• Postacute Care for Older People in Community Hospitals: A Multicentre Randomised, Controlled Trial

      Young, J.; Green, J.R.; Forster, A.; Small, Neil A.; Lowson, K.; Bogle, S.; George, J.; Heseltine, D.; Jayasuriya, T.; Rowe, J. (2007)
      OBJECTIVES: To compare the effects of community hospital care on independence for older people needing rehabilitation with that of general hospital care. DESIGN: Randomized, controlled trial. SETTING: Seven community hospitals and five general hospitals in the midlands and north of England. PARTICIPANTS: Four hundred ninety patients needing rehabilitation after hospital admission with an acute illness. INTERVENTION: Multidisciplinary team care for older people in community hospitals. MEASUREMENTS: The primary outcome was the Nottingham extended activities of daily living scale (NEADL); secondary outcomes were the Barthel Index, Nottingham Health Profile, Hospital Anxiety and Depression Scale, mortality, discharge destination, 6-month residence status, and satisfaction with services. RESULTS: Loss of independence at 6 months was significantly less likely in the community hospital group (mean adjusted NEADL change score group difference 3.27; 95% confidence interval 0.26–6.28; P=.03). The results for the secondary outcome measures were similar for the two groups. CONCLUSION: Postacute community hospital rehabilitation care for older people is associated with greater independence.
    • Posterolateral corner injuries of the knee: a serious injury commonly missed

      Pacheco, R.J.; Ayre, Colin A.; Bollen, S.R. (2011)
      We retrospectively reviewed the hospital records of 68 patients who had been referred with an injury to the posterolateral corner of the knee to a specialist knee surgeon between 2005 and 2009. These injuries were diagnosed based on a combination of clinical testing and imaging and arthroscopy when available. In all, 51 patients (75%) presented within 24 hours of their injury with a mean presentation at eight days (0 to 20) after the injury. A total of 63 patients (93%) had instability of the knee at presentation. There was a mean delay to the diagnosis of injury to the posterolateral corner of 30 months (0 to 420) from the time of injury. In all, the injuries in 49 patients (72%) were not identified at the time of the initial presentation, with the injury to the posterolateral corner only recognised in those patients who had severe multiple ligamentous injuries. The correct diagnosis, including injury to the posterolateral corner, had only been made in 34 patients (50%) at time of referral to a specialist knee clinic. MRI correctly identified 14 of 15 injuries when performed acutely (within 12 weeks of injury), but this was the case in only four of 15 patients in whom it was performed more than 12 weeks after the injury. Our study highlights a need for greater diligence in the examination and investigation of acute ligamentous injuries at the knee with symptoms of instability, in order to avoid failure to identify the true extent of the injury at the time when anatomical repair is most straightforward.
    • Postural stability changes in the elderly during sensory perturbations and dual tasking: the influence of refractive blur

      Anand, Vijay; Buckley, John G.; Scally, Andy J.; Elliott, David B. (2003)
      PURPOSE. To determine the influence of refractive blur on postural stability during somatosensory and vestibular system perturbation and dual tasking. METHODS. Fifteen healthy, elderly subjects (mean age, 71 ± 5 years), who had no history of falls and had normal vision, were recruited. Postural stability during standing was assessed using a force platform, and was determined as the root mean square (RMS) of the center of pressure (COP) signal in the anterior-posterior (A-P) and medial-lateral directions collected over a 30-second period. Data were collected under normal standing conditions and with somatosensory and vestibular system perturbations. Measurements were repeated with an additional physical and/or cognitive task. Postural stability was measured under conditions of binocular refractive blur of 0, 1, 2, 4, and 8 D and with eyes closed. The data were analyzed with a population-averaged linear model. RESULTS. The greatest increases in postural instability were due to disruptions of the somatosensory and vestibular systems. Increasing refractive blur caused increasing postural instability, and its effect was greater when the input from the other sensory systems was disrupted. Performing an additional cognitive and physical task increased A-P RMS COP further. All these detrimental effects on postural stability were cumulative. CONCLUSIONS. The findings highlight the multifactorial nature of postural stability and indicate why the elderly, many of whom have poor vision and musculoskeletal and central nervous system degeneration, are at greater risk of falling. The findings also highlight that standing instability in both normal and perturbed conditions was significantly increased with refractive blur. Correcting visual impairment caused by uncorrected refractive error could be a useful intervention strategy to help prevent falls and fall-related injuries in the elderly.
    • Postural Stability Changes in the Elderly with Cataract Simulation and Refractive Blur

      Anand, Vijay; Buckley, John G.; Scally, Andy J.; Elliott, David B. (2003)
      PURPOSE. To determine the influence of cataractous and refractive blur on postural stability and limb-load asymmetry (LLA) and to establish how postural stability changes with the spatial frequency and contrast of the visual stimulus. METHODS. Thirteen elderly subjects (mean age, 70.76 ± 4.14 [SD] years) with no history of falls and normal vision were recruited. Postural stability was determined as the root mean square [RMS] of the center of pressure (COP) signal in the anterior¿posterior (A-P) and medial¿lateral directions and LLA was determined as the ratio of the average body weight placed on the more-loaded limb to the less-loaded limb, recorded during a 30-second period. Data were collected under normal standing conditions and with somatosensory system input disrupted. Measurements were repeated with four visual targets with high (8 cyc/deg) or low (2 cyc/deg) spatial frequency and high (Weber contrast, ¿95%) or low (Weber contrast, ¿25%) contrast. Postural stability was measured under conditions of binocular refractive blur of 0, 1, 2, 4, and 8 D and with cataract simulation. The data were analyzed in a population-averaged linear model. RESULTS. The cataract simulation caused significant increases in postural instability equivalent to that caused by 8-D blur conditions, and its effect was greater when the input from the somatosensory system was disrupted. High spatial frequency targets increased postural instability. Refractive blur, cataract simulation, or eye closure had no effect on LLA. CONCLUSIONS. Findings indicate that cataractous and refractive blur increase postural instability, and show why the elderly, many of whom have poor vision along with musculoskeletal and central nervous system degeneration, are at greater risk of falling. Findings also highlight that changes in contrast sensitivity rather than resolution changes are responsible for increasing postural instability. Providing low spatial frequency information in certain environments may be useful in maintaining postural stability. Correcting visual impairment caused by uncorrected refractive error and cataracts could be a useful intervention strategy to help prevent falls and fall-related injuries in the elderly.
    • The potential role of the occupational therapist in acute psychiatric services: A comparative evaluation

      Fitzgerald, Martin (2016)
      Aims and background: This analysis paper describes a comparative evaluation of service deliverables within the Service Level Agreements (SLA) of two acute psychiatric services; one inclusive and the other exclusive of occupational therapy. Methods: Six SLA agreements provided the standards by which the two services were evaluated. The SLAs were evaluated because they are used by the service managers and commissioners to measure performance and clinical effectiveness. The role of the occupational therapists and their contribution to the planning and delivery of the performance indicators is also considered. An evaluation framework was applied to explore the potential role occupational therapy may have had in any performance difference between the two sites. In doing so it is hoped to provide some evidence to support and inform occupational therapists and service managers on the role and of occupational therapy in acute mental health services. This comparative evaluation followed the first three of the five audit stages: 1. Preparing for audit; 2. Selecting criteria; and 3. Measuring performance level. Findings: The service with occupational therapy performed better on home leave day use, ward occupancy and less than 3-day admissions. Conclusions: By delivering their key roles of individual assessment, therapeutic groups, individual treatment and discharge planning occupational therapist were able to contribute to the overall efficiency of service delivery. These findings support the role of the occupational therapist in an acute psychiatric setting and provide guidance for managers on how to utilise occupational therapy in the delivery of service outcomes.
    • Potential social, economic and general health benefits of consanguineous marriage: results from the Born in Bradford cohort study

      Bhopal, R.S.; Petherick, E.S.; Wright, J.; Small, Neil A. (2014)
      BACKGROUND: More than 1 billion people live in societies where consanguineous marriages are common. When children are born to consanguineous unions, there is an increased probability of the expression of single-gene disorders with a recessive mode of inheritance. There are presumptive social benefits of consanguineous marriages reported in the literature. METHODS: The UK's Born in Bradford birth cohort study recruited 12 453 women at 26-28 weeks' gestation between 2007 and 2010. In all, 11 396 completed a questionnaire, including questions about their relationship to their baby's father. We compared Pakistani and Other ethnic groups in consanguineous relationships and Pakistani, Other and White British groups not in consanguineous relationships, calculating percentages and age-adjusted prevalence ratios (95% confidence intervals). RESULTS: In the Pakistani group, 59.3% of women (n = 3038) were blood relatives of their baby's father. Consanguinity was uncommon in the Other ethnic group (7.3%, n = 127) and rare (n = 5) in the White British group. Compared with non-consanguineous counterparts, mothers in consanguineous relationships were socially and economically disadvantaged (e.g. never employed, less likely to have higher education). The Pakistani consanguineous group's social, economic and health lifestyle circumstances were equivalent to, in some cases better than, women in non-consanguineous relationships (e.g. up-to-date in paying bills, or in disagreeing that they wished for more warmth in their marital relationship). The consanguineous relationship group had less separation/divorce. Rates of cigarette smoking during pregnancy were lower in mothers in consanguineous relationships. CONCLUSION: Debate about consanguinity should balance the potential protective effect of consanguineous relationships with established genetic risk of congenital anomaly in children.
    • The Power of Belief? Review of the Evidence on Religion or Belief and Equalities in Great Britain.

      Macey, Marie; Carling, Alan; Furness, Sheila M. (University of Bradford, 2009)
      A new legal framework has been developed in Great Britain over the last ten years which protects individuals against unfair treatment on the grounds of their religion or belief. This framework regards all the major faith groups, secular belief systems (such as Humanism or Atheism), and non-belief on formally equal terms. There has also been a rapid growth of research interest in religion/belief in contemporary scholarship on equalities. This report provides a critical overview of this extensive research base relating mainly to England, Scotland and Wales up until 2008.
    • A practical introduction to medical statistics.

      Scally, Andy J. (2014-04-23)
      Medical statistics is a vast and ever-growing field of academic endeavour, with direct application to developing the robustness of the evidence base in all areas of medicine. Although the complexity of available statistical techniques has continued to increase, fuelled by the rapid data processing capabilities of even desktop/laptop computers, medical practitioners can go a long way towards creating, critically evaluating and assimilating this evidence with an understanding of just a few key statistical concepts. While the concepts of statistics and ethics are not common bedfellows, it should be emphasised that a statistically flawed study is also an unethical study.[1] This review will outline some of these key concepts and explain how to interpret the output of some commonly used statistical analyses. Examples will be confined to two-group tests on independent samples, using both a continuous and a dichotomous/binary outcome measure.
    • Predicting mortality among a general practice-based sample of older people with heart failure

      Barnes, S.; Gott, M.; Payne, S.; Parker, C.; Seamark, D.; Gariballa, S.; Small, Neil A. (2008)
      Objective: To identify factors available to general practitioners (GPs) that are predictive of mortality within a general practice-based population of heart failure patients, and to report the sensitivity and specificity of prognostic information from GPs. Methods: Five hundred and forty-two heart failure patients aged >60 years were recruited from 16 UK GP surgeries. Patients completed quality-of-life and services use questionnaires every 3 months for 24 months or until death. Factors with independent significant association with survival were identified using Cox proportional hazards regression analysis. Results: Women had a 58% lower risk of death. Patients self-reporting New York Heart Association Classification III or IV had an 81% higher risk of death. Patients aged 85+ years had over a five-fold risk of death as compared with those aged <65 years. Patients with a co-morbidity of cancer had a 78% higher risk of death. Of the 14 patients who died in a 12-month period, the GPs identified 11 (sensitivity 79%). They identified 133 of the 217 who did not die (specificity 61%). Discussion: Predictors readily available to GPs, such as patient characteristics, are easy to adapt to use in general practice, where most heart failure patients are diagnosed and treated. Identifying factors likely to influence death is useful in primary care, as this can initiate discussion about end-of-life care.
    • Predictors of self-reported adherence to antihypertensive medicines: A multinational, cross-sectional survey

      Morrison, V.L.; Holmes, E.A.F.; Parveen, Sahdia; Plumpton, C.O.; Clyne, W.; de Geest, S.; Dobbels, F.; Vrijens, B.; Kardas, P.; Hughes, D.A. (2015-03)
      Background Nonadherence to antihypertensive medicines limits their effectiveness, increases the risk of adverse health outcome, and is associated with significant health care costs. The multiple causes of nonadherence differ both within and between patients and are influenced by patients’ care settings. Objectives The objective of this article was to identify determinants of patient nonadherence to antihypertensive medicines, drawing from psychosocial and economic models of behavior. Methods Outpatients with hypertension from Austria, Belgium, England, Germany, Greece, Hungary, The Netherlands, Poland, and Wales were recruited to a cross-sectional online survey. Nonadherence to medicines was assessed using the Morisky Medication Adherence Scale (primary outcome) and the Medication Adherence Rating Scale. Associations with adherence and nonadherence were tested for demographic, clinical, and psychosocial factors. Results A total of 2595 patients completed the questionnaire. The percentage of patients classed as nonadherent ranged from 24% in The Netherlands to 70% in Hungary. Low age, low self-efficacy, and respondents’ perceptions of their illness and cost-related barriers were associated with nonadherence measured on the Morisky Medication Adherence Scale across several countries. In multilevel, multivariate analysis, low self-efficacy (odds ratio = 0.73; 95% confidence interval 0.70–0.77) and a high number of perceived barriers to taking medicines (odds ratio = 1.70; 95% confidence interval 1.38–2.09) were the main significant determinants of nonadherence. Country differences explained 11% of the variance in nonadherence. Conclusions Among the variables measured, patients’ adherence to antihypertensive medicines is influenced primarily by their self-efficacy, illness beliefs, and perceived barriers. These should be targets for interventions for improving adherence, as should an appreciation of differences among the countries in which they are being delivered.
    • Preference of non-pharmaceutical preoperative anxiety reduction intervention in patients undergoing elective surgery

      Dagona, Sabo S.; Archibong, Uduak E.; McClelland, Gabrielle T. (2018-12)
      For patients to be treated, decisions about their care must be made before treatment begins. In case of pre-operative anxiety, it is currently unknown how clinicians and patients discuss information about the issue, and it is also not known whether clinicians consider (or are ready to consider) their patients’ preferences of non-pharmaceutical pre-operative anxiety reduction interventions. At present no study has been conducted to find information on surgical patients’ preferences of, and their involvement in decisions about non-pharmaceutical interventions for reducing their pre-operative anxiety. This paper investigates elective surgical patients’ involvement in treatment decisions with the aim of finding out their preferred non-pharmaceutical pre-operative anxiety reduction interventions before they undergo elective surgery. Method: A survey method was used to collect data on patients’ preference of non-pharmaceutical preoperative anxiety reduction interventions at a tertiary health facility in Nigeria. Participants: A sample of 30 participants-17 male and 13 female, schedule to undergo surgical operations was selected using a convenient sampling method. Their ages range between 17 to 70 years (mean age = 41.03 and standard deviation = 16.09). Study design/procedure: To elicit preference of interventions, the study participants were presented with cards that contain picture of surgical patient receiving one of the non-pharmaceutical interventions used in reducing pre-operative anxiety. The pictures were presented one at a time for 30-40 seconds. The researcher then gives the participants a sheet of paper with the different interventions boldly written for the participants to rank order them according to the degree of their preferences. Through this process, data was collected from all the 30 participants. Results: The results obtained were entered into SPSS for analysis. Descriptive statistics, at 95 % confidence was calculated to estimate the percentage, mean, standard deviation and confidence intervals based on the participants’ preference of the interventions. Discussions: The findings were discussed alongside the existing literature and recommendations were offered for clinical practice and further research.
    • Pregnancy related telephone consultations to an out-of-hours provider: a retrospective database study

      Haith-Cooper, Melanie; Stacey, T.; Clements, E.; Mohammed, Mohammed A.; Edwards, E. (2015)
      There is a marked increase in the number of General Practitioner (GP) organisations across Europe providing out of hours (OOH) emergency primary care services whereby GPs and/or Nurse Practitioners (NPs), provide telephone consultations to patients (Giesen et al., 2007a, McKinstry et al., 2009, Derkx et al., 2009). This has been an important development to manage the rising demand for health care with increasingly scarce resources (Blank et al., 2012, Purc-Stephenson and Thrasher, 2010) and also reduces unnecessary attendance at accident and emergency departments or home visits by GPs (Bunn et al., 2005, Roberts et al., 2008)... In this study we describe the characteristics of telephone consultation calls made by pregnant women to an OOH service run by a GP co-operative and also to compare and contrast the differences between the way the calls were handled by GPs and Nurse Practitioners (NPs). The NPs were qualified and registered nurses experienced in primary care or emergency care settings and none were practicing.
    • Pregnant and seeking asylum; exploring experiences ‘from booking to baby’.

      Lephard, E.; Haith-Cooper, Melanie (2016)
      Pregnant women seeking asylum in the UK may be particularly vulnerable with poor underlying health, more complex pregnancies and an increased risk of maternal and perinatal mortality. Studies have shown that some women seeking asylum have poor experiences of maternity care. This is despite the implementation of NICE guidelines to improve care for women with complex social factors. This article reports on a phenomenological study undertaken in West Yorkshire, aiming to explore the maternity care experiences of local pregnant asylum seeking women, to inform service development. Six women were interviewed over a three-month period. The findings focused more broadly on their experiences of living in the UK whilst being an asylum seeker and pregnant rather than focusing on maternity care, although this was included. Five key themes emerged: ‘pre-booking challenges’, ‘inappropriate accommodation’, ‘being pregnant and dispersed’, ‘being alone and pregnant’ and ‘not being asked or listened to’. These findings could be used as the basis for training midwives to understand how the difficulties women experience can impact on their health and social needs.
    • Prehension of a flanked target in individuals with amblyopia.

      Buckley, John G.; Pacey, Ian E.; Scally, Andy J.; Barrett, Brendan T.; Panesar, Gurvinder K. (2015-11)
      Purpose: Reduced binocularity is a prominent feature of amblyopia and binocular cues are thought to be important for prehension. We examine prehension in individuals with amblyopia when the target-object was flanked, thus mimicking everyday prehension. Methods: amblyopes (n=20, 36.4±11.7 years; 6 anisometropic, 3 strabismic, 11 mixed) and visually-normal controls (n=20, 27.5±6.3 years) reached forward, grasped and lifted a cylindrical target-object that was flanked with objects on either (lateral) side of the target, or in front and behind it in depth. Only 6 amblyopes (30%) had measurable stereoacuity. Trials were completed in binocular and monocular viewing, using the better eye in amblyopic participants. Results: Compared to visual normals, amblyopes displayed a longer overall movement time (p=0.031), lower average reach velocity (p=0.021), smaller maximum aperture (p=0.007) and longer durations between object contact and lift (p=0.003). Differences between groups were more apparent when the flankers were in front and behind, compared to either side, as evidenced by significant group-by-flanker configuration interactions for reach duration (p<0.001), size and timing of maximum aperture (p≤0.009), end-of-reach to object-contact (p<0.001), and between object contact and lift (p=0.044), suggesting that deficits are greatest when binocular cues are richest. Both groups demonstrated a significant binocular advantage, in that in both groups performance was worse for monocular compared to binocular viewing, but interestingly, amblyopic deficits in binocular viewing largely persisted during monocular viewing with the better eye. Conclusions: These results suggest that amblyopes either display considerable residual binocularity or that they have adapted to make good use of their abnormal binocularity.
    • The preparation and practice of disabled health care practitioners: exploring the issues.

      Hargreaves, J.; Dearnley, Christine A.; Walker, Stuart A.; Walker, L. (2014)
      Regulatory bodies governing health professions and professional education set clear expectations regarding fitness to practise. Within the UK, the Equality Act, 2010, poses a challenge to regulators, educators and employers to ensure that people are not excluded on the basis of disability and to facilitate inclusion. This research took a mixed methods approach to exploring the tensions between Higher Education providers and placement providers in the health sector. Disabled and nondisabled students and health professionals engaged in semistructured interviews and a survey in order to explore their beliefs and experiences. The findings suggest that applying equality legislation within health settings may be particularly difficult and that ¿disability¿ is an ambiguous and multifaceted concept. Whilst small in scale, the findings have given a voice to a professional group who are underrepresented in research and have raised a number of important issues that merit discussion and further scrutiny.
    • Presence of bias in radiographer plain film reading performance studies

      Brealey, S.; Scally, Andy J.; Thomas, N. (2002)
      Purpose To raise awareness of the frequency of bias that can affect the quality of radiographer plain film reading performance studies. Methods Studies that assessed radiographer(s) plain film reading performance were located by searching electronic databases and grey literature, hand-searching journals, personal communication and scanning reference lists. Thirty studies were judged eligible from all data sources. Results A one-way analysis of variance (ANOVA) demonstrates no statistically significant difference (P=0.25) in the mean proportion of biases present from diagnostic accuracy (0.37), performance (0.42) and outcome (0.44) study designs. Pearson¿s correlation coefficient showed no statistically significant linear association between the proportion of biases present for the three different study designs and the year that the study was performed. The frequency of biases in film and observer selection and application of the reference standard was quite low. In contrast, many biases were present concerning independence of film reporting and comparison of reports for concordance. Conclusions The findings indicate variation in the presence of bias in radiographer plain film reading performance studies. The careful consideration of bias is an essential component of study quality and hence the validity of the evidence-base used to underpin radiographic reporting policy.
    • Preservation of self in people with dementia living in residential care: A socio-biographical approach.

      Surr, Claire A. (2006)
      The maintenance of self in dementia is associated with socio-biographical factors. The theoretical literature suggests that interpersonal relationships, the social context, and the generation of stories are important in maintenance of self. Empirical research on self in dementia supports this but has been predominantly conducted with participants living in the community. Living in residential care brings additional threats to self. This paper presents a study examining the relevance of a socio-biographical theory of self to people with dementia living in residential care. Between 3 and 8 tape-recorded and transcribed unstructured interviews were conducted with 14 people with dementia who were living in 4 residential homes throughout England and Wales, over a 6-24-month period. They were analysed using an interpretive biographical methodology. The results provide evidence to support the relevance of a socio-biographical theory of self to this group. Relationships with family, other residents and care home staff were important for maintenance of self. Social roles related to work, being part of a family, caring for others and being cared for, were particularly significant for self in this group. The creation of a life story, stories of selected life events, and the telling of stories with possible metaphorical interpretations were also important for the maintenance of self. The results also suggest that psychological and embodied factors may be relevant to the self in dementia. The study suggests that staff working in residential homes should consider these elements if they are to provide care that supports maintenance of self for people with dementia. Implications for future research are discussed.
    • Pressure ulcer incidence: do patients retain information

      Vowden, Kath; Warner, V.; Collins, Jane B. (2016)
      Many service commissioners are demanding a reduction in pressure ulcer prevalence and regard pressure ulceration as a key indicator of care quality. Within our area of practice, local commissioners have indicated that all health care providers in the district should work together to reduce pressure ulceration across the local health care economy. Health care professionals clearly have a critical role to play in patient assessment, risk categorisation, care planning and equipment provision. However, this alone will not be sufficient to achieve the reduction targets which will involve effective patient engagement. National and International guidelines all recognise the importance of patient education in care and recognise the significance of patient involvement in personalised care planning and service provision. Hartigan et al have demonstrated the value of education leaflets in supporting pressure ulcer prevention in an elderly population. Patient support applications running on mobile phones and tablets are also available to assist in pressure ulcer prevention and patient education but are not widely used in a hospital setting. This study examines how effective standard verbal and written information is at delivering patient education for pressure ulcer prevention. Local hospital policy is that all patients identied as being at risk of developing pressure ulceration are provided with information on what a pressure ulcer is, what constitutes risk and how to assist staff in pressure ulcer prevention. The policy includes patient and carer involvement in care planning, and encouragement to report skin changes and pain to staff.
    • The prevalence and predictors of loneliness in caregivers of people with dementia: findings from the IDEAL programme

      Victor, C.R.; Rippon, I.; Quinn, Catherine; Nelis, S.M.; Martyr, A.; Hart, N.; Lamont, R.; Clare, L. (2020)
      Objectives: To establish the prevalence of loneliness among family caregivers of people with dementia and to identify potential risk factors for loneliness. Methods: Using data from the baseline wave of the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort study, we examined loneliness in 1283 family caregivers of people with mild-to-moderate dementia living in Great Britain. Multinomial regression was used to examine the relative influence of a series of risk factors for caregiver loneliness. Results: Almost half, 43.7%, of caregivers reported moderate loneliness and 17.7% reported severe loneliness. Greater social isolation and increased caregiving stress were linked with both moderate and severe loneliness. Better quality of relationship with the person with dementia along with increased levels of well-being and life satisfaction were associated with a lower relative risk of reporting both moderate and severe loneliness. Discussion: This study examines the prevalence and predictors of loneliness in a large sample of family caregivers of people with dementia. Notably over two-thirds of caregivers in our sample reported feeling lonely. Interventions aimed at reducing caregiving stress and supporting meaningful relationships may go some way towards helping to reduce loneliness.