Translating dementia research into practice

1. Translating Research into Practice The Dementia Outcomes Measurement Suite (DOMS) What is the Dementia Collaborative Research Centre? Three CentresAssessment and Better Care Early Diagnosis and Prevention Carers and Consumers Translating dementia research into practice

2. ACAP Presentation 21 May 2010 Phase I: 2007 Dementia Outcomes Measurement Suite (DOMS) Jan Sansoni & 10 Investigators Phase II: Aug 2009--Translating the 2007 DOMS research into practice Readiness & Dissemination Translating dementia research into practice

3. KT-DOMS Project Background The Dementia Outcomes Measurement Suite (DOMS), a project commissioned under the National Dementia Initiative, was designed to develop a standard suite of instruments that would be promulgated throughout Australia to encourage clinicians to ‘talk the same language’ by using the same instruments as much as possible. The DOMS Report was delivered in 2007. KT-DOMS Purpose To increase the quality of dementia assessment and encourage clinicians to ‘talk the same talk’ by promulgating DOMS (2007) throughout Australia. Translating dementia research into practice

4. 2009 KT DOMS Project: Implementation Aug Sept Oct Nov Dec Done Project start-up DEMENTIA RESEARCH Done 35 Authors Permission 35 scales, manuals, etc. Done Done Clinician needs analysis Done Website Product Done Clinician consultation Done Website launched Done 2009 Dementia Assessment Clinician Report Done 2010 Implementation Plan Translating dementia research into practice

5. KT DOMS Project • 2009 Clinician Data Report • Clinicians Surveyed • Acute Care: CNCs, Geriatricians, etc. • Primary Care: GPs, Practice Nurses, Nurse Practitioners • Community Care: ACAT • Residential Nursing homes • 2009 Total Clinicians Surveyed = 260 • 2007 Focus Group Report = 22 surveyed Translating dementia research into practice

6. KT DOMS Project Website Product www.dementia-assessment.com.au Core Navigation example: Two clicks Translating dementia research into practice

10. CLINICAL DEMENTIA RATING (CDR) : 0 0.5 1 2 3 Impairment None 0 Questionable 0.5 Mild 1 Moderate 2 Severe 3 Consistent slight forgetfulness; partial recollection of events; “benign” forgetfulness Moderate memory loss; more marked for recent events; defect interferes with everyday activities Severe memory loss; only highly learned material retained; new material rapidly lost No memory loss or slight inconsistent forgetfulness Severe memory loss; only fragments remain Memory CLINICAL DEMENTIA RATING (CDR) Fully oriented except for slight difficulty with time relationships. Moderate difficulty with time relationships; oriented for place at examination; may have geographic disorientation elsewhere Severe difficulty with time relationships; usually disoriented to time, often to place. Orientation Fully oriented Oriented to person only Solves everyday problems & handles business & Financial affairs well; Judgment good in relation To past performance Moderate difficulty in handling problems,’ similarities, and differences social judgment usually impaired Severely impaired in handling problems, similarities, and differences; social Judgment usually impaired Judgment & Problem Solving Slight impairment in solving problems similarities, and differences Unable to make judgments or solve problems Unable to function Independently at these activities although may still be engaged in some; appears normal to casual inspection No pretense of independent function outside home Community Affairs Independent function at usual level in job, shopping, volunteer and social groups.. Slight impairment in these activities Appears well enough to be taken to functions outside a family home Appears too ill to be Taken to functions outside a family home Mild but definite impairment of function at home; more difficult chores abandoned; More complicated hobbies and Interests abandoned Life at home, hobbies, and intellectual interests well maintained Only simple chores preserved; very restricted Interests, poorly maintained. Home & Hobbies Life at home, hobbies, and intellectual interests sightly impaired. No significant function in home Personal Care Fully capable of self-care Needs prompting Requires assistance in dressing, hygiene, keeping of personal effects. Requires much help With personal care; frequent Incontinence. Score only as decline from previous usual level due to cognitive loss, not impairment due to other factors John C Morris, Washington University School of Medicine, St Louis, MO, USA

11. Folstein (1975) Mini Mental State Exam MMSE Aka Mini Mental Recommended because it is brief and easy to score Translating dementia research into practice

12. MMSE Limitations • Insufficient guidelines for its application • Dichotomised responses disallowing credit for near misses • Narrow score range (0-30) • Floor and ceiling effects • False positive responses due to low education • Limited sensitivity and specificity, e.g. for a mild form • of cognitive impairment or dementia.. • Professor Yun-hee Jeon, RN, PhD | Associate Professor in Nursing • Faculty of Nursing and Midwifery (M02) • The University of Sydney • Weak on frontal lobe function, i.e. Planning and conceptualising Translating dementia research into practice

13. What next? Dementia Assessment Website With Free Assessment Tools www.dementia-assessment.com.au Translating dementia research into practice

14. Partner logo here Thank you and please pass the word Translating dementia research into practice

15. Dementia Outcomes Measurement Suite DOMS Global Dementia Assessment Global Deterioration Scale (GDS) Clinical Dementia Rating (CDR) Dementia Severity Rating (DSR) Cognition Assessment Modified MMSE (3 MS) ADAS-Cog GP-Cog RUDAS Psychogeriatric (PAS) KICA-Cog Translating dementia research into practice

16. DOMS (Continued) Global Behavioural and Psychological (BPSD) NPI BEHAVE-AD Delirium CAM Depression CSDD Geriatric GDS DEMENTIA RESEARCH Translating dementia research into practice

17. DOMS continued Functional Dementia Specific ADCS-AD: DAD CSADL Dementia Specific Health Related Quality of Life QOL-AD QUALID AQoL DEMQOL DEMENTIA RESEARCH Translating dementia research into practice