title: Operationalising ethical challenges in dementia research-a systematic review of current evidence.
abstract: the worldwide number of dementia cases is increasing, and this is a trend that is expected to continue as a growing proportion of the population ages. However, conducting research with persons suffering from dementia can be fraught due to fears surrounding research risks in vulnerable populations. This can make seeking approval for studies difficult. As research directly involving persons with dementia is key for the development of evidence-based best practice, the development of a coherent ethical strategy to perform such research feasibly and effectively is of paramount importance.
  
  
  
  this paper aims to review and synthesise ethical challenges in performing research with persons who have dementia.
  
  
  
  in undertaking a systematic review of the current research literature, we will identify the central issues and arguments characterising research that concerns the ethical dimensions of research participation in the dementia population. Data were analysed using both inductive and deductive content analysis. Ethical considerations in research involving persons with dementia primarily concern the representation of the interests of the person with dementia and protection of their vulnerabilities and rights.
  
  
  
  a total of 2,894 results were returned from initial searches, following deduplication. In total, 2,458 were excluded at title review, and following abstract review 158 papers remained; 29 papers were included for analysis after full paper review and data extraction. Papers ranged between 1995 and 2013.
  
  
  
  this review has highlighted a lack of consensus in current research and guidelines addressing these concerns; a clear stance on ethical governance of studies is important for future research and best evidence-based practice in dementia.
authors.affiliation: Institute for Research in Extramural Medicine, Amsterdam 1081 BT, The Netherlands.
authors.forename: Emily
authors.initials: E
authors.lastname: West
authors.affiliation: Universite de Geneve-Institut de sante globale, Geneve, GE, Switzerland.
authors.forename: Astrid
authors.initials: A
authors.lastname: Stuckelberger
authors.affiliation: Division of Palliative Medicine, Rehabilitation and Geriatrics, 11. ch de la Savonnière, Collonge-Bellerive 1245, Switzerland.
authors.forename: Sophie
authors.initials: S
authors.lastname: Pautex
authors.affiliation: Universiteit Bibliotheek, Unvisersiteit van Amsterdam, Amsterdam, The Netherlands.
authors.forename: Janneke
authors.initials: J
authors.lastname: Staaks
authors.affiliation: Amsterdam Institute for Social Science Research, Amsterdam, North Holland, The Netherlands.
authors.forename: Marjolein
authors.initials: M
authors.lastname: Gysels
mesh_terms: D035843:Biomedical Research / Q000941:ethics*; D003704:Dementia / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D019317:Evidence-Based Medicine / Q000941:ethics*; D005853:Geriatrics / Q000941:ethics*; D006801:Humans; D007258:Informed Consent / Q000941:ethics; D028701:Patient Rights / Q000941:ethics; D061214:Patient Safety; D018579:Patient Selection / Q000941:ethics; D035842:Research Subjects / Q000523:psychology; D018570:Risk Assessment; D035862:Vulnerable Populations / Q000523:psychology
keywords: consent procedures; dementia; lack of consensus; older people; research ethics; safeguarding patients; systematic review