Objectives: Understanding how the importance of modifiable risk factors for dementia varies by cognitive status and sex is vital for the development of effective approaches to dementia prevention. We aimed to calculate population attributable fractions (PAFs) for incident dementia associated with sets of risk factors while exploring sex differences in individuals who are cognitively normal (CN) or has mild cognitive impairment (MCI).

Methods: Longitudinal data from the Rush University Memory and Aging Project (MAP) were analysed. Included participants were aged over 50 years and were CN or with a diagnosis of MCI at their baseline assessment. Analyses considered fifteen potential dementia risk factors covering cardiometabolic, lifestyle, psychosocial and sensory domains. We used Cox proportional hazard models to estimate the hazard ratios for incident dementia associated with dementia risk factors and calculated weighted PAFs. All analyses were repeated stratified by sex.

Results: The analytical sample comprised 754 cognitively normal participants (77.2% female) and 242 participants with a diagnosis of MCI (71.9% female), of whom 214 (28.4%) and 120 (49.6%) were diagnosed with dementia across the follow-up, respectively. Although the weighted overall PAF was similar for CN (24.7%) and MCI (25.2%) subgroups, sex differences were present in both. Compared to in females, PAFs were higher in males in both CN (42.5% vs. 25.1%) and MCI (51.6% vs 12.3%) subgroups. The profiles of contributing risk factors also varied by sex. In males, the highest PAFs were smoking (11.1%), vision impairment (6.2%) and stroke (6.0%) in CN and smoking (13.3%), physical inactivity (12.9%) and heart attack (7.9%) in MCI. In females, the highest PAFs were unmarried marital status (4.9%), depression (4.1%) and social isolation (3.8%) in CN and vision impairment (4.4%), increased alcohol intake (3.5%) and depression (2.6%) in MCI.

Conclusions: These findings support the notion that dementia risk is modifiable after the onset of MCI. They also highlight the potential benefits of considering an individual’s cognitive status and sex when formulating dementia prevention strategies.

Introduction: In public discourse and media, as well as in medical settings, dementia is often portrayed as a tragedy, a perspective that contributes to stigma. Descriptions using metaphors like decaying fruit, or statements labeling dementia as death in life’’ and a tsunami for healthcare systems,’’ not only perpetuate negative emotions like fear and helplessness, but also promote social distance. These dehumanizing expressions can intensify the suffering of those living with dementia and those around them, besides complicating understanding of the condition, exacerbating social isolation, and hindering timely medical attention. Questioning the narrative of dementia as a tragedy does not imply denying or underestimating the challenges and suffering associated with this condition. However, diagnosis should not hinder the recognition of moments of pleasure, the potential for internal growth of the person living with dementia and those around them, as well as the persistence of connection and dignity. The philosophy of ambiguity offers a useful framework for countering a stigmatizing narrative and addressing dementia with a more compassionate and nuanced approach. The philosophy of ambiguity, primarily expounded by Simone de Beauvoir, invites us to recognize the coexistence of multiple realities and the simultaneous presence of contradictions. This is reflected in the complex contradictions and paradoxes present in our experiences, both personal and social. Health itself is an ambiguous concept, representing not only the absence of illness but also a dynamic and multifaceted state, culturally and contextually influenced. By focusing on preserved abilities, we can contribute to the well-being of those living with dementia, reinforcing their dignity and self-esteem. The success of this approach depends on having adequate social support and an effective healthcare system. Understanding dementia in a broad social and cultural context allows us to overcome the traditional Manichean view that categorizes it strictly as either tragedy or well-being. It is crucial for medical personnel to use empathetic and respectful communication to maintain dignity and foster hope in those living with dementia. Listening carefully and avoiding stigmatizing language are fundamental to recognizing individual worth and creating a more compassionate and humane care environment.

Introduction: The ageing population with chronic kidney disease (CKD) has been increasing in developing countries and many of them are receiving Hemodialysis (HD) [1]. The prevalence of depression and other geriatric syndromes as well as the quality of life (QoL) in this population remains unknown since patients undergoing HD seldom receive a Comprehensive Geriatric Assessment (CGA) [2].

Objectives: To investigate the prevalence of depression and other geriatric syndromes as well as QoL in older patients with ESKD receiving HD.

Methods: In patients 50 years and older, receiving HD in a private tertiary hospital in northern Mexico, we applied a CGA consisting of functionality (Barthel and Lawton & Brody), comorbidity (Charlson Index), cognition (MoCA), depression (GDS), frailty (CFS), nutrition (MNA- SF), sarcopenia (EWSOP2), falls, and quality of life (OPQOL-Brief). Of 52 patients in the HD unit, 35 were eligible for the study. 9 patients did not give consent to participate in the study, resulting in a population of 26 patients.

Results: The mean age of the population was 68.85 years and 61% were women. Using a cut-off point of 5 points in the 15-item GDS to define the presence of depressive symptoms, 42.3% of the studied population presented depressive symptoms. Wefurther stratified the severity of this symptoms into mild, moderate and severe (Table1). Most patients presented mild depressive symptoms (72.81%).

Additionally, by OPQOL-Brief, the majority of patients (34%) reported having a very bad quality of life (Table 2). Of note, we also found that the median number of geriatric syndromes presented by each patient was 6, which is higher than what has been reported internationally in similar populations [2]. Of these, the most common geriatric syndromes were: dependence in Instrumented Activities of Daily Living (IADL) (92.3%), followed by cognitive impairment (84.6%) and inadequate nutritional status (80.8%).

Conclusions: Our findings revealed that 4 out 10 older patients with ESKD receiving HD presented depressive symptoms, however most of them presented only mild depressive symptoms. Additionally, the majority of patients reported having a very bad quality of life.

Objectives: Indoor air pollution exposure is harmful to people’s physical and mental health, especially in the elderly population, and represents a major issue for human health. Natural ventilation can improve indoor air quality and remove indoor contamination, thus reducing the adverse effects of indoor air pollution exposure on physical and mental health. Depressive symptoms are the most common mental health issue among elderly individuals. However, evidence linking the frequency of indoor natural ventilation to depressive symptoms in the elderly population is limited.

Methods: This study included 7887 individuals 65 years and older from 2017 to 2018 in the China Longitudinal Healthy Longevity Survey (CLHLS). The frequency of indoor natural ventilation was measured as the self-reported frequency of window opening per week in each season. Depressive symptoms were measured by the 10-item Center for Epidemiologic Studies Short Depression Scale (CES-D). Using a model adjusted for demographic, socio- economic, health status, and environmental factors, the correlation between indoor ventilation frequency and depressive symptoms was verified through logistic regression.

Results: Among the 7887 elderly people included in this study, 1952 (24.7%) had symptoms of depression. In the fully adjusted model, compared with the lower indoor overall ventilation frequency group (indoor ventilation frequency: 0–3 times/week), the higher indoor overall ventilation frequency group (indoor ventilation frequency: 6–8 times/week) showed a decrease in depressive symptoms by 33 % [OR: 0.67, 95 % (CI): 0.51–0.88]. Subgroup analysis and sensitivity analysis yielded similar results.

Conclusions: High frequency of indoor ventilation is significantly associated with the reduction of depressive symptoms in Chinese individuals 65 years old or older. This result provides strong evidence for health intervention and policy formulation. Encouraging an increase in indoor ventilation frequency will be an economically beneficial measure to promote healthy aging of the Chinese population.

Introduction: Late-life depression (LLD) is associated with cognitive deficit with risk of future dementia. By examining the entropy of the spontaneous brain activity, we aimed to understand the neural mechanism pertaining to cognitive decline in LLD.

Methods: We collected MRI scans in older adults with LLD (n = 32), mild cognitive impairment [MCI (n = 25)] and normal cognitive function [NC, (n = 47)]. Multiscale entropy analysis (MSE) was applied to resting-state fMRI data. Under the scale factor (tau) 1 and 2, reliable separation of fMRI data and noise was achieved. We calculated the brain entropy in 90 brain regions based on automated anatomical atlas (AAL). Due to exploratory nature of this study, we presented data of group-wise comparison in brain entropy between LLD vs. NC, MCI vs. NC, and LLD and MCD with a p-value below 0.001.

Results: The mean Mini-Mental State Examination (MMSE) score of LLD and MCI was 27.9 and 25.6. Under tau 2, we found higher brain entropy of LLD in left globus pallidus than MCI (p = 0.002) and NC (p = 0,009). Higher brain entropy of LLD than NC was also found in left frontal superior gyrus, left middle superior gyrus, left amygdala and left inferior parietal gyrus. The only brain region with higher brain entropy in MCI than control was left posterior cingulum (p-value = 0.015). Under tau 1, higher brain entropy was also found in LLD than in MCI in right orbital part of medial frontal gyrus and left globus pallidus (p-value = 0.007 and 0.005).

Conclusions: Our result is consistent with prior hypothesis where higher brain entropy was found during early aging process as compensation. We found such phenomenon particular in left globus pallidus in LLD, which could be served as a discriminative brain region. Being a key region in reward system, we hypothesis such region may be associated with apathy and with unique pathway of cognitive decline in LLD. We will undertake subsequent analysis longitudinally in this cohort

Key words: resting-state fMRI, Late-life depression, Brain entropy, globus pallidus, cognitive decline

The World Health Organization (WHO) proclaimed September 21 as World Alzheimer’s Disease Awareness Day and extended the observance to the entire month. Various awareness campaigns are being conducted around the world, with special emphasis on the importance of education to improve the quality of life for patients, families, and the community at large, and to eliminate stigma and ageism.

It is estimated that there are approximately 44 million people worldwide with some form of dementia, while in the United States it reaches 5.4 million. In Puerto Rico, it is estimated that there are approximately 60,000 people with Alzheimer’s disease. An AARP study (2021) showed that there are over 500,000 caregivers of older adults, making Puerto Rico one of the top three countries with the largest aging population and the 6th country in the world. While in Latin America and the Caribbean there is a prevalence between 6.2 and 6.5 per 100 adults aged 60 years or older (WHO).

This health and social situation require an educated and empowered society to meet the challenges. Muñoz et. al (2023) conducted a qualitative study with caregivers and found that 91% of the participants stated that training would help them provide better care to the elderly. Social work is one of the main disciplines dealing with this social phenomenon and should therefore play a leading role in education and therapeutic intervention.

For the past five years, the Department of Social Work at Inter-American University, Metro Campus, has joined and supported the cause through the celebration of the Alzheimer’s Symposium: A Perspective from the Academy. This event involves the entire university community, as well as the community at large, which includes caregivers, government and non- profit agencies, and professionals from various disciplines. There will be concurrent lectures, Discussions among local and international professionals, a film forum, poster presentations, artistic expressions, and educational tables. The 6th Symposium will be held on September 20, 2024. The Symposium is promoted through various media. This activity has generated alliances, recommendations and new educational projects that contribute to the well-being of older adults.

Objectives: 1) To evaluate interest, logistics, and content for a curriculum to promote well-being in older adults by gathering data through surveys of nursing home populations. 2) To design a curriculum syllabus that can be carried out and shared by analyzing our survey data and combining it with evidence-based practices from the literature including positive psychiatry approaches and elements of different psychotherapies.

Methods: Long-term and short-term care patients from Budd Terrace and A.G. Rhodes nursing homes were recruited to participate in a survey. Categorical frequency calculations were used to evaluate participant interest and logistical preferences. Ranked scores and distribution columns were used to evaluate course content.

Results: 100 participants completed the survey. 55.1% expressed interest in attending this type of course. For class length, frequency, duration, and size, average preference was for 30 minutes, once a week, 2– 4 weeks, and 6–10 people, respectively. Between pillars, in order of priority, preferences were: meaning in life (ranked score 215), mindfulness (198), and social connection (157). Within the meaning in life pillar, preferences in order of priority were: gratitude for life lived (268), life priorities (249), sources of meaning (235), and goals (188). Within the mindfulness pillar, preferences in order of priority were: emotional stability (272), focusing awareness on the present moment (261), acknowledging and accepting thoughts and feelings (240), and self-compassion (187). Within the social connection pillar, preferences in order of priority were: increasing opportunities for social connections (266), enhancing social support (245), improving social skills (240), and addressing worries about social situations (169).

Conclusions: By combining logistical and content preferences from our population sample with evidence-based practices from the literature, we have developed a psychoeducational course to promote mental health in older adults, centered around three pillars: meaning in life, mindfulness, and social connection. A curriculum syllabus complete with course description, learning Objectives, weekly topics/timelines, materials needed, notes, and handouts will be included with the final manuscript. The handouts can also be selected and distributed outside of a course context, such as outpatient clinics or inpatients settings, and curriculum elements can be incorporated into group or individual therapy.

Background: Older adults may exhibit behavioral disturbance while medically hospitalized. Restlessness, removing medical devices, or wandering may lead to sentinel events including falls, elopements, or violence. The traditional consultation-liaison model addresses challenging or high-risk behaviors but is often reactive and may lead to missed opportunities. The interdisciplinary Behavioral Intervention Team (BIT) was implemented on the campus of Prisma Health Baptist Hospital in Columbia, SC to address and anticipate the need for behavioral health support on medical units.

Methods: A pilot BIT program was implemented in September 2019. Two psychiatric nurses were embedded on med-surg units as a part of medical and psychiatric interdisciplinary teams. After obtaining approval from the Prisma Health Institutional Review Board, a retrospective review was conducted to evaluate the correlation between BIT interventions and patient safety events. Two time periods were examined: six months with early-BIT efforts and six months with expanded-BIT efforts. Medical records and safety reports were reviewed, and statistical analysis was conducted in SAS Enterprise Guide 8.3. Statistical significance was based on associated p- values (p < 0.05).

Results: Of admitted patients during the study period (N = 1413), almost half were age 65+. Pre- existing psychiatric diagnoses were present in 58% of cases with mood, anxiety, and neurocognitive disorders being most common. A majority of patients were on psychotropic medications during both study periods; however, there was a significant decrease in the use of psychotropic medications with expanded-BIT efforts (71.2% vs 61.3%, p < 0.001). In comparing early-BIT efforts to expanded-BIT efforts, significant reductions in workplace aggression (6.7% vs 2.3%, p < 0.001), use of restraints (5.8% vs 3.4%, p = 0.034) and need for security (4.2% vs 0.8%, p < 0.001) were observed. Geriatric subgroup analysis demonstrated a significant decrease in the need for security only (4.6% vs 0.6%, p < 0.001).

Conclusions: Engaging BIT significantly reduced aggression, restraint use, and security interventions. As psychiatric comorbidities continue to impact overall treatment plans, care teams will need to prevent high-risk behaviors and events. Implementing an interdisciplinary BIT is feasible and effective in reducing negative outcomes.

Introduction: This study explores the psychological effects of the COVID-19 pandemic on elderly Chileans, focusing on the role of social isolation (SI), loneliness, depressive symptoms, and pandemic-related concerns. With 150 participants, our cross-sectional descriptive study revealed significant relationships between SI, loneliness, depressive symptoms, and gender differences in their experiences. Despite no longer being in a restrictive phase of the pandemic, the findings highlight the interconnectedness of these factors and their ongoing impact on the mental health of the elderly population.

Methods: Utilizing a cross-sectional descriptive design, this research involved 150 elderly participants from Santiago, Chile. We assessed SI, loneliness, depressive symptoms, and pandemic-related concerns using the Steptoe Social Isolation Index, the Three-item UCLA Loneliness Scale, the Yesavage Geriatric Depression Scale (GDS-15), and a Likert scale for pandemic concern, respectively. Statistical analyses were conducted using JAMOVI 2.36, employing chi-square tests, U-Mann Whitney tests, and Spearman correlations.

Results: Our findings indicate a significant portion of participants experienced SI (42%) and loneliness (26%), with women showing higher frequencies of loneliness and depressive symptoms. Significant correlations were found between SI and loneliness, and both were closely linked to depressive symptoms. Interestingly, a significant negative correlation was observed between pandemic-related concerns and loneliness, suggesting an active coping mechanism among the elderly.

Objectives:

1. 1. Consider the role of Meaning in Life (MIL) in potentially promoting psychological resiliency and well- being and reducing suicide risk among older adults;

2. 2. Describe Online Meaning-Centered Groups (OMG) for older adults experiencing loneliness, social isolation, and/or psychological distress; &

3. 3. Discuss preliminary findings from a study of OMG for Canadian Retirement Home and Community residents 60 and older, both during and following the COVID pandemic.

Key words: Meaning-Centered Groups; Online Interventions; Psychological Well-Being; Upstream Suicide Prevention

Background: The COVID pandemic had a negative impact on the health and well-being of older adults. As older adults additionally have among the highest rates of suicide globally, psychological distress due to lockdowns, fear of infection, and reduced access to mental healthcare and social supports threatened to increase suicide risk, necessitating innovative interventions. Online Meaning-Centered Groups (OMG) were designed to address this concern.

Objectives: To summarize initial findings of an on-going study to adapt, initially evaluate, and disseminate OMG for older adults potentially at-risk for suicide by virtue of loneliness, social isolation, or pandemic-related psychological distress.

Methods: Participants included English-speaking, cognitively-intact, Canadians 60 years and older, experiencing loneliness, social isolation, or psychological distress. Participants of all sexes and genders were recruited primarily via online advertisements for an 8-session, online course of OMG, adapted from Meaning-Centered Men’s Groups (MCMG; Heisel et al., 2020) for men struggling with the retirement transition. Participants completed an online eligibility assessment, and were administered a demographics form, a cognitive screen, and measures of functioning, psychological risk and resiliency factors, and suicide ideation and behaviour. Eligible participants were invited to take part in a course of OMG, and to additionally complete online pre-, mid-, post-group, and 2-month follow-up assessments of psychological risk and resiliency factors and group process.

Results: Two courses of OMG have been delivered to date (n = 15), with a third planned for Spring-Summer 2024. Participants reported high satisfaction with group (M = 44.7, SD = 3.4, on a 0-50 Group Satisfaction scale), a strong working alliance with group facilitators (Working Alliance Inventory-Short Form: M = 5.1/7, SD = 0.8), and experienced significant pre-post reductions in hopelessness (Beck Hopelessness Scale: t(13) = 2.16, p ≤ 0.05) and anxiety (Geriatric Anxiety Scale: t(13) = 2.18, p ≤ 0.05). Improvements in other negative psychological factors and in psychological well-being have not yet reached statistical significance.

Conclusions: Preliminary findings suggest potential benefit in OMG in promoting social connection and reducing psychological distress among older adults experiencing social isolation and/or psychological distress. These and other findings will be discussed in the context of the need for accessible psychological interventions and the importance of promoting meaning in life to enhance psychological well-being among older adults.

Objectives: Loneliness is a modifiable risk factor for depression and dementia in older age. Validated interventions are needed to mitigate the impact of loneliness in older adults. Some evidence suggests that mindfulness meditation may reduce stress, improve mood and cognitive function, and may also impact loneliness per se. Many meditation apps offer an accessible way to meditate at home. However, robust research is needed to assess the benefits of meditation using this technology for older adults. Muse is a meditation app that analyzes brain signals during meditation and provides users with real-time neurofeedback on their level offocus.

Methods: We conducted a pilot, randomized controlled trial to establish the acceptability and feasibility of a remote, mindfulness intervention using Muse in older adults, and to obtain preliminary data on its impact on mood and cognition. Twenty-six adults reporting feeling lonely were enrolled and randomized to an 8-week Muse- based meditation (MM) or a brain- training active control (BT) program. The MM group completed meditation sessions with real- time neurofeedback and guided meditation sessions using Muse. The BT group completed cognitively challenging games on the commercially available Peak app and listened to podcasts. The groups were matched on the amount of interactions with study staff and total program duration. Outcome measures included standardized self-report scales of loneliness, stress, depression, well-being, quality of life, sleep disturbance, resilience, and mindfulness. Staff blinded to program assignment administered cognitive tasks of episodic memory, working memory, and sustained attention, as well as a breath counting task. Assessments were taken at Pre, Mid, and Post intervention, and after a 2-month and 4-month (4M) follow-upperiod.

Results: Participants found both programs engaging and the remote assessments were feasible. The MM group showed a greater improvement in depressive symptoms, and psychological andphysical QOL, compared to the BT group, at Post and at 4M.

Conclusions: A Muse-based mindfulness program is an acceptable and accessible intervention for older adults. A large-scale randomized trial is warranted to evaluate the efficacy of this intervention in this group.

Objectives: Geriatric abuse, a grave violation of human right affecting older adults, remains a silent epidemic in India. This study provides an insight into the prevalence, manifestation, contributing factors and societal implications of geriatric abuse within the Indian context. Drawing from scholarly research and empirical evidence it aims to illuminate the multifaceted nature of this phenomenon and advocate for urgent attention from policy makers, healthcare professional, and society at large Despite its pervasive nature, geriatric abuse in India often goes unnoticed and unaddressed due to cultural norms, family secrecy and systemic neglect. The abuse may take various forms including physical, psychological, financial and neglect perpetrated by family members, care givers or institutional staff. Factors such as socio- economic disparities, gender inequalities and cultural attitudes towards aging intersect to exacerbate the vulnerability of older adults to abuse. Understanding the socio cultural dynamics shaping geriatric abuse its essential for effective intervention and prevention strategies, traditional values emphasizing familial duty and respect for elders coexist with modern challenges such as urbanization, migration, and changing family structures impacting elder care and support networks furthermore, inadequate legal protections, limited access to healthcare, and stigma surrounding aging compound the challenges faced by older adults experiencing abuse. Addressing geriatric abuse in India requires a comprehensive approach encompassing legislative reforms community mobilization and capacity building initiatives strengthening reforms legal frame works to protect elder rights tailored to the needs of older adults and promoting awareness campaigns to challenge ageism and stigma are critical steps to creating a society where older adults age with dignity and safety.

Methods: We used interview and survey Methods to derive a representative sample (based on race gender education) in order to measure elder abuse in west Rajasthan (India) based population. Participants undergone interviewed via in OPD, IPD by taken case history, about a variety of abuse/mistreatment types and mistreatment risk factors in addition to question regarding health, social support and demographic. Specific elder abuse categories included emotional, physical, sexual, financial and neglect.

Results: Results of this study will be discussed during my presentation at the conference.

Conclusions: In consistent, geriatric abuse in India represents a profound violation of human rights and a moral imperative for action by acknowledging the complexities of this issue and fostering collaboration among stake holders, India can strive towards a future where older adults are respected, empowered and free from abuse and neglect.

Background: Social connections are important for brain health. We explored the associations between positive and negative social connections and the rate of decline in brain health with ageing.

Methods: We analysed UK Biobank data from 5704 adults aged 40+ (Wave 1 Mage = 54.12, 51.19% female) with brain scans at waves 2 and 3. Predictor variables were positive (current household size, visits to friends/family, community engagement, having a confidante) and negative (loneliness, violence in romantic relationships, or belittling in romantic relationships) social connections at baseline. Outcome variables were brain volumes (total grey & white matter, hippocampus, amygdala) and white matter health (DDF- white matter integrity, white matter hyperintensities, PSMD- a marker of microstructural white matter changes) at waves 2 and 3. We ran linear mixed models controlling for age, sex, intracranial volumes (for brain volume analyses), physical activity, depression, alcohol use, smoking, education, pollution, hearing loss, BMI andhypertension.

Results: Having a greater household size was associated with a slower rate of decline in volumes of total white matter (3160.08, 95% CI: 418.75, 5888.47), right amygdala (43.18, 95% CI: 14.70, 71.02), left hippocampus (62.96, 95% CI: 18.20, 108.04), and right hippocampus (61.02, 95% CI: 15.39, 108.36), and white matter integrity/DDF (0.0014, 95% CI: 0.00047, 0.0022). Loneliness was associated with a slower rate of decline in the left amygdala (81.48, 95% CI: 19.59, 145.91).

Conclusions: In a large UK based sample, we found that living with more people was associated with slower decline in white matter volumes and integrity, and hippocampal volumes. Living with others may promote brain reserve and memory function. Loneliness was associated with slower decline in the left amygdala volume, which is associated with processing of aversive and fearful stimuli. This echoes previous findings indicating that people with depression and anxiety may experience less shrinkage in the amygdala. Our results highlight the importance of encouraging people to live with others, such as in intergenerational households. We also need to address loneliness at a population level to promote healthy brain ageing.

Objectives: People with dementia live with unmet needs due to dementia and other conditions. The EMBED-Care Framework is a co-designed app-delivered intervention involving holistic assessment, evidence-based decision- support tools and resources to support its use. Its intention is to empower people with dementia, family and practitioners to assess, monitor and manage needs. We aimed to explore the feasibility and acceptability of the EMBED-Care Framework and develop its underpinning programme theory.

Methods: A six-month single arm mixed-Methods feasibility and process evaluation, underpinned by an initial programme theory which was iteratively developed from previous studies. The settings were two community teams and two long term care facilities (LTCFs). People with dementia and family were recruited to receive the intervention for 12 weeks. Practitioners were recruited to deliver the intervention for six months. Quantitative data included candidate process and outcome measures. Qualitative data comprised interviews, focus groups and observations with people with dementia, family and practitioners. Qualitative and quantitative data were analysed separately and triangulated at the interpretation phase.

Results: Twenty-six people with dementia, 25 family members and 40 practitioners were recruited. Practitioners in both settings recognized the potential benefit for improving care and outcomes for people with dementia, and to themselves in supporting care provision. Family in both settings perceived a role in informing assessment and decisions about care. Family was integral to the intervention in community teams but had limited involvement in LTCFs. In both settings, embedding the intervention into routine care processes was essential to support its use. In community teams, this required aligning app functionality with care processes, establishing processes to monitor alerts, and clarifying team responsibilities. In LTCFs, duplication of care processes and limited time to integrate the intervention into routine care processes, affected its acceptability.

Conclusions: A theoretically informed co-designed digital intervention has potential to improve care processes and outcomes for people with dementia and family, and is acceptable to practitioners in community teams. Further work is required to strengthen the intervention in LTCFs to support integration into care processes and support family involvement. The programme theory detailing key mechanisms and likely outcomes of the EMBED-Care Framework is presented.

Objectives: Evidence is limited on the comparative impact of specific anesthetic agents used in electroconvulsive therapy (ECT) on outcomes in treatment-resistant depression (TRD). Our study aimed to compare the efficacy of methohexital vs propofol by examining the number of treatment sessions needed to transition from acute to maintenance ECT (NTS) (i.e., change from minimum of two to one or fewer treatments per week), missed treatment sessions, and seizure durations.

Methods: We conducted a retrospective cohort study via chart review of patients with TRD receiving ECT from October 2017 to October 2019. We included adult patients (3 18 years) diagnosed with TRD who received at least six ECT sessions. We analyzed our data using multilevel structural equation modeling(MSEM).

Results: We included 149 patients (36.9% or 55/149 were ³ 65 years): 54 were methohexital-treated (mean age 59 ± 17 years; 41% male) and 95 were propofol-treated (mean age 55 ± 17 years; 36% male). No significant differences between methohexital vs propofol groups were found in NTS (mean ± SD: 12.6 ± 6.6 vs 11.5 ± 6.1; p = 0.3) and missed treatment sessions (0.63 ± 1.2 vs 0.69 ± 1.2; p = 0.75). Patients receiving methohexital manifested longer motor (25.5 ± 10.6s vs 19.9 ± 8.4s; p < .001) and electroencephalographic (EEG) seizure durations (42 ± 17.5s vs .9± 13.1s; p < .001) vs propofol. MSEM revealed that (1) methohexital was associated with longer first-session seizure durations (motor seizure: b = 6.28, p < 0.05; EEG seizure: b = 8.03, p < 0.05) and more rapid decline in motor seizure duration across sessions (b = –.38, p < .05) over propofol, while accounting for relevant covariates; (2) regardless of anesthesia used, faster reductions in seizure durations across sessions predicted fewer NTS; and (3) methohexital was associated with fewer NTS adjusted for covariates which were driven by two indirect effects: (a) sharper decline in motor duration across sessions and (b) the association between a sharper decline in motor duration across sessions with fewer missed treatments. The outcomes were not influenced by age, indicating that the findings are relevant to older adults.

Conclusions: Our findings suggest that methoxexital had fewer NTS and longer seizure durations than propofol, indicating better ECT outcomes using methohexital for TRD. Further research is warranted to verify methohexital’s effects on cognitive and additional recovery outcomes within clinical practice.

Background: Black, Asian and Minority Ethnic (BAME) people continue to present later to specialist care centres and services for memory problems. This poses significant concerns due to implications for poorer treatment outcomes and higher treatment cost among this population. While diverse interventions to support improved help seeking for dementia have been proffered for other BAME communities, there is a paucity of research involving the Black African and Caribbean community. Furthermore, whilst community health professionals like the doctors and community nurses have been involved in such interventions, no previous research has considered the role of the community pharmacist. This research explored opportunities for community pharmacists to support improved help seeking for dementia among the Black African and Caribbean population.

Methods: This research was a multi-stage project involving surveys and interviews with community pharmacists and Black Africans and Caribbeans as participants.

Results: Knowledge, attitude and beliefs around dementia and it’s causes appeared to be major barriers to help seeking among the Black African and Caribbean population. For example, beliefs that dementia is caused by ‘the spirits’ and dementia is a repercussion for past wrongdoing and therefore not amenable to medical intervention. The community pharmacists believe they are well positioned to spot initial signs of dementia among their clients and are therefore willing to offer help seeking support to this population.

Conclusions: To offer intervention for timely help-seeking for dementia, a culturally tailored dementia education for the Black African and Caribbean population should be considered. In addition, training on the impact of cultural beliefs on help seeking for dementia should be considered for the communitypharmacists.

Objectives: To evaluate the relationship between Willis-Ekbom Disease/Restless Legs Syndrome and iron deficiency anemia in older people with dementia.

Methods: A cross-sectional study was conducted with 70 older people diagnosed with dementia and restless leg syndrome in a Psychogeriatric outpatient clinic in a city in the interior of São Paulo, Brazil. The older people filled in instruments of sociodemographic characterization, measures to evaluate the Restless Legs Syndrome, neuropsychiatric symptoms, sleep quality, sleepiness and cognition. Blood data were also collected levels of creatinine, ferritin, red blood cells, hemoglobin and hematocrit, the latter collected in the patients’ medical records.

Results: The sample consists mostly of older people with mixed dementia (i.e., Alzheimer’s disease + Vascular Dementia), with 39% of female patients and mean age of 77.80 years (9.36). This study identified a frequency of 15.7% of Restless Legs Syndrome. Patients with the syndrome present more frequency of neuropsychiatric symptoms, worse sleep quality, higher index of body mass and lower levels of ferritin (p < .05).

Conclusions: A frequency of 15.7% was identified for restless leg syndrome among patients with dementia. In addition, patients with the syndrome have ferritin deficiency.

Objectives: The International Psychogeriatric Association (IPA) definition of agitation in cognitive disorders set standard guidance for recognizing agitation behaviors in research and clinical care. Patients and caregivers were involved in developing a vocabulary to describe these behaviors and, per the IPA, additional studies will offer insights into application of the criteria in diverse cultural and linguistic populations. Based on the IPA criteria, the Agitation in Alzheimer’s Screener for Caregivers (AASC™) was developed in collaboration with clinical experts, patient advocates, and caregivers of individuals with Alzheimer’s dementia to support caregivers and healthcare professionals (HCPs) in communication and recognition of agitation in Alzheimer’s dementia. This study aims to translate and linguistically validate the AASC™ in Spanish, Simplified Chinese, and Traditional Chinese in US populations.

Methods: According to best practices outlined by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) (Figure 1), linguistic validation of the AASC™ includes translation and validation through cognitive debriefing interviews for each target language. This process applies rigorous Methods to obtain translations that are conceptually relevant to the original tool, culturally relevant to each target language, and easily understood by those to whom the tool will be administered. For each target language, lay subjects (n = 5) over 40 years old and representative of the target population (e.g., reside in the US and fluent in Spanish, Traditional Chinese, or Simplified Chinese) will be recruited for cognitive debriefing.

Results: The specific Methods will be used to produce the linguistically validated versions of the AASC™ tool in Spanish, Traditional Chinese, and Simplified Chinese. Translatability review, forward and back translations, clinician and linguist review, harmonization, and cognitive debriefing will ensure the accuracy and consistency of the translated tool. If needed, the original tool language will be updated to account for cultural differences.

Conclusions: The AASC™ is the first screener developed for agitation in Alzheimer’s dementia based on the IPA criteria. Translation and linguistic validation of the AASC™ in Spanish and Traditional and Simplified Chinese aim to ensure clear and culturally relevant translations for each target language. Ongoing and future studies will optimize the effectiveness and cultural acceptance of the AASC™ tool.

Introduction: Coping strategies are intentional, cognitive, and behavioral actions aimed at controlling the negative impact of a stressful event or situation.

Objectives: The Objectives of this study was to evaluate the coping strategies used by caregivers of patients with Alzheimer’s disease and the development of strategies to reduce dysfunctional behaviors by patients.

Methods: The sample for this study included 33 caregiver-patient dyads diagnosed with Alzheimer’s disease. Data were collected at the Alzheimer’s Disease Center - ADC, at the Institute of Psychiatry of the Federal University of Rio de Janeiro. Patients were assessed for cognition, quality of life, disease awareness, functionality, and depression. Caregivers were assessed for coping, resilience, depression, anxiety, burden, and locus of control. Caregivers also provided information about mood, neuropsychiatric symptoms, severity of decline, activities of daily living, and quality of life of the patients.

Results: 82% of caregivers were female, with a mean age of 56.36 (SD = 14.31). Caregivers showed high levels of resilience, with an average score of 141.9 (SD = 12.54), moderate level of coping strategies 66.55 (SD = 12.86), moderate level of locus of control 67.4 (SD = 10.3), moderate level of burden 37.61 (SD = 18.1), low level of anxiety .64 (SD = 5.91), and low level of depressive symptoms 8.91 (SD = 8.30). Patients had a mean age of 74 years (SD = 9.4) and 54.5% of patients were male. Patients had an average score of 18.45 on cognition assessment, 60% had mild dementia, low depression index 9.48 (SD = 5.75), moderate levels of neuropsychiatric symptoms 26.45 (SD = 23.63), partially compromised disease awareness 10.8 (SD = 5.31), and high quality of life indices 33.21 (SD = 5.8). The results show a positive correlation between coping strategies and clinical variables. The use of coping strategies associated with high levels of resilience and locus of control may have contributed to the low levels of anxiety, depression, and burden among caregivers.

Conclusions: Coping strategies focused on emotion seem to be more effective for patients with mild dementia, while problem-focused coping strategies yielded better results for patients with moderate dementia.

Introduction: Resilience is a dynamic process involving the interaction between risk and protective factors that act to modify the effects of adverse life events. Understanding the resilience of caregivers of patients with AD and its predictors is essential for the development of intervention strategies aimed at solutions that can contribute to the improvement of their emotional disorders, such as anxiety, stress, anddepression.

Methods: 93 dyads of patients diagnosed with AD, where 60 (64.5%) dyads had Late-onset AD (LOAD) and 33 (35.5%) dyads had Young-onset AD (YOAD). Patients were assessed for: quality of life (QoL), disease awareness, and depression. Caregivers were assessed for: resilience, depression, anxiety, burden, and QoL. Additionally, caregivers provided information about mood, neuropsychiatric symptoms, dementia severity, and patients’ activities of daily living.

Results: Caregivers showed moderate levels of resilience, with an average score of 140 (SD = 13.20), moderate level of burden 28.94 (SD = 14.74), low level of anxiety 7.56 (SD = 7.44), and low level of depressive symptoms 8.17 (SD = 6.34). Patients had an average cognition score of 18.81, 63.4% had mild dementia, low depression index .2 (SD = 5.78), low index of neuropsychiatric symptoms 16.11 (SD = 14.47), and partially compromised disease awareness 9.06 (SD = 5.12).

Conclusions: No relationship was found between caregivers’ resilience and patients’ clinical condition, indicating that resilience seems to be associated with caregivers’ individual characteristics. Interventions such as psychoeducational groups, behavioral or religious counseling, may stimulate or develop resilience characteristics in caregivers who exhibit avoidance or denial behaviors regarding the patient’s diagnosis.