The purpose of the current study was to understand the prevalence and patterns of cannabinoid use among LTC residents across Canada. We gathered data on cannabinoid prescriptions among LTC residents for one year before and after recreational cannabis legalization. Multi-level modelling was used to examine the effects of demographic and diagnostic characteristics on rates of cannabinoid prescription over time. All prescriptions were for nabilone. There was a significant increase in the proportion of residents prescribed nabilone following the legalization of recreational cannabis in Canada. Residents with relatively more severe pain (based on the Minimum Data Set pain scale), a diagnosis of depression, or a diagnosis of an anxiety disorder were more likely to have received a nabilone prescription. Our results provide valuable information regarding the increasing use of synthetic cannabinoids in LTC. The implications for clinical practice and policy decision-makers are discussed.

People living with dementia are often presumed to have no agency or capacity to act in the social world. They are often excluded from participating in research while research methodologies may not capture their embodied engagement with people and places. Yet, like everyone, people with dementia can express their agency in nuanced ways, for example, through emotions or embodied expression. In the conceptual framework discussed here, nuanced agency is conceived as consisting of non-deliberative elements (embodied, emotional, habituated, reflexive and intersubjective) and deliberative elements (choices or decisions and facilitative). Although people with dementia have been found to benefit from gardens with their sensory appeal, how they experience gardens is not well understood. This critical interpretive synthesis aims to explore how people with dementia experience nuanced forms of agency and citizenship in gardens. A conceptual framework of agency was developed to address the aim and support the analysis. Analysis of the 15 included studies highlighted the value of the conceptual framework in identifying a wider and more granular array of nuanced agency expressed in embodied form and through dialogue. This included expressions of intersubjective and facilitative agency that informed opportunities for people with dementia to experience relational citizenship socially in communal garden settings. These findings suggest an opportunity for researchers to explore the embodied agency of people living with dementia more comprehensively by applying theoretical concepts of agency. Further testing of the framework’s utility for guiding collection and analysis of primary data involving people with dementia in garden settings is recommended.

Persons living with dementia are at risk of becoming lost. While return discussions after missing incidents are common with children, these discussions are seldom done with persons living with dementia. Our objective was to describe the use of return discussions with persons living with dementia according to the literature and practice. We conducted a scoping review using 19 databases to locate scholarly and grey literature on return discussions, followed by 20 semi-structured interviews with first responders and service providers in Canada and the United Kingdom (UK). Eleven scholarly and 94 grey sources were included, most from the UK, related to missing children, none included persons with dementia. According to participants, although there was no standardized procedure, there were themes about conditions that facilitate return discussions. This was the first study to examine return discussion practice in dementia, and results can inform development of evidence-based protocols.

There is a need for new imaginaries of care and social health for people living with dementia at home. Day programmes are one solution for care in the community that requires further theorisation to ensure an empirical base that is useful for guiding policy. In this article we contribute to the theorising of day programmes by using an ethnographic case study of one woman living with dementia at home using a day programme. Data were collected through observations, interviews and artefact analysis. Peg, whose case story is central in this article, was observed over a period of nine months for a total of 61 hours at the day programme, as well as 16 hours of observation at her home and during two community outings. We use a material semiotic approach to thinking about the day programme as a health ‘technology in practice’ to challenge the taken-for-granted ideas of day programmes as neutral, stable, bounded spaces. The case story of Peg is illustrative of how a day programme and its scripts come into relation with an arrangement of family care and life at home with dementia. At times the configuration of this arrangement works to provide a sort of stabilising distribution of care and space to allow Peg and her family to go on in the day-to-day life with dementia. At other times the arrangement creates limits to the care made possible. We argue that how we conceptualise and study day programmes and their relations to home and the broader care infrastructure matters to the possibilities of care they can enact.

Objectives: Leveraging the non-monolithic structure of Latin America, which represents a large variability in social determinants of health (SDoH) and high levels of genetic admixture, we aim to evaluate the relative contributions of SDoH and genetic ancestry in predicting dementia risk in Latin American populations

Methods: Community-dwelling participants aged 65 and older (N = 3808) from Cuba, Dominican Republic, Mexico, and Peru completed the 10/66 protocol assessments. Dementia was diagnosed using the cross-culturally validated 10/66 algorithm. The primary outcome measured was the risk of developing dementia. Multivariate linear regression models adjusted for SDoH were used in the main analysis.

Results: We observed extensive three-way (African/European/Native American) genetic ancestry variation between countries. Individuals with higher proportions of Native American (>70%) and African American (>70%) ancestry were more likely to exhibit factors contributing to worse SDoH, such as lower educational levels (p <0.001), lower SES (p < 0.001), and higher frequency of vascular risk factors (p < 0.001). In unadjusted analysis, American individuals with predominant African ancestry exhibited a higher dementia frequency (p = 0.03) and both Native and African ancestry predominant groups showed lower cognitive performance relative to those with higher European ancestry (p < 0.001). However, after adjusting for measures of SDoH, there was no association between ancestry proportion and dementia probability, and ancestry proportions no longer significantly accounted for the variance in cognitive performance (African predominant p = 0.31 [–0.19, 0.59] and Native predominant p = 0.74 [–0.24, 0.33]).

Conclusions: The findings suggest that social and environmental factors play a more crucial role than genetic ancestry in predicting dementia risk in Latin American populations. This underscores the need for public health strategies and policies that address these social determinants to reduce dementia risk in these communities effectively.

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.

Objective: Higher intimacy is associated with less behavioral and psychological symptoms of dementia (BPSD) in people with dementia, however, the processes underlying this association remain unclear. This study investigates the role of expressed emotion (EE) and relationship closeness between caregivers and patients with dementia in the manifestation of BPSD.

Methods: We recruited 56 families with dementia and collected 3-month longitudinal data including demographic details of current family caregivers providing care, caregiving relationship closeness (RCS), and BPSD measured using the Neuropsychiatric Questionnaire (NPI-Q). We assessed EE using the validated Family Attitudes Scale (FAS), where higher scores indicate greater intensity of expressed emotion. Correlational and mediation analyses were conducted using baseline and three-month follow-up data to explore the relationships between RCS, EE, and BPSD. Mediation analysis was performed using the SPSS PROCESS Version 4.1 macro. The study received approval from the Institutional Review Board of Osaka University.

Results: Correlation analysis showed that there was significance between RCS and BPSD at baseline and third month (r = –0.301, p < 0.05), and between EE and BPSD (r = 0.378, p < 0.001). Furthermore, mediation analysis demonstrated that caregivers’ EE significantly mediated the association between RCS and BPSD in dementia patients. The indirect effect of RCS on BPSD through caregivers’ EE was found to be significant, with a 95% confidence interval (CI) of (–0.6097, –0.1790), where the CI excludes zero. This indicates that the mediation effect of caregivers’ EE on the relationship between RCS and BPSD is statisticallysignificant.

Conclusions: It suggests that interventions aimed at improving caregiver-patient relationships and managing caregivers’ EE could be crucial in mitigating BPSD, providing a direction for future research and intervention development to support both patients and their families in the dementia care.