NUR342: Evidence-Based Research Report on Dementia Risk Factors

This report, prepared as an evidence-based research assignment, investigates the multifaceted nature of dementia, a syndrome characterized by progressive brain function impairment. It begins by establishing the prevalence of dementia in Australia, highlighting the significant number of affected individuals and the projected increase in cases. The report emphasizes the importance of nursing interventions in dementia care, including patient education, advocacy, and policy participation. It presents a personal reflection on experiences with dementia patients in a rehabilitation facility, underscoring the significance of family involvement in care. The core of the report focuses on identifying and analyzing various risk factors associated with dementia, such as smoking and environmental exposures, as well as exploring potential preventive measures. The methodology involves a detailed search strategy using EBSCOhost databases to retrieve relevant articles published within the last five years. Findings from several studies are synthesized to reveal the impact of smoking, environmental pollutants, and other factors on dementia development. The report concludes with a discussion on the importance of early identification of individuals at risk and the need for comprehensive care strategies. The report is meticulously referenced, providing a solid foundation for the claims presented.

Running head: EVIDENCE-BASED RESEARCH 1
Evidence-Based Research
(Author’s name)
(Institutional Affiliation)

EVIDENCE-BASED RESEARCH 2
Dementia
ASSESSMENT 2A
Background
According to the Australian Institute of Health and Welfare (AIHW) 2016, dementia is
described as a syndrome rather than a disease characterised by continuous impairment of the
brain function. Currently, Australia has more than 400, 000 people who have dementia of which
55% are women ("Dementia statistics", 2018). More than half of individuals with dementia live
in government aged care facilities (AIHW, 2016). In addition, about 1.2 million people in the
country are involved in the care of someone with dementia. Other than that, studies show that, by
2025, there will more than 500,000 people with dementia in Australia (AIHW, 2016). More than
100 diseases are associated with dementia, but the most common ones are the vascular diseases
and Alzheimer disease (Cations, Radisic, Crotty & Laver, 2018). Alzheimer disease is believed
to cause about 80% of all cases though only 50% of these are estimated to be caused purely by
the Alzheimer disease.
Importance to Nursing
Although dementia affects aged people above 65 years, it is not a normal component of
ageing (AJDC, 2018). Various skills are usually affected when individuals have dementia. These
include personality, memory and cognition (Cations, Radisic, Crotty & Laver, 2018). However,
no symptoms of dementia are displayed early enough thus ongoing assessment is crucial.
Currently, there is no known cure for dementia, but evidence shows that certain lifestyles
contribute to early onset and development of the disease (AJDC, 2018). Nurses with
collaboration with other healthcare providers have an obligation to act as advocates and inform
the community the habits and lifestyles associated with dementia in order to prevent the disease

EVIDENCE-BASED RESEARCH 3
occurrence, avert dementia complications and provide early caring (Cations, Radisic, Crotty &
Laver, 2018). Other than that nurse have other responsibilities when caring for people with
dementia such as patient education, acting as team managers, and participating in policy making
that enhances the quality care of the patients(McMaster, Sanchez-Ramos & Kaunitz, 2015).
Personal Reflection
Reporting: While I was doing a visit to an aged-care rehabilitation facility, I came across
patients who have dementia. Surprisingly, the number of patients with mild to severe dementia
was about 50% of all clients in the facility. The patient had difficulty in remembering even the
names of their family relatives.
Responding: I looked after a patient with dementia and tried to connect him with family
members. The patient refused to talk to his son saying he has never seen him before.
Relating: In this scenario, I came to realise that encouraging family members to visit patients
with dementia is crucial. Frequent visiting from family always promotes or triggers a memory of
individuals with dementia(Mitchell, Hall, MacBeth, Gardner & Halton, 2015).
Reasoning: The event taught me why personal care centred which involve families and other
healthcare providers are essential when caring for individuals with severe dementia.
Reconstructing: In the future, I will study both the library and online sources about caring for
individuals with dementia and their families. I will try to incorporate families during care and
encourage them to support their relatives who have dementia.

EVIDENCE-BASED RESEARCH 4
ASSESSMENT 2B
Risk Factors for Dementia
Aim
In Australia, about 400,000 people have dementia of which majority are females.
Alzheimer disease and vascular diseases are the leading causes of dementia ("Dementia
statistics", 2018). Alzheimer disease only is estimated to cause more than 80% of dementia
("Dementia statistics", 2018). However, there are more other factors that facilitate development
and onset of dementia(Feneley, Hopley & Wells, 2015). This study aims to discuss various risk
factors associated with dementia and possible ways of prevention.
PICO and the Research Question
Population Individuals with dementia
Intervention Dementia prevention methods and control
Comparison/control Common diseases associated with dementia
including Alzheimer disease.
Outcome Minimize cases of Dementia
Research question
What are various risk factors and modes of prevention of dementia?
Search strategy
The search strategy was conducted on EBSCOhost databases in a library where PubMed
and CINAHAL with full texts and PsycINFO and journals were selected to retrieve the required
systemic review and meta-analysis articles. After that, more search was conducted on key terms
and alternative terms together combined with Boolean terms AND, OR. The following were the

EVIDENCE-BASED RESEARCH 5
key terms; dementia, risk factors, Alzheimer, prevention, nursing, lifestyle AND dementia
prevention, methods OR treatment methods and aged-care facilities. Afterword, specific filters
were used to only articles published in the last five years, full text, with references and in English
only. The level of evidence was determined before the articles were used.
Best Practice
Best Practice Level of Evidence and
Type of Study
Citation in CDU APA 6th
format
How smoking increases
dementia risks
Level 1: a meta-analysis (Zhong, Wang, Zhang, Guo &
Zhao, 2015)
Environmental risks for
dementia
Level 1: Systematic
review
(Killin, Starr, Shiue & Russ,
2016)
Current developments on
dementia risks predictions
Level 1: Systematic
review
(Tang et al., 2015)
Findings
The findings from the three articles claim that various risk factors may lead to the
development of dementia (Zhong, Wang, Zhang, Guo & Zhao, 2015). Smoking was found to
aggravate symptoms of dementia in people suffering from both Alzheimer diseases and vascular
disease (Zhong, Wang, Zhang, Guo & Zhao, 2015). The result showed that current smokers aged
between 65 and 75 years have a high risk of getting dementia than those aged below 65 years
(Zhong, Wang, Zhang, Guo & Zhao, 2015). A polyprotein E4 non-carriers demonstrated to have

EVIDENCE-BASED RESEARCH 6
more risks of having Alzheimer diseases through smoking than other groups(Zhong, Wang,
Zhang, Guo & Zhao, 2015). Therefore, heavy smokers have an increased risk of dementia and
cessation of smoking decreases risks equivalent to non-smokers.
Environmental factors were found to determine populations at risk of developing
dementia at later ages(Killin, Starr, Shiue & Russ, 2016). Most of these environmental factors
were attributed to all types of air pollution. These factors include silicon, aluminum and selenium
exposure, vitamin D, pesticides and magnetic and electronic fields (Killin, Starr, Shiue & Russ,
2016). Although the mechanism of how they affect was not precise, the results showed a
concrete conclusion. Air pollution was associated with cerebral blood flow thus concluded to be
neurotoxic. Children living in areas with air pollution developed brain changes, cognition and
biomarkers that were identified to cause dementia at later ages (Killin, Starr, Shiue & Russ,
2016). Accurate identification of a proper model of evaluating people at risk of dementia can
help in clinical care (Tang et al., 2015). However, no one model was recommended as it is
unlikely for one model to fit in evaluating all risk factors of dementia.

EVIDENCE-BASED RESEARCH 7
References
AJDC, (2018).Nurses can make a difference: caring for those living with dementia – Australian
Journal of Dementia Care. Retrieved from http://journalofdementiacare.com/nurses-can-
make-a-difference-caring-for-those-living-with-dementia/
AIHW, (2017). Dementia in Australia. Retrieved from
https://www.aihw.gov.au/reports/dementia/dementia-in-australia/contents/table-of-contents
Cations, M., Radisic, G., Crotty, M., & Laver, K. (2018). What does the general public
understand about prevention and treatment of dementia? A systematic review of population-
based surveys. PLOS ONE, 13(4), e0196085. doi: 10.1371/journal.pone.0196085
Dementia statistics. (2018). Retrieved from https://www.healthdirect.gov.au/dementia-statistics
Feneley, R., Hopley, I., & Wells, P. (2015). Urinary catheters: history, current status, adverse
events and research agenda. Journal Of Medical Engineering & Technology, 39(8), 459-
470. doi: 10.3109/03091902.2015.1085600
Killin, L., Starr, J., Shiue, I., & Russ, T. (2016). Environmental risk factors for dementia: a
systematic review. BMC Geriatrics, 16(1). doi: 10.1186/s12877-016-0342-y
Mitchell, B., Hall, L., MacBeth, D., Gardner, A., & Halton, K. (2015). Hospital infection control
units: Staffing, costs, and priorities. American Journal Of Infection Control, 43(6), 612-616.
doi: 10.1016/j.ajic.2015.02.016
McMaster, K., Sanchez-Ramos, L., & Kaunitz, A. (2015). Evaluation of a Transcervical Foley
Catheter as a Source of Infection. Obstetrics & Gynecology, 126(3), 539-551. doi:
10.1097/aog.0000000000001002

EVIDENCE-BASED RESEARCH 8
Tang, E., Harrison, S., Errington, L., Gordon, M., Visser, P., & Novak, G. et al. (2015). Current
Developments in Dementia Risk Prediction Modelling: An Updated Systematic
Review. PLOS ONE, 10(9), e0136181. doi: 10.1371/journal.pone.0136181
Zhong, G., Wang, Y., Zhang, Y., Guo, J., & Zhao, Y. (2015). Smoking Is Associated with an
Increased Risk of Dementia: A Meta-Analysis of Prospective Cohort Studies with
Investigation of Potential Effect Modifiers. PLOS ONE, 10(3), e0118333. doi:
10.1371/journal.pone.0118333