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Users may use the search function to find links to journals, books, policy papers and surveys and databases related to dementia in the Republic of Ireland and Northern Ireland. Users can search by keyword or theme and then use filters to refine results by content type, year and themes.

Improving Dementia Services in Northern Ireland: A Regional Strategy

Dept. of Health, Social Services and Public Safety
2011

The Bamford Action Plan 2009-2011 (DHSSPS, 2009) included a commitment by government to develop a regional dementia services strategy.

The Bamford Action Plan 2009-2011 (DHSSPS, 2009) included a commitment by government to develop a regional dementia services strategy.  A consultation process was carried out in 2010 to inform the development of the strategy.  This included consultation with a wide group of stakeholders and a targeted consultation for people living with dementia and their carers.  The strategy was formally launched in 2011 and aims to:

  • Promote a greater understanding of how dementia impacts on the lives of individuals, and how people can be supported to live well, with dignity and as valued members of our society.

  • Raise public awareness of dementia and how people can take some measures to reduce the risk of developing dementia or potentially delay its onset.

  • Encourage sharing of information on dementia to allow individuals, families and carers to make informed decisions.

  • Maximise independence and enhance daily living.

  • Respond to the voice of people with dementia and their carers, and promote access to earlier diagnosis and multidisciplinary assessment and support through further development of health and social care commissioning, thus placing the person with dementia, their families and carers at the centre of the care planning process.

  • Promote partnership working that recognises the pivotal role of carers and integrates the activity and skills of those who work in the statutory, community, voluntary and independent sectors.

The values underpinning the strategy are identified as dignity and respect; autonomy; justice and equality; safe, effective person-centred care; care for carers; and skills for staff.  A series of actions linked to one or more of these values were proposed.  These were reducing the risk or delaying the onset of dementia, raising awareness, promoting early assessment and diagnosis, supporting people with dementia, supporting carers, legislation and research.  The Department of Health, Social Services and Public Safety anticipated that the key actions required to improve services would be likely to cost an additional £6-8m per year. With additional support from The Atlantic Philanthropies, in September 2014 £11 million was allocated within the Delivering Social Change Initiative, targeting Raising Awareness; Information and Support for people living with dementia; Training and Development for those in the caring professions, both formally and informally; and Respite, Short Breaks & Support for Carers.   

The Irish National Dementia Strategy

Department of Health
2014

The Irish National Dementia Strategy, led by the Department of Health, was launched on 17 December 2014. The ROI Government made a commitment in The Programme for Government 2011-2016 to develop a National Dementia Strategy for Ireland by 2013.

The development of the strategy was informed by a research review, a review of international dementia policies/plans/strategies, review of Irish policy contexts, public consultation process, clinicians’ roundtable (2) on the national dementia strategy, workshops (2) with people with dementia and carers, and National Dementia Strategy Advisory Group. The aim of the Strategy is to improve dementia care so that people with dementia can live well for as long as possible, can ultimately die with comfort and dignity, and can have services and supports delivered in the best way possible. The Strategy identifies key principles to underpin and inform the full range of health and social care services provided to people with dementia, their families and carers. Six Priority Areas for Action have been identified in the Strategy, as follows:

  • Better awareness and understanding

  • Timely diagnosis and intervention

  • Integrated services, supports and care for people with dementia and their carers

  • Training and education

  • Research and information systems

  • Leadership

For each of the Priority Action Areas, considered key to the implementation of the Strategy, objectives are outlined, the area is discussed and Additional Actions are also identified. In the context of resource constraints, some of the actions will be implemented based on a review and reconfiguration of existing resources, whilst others will be progressed as resources become available in the future. The Department of Health and the Health Service Executive have agreed a joint initiative with The Atlantic Philanthropies with initial funding of €27.5m, with The Atlantic Philanthropies contributing €12m, and the HSE contributing €15.5m, to be used to implement the Strategy over the period 2014-2017. The National Dementia Implementation Programme aims to promote a greater focus on timely diagnosis of dementia and on the value of early intervention, along with the long-term objective of making people in ROI generally more aware and understanding of the needs of people with dementia, and of the contribution that those with dementia continue to make to our society.

Making Life Better: A Whole System Strategic Framework for Public Health, 2013-2023

Dept. of Health, Social Services and Public Safety
2014

Making Life Better is NI’s ten-year strategic framework for public health. Building on the earlier public health strategy, Investing for Health (2002), Making Life Better was developed to provide a direction for policy and actions to improve the health and wellbeing of people in NI.

It was informed by a consultative process and feedback on the draft framework titled Fit and Well: Changing Lives.  

Through strengthened co-ordination and partnership working in a whole system approach, Making Life Better seeks to create the conditions for individuals and communities to take control of their own lives and move towards a vision for NI where all people are enabled and supported in achieving their full health and wellbeing potential.

Making Life Better has adopted a set of values to underpin the strategy – social justice, equity and inclusion, engagement and empowerment, collaboration, evidence informed, and addressing local need. Based on feedback during the consultation, it takes a thematic approach structured around six themes:

  1. Giving Every Child the Best Start

  2. Equipped Throughout Life

  3. Empowering Healthy Living

  4. Creating the Conditions

  5. Empowering Communities

  6. Developing Collaboration

Apart from Theme 1 which focuses on the health and wellbeing of children, each of the other five themes is relevant to people with dementia and their families. Healthy Active Ageing, one of the key long-term outcomes of the second theme ‘Equipped Throughout Life’, is of particular relevance to older people, including those with dementia. One of the long-term outcomes identified under the theme of ‘Empowering Healthy Living’ is improved mental health and wellbeing. Here, the report highlights the intention in the development of a new positive mental health promotion policy in NI to address two main undertakings in relation to dementia:

  • public health efforts to prevent/delay dementia as far as possible and to encourage early diagnosis; and

  • improving the mental wellbeing of people who have dementia.

A final report on the public health strategy, Investing for Health (2002), referred to above,   can be found at http://www.dhsspsni.gov.uk/health_development-final_report_-_september_2010.pdf.

Healthy Ireland – A Framework for Improved Health and Wellbeing 2013-2025

Department of Health
2013

Healthy Ireland is ROI’s national framework for action to improve the health and wellbeing of the people of ROI, published in 2013. Its main focus is on prevention and keeping people healthier for longer.

Healthy Ireland’s goals are to:

  • Increase the proportion of people who are healthy at all stages of life

  • Reduce health inequalities

  • Protect the public from threats to health and wellbeing

  • Create an environment where every individual and sector of society can play their part in achieving a healthy Ireland

Healthy Ireland takes a whole-of-Government and whole-of-society approach to improving health and wellbeing and the quality of people’s lives. While there is no explicit mention of dementia in Healthy Ireland, one of its key goal is to decrease the prevalence of unhealthy behaviours that contribute to chronic disease, and to increase the degree to which diseases and conditions are either prevented, or detected early enough to allow for successful intervention.

With respect to dementia, whilst ageing is the strongest risk factor for dementia and genes can play a part, the likelihood of developing dementia is also influenced by a number of cardiovascular risk factors and factors related to lifestyle including physical exercise, smoking, alcohol consumption, diet and cognitive activity. There is strong evidence that a healthy lifestyle can help to reduce the risk of dementia. Under the National Dementia Strategy, public awareness and health promotion measures are to be implemented by the Health Service Executive to support the implementation of Healthy Ireland by highlighting the modifiable lifestyle and cardiovascular risk factors which can beneficially impact on risk and time of onset of dementia. 

Active Ageing Strategy 2014-2020 – Consultation Document

Office of the First Minister and Deputy First Minister
2014

NI’s ageing strategy, Ageing in an Inclusive Society, was published in 2005 and an active ageing strategy is currently being developed to replace the existing strategy. The purpose of the new strategy will be to transform attitudes to and services for older people.

When developed, it is intended to provide direction for Departments’ policies, make connections between a range of relevant Strategies and lead to the improvement of services for older people. As well as increasing the understanding of the issues affecting older people, the active ageing strategy is expected to facilitate a move away from an emphasis on needs, costs and burden of ageing to the promotion of rights, value and contribution of older people. NI’s national dementia strategy is referred to regularly in the consultation document. The consultation document has outlined five high level goals: independence, participation, care, self-fulfilment and dignity, all of which are significant goals for people with dementia. Feedback from The Active Ageing Strategy Consultation, which closed in May 2014, will inform the final version of the strategy due for publication in 2015. 

The National Positive Ageing Strategy: Positive Ageing Starts Now

Department of Health
2014

The National Positive Ageing Strategy (NPAS), published in April 2013, is a high level commitment from the Government outlining a vision for ageing and older people in ROI.

It is an over-arching cross-departmental policy that serves as a blueprint for age-related policy and service delivery across Government. It includes four national goals to serve as a direction in achieving the vision outlined:

  • Remove barriers to participation and provide more opportunities for the continued involvement of people as they age in all aspects of cultural, economic and social life in their communities according to their needs, preferences and capacities.

  • Support people as they age to maintain, improve or manage their physical and mental health and wellbeing.

  • Enable people to age with confidence, security and dignity in their own homes and communities for as long as possible.

  • Support and use research about people as they age to better inform policy responses to population ageing in ROI

Each of these goals is underpinned by several objectives that are relevant to specific policy areas and cross-cutting objectives of combatting ageism and improving information provision.

Healthy Ireland provides the basis for the implementation of the National Positive Ageing Strategy. The Strategy committed to the development of an Implementation Plan, based on the strategic direction laid out in the NPAS. This is still under development, but will when developed facilitate:

  • Translation of the Goals and Objectives of the Strategy into action on the ground

  • Development of key deliverables in a more detailed manner, taking account of relevant linkages with other statutory agencies

  • Development of timelines and performance indicators

  • Specification of ‘direct responsible individuals’ across Government and wider civil society

For each of the National Goals and Objectives, Priority Action Areas were also identified in the strategy.  These were selected as key areas in which actions should be developed. They are intended to set the strategic direction for activity rather than prescribe the specific measures that will be taken to progress the implementation of the Strategy. 

National Carers’ Strategy: Recognised, Supported, Empowered

Department of Health
2012

The National Carers’ Strategy sets the strategic direction for future policies, services and supports provided by Government Departments and agencies for carers.

This includes carers of people with dementia, the majority of whom live at home in their own communities and for whom carers are the cornerstone of their care. The Strategy is a Cross-Departmental Strategy. It sets out guiding principles, goals and objectives addressing priority areas (income support, health, information, respite, housing, transport, training, employment, children and young people with caring responsibilities) and a Roadmap for Implementation containing 42 Actions to be achieved on a cost-neutral basis in the short to medium term.

The four goals of the National Carers’ Strategy are to:

  • Recognise the value and contribution of carers and promote their inclusion in decisions relating to the person that they are caring for

  • Support carers to manage their physical, mental and emotional health and well-being

  • Support carers to care with confidence through the provision of adequate information, training, services and supports

  • Empower carers to participate as fully as possible in economic and social life

The implementation of the National Carer’s Strategy is reported in progress reports. The First Annual Progress Report (September 2012 – September 2013) can be accessed here.

The Second Progress Report (September 2013-September 2014 can be accessed here.  

Transforming Your Care: A Review of Health and Social Care in Northern Ireland

Dept. of Health, Social Services and Public Safety
2011

In December 2011 following an extensive consultation process the Minister for Health, Social Services and Public Safety published a report on the review of health and social care services.  This included a new model of care for NI based on 12 key principles:

  • Placing the individual at the centre of the model by promoting a better outcome for the service user, carer, and their family

  • Using outcomes and quality evidence to shape services

  • Providing the right care in the right place at the right time

  • Population-based planning of services

  • A focus on prevention and tackling inequalities

  • Integrated care – working together

  • Promoting independence and personalisation of care

  • Safeguarding the most vulnerable

  • Ensuring sustainability of service provision

  • Realising value for money

  • Maximising the use of technology

  • Incentivising innovation at a local level

Work continued after the report was published to develop implementation plans, including a further consultation process that resulted in the publication of: The Vision to Action Consultation Report.

The final strategic implementation plan was published in October 2013.

Future Health: A Strategic Framework for Reform of the Health Service (2012-2015)

Department of Health
2012

Future Health maps out the key actions, with timelines, that are required to achieve the Government’s objective to transform the Health System to a single-tier health service, supported by Universal Health Insurance (UHI) that is designed in accordance with the principles of social soli

darity.  Recognising the need for large-scale change that delivers fundamental reform, the policy is built on four key inter-dependent pillars:

  1. Health and Wellbeing

  2. Service Reform

  3. Structural Reform

  4. Financial Reform

While this policy does not specifically address dementia, it proposes fundamental change to the systems and service provision in ROI.  It highlights an ageing population as one of the key future issues in service provision.  The Strategic Framework has been designed to do three things:

∙ Set out the strategic policy direction for health reform up to 2015

∙ Deliver real tangible improvement in the quality of patient care well ahead of the introduction of UHI

∙ Prepare the ground for the introduction of UHI by radically reforming the way in which the current health system is organised, financed and delivered.

Bamford Action Plan 2012-2015

Dept. of Health, Social Services and Public Safety
2012

The Bamford Action Plan (2009-2011) was produced in response to the Bamford Review (2007) - an independent review of mental health and learning disability law, policy and service provision commissioned by the DHSSPS

http://www.dhsspsni.gov.uk/bamford.htm/.  This 2012-2015 plan carries forward the work of the earlier Bamford Action Plan, and in terms of dementia commits to continuing to improve dementia services in line with the dementia strategy in NI, with its emphasis on ensuring that people with dementia are treated with awareness and respect, especially by those providing services, and that they are supported to maintain their independence for as long as possible.

A Strategy to Improve the Lives of People with Disabilities 2012-2015

Office of the First Minister and Deputy First Minister
2012

Addressing their responsibility to deliver the commitments in the United Nations Convention on the Rights of Persons with Disabilities this policy was also informed by the recommendations of the Promoting Social Inclusion (PSI) Working Group’s report on Disability.

The strategy addresses a series of cross cutting themes (e.g. participation and active citizenship, awareness raising, independent living/choice and control).

While dementia is not referred to specifically, the theme addressing transition from adulthood to later life recognises that many areas of public service do not distinguish between growing old and acquiring a disability and that the prevalence of disability in those aged between 60 and 74 is four times that in those aged between 26 and 44 (Northern Ireland Survey of people with Activity Limitations (NISALD)). The strategy argues that older people with disabilities should be supported in addressing their needs so that they have the same opportunities as older people who do not have a disability. 

National Housing Strategy for People with a Disability 2011-2016

Department of Environment, Community and Local Government
2011

The National Housing Strategy for People with a Disability 2011-2016 sets out nine strategic aims including “to promote and mainstream equality of access for people with a disability to the full range of housing options suited to individual and household need” and “to support people with a disabi

lity to live independently in their own houses and communities”. The latter is in keeping with a key objective of the Irish National Dementia Strategy, which states that “people with dementia should be facilitated to remain living in their own homes and to maintain existing roles and relationships for as long as possible” (2014: 24). The National Housing Strategy for People with a Disability supports the Programme for Government commitment to promote and support universal design, particularly to ensure accessible housing. It states that ’technology can assist people with dementia, in association with safe and well-designed living spaces, to live as independently as possible’ (2014: 95). 

National Disability Strategy Implementation Plan 2013-2015

Department of Justice and Equality
2013

Disability policy in ROI remains largely as set out in the National Disability Strategy which was published in 2004. The Disability Act 2005 and the Citizens Information Act 2007, which are legislative parts of the strategy, have been passed but have not been fully implemented.

The National Housing Strategy for People with a Disability (2011), the Value for Money Review of Disability Services in Ireland (2012) and the allied Report of Disability Policy Review by the Expert Reference Group (2011) are among the key reports published in 2011 and 2012 that signalled new directions for disability policy and significant changes in how disability support services are to be delivered in ROI. The National Implementation Framework for the recommendations of the Value for Money and Policy Review of the Disability Services Programme provides a mechanism for the implementation of significant change in disability services as does the National Disability Strategy Implementation Plan published in 2013, which sets out the practical measures that will be taken to advance the National Disability Strategy over the period 2013 to 2015. The latter strategy aims to promote an inclusive Irish society where people with disabilities can reach their full potential and participate in the everyday life of the community. Four High Level Goals (Equal citizens, Independence and choice, Participation, Maximising potential) were agreed by the National Disability Strategy Implementation Group (NDSIG), with key actions under each goal and objective. While there is no explicit mention of dementia in the Implementation Plan, one of the high level goals of the plan is that people with disabilities are free from discrimination and treated as equal citizens by their fellow citizens and this applies equally to all people with a disability including those affected by dementia.

Aspects of the NDSIP that exemplify relevance to people with dementia include:

  • Publication and enactment of the Assisted Decision Making (Capacity) Bill to give full legal capacity to people with disabilities.

  • Provision of disability awareness training by public transport operators to their staff and management.

  • Improved accessibility of public buildings and facilities.

  • Support for the provision of advocacy services for persons with disabilities and mental health difficulties.

  • Support for new models of respite support.

  • Development of policy guidelines to improve access for people with disabilities in relation to public roads and pedestrian facilities.

  • Development of a protocol for strategic assessment of nature and extent of housing needs of persons with disabilities.

  • Encouragement of service providers to develop health promotion programmes for persons with disabilities.

  • Support for sports partnership, Age Friendly and Social Inclusion programmes to assist people with disabilities to engage in activities, including through requirement of funding for programmes such as Sports Capital Grants.

Living Matters, Dying Matters: A Palliative and End of Life Care Strategy for Adults in Northern Ireland

Dept. of Health, Social Services and Public Safety
2010

This strategy identifies palliative and end of life care as a continuum of care that can evolve as a person’s condition progresses.

 The five year Strategy sets out a vision and direction for service planning and delivery, within the existing legal framework.  The strategy includes dementia among the chronic conditions considered and refers to the work already completed in “Dementia; NICE-SCIE Guideline on Supporting People with Dementia and their Carers in Health and Social Care” (NICE 2006). 

Developing theoretical understandings of dementia and their application to dementia care policy in the UK

INNES, A., MANTHORPE, J.
Dementia
2013

Innes and Manthorpe (2013) critically assessed three influential theoretical perspectives (biomedical, psycho-social and critical social gerontology) in shaping dementia policy in different regions of the UK.

They offer the policy document used in the consultation process of the national dementia strategy in NI as an illustrative example of policy on dementia that engages with person-centred principles, a hallmark of social-psychological perspectives on dementia.  They argue that lessons from different theoretical perspectives need to be explicitly recognised, challenged and valued for a truly integrated dementia care policy model to evolve. 

Reconciling mental health recovery with screening and early intervention in dementia care

IRVING, K, LAKEMAN, R
International Journal of Mental Health Nursing
2010

Irving and Lakeman (2010) acknowledge that the concept of person-centred care has become a catchphrase for good care but has not resulted in improvements in care for everyone with dementia.

They take a critical look at the concept of recovery as used in mental health and its potential application to dementia care. They explore the similarities and differences between it and person-centred care, the difficulties of using the concept of recovery in the context of a degenerative condition such as dementia and take a closer look at its relevance for dementia screening and early intervention. They conclude that the recovery movement has much to offer dementia care and vice versa. 

Older people and legal advice - the need for joined up and creative approaches

DUFFY, J., BASU, S., PEARSON, K.C.
Journal of Social Welfare and Family Law
2012

Duffy et al. (2012) use a mixed methods approach to examine the potential of the Internet as a source of legal advice and information for older people.

 While the paper is not about people with dementia it highlights the need for timely, legal advice on diagnosis of dementia and the impact on carers who are often exhausted and do not have the energy to pursue legal issues.

Legal implications regarding self-neglecting community-dwelling adults: a practical approach for the community nurse in Ireland

BALLARD, J.
Public Health Nursing (Boston, Mass.)
2010

Ballard (2010) examines the legal implications for nurses working in the community when they encounter clients who are believed to be self-neglecting.  The paper examines the literature and reports on a case study where the client had dementia.

 Ballard highlights the complexity of capacity and competency, mandatory or discretionary reporting, trespass, homelessness and confidentiality concluding that it is often unclear where the community nurse’s legal responsibilities lie.

Sexuality and Dementia: Law, Policy and Practice

LENNOX, R., DAVIDSON, G.
Practice
2013

Lennox and Davidson (2013) identify areas of law, policy and practice in NI that could be improved to manage sexuality and dementia, particularly in care home settings.

 They highlight the difficulties of establishing capacity and consent and the need for more open discussion, debate and research in this area.  A particular gap identified in research is the lack of service user perspectives.  They conclude that staff must be better informed on legislation and policy and must receive better training and support on effectively managing sexuality and dementia.  

Planning dementia services: new estimates of current and future prevalence rates of dementia for Ireland

PIERCE, M., CAHILL, S., O'SHEA, E
Irish Journal of Psychological Medicine
2013

Pierce et al. (2013) present estimates on the prevalence of dementia at a national and local level for ROI based on the application of European prevalence rates to Census of Population data for 2006.

Future projections of dementia were also calculated using population projections available from the Central Statistics Office. The estimates are that there were 41,740 people with dementia in ROI in 2006 and that the prevalence of dementia is expected to double over the next twenty years. Although there are limitations to such estimates, the data are useful for planning purposes and for awareness about dementia.

Informal cost of dementia care - a proxy-good valuation in Ireland

TRÉPEL, D.
Economic and Social Review
2011

Trepel (2011) focuses on the informal costs of dementia care and uses a proxy-good valuation method. Survey data gathered by the Alzheimer Society of Ireland to assess the dynamics of informal dementia care is used.

Data on minimum and maximum hours provided in informal care in early, mid and late stages of dementia are presented, to which a general replacement value is applied. The results show that dementia care places a substantial demand on informal carers, with costs increasing with dementia progression. The study highlights the high costs of replacing an informal carer full-time, and the importance of targeting interventions for carers to minimise carer burnout.    

The effects of dependence and function on costs of care for Alzheimer's disease and mild cognitive impairment in Ireland

GILLESPIE, P., O'SHEA, E., CULLINAN, J., LACEY, L., GALLAGHER, D., NI MHAOLAIN, A.
International journal of geriatric psychiatry
2012

Gillespie et al.

(2012) using data from the Enhancing Care in Alzheimer’s Disease (ECAD) study estimate the costs of formal and informal care for a sample of people with Alzheimer’s disease and amnestic and mild cognitive impairment (MCI) living in the community in ROI over a six month period. They then undertook a multivariate statistical analysis to explore the effects of dependence and function on costs of care.  They found that dependence and function of a person with dementia were both independently associated with the total cost of formal and informal care. As dependence on others increased, total costs increased. Conversely, an improvement in patient function led to a decline in the total cost of care. 

Estimating the economic and social costs of dementia in Ireland

CONNOLLY, S., GILLESPIE, P., O'SHEA, E., CAHILL, S., PIERCE, M.
England)
2014

Connolly et al. (2014) using a cost of illness studies approach provide an estimate of the social and economic costs of dementia in ROI.

The total cost of dementia is estimated to be €1.69bn per annum, 48% of which can be attributed to costs of informal care provided by family and friends to people with dementia living in the community. Another 43% is attributed to long-stay residential care with only 9% of the total costs attributed to formal health and social care costs. The results are broadly in line with international studies. The study highlights the significant costs associated with dementia in ROI and the very heavy burden that falls on the family caregivers. 

Education, occupation and retirement age effects on the age of onset of Alzheimer’s disease

LUPTON, M.K., STAHL., D., ARCHER, N., FOY, C., POPPE, M., LOVESTONE, S., HOLLINGSWORTH, P., WILLIAMS, J., OWEN, M.J., DOWZELL, K., ABRAHAM., R., SIMS, R., BRAYNE, C., RUBINSZTEIN, D., GILL., M., LAWLOR, B.A., LYNCH, A., POWELL., J.F
International journal of geriatric psychiatry
2010

This study by Lupton et al. (2010) is based on data from a sample of 1,320 people with probably Alzheimer’s disease from the UK and the ROI, who were primarily recruited to investigate candidate genes that may increase susceptibility to Alzheimer’s disease.

Data was analysed (using multiple regression analysis) to determine the effects of early life education, midlife employment and later life age of retirement on the age of onset of Alzheimer’s disease. This study found no effect of education or employment on the age of onset of Alzheimer’s disease, but found a significant effect of a later retirement age in delaying the onset of Alzheimer’s disease.   

Lithium and prevention of cognitive impairment

ABIDAN, Z., COONEY, C., JACKSON, D., FREYNE, A.
Irish Journal of Psychological Medicine
2014

A retrospective study by Abidan et al. (2014) was undertaken in the context of increased interest in the neuro-protective effects of lithium and studies suggesting lithium may have a protective role in dementia.

Covering the period 1998 to 2007, it involved 29 patients attending a lithium treatment clinic who had been commenced on lithium treatment for affective disorders such as depression, bipolar disorder and schizoaffective disorder. The study reported that no new cases of dementia developed over a mean follow-up period of 38 months. Given the limitations, the authors tentatively suggest that lithium may have a protective effect against cognitive decline in people with affective disorder and in those with concurrent affective disorder and cognitive impairment.

Very rare and unusual causes account for about 5% of cases of dementia.  Variant CJD, a human prion disease, is one of the rarer causes of dementia, caused when meat from cattle infected with bovine spongiform encephalopathy (BSE) is eaten. It typically affects younger adults. ROI has the second highest rate of vCJD in the world, with four cases reported to date. To complement existing measures adopted to contain the risk of vCJD transmission from transfusion of blood or blood products originating from subclinical carriers of the disease, prion-removing filters have been developed to reduce the risk of vCJD transmission.