Tom Dening

Tom Dening
University of Nottingham | Notts · Institute of Mental Health

MA MD FRCPsych

About

359
Publications
101,343
Reads
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9,807
Citations
Additional affiliations
October 2012 - present
The Institute of Mental Health
The Institute of Mental Health
Position
  • Professor of Dementia Research
April 1991 - September 2012
Cambridgeshire and Peterborough NHS Foundation Trust
Position
  • Consultant Psychiatrist
Description
  • Clinical Director 1991-2002 Medical Director 2002-2011
October 2012 - present
University of Nottingham
Position
  • Professor of Dementia Research

Publications

Publications (359)
Article
Background The overlap between physical and mental health is a common challenge for older adults, and many live with co-occurring physical and mental health disorders. Different service models have been adopted; however, the majority provide specialist mental health input to older adults with physical health needs in acute hospital trusts. Few serv...
Article
Full-text available
Background Alzheimer’s Disease (AD) is a neurodegenerative disorder characterized by progressive cognitive decline and memory loss. Early and accurate diagnosis of AD is crucial for patient information, advance planning, and potentially effective intervention and treatment. The integration of machine learning techniques with brain connectome graphs...
Article
Full-text available
Introduction Both hearing loss and dementia are associated with ageing, and it is thought that many individuals living with dementia also live with hearing loss. Despite the large comorbidity between these two disorders, there remains a clear lack of established guidelines in audiological services for assessing and managing patients living with dem...
Article
Full-text available
INTRODUCTION This study presents a novel multi‐view learning approach for machine learning (ML)–based Alzheimer's disease (AD) diagnosis. METHODS A diffusion model is proposed to synthesize the fluorodeoxyglucose positron emission tomography (FDG PET) view from the magnetic resonance imaging T1 weighted imaging (MRI T1WI) view and incorporate two...
Article
Full-text available
Objectives: Deaf people face complex challenges in accessing healthcare, particularly for age-related conditions, yet the Deaf community is largely overlooked in dementia research. This study explores healthcare issues in relation to dementia for older Deaf individuals, and perspectives of stakeholders regarding dementia and the Deaf community. M...
Article
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Objective To investigate whether different anticholinergic drug treatments for overactive bladder have differential risks for incident dementia, in a large representative population of older adults in England. Design Nested case-control study. Setting General practices in England providing data to the Clinical Practice Research Datalink (CPRD) GO...
Article
Background: People living with advanced dementia risk being seen as someone without personhood in contemporary societies, an understanding that has been described and challenged for decades in dementia scholarly literature. Such perception can be characterised as forms of existential dehumanisation, which still asserts itself in dementia care pract...
Article
Background Many older people are now living with co‐occurring physical and mental health disorders, but these often managed separately. The aim of this systematic review was to explore integrated physical‐mental health care services available internationally for older people living with mental health diagnoses, and whether these result in improved...
Article
Full-text available
Family caregivers are vital to enabling people with dementia to live longer in their own homes. For these caregivers, chatting with clinicians—being listened to empathetically and receiving reassurance—can be seen as not incidental but important to supporting them. This paper considers and identifies the significance of this relational work for fam...
Article
The theoretical approach presented in this paper describes a novel experimental-theoretical methodology to conceptualise pain in people with dementia. Existing procedures for assessment of pain rely on subjective self-report using pain questionnaires and rating scales that have proven to be highly problematic where a person has dementia. Consequent...
Article
Introduction Hearing loss (HL) affects 12 million UK adults, including 70% of those aged over 70 years. It is associated with social isolation, anxiety, and depression. Furthermore, HL in midlife is the largest modifiable risk factor for dementia. However, many individuals delay or avoid treatment. This may be due to limited understanding of HL amo...
Article
Background Older people have complex health needs, with the inter-play between physical and mental health being a prominent issue. The ageing population has resulted in a large proportion of older people living with co-occurring physical and mental health disorders, which can prove challenging to manage simultaneously, particularly for serious ment...
Article
Background Vaccine hesitancy is a risk to global health and has become particularly salient considering the COVID‐19 pandemic. To date, no studies have investigated COVID‐19 vaccination behaviour in people with young‐onset dementia (YOD) and their carers. This study aimed to fill this gap. Method 26 participants with YOD and 24 carers for a person...
Article
Background Alzheimer’s Disease (AD) is a neurodegenerative disease which is characterized by cognitive and functional impairment, and defined by triad of Amyloid status, Tau pathology, and Neuroimaging marker of neurodegeneration or neuronal injury. An early diagnosis of AD can be challenging and it can be detected earlier in brain functional imagi...
Chapter
Full-text available
Both dementia and hearing loss are highly prevalent in older adults and often co-exist, increasing the complexity of diagnosis and management of both conditions. As the population ages, an increasing number of people will experience both long-term conditions. The cause of the association is unclear, although there are several commonly proposed mech...
Article
Hearing conditions such as hearing loss, tinnitus and hyperacusis are highly prevalent in the population and can severely impact communication and quality of life. We searched Age and Ageing for articles on hearing conditions published since 2000. This resulted in 22 articles included within the collection. They examine a range of important topic...
Article
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This paper presents shortened versions of talks given at a symposium about concussion in sport. The piece is designed, in similar lines as the event, to help communicate knowledge and ideas between academics in multiple disciplines, communities of practice and to develop public and patient involvement. The seven short essays are presented in the st...
Article
Full-text available
Hearing conditions such as hearing loss, tinnitus and hyperacusis are highly prevalent in the population and can severely impact communication and quality of life. Hearing is affected by multiple factors, including heredity, noise exposure, age, sex, ear disorders and lifestyle factors. Globally, hearing loss affects over 80% of adults aged 80 year...
Article
Full-text available
Introduction Dementia and hearing loss (HL) are becoming increasingly prevalent in society and commonly co-exist. People living with concurrent conditions have complex needs and face additional barriers to diagnosis and management. There is a paucity of research regarding the current and optimal management of HL in people living with dementia. This...
Article
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This study was designed to advance our understanding of how feelings of empowerment in people living with dementia still residing at home can be promoted. We conducted qualitative interviews with 12 participants with mild-to-moderate stages of dementia in Germany and Spain as part of a European study on mindful design for dementia. A qualitative th...
Article
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Background It is important to investigate the needs, experiences, and outcomes of older forensic mental health inpatients. In this consensus document, we offer practitioners working with older forensic inpatients recommendations to meet the unique older-age-related needs of this group. Method We report on the findings of a scoping review of servic...
Article
Full-text available
Technology is widely promoted as a solution to greater independence and better health for the rapidly growing UK older population. If this is to be realised, we need to understand barriers and facilitators to uptake and investigate who wants this technology and who does not express an interest in use. This analysis is based on data from a populatio...
Article
Full-text available
Purpose There is a lack of research informing service requirements for older (aged≥55 years) forensic mental health patients. The aim of this research was to increase knowledge about older forensic mental health patients’ quality of life, wellbeing, recovery, and progress, in order to make recommendations of how to facilitate and enhance these fact...
Article
Full-text available
Introduction Both hearing loss and dementia are extremely pervasive, especially amongst older adults. As hearing loss and dementia have common symptoms, misdiagnosis can be common, and failure to address hearing loss for people with dementia could accelerate cognitive decline. The timely detection of cognitive impairment is clinically important, ho...
Article
Full-text available
Many people are keen to be actively involved in social life and activities, but even at an early stage, dementia can have a negative impact on social participation and access to leisure activities. As part of the IDoService project, this study has investigated people’s needs and wishes, barriers and facilitators to identify opportunities for improv...
Article
Full-text available
AimAlthough multiple COVID-19 vaccines are approved for global use, vaccine hesitancy poses a substantial risk for global health. Therefore, the aim of this umbrella review is to identify those factors that influence COVID-19 vaccination hesitancy in the general population. This is necessary to improve the effectiveness of future vaccination progra...
Article
Full-text available
Background Interventions involving exercise appear to have positive effects, both for people with dementia and for their carers. Quality of life and well-being are especially important outcomes. This study investigated how a sports and exercise group for people with dementia and their carers could contribute to the well-being of those attending the...
Article
Aim: This thesis presents nine of my published papers based around a common theme of meaningful activity in dementia. The papers and the accompanying text will explore the concept of meaningful activity and whether it is relevant to dementia; the use of meaningful activities for people living with dementia in various settings; and the experiences o...
Article
Full-text available
Background: Older individuals (e.g., 55 years and over) constitute a growing proportion of the forensic mental health patient population. As a group, they are vulnerable to health outcomes similar to other individuals with serious mental disorders of the same age; however, these concerns can be compounded by complex forensic-related care background...
Article
Introduction Research shows delivery of advance care planning (ACP) in care homes is highly acceptable, increases the proportion of residents dying in their preferred place, and reduces hospital admissions. We examined whether implementation of a service delivering ACP to care homes in Lincoln (UK) realised the research outcomes in routine practice...
Article
Full-text available
Background and Objectives Among the various psychosocial interventions aiming at improving behaviour, quality of life and the well-being of people with dementia, one that has attracted recent attention has been object handling. This scoping review synthesizes available studies on object handling for people with dementia, their effects and methodolo...
Article
Older forensic mental health patients have complex needs and requirements; service provision is required to address mental health, offending risk and issues associated with aging (geriatric care). This study aimed to identify the systems and processes that enable valued progress (in terms of quality of life, health, wellbeing, recovery and reduced...
Article
Objectives: There is a lack of research informing service delivery for older forensic mental health patients. This study explored service provision in forensic mental health inpatient and community services in England, investigating what is required for progress in terms of quality of life, health, wellbeing, recovery and reduced risk, and the bar...
Article
Full-text available
Background: There are few effective interventions for dementia. Aim: To determine the clinical effectiveness and cost-effectiveness of an intervention to promote self-management, independence and self-efficacy in people with early-stage dementia. Objectives: To undertake a randomised controlled trial of the Journeying through Dementia interven...
Article
Full-text available
There is a growing interest in using olfactory (smell) stimulation in dementia care. This study aims to extend current knowledge by synthesising the evidence on the efficacy of interventions using olfactory stimulation for people with dementia and to assess the effects of different types of odours and administration methods using a mixed methods ap...
Article
Full-text available
Background There is an urgent clinical need for evidence-based psychosocial interventions for people with mild dementia. We aimed to determine the clinical benefits and cost-effectiveness of Journeying through Dementia (JtD), an intervention designed to promote wellbeing and independence in people with mild dementia. Methods We did a single-blind,...
Article
Full-text available
Introduction: advance care planning (ACP) in care homes has high acceptance, increases the proportion of residents dying in place and reduces hospital admissions in research. We investigated whether ACP had similar outcomes when introduced during real-world service implementation. Methods: a service undertaking ACP in Lincoln, UK care homes was...
Article
Full-text available
Background: Older individuals (e.g., 55 years and over) constitute a growing proportion of the forensic mental health patient population. As a group, they are vulnerable to health outcomes similar to other individuals with serious mental disorders of the same age; however, these concerns can be compounded by complex forensic-related care background...
Article
Full-text available
Introduction Inadequate and varied quality of care in care homes has led to a proliferation of quality improvement (QI) projects. This study examined the sustainability of interventions initiated by such projects. Method This qualitative study explored the sustainability of seven interventions initiated by three QI projects between 2016 and 2018 i...
Article
Background Most cases of dementia are due to Alzheimer's disease or vascular dementia, but attention on these disorders means that other important causes of dementia may be relatively neglected. About 10–15% of people with dementia have other diagnoses, and there are numerous causes of the less common types of dementia. Aims This paper provides in...
Article
Full-text available
The quality of care in long-term care settings is a concern felt across the world given the growing number of dependent older people [...]
Article
Software apps for health and wellness are proliferating rapidly.1 Policy makers, health-care providers, and consumers can benefit from assessment and standardisation of these apps, to support decision making in a rapidly developing field. Recognising this unmet need, the International Organization for Standardization (ISO) published a standard in J...
Article
Full-text available
Background Improving care at home for people with dementia is a core policy goal in the dementia strategies of many European countries. A challenge to effective home support is the occurrence of crises in the care of people with dementia which arise from changes in their health and social circumstances. Improving the management of these crises may...
Preprint
Full-text available
BACKGROUND Improving care at home for people with dementia is a core policy goal in the dementia strategies of many European countries. A challenge to effective home support is the occurrence of crises in the care of people with dementia which arise from changes in their health and social circumstances. Improving the management of these crises may...
Conference Paper
Background: The presence of apathy is associated with less favourable outcomes in dementia, including more rapid functional and cognitive decline, greater disease severity and increased mortality. We aimed to explore and gain an understanding into how people with dementia experience apathy, and consequently suggest effective interventions to help...
Article
Full-text available
Objectives More than 60% of people with dementia live at home, where assistance is usually provided by informal caregivers. Research on the experiences of the Lesbian, Gay, Bisexual and Transgender (LGBT) caregivers is limited. This scoping review of the literature synthesizes international evidence on support provision for the population of LGBT c...
Article
Full-text available
Objective To assess the risks of developing dementia associated with different types and durations of menopausal hormone therapy. Design Two nested case-control studies. Setting UK general practices contributing to QResearch or the Clinical Practice Research Datalink (CPRD), using all links to hospital, mortality, and social deprivation data. Pa...
Article
Full-text available
Apathy, defined as a lack of motivation, is a prevalent and persistent behavioural and psychological symptom of dementia. Limited research suggests that apathy is associated with increased carer burden, but there are no studies investigating carers’ subjective experiences of apathy. This study aimed to fill this gap and explore the lived experience...
Article
Background Although most cases of dementia are caused by Alzheimer's disease or vascular dementia, around 10-15% of cases are due to other disorders, including dementias with Parkinsonian features, Huntington's disease, frontotemporal dementia, human immunodeficiency virus (HIV), and alcohol. Aims These less common dementias are important as they...
Article
Full-text available
We aimed to explore and gain an understanding into how people with dementia experience apathy, and consequently suggest effective interventions to help them and their carers. Twelve participants (6 dyads of 6 people with dementia and their family carers) were recruited from "memory cafes" (meeting groups for people with dementia and their families)...
Article
Background Social connectedness interventions may improve the clinical outcomes and personal recovery of adults with mental disorders but many interventions lack a clear theory-base and show limited effectiveness. Aim To evaluate the validity of a newly developed conceptual framework (the CIVIC framework: Closeness, Identity, Valued relationships,...
Article
Abstract Background: Teams working in the community to manage crisis in dementia currently exist, but with widely varying models of practice, it is difficult to determine the effectiveness of such teams. Objective: The aim of this study is to develop a “best practice model” for dementia services managing crisis, as well as a set of resources to h...
Preprint
Full-text available
Key points: • Quality Improvement Collaboratives bring staff from different organisations together to improve healthcare in care homes. • Healthcare improvement should align with existing work priorities and be led by staff with experience of collaboration. 2 • Care home staff can lead healthcare improvement if approaches and structures are adopted...
Article
Full-text available
Background: Quality improvement collaboratives (QICs) bring together multidisciplinary teams in a structured process to improve care quality. How QICs can be used to support healthcare improvement in care homes is not fully understood. Methods: A realist evaluation to develop and test a programme theory of how QICs work to improve healthcare in...
Article
Purpose Improving hospital care for people with dementia is a well-established priority. There is limited research evidence to guide nursing staff in delivering person-centred care, particularly under conditions where patients are emotionally distressed. Misunderstood distress has negative implications for patient well-being and hospital resources....
Article
Young-onset dementia refers to dementia that develops before the age of 65 years. It can present with a wide variety of symptoms including cognitive, behavioural, neurological and systemic symptoms, which reflects the wide range of possible causes. Young-onset dementia profoundly affects all aspects of people's lives, including relationships, emplo...
Poster
Full-text available
Background Multi‐sensory intervention is a sensory stimulate approach that has received great interest within the field of dementia treatment, particularly for the management of responsive behaviours (Strøm, et al., 2016). The encouraging results on handling objects activities (Camic et al., 2019) and the unique relationship between olfaction, memo...
Article
Full-text available
Given considerable variation in diagnostic and therapeutic practice, there is a need for national guidance on the use of neuroimaging, fluid biomarkers, cognitive testing, follow-up and diagnostic terminology in mild cognitive impairment (MCI). MCI is a heterogenous clinical syndrome reflecting a change in cognitive function and deficits on neurops...
Chapter
The term: ‘behavioural and psychological symptoms of dementia’ (BPSD) refers to a mixed group of phenomena. BPSD are the non-cognitive features of dementia and include depression, anxiety, psychotic symptoms, apathy, irritability, aggression, and sleep and eating problems. They occur in around 80% of people with dementia at some stage, several of t...
Article
Full-text available
Background Teams delivering crisis resolution services for people with dementia and their carers provide short-term interventions to prevent admission to acute care settings. There is great variation in these services across the UK. This article reports on a consensus process undertaken to devise a Best Practice Model and evaluation Tool for use wi...
Article
Full-text available
Background Specialist community teams often support people with dementia who experience crisis. These teams may vary in composition and models of practice, which presents challenges when evaluating their effectiveness. A best practice model for dementia crisis services could be used by teams to improve the quality and effectiveness of the care they...
Article
Full-text available
The Brazilian care home sector is underdeveloped, and the limited available evidence suggests that care quality falls below international standards. Development of the Brazilian care home sector could be associated with better outcomes for those receiving care, and more efficient use of resources across health and social care. Research has an impor...
Chapter
Globally increasing numbers of older people bring both challenges and opportunities for old age psychiatry services. This chapter outlines the history, underlying principles, and policy context for contemporary mental health services for older people. It discusses components of services, including community health teams, memory assessment services,...
Chapter
This chapter consists of four sections that consider various aspects of the journey through dementia. The first two parts (by Keith Oliver and Hilary Doxford) describe the early stages of dementia, the process of getting a diagnosis, and the challenges of living well with dementia. The third section (Louise Lafortune and Carol Brayne) discusses the...
Chapter
The care home sector has changed significantly in recent years: the vast majority of care homes are now in the independent sector, funding of care is complex, with greater reliance on self-funders to ensure profitability, and regulation has shifted to a more targeted model. In terms of the care home population, as most people are admitted at a late...
Chapter
Severe and enduring mental illness refers mainly to the long-term experience of schizophrenia and psychosis but also to other chronic functional disorders. The prevalence of psychoses in older people is hard to measure but estimates are around 0.5% of the population. Historically many people with long term illness resided in psychiatric hospitals b...
Article
The Oxford Textbook of Neurologic and Neuropsychiatric Epidemiology is designed to focus on the overlaps and inter-relationships between neuro-epidemiological disorders, as well as on ways to harmonize large cohort studies to maximize opportunities for determining causes related to rarer disorders. Divided into three main parts, the book covers: (1...
Chapter
Wilson’s disease (WD) is a recessively inherited condition caused by mutations to the ATP7B gene on chromosome 13, which is involved in copper homeostasis. As a result, affected individuals accumulate copper, causing hepatic and cerebral damage. The condition is treatable with chelating agents such as penicillamine, first used by Dr. John Walshe, w...
Preprint
Full-text available
Background: Teams delivering crisis resolution services for people with dementia and their carers provide short-term interventions to prevent admission to acute care settings. There is great variation in these services across the UK. This article reports on a consensus process undertaken to devise a Best Practice Model and evaluation Tool for use w...
Preprint
Full-text available
Background: Teams delivering crisis resolution services for people with dementia and their carers provide short-term interventions to prevent admission to acute care settings. There is great variation in these services across the UK. This article reports on a consensus process undertaken to devise a Best Practice Model and evaluation Tool for use w...
Preprint
Full-text available
Background: Teams delivering crisis resolution services for people with dementia and their carers provide short-term interventions to prevent admission to acute care settings. There is great variation in these services across the UK. This article reports on a consensus process undertaken to devise a Best Practice Model and evaluation Tool for use w...
Preprint
Full-text available
Background: Teams delivering crisis resolution services for people with dementia and their carers provide short-term interventions to prevent admission to acute care settings. There is great variation in these services across the UK. This article reports on a consensus process undertaken to devise a Best Practice Model and evaluation Tool for use w...