Changing practice in dementia care in the community: developing and testing evidence-based interventions, from timely diagnosis to end of life.

Award Number
Programme Grants for Applied Research
Status / Stage
2 August 2007 -
31 January 2013
Duration (calculated)
05 years 05 months
Funding Amount
Funder/Grant study page
Contracted Centre
Central and North West London NHS Foundation Trust
Contracted Centre Webpage
Principal Investigator
Professor Steve Iliffe
PI Contact
WHO Catergories
Development of clinical assessment of cognition and function
Methodologies and approaches for risk reduction research
Models across the continuum of care
Disease Type
Dementia (Unspecified)

CPEC Review Info
Reference ID125
ResearcherReside Team


Award NumberRP-PG-0606-1005
Status / StageCompleted
Start Date20070802
End Date20130131
Duration (calculated) 05 years 05 months
Funder/Grant study pageNIHR
Contracted CentreCentral and North West London NHS Foundation Trust
Contracted Centre Webpage
Funding Amount£2,080,666.00


The programme will also evaluate the impact of the Mental Capacity Act 2005, and develop educational interventions to support the use of the Act. Background: Dementia has an enormous impact on the lives of individuals and families, and on health and social services, and this will increase as the population ages. The needs of people with dementia and their carers’ for information and support are inadequately addressed at all key points in the illness trajectory. The consequences are poor quality of life, inappropriate and costly responses to the problems that emerge, prolonged in-patient stays, and further disablement. Research Plans: We will assemble a cohort of people with dementia and their families, recruiting through primary and secondary health care, social services and voluntary organizations, and will nest five projects within it: 1. An educational intervention (including a computer decision support system) for primary care management, psychosocial interventions & shared care of medication will be developed & tested it in an experimental study. 2. A study of the incidence and temporal course of BPSD, and a randomised trial of its optimal management. 3. The development and testing of an evidence-based toolkit to reduce the impact of incontinence. 4. A study of the pathway to death of older people with dementia and the development and testing of interventions that support them and their carers in palliative care. 5. Evaluation of the impact of the Mental Capacity Act 2005, and practice guidance to enhance concordance with the Act. Research Team: We are a multidisciplinary research team, with experience of different methodologies, a track record of collaboration and project completion and an international reputation. This programme builds on our successful earlier work on dementia diagnosis and management in primary care. We have close working relationships with the Dementias and Neurodegenerative diseases research network (DeNDRoN). We can draw on expertise from the NICE/SCIE dementia clinical guidelines development group, the Greater London Local Research Network (GL-LRN) and the National Care Home Research and Development forum. Research Environment: North West London Mental Health Trust will host this programme. The cultural and social diversity of London and surrounding areas will provide opportunities for testing interventions in different population groups and contexts. The Trust has an energetic user forum that will play a role in the design and management of projects. Anticipated outputs, outcomes and impact: The programme will produce the following main deliverables: 1) An educational intervention for general practice, tested in an RCT, combining timely diagnosis and psychosocial support around the period of diagnosis. 2) A computer decision support system that includes the above, and also shared care guidelines for medication use, to enhance the quality of primary care practice. 3) The outcome of an RCT of medication versus exercise promotion for management of BPSD, an additional management option for a challenging problem 4) A toolkit for management of incontinence in people with dementia living at home, to improve the quality of life of people with dementia and their carers. 5) A toolkit for palliative care in dementia, suitable for use in both community and care home settings, to assist carers to provide optimal end of life care. 6) Practice guidance on the use of the Mental Capacity Act 2005, including its use in adult protection work. 7) I


To assemble a community cohort of people with dementia and their families, within which intervention studies can be nested. The objectives are to develop and test interventions that improve patient, carer and service outcomes at three major stages of dementia: 1) recognition and first response; 2) management of behavioural and psychological symptoms of dementia (BPSD), and of incontinence; and 3) end of life care.