neovascularisation.

UK's National Institute for Clinical Excellence (NICE) has issued guidance to local councils on the use of drugs for the treatment of Alzheimers Disease. Three drugs, Aricept, Exelon and Reminyl, have been approved for treatment of mild to moderate Alzheimers. NICE estimates that there are about 400,000 people in the UK with Alzheimers, and that about 250,000 of them have mild to moderate levels of the disease.

NICE reports that Donepezil is marketed by Pfizer/Eisai as Aricept, rivastigmine by Novartis as Exelon and galantamine by Shire Pharmaceuticals and Janssen Cilag as Reminyl. The annual cost in the UK of donepezil is 891 (5 mg)/1,248 (10 mg), taken in a single daily dose, for rivastigmine is £821 (all doses), taken twice per day, and for galantamine is £876 (16 mg)/1049 (24 mg) (allowing for an initial starting dose of 8 mg daily), taken as 8 mg or 12 mg twice per day.

NICE points out that it is difficult to estimate the total aggregate cost of using these medications, but that the cost may be offset by later entry to a nursing home. For example, a delay of 12 weeks at £370 per week would yield a cost saving of about £4,500.

The NICE website includes full guidance for local councils and leaflets for patients.

The British National Health Service (NHS) has unveiled a pilot of an online "best practices" health library which will be available to both professionals and patients over the Internet. The National electronic Library for Health (NeLH) is expected to be fully functional by March 2002. The role of the NeLH will be to provide health care professionals and the public (through NHS Direct Online and the New Library Network) with knowledge and know-how to support health care related decisions.

The NeLH aims to become one of the great libraries of the world. It will provide easy access to best, current knowledge and know-how; improve health and healthcare, clinical practice & patient choice; and will be available via NHSnet and the Internet. The library's goal in its first phase it is to provide clinicians with access to information within 15 seconds, with a longer term goal of reducing the wait to one second. One of the main features of the library will be its ability to act as a quality filter so that the data accessed through the site, for both clinicians and the public, will not only be the best current knowledge, but will also be free from bias and conflict of interest.

The Genetics and Insurance Committee (GAIC) of the British Department of Health announced that genetic tests for Huntington's Disease can be used by insurance companies when assessing applications for life insurance. The Association of British Insurers is trying to have the policy extended to include testing for Alzheimer?s and breast and ovarian cancer. Patients will not be required to have testing performed, but they will have to disclose results if tested in the past. If a patient refuses to disclose results, insurers can either deny or charge much higher fees for coverage. Critics in the UK view the policy as discriminatory and have expressed concern over the government?s plan to expand the practice.

Professor John Durant, Chairman of GAIC said, "Genetic test results are already used in certain circumstances by insurers and the Committee was asked to look at the reliability and accuracy of the genetic test for Huntingdon's Disease...This decision will mean that those with a negative test result will not be asked to pay more for life insurance because of their family history of Huntington's disease...Many who have a family history of a genetic disorder such as Huntington's Disease have difficulty in obtaining insurance because of their family history. The approval of the two tests for Huntington's Disease will allow insurance to be provided at normal rates to those who have a normal test result."

British scientists have announced what they say is the first evidence of a cure for rheumatoid arthritis. A research team at University College in London led by Professor Jonathan Edwards says it has discovered what causes the body's defenses mistakenly to attack healthy joints and tissue. Its cure focuses on the role of B-cells, white blood cells that defend the body against viruses and bacteria by making antibodies that attack the hostile microbes. B-cells can accidentally make antibodies that attack healthy tissue. In the case of arthritis, the result is a self-sustaining attack on joints and tissue.

Researchers followed 20 patients who have had rheumatoid arthritis for an average of 20 years and who all failed to respond to any standard therapy, and put them through 18 months of treatment. Of the 20, five now have only some residual pain from the damage already done. Researchers said they have returned to leading a more or less normal life, with one going to the gym and one taking up gardening for the first time in ages.

Prof Edwards and his colleagues believe that they have found a way to break the circle, using drugs that seek out and destroy B-cells. He said: "Unlike with other cells in the immune system, most people can live without any B-cells for a while. By the time we reach adulthood we have already made most of the antibodies we need." After a single treatment to wipe out all the B-cells, the body responds by making fresh ones. The chances of these new B-cells making the same mistake as their predecessors, however, thereby triggering a return of rheumatoid arthritis, is small.

Edwards said the B-cell based therapy might also offer hope to patients with other auto-immune diseases, such as Crohn's disease, lupus and even multiple sclerosis.

The team will announce the results of its research Monday at the annual scientific meeting of the American College of Rheumatology in Philadelphia. The findings will be also published in the leading journal Rheumatology.