Megan Rose Readman

Background: In 2023, Age UK developed the UK's first day centre dementia village at a facility in the North West of England, designed to evoke positive memories and promote engagement in meaningful everyday activities. However, the impacts introducing this dementia village facility have not yet been systematically explored. This study aimed to qualitatively examine the experiences and perceived impacts of engaging with the Age UK dementia village. Methods: This is an in‐person qualitative semi‐structured interview study with people with dementia (PLWD) and Age UK staff. Eligible participants were adults aged 18 and over who either attended or worked at this Age UK day centre. Data was analysed using reflexive thematic analysis within a social constructivist paradigm. Results: Twenty‐two interviews comprising 11 members of Age UK Wirral staff and 11 PLWD were conducted. Thematic analysis identified three over‐arching themes: (1) Seeing the client as a person; (2) meaningful activity and engagement; and (3) factors shaping engagement with the dementia village. Conclusions: Findings suggest that dementia village approaches embedded within day care settings may offer a promising model for enhancing person‐centred care by supporting staff to engage with individuals' identities and tailor meaningful activities. While such initiatives show potential to enhance engagement and social inclusion, their effectiveness is likely to depend on careful adaptation to individual needs, alongside appropriate resourcing and staff support. Further research is required to evaluate long‐term outcomes, cost‐effectiveness, and the ethical implications of increasingly immersive dementia care environments.

Hearing impairment (HI) and dementia often co-exist, however, little is known about the experience of concurrent HI and dementia. Prior literature focuses on all-cause dementia, leaving the experience of HI in Lewy body dementias (LBDs) unknown. This study explored the experience of HI in people with LBDs and carers within the United Kingdom. A remote interview study, using topic guides co-produced with one person living with Parkinson's disease dementia (PDD) and HI and one former carer. Data were analysed using reflexive thematic analysis within a critical realist framework. People with LBDs (n = 9) and concurrent HI, and unpaid carers of people living with LBDs and HI (n = 11). Three overarching themes were generated: (1) The Interpersonal, Emotional, and Somatic Impacts of Hearing Impairment; (2) Accessibility and Availability of Audiology Services; and (3) Perceived Inappropriateness of Audiology Services for People with LBDs. The impact of HI extended beyond communication and included emotional and somatic effects. Audiology access was inconsistent, and standard assessments were often poorly suited to LBD needs. HI has multifaceted consequences for people with LBDs and carers. Audiology assessments require review, alongside improved support for people with LBDs and concurrent HI.

Hearing impairment is implicated as a risk factor for the incidence of all-cause dementia. However, few studies have explored the relationship between hearing loss and specific rarer dementia subtypes. Therefore, this pilot study sought to explore whether hearing impairment, estimated using a speech-in-noise test (the digit triplet test, DTT), is a risk factor for Parkinson’s disease dementia (PDD) incidence. We conducted a pre-registered prospective cohort study using UK Biobank data from 158,686 individuals (72,015 males; 86,671 females), who underwent the DTT, and were free from PDD at the point of assessment. A Cox Proportional Hazard model, controlling for age, sex and educational attainment was conducted. Over a median follow-up of 8.93 years (SD = 2.29), 101 cases of incident PDD were observed. While the hazard ratio were in the direction of a positive relationship between baseline DTT and PDD incidence, imprecision in estimates leaves it uncertain as to whether risk was influenced by speech-reception-threshold (HR = 2.39, 95% CI: 0.75,7.63; p = .141), and findings should be treated as exploratory. An exploratory analysis, in which speech-reception-thresholds were categorised according to UK Biobank norms, showed that ‘insufficient’ ( p = .024), but not ‘poor’ ( p = .236) hearing increased PDD risk. The observed HR directionally aligns with the previously observed positive relationship between hearing loss and all-cause dementia incidence. However, further studies employing alternative datasets with more PDD cases are required to substantiate these findings. If further supported, these findings may have clinical and public health implications.

Background: In England, people aged > 60 are typically required to pay for their prescriptions. Whilst exemption criteria enable people living with specified long-term health conditions to receive free prescriptions, Parkinson’s disease is omitted from this list. People with Parkinson’s are often reliant upon medications, and evidence suggests that medical fees can reduce quality of life and medicine adherence. We, therefore, aimed to explore the impact of prescription charges on people with Parkinson’s and their family care partners (caregivers). Methods: This is a qualitative focus group study with people with Parkinson’s and caregivers. Focus groups were semi-structured and conducted online. Participants were recruited through opportunity sampling. Eligible participants were adults aged 18 and over living in England who either (1) had a diagnosis of Idiopathic Parkinson’s Disease or (2) provided unpaid care for someone with Parkinson’s, including parents, adult children, siblings, or close friends. Data was analysed using reflexive thematic analysis within a critical realist paradigm. Results: Five focus groups were conducted with people with Parkinson’s (n = 12) and caregivers (n = 12). All focus groups comprised both people with Parkinson’s and caregivers. Thematic analysis identified three overarching themes: (1) The financial toll of medication and its ripple effects; (2) Lack of inclusion and support; and (3) Difficulties of seeking support. People affected by Parkinson’s disagreed with current policy and suggestions of per-prescription charge re-evaluation were expressed. Conclusions: Prescription charges have multifaceted negative impacts on people affected by Parkinson’s. Current prescription charge policies, including their exemption criteria, should be reviewed, alongside initiatives to raise awareness of existing financial support systems, such as pre-payment certificates. Registration: Study protocol and analysis strategy are pre-registered on Open Science Framework (https://osf.io/y8ve5/).

Background and Aims: Non-pharmacological arts interventions are increasingly being recognised as effective and beneficial ways to support and improve cognition and general well-being for people with dementia. However, accessing and engaging with beneficial arts interventions and support services can be challenging for people with dementia and their carers and it is important to understand barriers and facilitators that may impede access. This systematic review aimed to synthesise evidence on the barriers and facilitators to accessing and engaging with arts interventions and services for people living with dementia. Methods: We systematically searched five electronic databases (PubMed, PsycINFO, CINAHL, Scopus, Web of Science) for studies reporting barriers and facilitators to accessing and engaging with arts interventions for people with dementia in July 2024, screening a total of 7815 articles. Nineteen papers were deemed eligible for inclusion in this review including 567 people with dementia, 320 unpaid carers and 355 paid carers. Results: This review highlights key facilitators and barriers to accessing and engaging with arts interventions for people with dementia. Key facilitators included the assistance of volunteers, the inclusion of unpaid carers in the sessions, and the effective facilitation of sessions. Barriers to access and engagement were identified for people with dementia and their unpaid carers such as increased reliance on unpaid carers and a lack of training and time for paid carers. Conclusions: Increased awareness of these barriers and facilitators could aid in designing future arts interventions and support services to promote wider access and engagement for people with dementia and their carers.

Objectives Since their introduction in 1952, per-prescribed item charges in England have continually risen. This study investigated the acceptability and impact of per-prescribed item charges, and awareness and use of initiatives designed to reduce prescription charge financial burden (the prescription prepayment certificate (PPC) initiative), in people living with and without long-term health conditions (LTHCs) in the UK. Design Cross-sectional mixed-method survey of people with and without an LTHC across the UK. Participants 381 people, 267 people with an LTHC and 114 people without an LTHC, participated. Outcome measures Acceptability and impact of prescription charge policy, awareness and use of the PPC. Results Over half (53.2 %) of participants disagreed with current per-prescribed item charges. In most domains, the impact of prescription charges did not differ between people with and without LTHCs. However, people with LTHCs were more likely to report financial burden and deviate from prescribed medication regimes. 35.29% of respondents were aware of the PPC, with people with LTHCs being more likely to be aware of and use this initiative. Qualitative findings indicate perceived inequalities in current policy with themes including (1) the need for re-evaluation; (2) the burden of prescription charges; (3) inconsistencies and inequalities in current policy; and (4) positive reflections of prescription charge policy. Conclusions Inconsistencies in current policy and a lack of public support may suggest that a re-evaluation of current policy is required. The lack of difference in the impact of prescription charge policy between people with and without LTHCs indicates that the effects of such policy are not constrained to people with LTHCs. Thus, policy amendments would benefit the wider population. Systematic efforts to increase awareness of the PPC and reduce inequalities in medical exemption criteria are suggested. Trial registration number Study protocol and analysis strategy are preregistered on Open Science Framework (https://shorturl.at/IrvnS).

Introduction: Cognitive dysfunction is commonplace in Motor Neurone Disease (MND). However, due to the prominent motor symptoms in MND, assessing patients’ cognitive function through traditional cognitive assessments, which oftentimes require motoric responses, may become increasingly challenging as the disease progresses. Oculomotor pathways are apparently resistant to pathological degeneration in MND. As such, abnormalities in oculomotor functions, largely driven by cognitive processes such as saccades and smooth pursuit eye movement, may be reflective of frontotemporal cognitive deficits in MND. Thus, saccadic and smooth pursuit eye movements may prove to be ideal mechanistic markers of cognitive function in MND.Methods: To ascertain the utility of saccadic and smooth pursuit eye movements as markers of cognitive function in MND, this review summarizes the literature concerning saccadic and smooth pursuit eye movement task performance in people with MND.Results and discussion: Of the 22 studies identified, noticeable patterns suggest that people with MND can be differentiated from controls based on antisaccade and smooth pursuit task performance, and thus the antisaccade task and smooth pursuit task may be potential candidates for markers of cognition in MND. However, further studies which ascertain the concordance between eye tracking measures and traditional measures of cognition are required before this assumption is extrapolated, and clinical recommendations are made.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=376620, identifier CRD42023376620.