CASL
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/22
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Item A hypothetical intervention on the use of hearing aids for the risk of dementia in people with hearing loss in UK Biobank(Oxford University Press, 2024-12-16) Mur, J; Klee, M; Wright, H R; Solomon, A; Johnson, Christine; Littlejohns, T J; Muniz-Terrera, G; Leist, A KObservational studies have reported that hearing aid (HA) use is associated with a reduced risk of dementia diagnosis, suggesting a possible protective effect. However, extant observational studies do not explicitly model causal effects, while randomised controlled trials on the effect of HA on dementia exhibit short follow-up. Here we used self-report, hearing tests, and healthcare records in UK Biobank to design a hypothetical intervention for the effect of HA use on the risk of dementia diagnosis in people with incident hearing loss (HL). HA users exhibited a higher risk of dementia diagnosis than non-users (RR=1.43, 95%CI=1.08-1.88). Associations between HA use and dementia diagnosis were robust across sensitivity analyses (RRs: 1.34-1.59) but adjustment for primary healthcare utilisation (0.77, 0.44-1.33) or primary and secondary care utilisation (0.68, 0.39-1.18) substantially decreased the observed effect. The decrease in effect estimates upon adjustment for primary (1.30, 0.95-1.78) and primary and secondary healthcare utilisation (1.30, 0.94-1.78) was smaller when participants with relatively early diagnoses of HL were included in the sample compared to when they were not. While the findings are not conclusive, they suggest residual confounding by healthcare utilisation and dating of HL diagnosis in participants without primary care data in UK Biobank.Item Assessing the Joint Prevalence of Dementia and Hearing Loss in Scotland: An Epidemiological Model for Public Health Planning(Springer, 2023-08-03) Koesters, Nils Bernd; McMenemy, Andrena; Johnson, ChristineAim: Data in Public Health studies often comes in mismatched age groups. This study investigated how mathematical modeling techniques could be used to estimate the number of individuals with dementia and hearing loss in Scotland given heterogeneous age group data. Subject and Methods: Using established criteria for modeling hearing loss, current population level estimates from the Scottish National Records office were employed to calculate general estimates of the number of individuals with hearing loss in Scotland. Additionally, age group models developed by the European Collaboration on Dementia were used to generate estimates of the number of people with dementia in Scotland. To estimate the number of individuals with both conditions, the two models were combined in a single formula. Parameter optimization was performed on various growth models to determine the best fit to the data. Results: The Stannard growth model was found to be the best fit to the data. Conclusion: The prevalence of hearing loss, dementia, and their co-occurrence exhibit a sigmoidal pattern, which is well-captured by the Stannard growth model, a logistic, sigmoidal type model. This study demonstrates the potential of mathematical modeling to provide nuanced and robust estimates of the prevalence of hearing loss, dementia, and their co-occurrence given heterogeneous data sources. A lookup table is provided.Item A different story: exploring patterns of communication in residential dementia care(2008-07) Ward, Richard; Vass, Antony A.; Aggarwal, Neeru; Garfield, Cydonie; Cybyk, BeauThis article reports findings from a three-year project on 'Communication patterns and their consequences for effective care' that explored communication in dementia-care settings. As the proportion of people with dementia living in British care-homes continues to grow, there is a need to understand better their care. Using a range of qualitative methods, the project set out to identify the constituent elements of dementia-care practice and the patterns that characterise day-to-day relations in care homes. The tightly prescribed and standardised nature of the interactions between staff and residents is described: it raises questions about the capacity for dementia care to be truly person-centred. The project found that people with dementia are both capable of communication, and invest much effort in seeking to engage those around them, but are excluded from the monitoring, planning and provision of care in ways that we argue are discriminatory. The case is made for promoting and supporting communication as key skills and competencies for care workers. The value of measuring the level and quality of communication as a means to evaluate care is demonstrated. The authors question the priorities that currently guide care practice and argue that we need to listen to people with dementia and rethink what lies at the heart of dementia care. 2008 Cambridge University Press.