c l i n i c a l p r a c t i c e
dementia survey results help reduce evidence-to-practice gap
Results of a 2012 survey
conducted to determine what health care providers know about sleep problems in older adults living with dementia, as well as what types of assessments and interventions are commonly used to address sleep problems.
In 2012, NLMA members were invited to
participate in a cross-Canada survey on the use of
non-pharmacological sleep interventions for persons with dementia.
The survey was conducted by the Sleep and Function Interdisciplinary
Group (SAFIG) at the University of Alberta. It aimed to determine
what health care providers know about sleep problems in older adults
living with dementia, as well as what types of assessments and
interventions are commonly used to address sleep problems.
The survey also asked health care
providers about what prevents or helps them to recommend non-drug sleep
interventions such as massage, bright light therapy, temperature control
and other types of environmental modification to promote better sleep.
“Over 2000 people participated in the
survey, so although it took a long time to analyze such extensive data,
we learned a great deal from the findings and are very pleased to be
able to now share the report,” said research lead Dr. Brown, Associate
Professor, Department of Occupational Therapy, Faculty of Rehabilitation
Medicine, University of Alberta.
“We are now in the planning stages for an
intervention study and thanks to (the survey participants) we are better
informed about the priority knowledge needs in the health care
Between 50-70% of older adults with
Alzheimer’s and other dementias (AOD), have sleep problems. These sleep
problems result from, and contribute to, the development of dementia and
can lead to accelerated cognitive and functional decline. Sleep
disturbances in people with AOD are also one of the most common causes
of anxiety and sleeplessness for family caregivers, which increases the
probability of institutionalization.
The survey revealed that, like similar
studies in other countries, many health care providers had little
knowledge about what the risk factors for poor sleep were, what types of
health conditions insomnia could make worse, and what types of
assessments and non-drug interventions were research tested and
available. It also found that health care providers were concerned about
sleep problems and were very eager for more information about
assessments and non-drug sleep interventions for older adults with
Alzheimer’s and other dementias.
People in each health care provider
category also identified the best ways to get information from research
studies to their group so that they could begin to apply it in their
Based on the survey findings, researchers
developed specific recommendations about how best to reduce the sleep
and dementia evidence-to-practice gap. They can be applied by policy
makers and health educators to develop specific educational strategies
and care guidelines to improve health care providers’ ability to provide
the best, research-informed, care for older adults living with sleep
problems and dementia.
The recommendations include building sleep
problem screening and advocacy capacity in the health care providers who
spend the most time with persons with dementia (PWD); making sleep a
higher priority topic for education of health care providers; educating
providers about the effect of caregiver beliefs and co-morbid conditions
on disordered sleep for PWD; educating providers about effective
non-drug sleep interventions; tailoring providers’ education to fill the
specific knowledge gaps of each discipline; and, educating caregivers to
facilitate a change in their beliefs and awareness of effective non-drug
interventions for disordered sleep.
They also call for improved sleep
screening and assessment by embedding sleep-related questions in generic
elder-care screening tools, and improving access to appropriate sleep
The priority requirements for delivering
effective knowledge translation strategies to reduce the
research-to-practice gap include customizing local context;
incorporating a range of formats for learners’ preferences; developing
strategies based on an awareness of organizational culture; respecting
and building on prior knowledge; avoiding ageist assumptions of
communication methods, focusing on evidence-based principles for
increased health literacy; and, focusing on practicality of the
The full report is available online at the
University of Calgary website.