Identifying factors that lead to problems with everyday tasks for people with dementia

Lead Investigator: Eneida Mioshi

Institution: University of East Anglia

Grant type: Project Grant

Duration: 4 years

Amount: £399,926

Scientific Title: Interaction of intrinsic and extrinsic factors underpinning functional disability in dementia

Why did we fund this project?

Comments from members of our Research Network:

'I do feel that the development of a carers skills package and the pragmatic activity planning toolkit could prove very useful in supporting carers.'

'The development of any nonpharmaceutical and carer-supportive intervention should be welcomed.'

'This is a good proposal in a necessary research area. The development of a therapeutic toolkit is an exciting prospect and should enable carer to enable people with dementia to continue activities for much longer. Dr Mioshi has experience in applying clinical research to everyday practice and this is a commendable project.'

What do we already know?

Functional disability is the lack of ability to carry out everyday activities as normal. This increases as dementia progresses, partly because functional abilities are directly related to cognitive and thinking abilities, which are progressively affected in dementia. The increasing impairment in everyday activities is well-known, but the key scientific factors which determine this loss of functional abilities have not been well established. This is a significant gap in our knowledge given that disability plays an important role in nursing home placement and is associated with stress in carers.

Most of the studies to date have focused on only dementia symptoms (intrinsic factors such as apathy, memory loss and changes in behaviour) as factors in functional disability. However, there are also factors not directly arising from the dementia but likely to affect functional disability, such as the home environment and people around the person, which are known as extrinsic factors. These extrinsic factors are important to identify, particularly because they have the potential to be changed to a greater extent than the dementia symptoms.

What does this project involve?

The aim of this project is to determine the main factors associated with functional disability. Dr Mioshi will be looking to find out which intrinsic and extrinsic factors affect functional disability in the mild, moderate and severe stages of dementia. This will help to understand the importance of carer burden and carer interaction on functional disability in each dementia stage.

By following people with dementia over a period of time, this fellowship aims to identify which factors can predict the decline of independence for a person with dementia. It is then hoped that this can be translated into the development of new therapies.

How will this benefit people with dementia?

The target outcome of this project is the production of a pilot intervention for activity engagement in dementia which will have two parts: a carer package to enhance carers' skills and resources, followed by activity planning tools (analysis and simplification of activities) to support the routine of the person with dementia at different stages of the disease. Results from this fellowship can also be used to predict those families who will require more support in the future.