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Background Diabetes is a risk factor for dementia, but we do not know whether specific diabetes medications ameliorate this risk. Objective: To systematically review and meta‐analyze such medication's effect on the risk of developing dementia, mild cognitive impairment (MCI), or cognitive decline. Method We searched three databases until 21.11.23. We included randomized controlled trials (RCT), cohort, and case‐control studies assessing association between antidiabetic medication and future dementia, MCI, or cognitive decline. We meta‐analyzed studies separately for individual drug classes and their comparators (no medication, placebo, or another drug). We appraised study quality using the Newcastle‐Ottawa Scale and Physiotherapy Evidence Database Scale. Result 42 studies fulfilled inclusion criteria. Glucagon‐like peptide‐1 receptor agonists (GLP‐1 RA) versus placebo reduced dementia risk by 53% in 3 RCTs (n = 15,820, RR=0.47[0.25,0.86]) and 27% in 3 case‐control studies (n = 312,856, RR=0.73[0.54,0.99], I2=96%). Repaglinide was superior to glibenclamide by 0.8 points on the Mini‐Mental State Examination scale in another RCT. Meta‐analysis of 7 longitudinal studies showed glitazones (n = 1,081,519, RR=0.78[0.76,0.81], I2=0%) were associated with reduced dementia risk. Metformin (n = 999,349, RR=0.94[0.79,1.13], I2=98.4%), sulfonylureas (RR=0.98[0.78,1.22], I2=83.3%), dipeptidyl peptidase‐IV inhibitors (DPP‐1V) (n = 192,802, RR=0.86[0.65,1.15], I2=92.9%) and insulin (n = 571,274, RR=1.09[0.95,1.25], I2=94.8%) were not. Most studies were observational and limited by confounding by indication. Conclusion In people with diabetes, RCTs consistently showed GLP‐RAs reduce future dementia risk. Glitazones consistently showed protective effects, without heterogeneity, suggesting potential generalizability of these results. Metformin, sulfonylureas, insulin, and DPP‐1V studies had inconsistent findings. If information is available future studies should consider dosage, severity, and duration.

Sharing a dementia diagnosis with others is a prerequisite to accessing important support for social, cognitive, and physical activity. However, due to the stigma associated with dementia, individuals may be hesitant to disclose their diagnosis. Despite the importance of this issue, there is limited research on personal experiences with sharing one's diagnosis. This study explored how people with young-onset dementia disclose their diagnosis to other people, also known as self-disclosure, and how time affects self-disclosure. We conducted an exploratory qualitative study, using semi-structured interviews with nine people with young-onset dementia living in the United Kingdom (UK). A narrative approach to analysis was applied, focusing on understanding the core narratives, themes, tone, and imagery of each participant's narratives as well as providing a cross-case analysis to identify patterns across narratives. Participants openly disclosed their diagnosis, accepting it as an illness that did not define their identity. Several were met with stigmatizing reactions, which affected their levels of openness, and a lack of understanding, which caused shrinking social networks for some. Peer support groups, advocacy activities, and strategic concealment were used to support self-disclosure. This study provides a holistic understanding of people with young-onset dementia's experiences with self-disclosure and how these evolved. Policies should prioritize the creation of dementia-friendly communities, while recommendations for practice include integrating empowerment interventions and peer support into post-diagnostic support. These efforts will support individuals in their self-disclosure journey, promote social engagement and reduce stigma.

Family caregivers of people with dementia often face unique challenges in their caregiving role, including the complex task of sharing their caregiving experiences and identity with their social networks. Social media platforms provide a valuable avenue for self-disclosure of stigmatized identities such as dementia, enabling access to support. This study explores the patterns and purposes of self-disclosure by family caregivers of people with dementia on social media. A cross-sectional online survey was conducted with 323 respondents, aged 20 to 86 (M = 59.2, SD = 12.34), of whom 78% were female. Among the whole sample, 255 (79%) reported using social media, with 66% of them using it daily. Facebook was the most frequently used platform (81%), followed by Twitter (42%) and Instagram (33%). Of the social media users, 121 (47%) also posted dementia-related content. Content analysis of open-ended questions revealed that these caregivers use social media to share their dementia caregiving journey, including providing insights into the lives and experiences of the person they support, while also engaging in awareness raising and mutual support activities with other caregivers. The findings show that social media is an important resource for family caregivers of people with dementia, facilitating the sharing of personal experiences, building support networks, and engaging in advocacy. The high rate of regular use underscores its value in navigating caregiving experiences and challenges. Healthcare professionals and organizations should leverage these platforms to offer targeted support, while future research should explore how social media can be integrated into support strategies.

Diabetes is a risk factor for dementia, but we do not know whether specific diabetes medications ameliorate this risk. To systematically review and meta-analyze such medication's effect on the risk of developing dementia, mild cognitive impairment (MCI), or cognitive decline. We searched three databases until 21.11.23. We included randomized controlled trials (RCT), cohort, and case-control studies assessing association between antidiabetic medication and future dementia, MCI, or cognitive decline. We meta-analyzed studies separately for individual drug classes and their comparators (no medication, placebo, or another drug). We appraised study quality using the Newcastle-Ottawa Scale and Physiotherapy Evidence Database Scale. 42 studies fulfilled inclusion criteria. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) versus placebo reduced dementia risk by 53% in 3 RCTs (n = 15,820, RR=0.47[0.25,0.86]) and 27% in 3 case-control studies (n = 312,856, RR=0.73[0.54,0.99], I =96%). Repaglinide was superior to glibenclamide by 0.8 points on the Mini-Mental State Examination scale in another RCT. Meta-analysis of 7 longitudinal studies showed glitazones (n = 1,081,519, RR=0.78[0.76,0.81], I =0%) were associated with reduced dementia risk. Metformin (n = 999,349, RR=0.94[0.79,1.13], I =98.4%), sulfonylureas (RR=0.98[0.78,1.22], I =83.3%), dipeptidyl peptidase-IV inhibitors (DPP-1V) (n = 192,802, RR=0.86[0.65,1.15], I =92.9%) and insulin (n = 571,274, RR=1.09[0.95,1.25], I =94.8%) were not. Most studies were observational and limited by confounding by indication. In people with diabetes, RCTs consistently showed GLP-RAs reduce future dementia risk. Glitazones consistently showed protective effects, without heterogeneity, suggesting potential generalizability of these results. Metformin, sulfonylureas, insulin, and DPP-1V studies had inconsistent findings. If information is available future studies should consider dosage, severity, and duration.

Effective communication in healthcare is crucial, especially for older adults with complex health issues. Late-deafened older adults, who develop severe to profound bilateral hearing loss post-lingually, face unique challenges in communicating their health needs. This issue is not well understood, and research describing strategies to manage these communication challenges in clinical settings is lacking. Understanding these challenges and responses for healthcare activities is essential to support late-deafened older adults and health professionals, ensuring quality care. Data were collected through the Aging Concerns, Challenges, and Everyday Solutions (ACCESS) study wherein questionnaires and interviews were completed by 56 late-deafened participants aged 60 to 80 (M = 69.4, SD = 6.0), living with a diagnosis of hearing loss for at least ten years (age of onset: M = 31.8, SD = 19.9). We conducted a detailed content analysis of interview data about challenges and response strategies in healthcare settings. The most difficult activity was participating in healthcare appointments (n = 38), followed by managing health, diet, and nutrition (n = 13). Communication barriers included conversational partners using verbal communication and insufficient visual cues, lack of support, and unclear speech. Response strategies included using external assistive technology, adaptive communication strategies (e.g., lip-reading), and educating healthcare providers about their needs. Our findings highlight the need for health professionals in clinical practice to understand and adapt to the specific communication challenges faced by late-deafened older adults. Implementing effective communication strategies and providing tailored support can lead to more accurate diagnosis and treatment, ultimately enhancing patient care.

Abstract Learning to live with a diagnosis of dementia is a complex process. Many people affected by dementia choose not to disclose the diagnosis to others and avoid social activities due to fear of others' adverse reactions. This in turn can limit their social participation and negatively affect their psychosocial health. A systematic review explored factors influencing the decision to disclose or conceal a dementia diagnosis to one's social network, including individuals' attitudes and experiences regarding this decision. The sixteen studies included reveal the complexity of this decision. Findings highlight the role of stigma and individuals' wishes to remain 'normal', but also the need of explaining what has changed. Results were further discussed with people with dementia and informal caregivers as part of patient and public involvement. End users expressed their attitudes, needs, and wishes towards the design of an online empowerment intervention supporting disclosure decision-making in people affected by dementia.