Dementia Care Practice Recommendations

The new Dementia Care Recommendations are meant for “professional care providers who work with individuals living with dementia and their families in residential and community based care settings” and are available online for download.

The published document contains 10 articles that that cover the Alzheimer’s Association 2018 Dementia Care Practice Recommendations. Within the articles are 56 recommendations for providing dementia care with specific details on each recommendation.

Recommendations offered include new guidance to nonphysician residential and community-based care providers on detection, diagnosis and ongoing medical management. Typically these have been topic areas usually reserved for clinicians.


Person-centered care, Detection and diagnosis, Assessment and care planning, are just some of the “Person Centered Focus” points mentioned on the Alzheimer’s Associations webpage announcing the new recommendations. And the Practice Recommendations are published as a February 2018 supplement to The Gerontologist.

On the website with the announcement of the Recommendations you will see a colored chart and bullet points that illustrate how each aspect of care is “focused” and “centered” around the dementia patient. Also on the webpage is a short video giving an overview of the Dementia Care Practice Recommendations.


Along with the announcement is a downloadable 20 page guide, “A GUIDE TO QUALITY CARE FROM THE PERSPECTIVES OF PEOPLE LIVING WITH DEMENTIA”

The graphic document Themes in Quality Care and includes many sections titled “PERSPECTIVES OF PEOPLE LIVING WITH DEMENTIA”. These are written in order to give a caregiver a viewpoint of what the patient with dementia may be thinking and how to address an aspect of care to address that point of view.

The announcement and the related downloads and video can be viewed on the Alzheimer’s Association website here:


The guide and the recommendations have the goal of helping a person practicing person-centered care better support individuals with dementia and their families and enhance their overall quality life throughout the course of the


According to a new study published Thursday, April 20th in the American Heart Association’s journal Stroke, people who drank at least one artificially-sweetened beverage a day had almost three times the risk of developing stroke or dementia and Alzheimer’s disease .

Does this mean that drinking diet soda can cause dementia or stroke or even increase the risks? Not necessarily.


What the Results of the Study Showed:

The study was published in the Journal Stroke. The journal is affiliated with the American Heart Association/ American Stroke Association.
The researchers caution that the study only shows an association -- it does not prove that diet drinks actually cause stroke or dementia. However more research is warranted according to the studys authors.

“Although we did not find an association between stroke or dementia and the consumption of sugary drinks, this certainly does not mean they are a healthy option,” Matthew Pase, Ph.D., the lead author of the study and a senior fellow in the department of neurology at Boston University School of Medicine, said in a statement. “We recommend that people drink water on a regular basis instead of sugary or artificially sweetened beverages.”


How the Study was Conducted:

The researchers analyzed data on nearly 2,888 people over the age of 45 for the stroke study and almost 1,500 people over age 60 for the dementia study.
The participants recorded their eating and drinking habits in questionnaires. The researchers reviewed this information at three different points in time over a period of seven years. The participants were then followed up on for the next 10 years to see who developed stroke or dementia and then compared dietary habits to the risk of developing these health problems.
At the end of the 10 year follow-up , the researchers found 97 cases of stroke, 82 of which were ischemic (caused by blockage of blood vessels), and 81 cases of dementia, 63 of which were diagnosed as Alzheimer’s disease.

The studies control factors, other possible risk factors taken into account, included age, sex, caloric intake, education, diabetes, and the presence of genetic risk factors for Alzheimer’s.

diet soda

Conclusions of the Diet Soda Study:

The results showed that people who consumed at least one artificially-sweetened drink a day were three times as likely to develop ischemic stroke and 2.9 times as likely to develop Alzheimer’s disease dementia.

In addition to being an observational study which cannot prove cause and effect, the authors noted the studys other limitations, including that fact that the overwhelming majority of participants were white. People did not drink sugary drinks as often as diet ones, which the authors said could be one reason they did not see the same link with regular soda.
The number of people in the study was also limited, under 2900 over a ten year period.

“Even if someone is three times as likely to develop stroke or dementia, it is by no means a certain fate,” Dr. Pase said. “In our study, three percent of the people had a new stroke and five percent developed dementia, so we’re still talking about a small number of people developing either stroke or dementia.”

In an accompanying commentary, Ralph Sacco, M.D., a former president of the American Heart Association and the chairman of the department of neurology at the Miller School of Medicine at University of Miami in Florida, says that current research is “inconclusive” in determining whether or not drinking artificially sweetened beverages frequently can lead stroke, dementia, and other heart-related conditions.

However, the current study, as well as other recent research showing associations between diet soft drinks and negative effects on blood vessels throughout the body, suggest that consumers may want to use caution before turning to these drinks as an alternative to sugar-sweetened beverages.

“Both sugar and artificially sweetened soft drinks may be hard on the brain,” Dr. Sacco writes.

Other professionals are in agreement. “We know that limiting added sugars is an important strategy to support good nutrition and healthy body weights, and until we know more, people should use artificially sweetened drinks cautiously,” said Rachel K. Johnson, Ph.D., past chair of the American Heart Association’s Nutrition Committee and professor of nutrition at the University of Vermont. “They may have a role for people with diabetes and in weight loss, but we encourage people to drink water, low-fat milk or other beverages without added sweeteners.”

Responding to the published study, Lauren Kane, a spokeswoman for the American Beverage Association, issued a statement from the group that said low-calorie sweeteners found in beverages have been proven safe by worldwide government safety authorities.  Those authorities includes "The FDA, World Health Organization, European Food Safety Authority and others".

Link to study:

Sugar- and Artificially Sweetened Beverages and the Risks of Incident Stroke and Dementia
A Prospective Cohort Study

What does this new Calcium Study Mean for Seniors?

Calcium supplements are used by many seniors, especially women, to help keep the risk of developing osteoporosis at a minimum. However a new study may indicate that such supplements could raise an older woman’s risk of dementia.

This new study does not prove cause-and-effect, yet the findings of the study seemed to have shown that dementia risk was seven times higher in female stroke survivors who took calcium supplements, compared to women with a history of stroke who didn’t use the supplements.

According to lead researcher Dr. Silke Kern, a neuropsychiatric researcher at the University of Gothenburg in Sweden, women with cerebrovascular disease and osteoporosis should discuss this new information with their clinicians…”.

Oddly enough though, Dr. Kern stressed that the findings apply only to calcium supplements, and that calcium from food appears to affect the brain differently and appears to be safe or even protective.

Is this another example of a new study that seems to be ground breaking, yet confusing and contradictory?

Consider the way the study was conducted.

"The risk of dementia also was three times higher in women with white matter brain lesions who took calcium supplements, compared to women with white matter lesions who didn’t take the supplements. Lesions in white matter tissue are evidence of a mini-stroke or some other problem impeding blood flow within the brain."

The study included information from 700 dementia-free women. The participants were between the ages of 70 and 92 at the start of the study. The study began in 2000, and researchers followed the women’s health for five years.

The study participants took a variety of tests at the beginning and end of the study, including tests of memory and thinking skills. Researchers also conducted CT brain scans on 447 participants at the start of the study, which revealed that 71 percent of these women had white matter lesions.

A total of 98 women were taking calcium supplements at the start of the study, and 54 women had already experienced a stroke. During the study, 54 more women had strokes and another 59 women developed dementia.

Initially, the research team found that the women taking calcium supplements were twice as likely to develop dementia as women who did not take supplements.

It seems that Dr. Kern isn’t sure why calcium supplements might have this effect. Calcium plays a crucial role in cell death, she said, and high levels of calcium in the blood might prompt the early death of neurons. Excess calcium also might somehow affect the blood vessels within the brain.

More Study may be Needed Before Conclusions Can Be Made

“I would hope this type of study will be reproduced in larger populations and more ethnically diverse populations.” - Dr. Neelum Aggarwal

According to Dr. Neelum Aggarwal, an Associate professor of neurological science and director of research for the Rush Heart Center for Women at Rush University Medical Center in Chicago, other factors may be a work as well. She said that calcium also can affect brain chemistry, and too much calcium might cause a cascade of events that lead to brain cell degeneration.

food sources of calcium

And Dr. Aggarwal cautioned against blaming calcium supplements alone for any person’s dementia risk.

“We need to consider that the combination of nutrients will be more predictive than one nutrient,” she said. “For example, calcium, phosphorus and magnesium all are typically looked at for their effects on multiple organs, and cognitive [mental] functioning will be affected most likely by a combination of these nutrients. To say that only one nutrient increases the risk of dementia is premature, and more studies need to look at a combination of nutrients.”

What May Some Conclude From This New Study Regarding Calcium Supplements?

Osteoporosis is a major problem for seniors, and it’s worth looking further into the tradeoffs that come with calcium supplements

“This new calcium study provides limited evidence to support its hypothesis, and therefore we caution against jumping to conclusions. Even the authors acknowledge these findings ‘need to be confirmed,’” - Duffy MacKay, spokesperson for the Council for Responsible Nutrition, a supplement trade association.

According to MacKay, the authors of the study ‘mined data from a decade-old observational study, which was not originally designed to assess calcium intake’. And the study ‘included only 98 women who took calcium supplements and did not include any information on their supplemental calcium dose or duration, or dietary intake of calcium,’

Clearly, while studies about the effects of dietary supplements are interesting, all such are not conclusive. Each of us must make decisions of our own when it comes to diet, dietary supplements and changes in our food intake.

Note: The findings were published online Aug. 17 in the journal Neurology -
Calcium supplementation and risk of dementia in women with cerebrovascular disease

residents dietary needs and requests

Senior Home Search points out that many of the Senior Care Homes, Adult Foster Care Homes and other facilities listed on our website cater to resident’s dietary needs and requests. Many make provisions for individual diet and meal requirements, with trained staff and even dieticians.

Senior Home Search is a website that is designed to help you in your search for such Senior Care facilities near you, as well as provide you with up to date information about Assisted Living and Senior Homes in your area. We always give you contact information so you can talk directly with these homes.

Please take advantage of this free and easy to use website to find Assisted Living and Senior Homes near you. And remember to tell your friends about it. Good luck to all in your search.

Find Senior Care Homes Now