Ageing and dementia affect many aspects of life, including intimate relationships, sex and sexual expression. Older people, including those living with dementia, can have sexual relationships and form new ones. Their sexual and physical health, quality of life, and psychological well-being can be improved by respecting their intimacy and sexuality expression preferences. However, due to ageism and stigma, healthcare professionals often ignore the sexual feelings and needs of those with dementia living in long-term care. Discussions with stakeholders and literature show limited attention paid to understanding the sexual preferences of people living with dementia in health and social care. In 2020, the Intimacy and Sexuality Expression Preference (ISEP) tool was developed for use in long-term care to gather information on intimate and sexual expression preferences of older people, including those living with dementia, to assist in care provision. The ISEP tool was trialled in a Queensland, Australia, nursing home with 14 older residents. This presentation will share insight into the use of the ISEP tool and how it informs the development of ‘ISEP: A Practical User Guide’. This guide provides information on how to (a) use the ISEP tool for assessment; (b) interpret and integrate findings into care (i.e., identify a potential course of action); and (c) evaluate outcomes. Illustrative examples will be included. It will inform how preferences for the expression of sexuality can be practically addressed to improve care practices and care outcomes (i.e., satisfaction and quality of life) for people with dementia.

Older patients (≥65yo) admitted to general hospitals have increased in the past years. This resulted in an increase in hospitalization periods, health costs, and morbi-mortality rates in this group of patients.

Previous evidence points that the reduced time to referral (TTR) to Consultation-Liaison Psychiatry Units (CLP) leads to a reduced length of stay (LOS) in GH improving long-term prognosis of medical conditions.

This study aims to explore whether a prior disability in older patients leads to delay the search for psychiatric help. And to explore whether early referral to CLP is associated with reduced LOS in general hospitals.

This is an observational, cross-sectional, multicentre study. We obtained a complete data set from a sample of 152 patients (≥65 years old) admitted to 7 general hospitals in Spain referred to CLP unit for 1,5 months.

Mean age of the sample was 76.3 (±6.4). TTR was 14.5 (±18.0) days. LOS was 26.7 (±22.4) days, and length of stay after consultation was 12.3 (±10.3) days. Barthel Index before admission was 87.3 (±18.0) and Lawton&Brody Index before admission was 5.3 (2.7). We found a significant positive association of Barthel Index (r=0.17, p=0.042) and Lawton&Brody Index (r=0.20, p=0.014) before admission with TTR, which indicates that patients with a worse clinical status were attended earlier. Similarly, antecedents of both falling episodes (r=-0.2, p= 0.013) and walking difficulties (r=-0.24, p= 0.003) were associated with shorter TTR. TTR in Medical Departments was 11.7 (±15.0) days and in Surgical Departments was 24.0 (±22.8) days (t=-3.5, p= 0.001). TTR showed a highly significant positive correlation with LOS (r=0.89, p<0.0001) and a more discrete positive correlation with length of stay after consultation (r=0.20, p=0.016).

We confirm that a shorter TTR to CLP was related to a shorter LOS. Also, patients in medical wards had shorter TTR. In contrast to our hypothesis, we found that a higher disability prior to hospitalization led to earlier referral to CLP, meaning that these patients were assessed and treated earlier leading to better long- term prognosis and lower health costs.

Patients with hoarding disorder (HD) show difficulty discarding items due to the perceived need to save the items and to distress about discarding them, which causes domestic squalor (DS), especially in young people. In older people, dementia also causes DS. In this case series, we report five cases of older people with DS and compare DS due to HD with DS due to dementia.

Case 1 was an 82-year-old female who showed hoarding symptoms in her 60s. She was diagnosed with late-onset HD. Case 2 was a 73-year-old female who showed hoarding symptoms in her 10s. She was diagnosed with early-onset HD. Cases 1 and 2 showed difficulty discarding. Case 1 went to the dump site to collect items that had been discarded by her family. Case 2 strongly refused to throw away items that were considered unnecessary by her family. However, cases 1 and 2 could continue to live at home with nonpharmacological treatment, such as limiting shopping items and getting items from friends and discarding items with their family step by step. Case 3 was a 56-year-old male who showed hoarding symptoms in his 50s. Case 4 was a 72-year-old female who showed hoarding symptoms in her 60s. Cases 3 and 4 were diagnosed with behavioral variant frontotemporal dementia. Case 5 was a 67-year-old female who showed hoarding symptoms in her 60s. She was diagnosed with dementia with Lewy bodies. Case 3-5 did not feel distressed that their family discard their items in their absence. However, despite adjustments to their living environment, they could not continue to live at home and were admitted to a nursing home.

In this case series, although cases with DS due to HD showed difficulty discarding items, they could continue to live at home. However, in cases with DS due to dementia, although their house was easily cleaned, they cloud not continue to live at home due to impairment of their daily activities. Therefore, it is important not to miss HD in older people, and DS due to dementia may be a sign they have difficulty living at home.

Deaths from suicide often incur a misclassification. Suicide is in fact subject to stigma and shame; in some countries it is even criminalized. Furthermore, there are situations in which the intentionality of the suicidal behavior is really equivocal or there was a desire to disguise the death by suicide, for example for insurance reasons. In many cases, it can be difficult to ascertain if death was due to a deliberate act (such as not taking life-saving medication or overdosing on them; an accident or a voluntary fall, etc.). Suicide deaths involving older adults are particularly prone to under-reporting. The advanced age of the deceased may imply less investigative interest than a death in childhood or from medical complications. In addition, there are cases in which it is really difficult to classify the type of death. The following story may underline such a difficulty.

Angela was 81 years old. A childless widow, sufficiently independent, was a guest in a nursing home for about a year; she was there - she said - mainly to fight her loneliness. However, in the nursing home she felt even lonelier than at home.

Her house was sold shortly before entering her residence. She felt very frightened by the pandemic, which she followed for long hours on television: she had begun to say aloud that she didn't want to be intubated, and that there was no more oxygen for anyone anyway. Everybody would have died soon. She was given sedatives to calm her down, but in one occasion a nurse saw her holding the pills in her mouth and then spitting them down the toilet. Her roommate got sick and was taken away. Angela kept asking about her, receiving no answer. She was noticed having difficulties falling asleep and although she showed no signs of infection or disease, she was heard saying that her days were over. One day, she told the nurse that she had finally figured out what to do. A few days later, she was found dead during lunchtime, apparently suffocating on a piece of turkey.

How an individual is informed of the traumatic loss of a loved one can influence the grieving process and quality of life for survivors. Objective: this qualitative survey aimed to explore how age influences the experience and feelings of those who have received communication of this type of death from a professional figure.

30 people recruited through the use of social networks and word of mouth participated in the study. The participants were divided into three groups according to the age variable (1 group: 10 participants up to 35 years old; 2 group: 10 participants aged between 45 and 55 years; 3 group: 10 participants aged 60 and over) who have received notification of the death of a loved one from police officers or health care professionals. The data was collected through an ad hoc questionnaire, completed online. The thematic analysis technique used Atlas.ti software 8.

the following four key themes were identified: (a) how the communication took place; (b) reactions; (c) support; and (d) coping strategies.

it is possible that advanced age confers greater resilience and coping strategies through life experiences to mitigate the stressful impact of communicating an unexpected and violent death.

Informed consent practices in healthcare are a fundamental element of patient-centred care; however, the traditional written description of the medical procedure for obtaining informed consent seems to have several limitations. Aim: This research aimed to evaluate the effects of an alternative method of obtaining informed consent, based on a short informative video for patients waiting to undergo a coronary angiography procedure in Italy.

The study involved 40 participants, 28 males and 12 females (mean age: 68.55, SD = 13.03), equally divided into two groups, one that received video informed consent and the other the traditional written one. Each group was asked to fill out two questionnaires, one created ad hoc by the authors to measure the level of understanding of the information provided and the perception of usefulness of informed consent, and the other the DASS-21 scale, able to assess anxiety, depression and stress levels.

Comparing the results of the two groups showed that informed consent via video enabled participants to better understand the information provided, as well as feel more confident in their subjective understanding of it, while perceiving informed consent via video as more useful than the traditional one. Video informed consent did not lead to higher levels of anxiety, depression, or stress among participants.

it can be hypothesized that video formats could represent a more useful and understandable alternative to traditional informed consent in the coronary angiography procedure sector.

Caregiving can be a daunting and isolating experience, especially when supporting a loved one with Dementia The objective of this intervention was to provide a series of educational sessions available to caregivers to help educate them on strategies to enhance their well-being and interactions with a loved one living with dementia.

The Caregiver Literacy Series is a compilation o 18 webinar sessions with therapeutic workbooks designed to help caregivers understand the nature of specific dementia-related issues, and designed to help the caregiver build some personal strategy to help better manage their caregiving role. Based upon a Framework that uses the Perceived Self-Efficacy Theory, each webinar provides educational materials, and resources and is designed to help build an action plan for the caregiver. Topics include “What is Caregiving?”, “Caregiving and Compassion Fatigue and Self-Care” and topics address coping and communication strategies. The webinar sessions were administered monthly and semi-monthly to consumers through a local Alzheimer’s Association network in the rural Midwest of the United States.

Feedback from consumers who have used the materials suggest that the materials have provided some measure of information and helpful educational materials. The workbooks have also been an effective tool to help guide and empower the caregiver.

The Caregiver Literacy Series provides some effective and needed materials to help equip caregivers living with a loved one that has Dementia or Alzheimer’s disease with some measure of health literacy and empowers them to feel some sense of empowerment and comfort in the process.

The purpose of this article is to review all the interventions that researchers have used to reduce ageist attitudes in the population.

We performed a literature search using PubMed database including the following MeSH terms: (“Ageism”[Mesh] OR “ageism”[tiab] OR “Age discrimination”[tiab]) AND (intervention* [tiab] OR therapy * [tiab] OR training* [tiab] OR prevention* [tiab]). 257 studies were found and only 18 were selected based on their language (only Spanish and English ones were included) and according our inclusion criteria.

To date, most widely strategies used in previous studies included: Intergenerational contact, education or both. Other techniques such as performing arts (theater and cinema), museums exhibitions and the simulation of activities for the elderly have been also studied with successful results. Likewise, two of the articles mentioned mindfulness and cognitive behavioral therapy as a preventive ageism strategy have not been demonstrated yet.

Different interventions have been tried to reduce ageist attitudes. The greatest benefits have been seen with the combination of intergenerational contact and population education. Ageism is an important problem that concerns today's society; further studies focused on strategies to reduce ageist attitudes in the general population are needed.

The study aimed to examine the effect of social prescribing on improving cognitive performance among community-dwelling older adults, and to explore the potential association between social support and the change of cognitive performance.

One hundred and eighteen older adults from Changtang community participated in the study and were followed up for three months. Cognitive function was assessed with Hong Kong Brief Cognitive test (HKBC) at baseline and 3-month follow-up. Pre- and post-social prescribing difference in cognitive performance was examined with paired t-test. Multivariate regression analysis was used to explore the potential factors of social support associated with the change of cognitive function.

Compared with baseline measurement (25.4±4.1), the total score of HKBC improved significantly after three-month social prescribing (26.5±3.6; t=-3.300，P=0.001). Multivariate regression analysis showed that baseline level of social support utilization was associated with the change of cognitive performance. The lower the utilization of social support at baseline, the more the change of cognitive performance due to social prescribing (β= -0.25, 95%CI = - 0.88 ~ -0.05).

Social prescribing may have a beneficial effect on cognitive function for community older adults. The utilization of social support may be one of the factors associated with its effect on cognitive performance.

The COVID-19 pandemic has been a mass bereavement event disrupting social functioning of individuals in the general population, restricted and changed end-of-life, mourning and grief processes. In these circumstances grief may become pathologic and complicated grief (CG) may rise. The vulnerability of elders to CG in times of loss and bereavement in the COVID-19 context has been hardly studied. The current study aimed to examine grief processes, complicated grief and their relationship with protective and vulnerability factors among adults and elders (45 years old and above) who experienced loss at the time of the COVID-19 pandemic. Methods: A total of 113 adults aged 45 and above were included in the analytic convenience sample. Quantitative data was collected by self-reported questionnaires of CG, resilience, well-being, state anxiety and negative engagement with hostile world scenarios (HWS). Additionally, qualitative data on grief experiences was collected in semi-structured interviews of 9 participants.

Factor analysis results supported prior identified factors of CG among the aged. Multivariate analysis and stepwise regression identified factors associated with CG: female gender, state anxiety and negative engagement with HWS were identified as vulnerability factors whereas resilience emerged as a protective factor. Thematic analysis identified two main themes among participants: (1) COVID-19 as an emotional accelerator and (2) Support from social resources in COVID-19 times.

Findings add to our understanding of complicated grief among adults and elders in epidemic times. A unique and novel finding is the relationship found between negative engagement with HWS and complicated grief. This highlights the importance of examining how individuals facing adversities in general and loss in particular, perceive their ability to cope with life hardships. Furthermore, further research for establishing diagnostic criteria of CG for the aged is recommended.

There is great concern about the care of the older adults in institutions, especially in recent years. One of the reasons is the cases of elder abuse, not only highlighted by academic and scientific sources, but also by the media. Humanization, respect, empowerment and non-infantilization are key elements to promote good treatment in nursing homes (López et al., 2021).

The aim of this study was to evaluate the care in nursing homes using the Professional good care scale in nursing homes (Pérez-Rojo et al., 2021).

The sample for this study consisted of 269 employees working in different older adults nursing homes in Spain (182 nursing aides and 87 other nursing home professionals: nurses, occupational therapists, psychologists, physiotherapists, social workers, sociocultural animators, speech therapists). The employees' evaluations of themselves (their own performance) and their own evaluation of their coworkers in the nursing home (the overall good care in the nursing home) in these two groups of professionals (nursing aides and nursing home staff that care residents) were assessed and compared. T-test were used for data analyses.

The results showed no significant differences between the two groups of professionals when they considered their own performance.

However, statistically significant differences were found when they considered the overall performance in their residency in humanization (p<.001), non-infantilization (p<.001) and in the overall score of the good care scale (p<.001). Good care in nursing homes was significantly perceived as less frequent among nursing aides.

It is important for the evaluation of good care of older adults by the staff to assess both their perception of themselves and their assessment of their coworkers. Good care is the result of a complex construct in which a wide range of factors converge. Therefore, it is essential to contemplate the most accurate assessment of it. To evaluate and promote good care, it seems appropriate to assess the overall performance of all the employees of the nursing home and not only the assessment that each one makes of the treatment he/she gives to the older adults with whom he/she works.

Effective risk identification and assessment is important to help inform personalised care decisions, positive risk management, policy making and clinical practice in dementia. This mixed-method systematic review identified key components of risk assessment for people with dementia living within the community and care homes, examined attitudes towards risk identification and risk assessment, and appraised existing risk assessment tools.

Systematic searches of eight databases on two platforms (EBSCO, OVID) and grey literature databases (Open Grey, Base) were conducted. Studies were systematically screened for inclusion based on predetermined eligibility criteria and quality assessed using the Mixed Methods Appraisal Tool. Findings were tabulated and synthesised using thematic synthesis.

Twenty studies consisting of qualitative and mixed-method designs were included in the review. Five overarching themes emerged from the synthesis: Conceptualisation of risk - individual perceptions of risk, including how different individuals define, construct, and identify risk situations. Components of risk –key elements included in risk and safety assessments. Contributors to risk –factors that impact the risk level and how risk assessments are conducted. Perspectives on risk assessment –how individuals assess risk and approaches to risk management. Risk reduction –strategies to mitigate risk following an assessment.

Our review found differences in how risk is conceptualised between people with dementia, their family carers, and healthcare professionals, with views being shaped by media perceptions, personal experiences, sociocultural influences, dementia knowledge and severity. We found that mobilisation both inside and outside of the home is the most frequently identified risk factor. Our findings show people with dementia and carers are generally risk- tolerant, while healthcare professionals adopt risk-averse approaches that reflect organisational requirements and ensure safety. We found factors that disrupt daily routines, living and caring arrangements, medication management, and unclear care pathways contribute towards adverse risk events. Few studies considered people with dementia’s insight into the risk being assessed.

Accurate risk assessment and effective communication strategies are needed to enable risk- tolerant practices and ensure these approaches can be evaluated effectively. We did not find any instrument which to date had been shown to be widely acceptable and useful in practice.

Agitation is a common neuropsychiatric symptom in patients with Alzheimer’s dementia, resulting in significant burden to patients and caregivers. This study was conducted to better understand caregiver perspectives on the frequency and severity of agitation behaviors, captured by the Cohen-Mansfield Agitation Inventory, and to assess what constitutes a meaningful change in these behaviors.

This was a qualitative, non-interventional, descriptive study conducted in the United States. Semi-structured 1:1 interviews were completed with non- professional caregivers of patients with Alzheimer’s disease (AD) (i.e., family caregivers providing unpaid, informal care) who met the following inclusion criteria: ≥21 years old; caring for an individual with clinically confirmed AD; noticed agitation behaviors including emotional distress, excessive movements, verbal aggression, physical aggression; spent ≥4 days a week for ≥2 hours with the person with AD; and willing to participate in the virtual interview in English. Interview transcripts were analyzed thematically through detailed line-by-line inductive and deductive coding approaches using the ATLAS.ti software.

Thirty caregivers participated. Participants’ mean age was 64 (±13) years. Most participants were Caucasian/white (77%), non-Hispanic or Latinx (97%), and female (70%). Approximately half were providing care to their spouse (53%), and the remainder for a parent or parent-in-law. Several key themes on what constitutes ‘meaningful change’ emerged. All caregivers tied a meaningful change in agitation behaviors to a change in behavior frequency (becoming less frequent or stopping entirely). Beyond frequency, themes describing meaningful change included: change in behavior intensity; apparent intent to disturb or cause harm to self or others; potential to cause serious harm; amount of harm caused; more “normal” behavior; shorter episode duration; and less worry, frustration, or isolation. Additionally, a shift from verbally aggressive behavior to physically aggressive behavior was considered an escalation in agitation severity and meaningful worsening. Thus, unique to physical aggression, a meaningful change was described as a de-escalation to verbal aggression.

Caregivers report several themes on what constitutes meaningful improvement or worsening of agitation behaviors in individuals with AD. A change in the frequency of agitation behaviors was consistently reported by caregivers as important, with decreased frequency perceived as a meaningful improvement.

Agitation is a common neuropsychiatric symptom in Alzheimer’s dementia. The Cohen-Mansfield Agitation Inventory (CMAI) assesses the frequency of 29 agitation behaviors in elderly persons. The frequency of each behavior is rated from 1–7 (1=never, 2=less than once a week, 3=once or twice a week, 4=several times a week, 5=once or twice a day, 6=several times a day, 7=several times an hour), typically reported as a single total score. This post hoc analysis explored the efficacy of brexpiprazole on the frequency of individual agitation behaviors.

Post hoc analyses were conducted for two 12-week, randomized, double- blind, placebo-controlled, parallel-arm, fixed-dose trials of brexpiprazole in patients with agitation in Alzheimer’s dementia (NCT01862640, NCT03548584). Data are reported using descriptive statistics for brexpiprazole (2 or 3 mg/day) and placebo, for patients who completed 12 weeks of treatment.

In the first fixed-dose trial (brexpiprazole 2 mg/day, n=120; placebo, n=118), baseline behavior frequency was similar between groups (range 1.12 to 4.92). At baseline, the most frequently observed behavior was “general restlessness” (brexpiprazole, 4.92; placebo, 4.82; approximately “once or twice a day”), and the least frequently observed behaviors were “biting” (brexpiprazole, 1.12) and “making physical sexual advances” (placebo, 1.14). At Week 12, the average reduction in mean frequency was -0.73 (brexpiprazole) and -0.60 (placebo), with a greater numerical reduction for 21/29 behaviors with brexpiprazole versus placebo. In the second fixed-dose trial (brexpiprazole 2 or 3 mg/day, n=192; placebo, n=103), baseline behavior frequency was similar between groups (range 1.12 to 5.22), and higher than in the first trial due to study inclusion criteria. At baseline, the most frequently observed behavior was “general restlessness” (brexpiprazole, 5.22; placebo, 5.09; approximately “once or twice a day”), and the least frequently observed behaviors were “making physical sexual advances” (brexpiprazole, 1.13) and “intentional falling” (placebo, 1.12). At Week 12, the average reduction in mean frequency was -0.78 (brexpiprazole) and -0.54 (placebo), with a greater numerical reduction for 26/29 behaviors with brexpiprazole versus placebo.

In this post hoc analysis, brexpiprazole was associated with numerically greater reduction in the frequency of most individual agitation behaviors versus placebo.

Seamless transition to the community and a shorter Length of Stay (LOS) at hospitals are considered priorities in many health care systems. In Hong Kong, Hospital Admission Risk Reduction Program for the Elderly (HARRPE)1 - a risk prediction tool has been used by hospitals to facilitate discharge of older patients and minimize the need for hospital or emergency re-admission. Older patients score > 0.2 and present greater social-care needs than medical issues will be followed up by a community NGO, in service partnership with the hospital, through an 8-week, home-based, Intensive Discharge Support Program (IDSP)2. Apart from evaluating the success in admission risk reduction, this study was also to assess the program’s effects on patients’ health status and well-being for both discharged patients and family carers, and to understand the underlying supportive mechanism of IDSP.

A mixed-method approached was used, as establishing control groups was not feasible due to both ethical and practical concerns. Structured interviews integrating standardized instruments were employed to evaluate changes in outcome variables pre-and-post IDSP intervention for both the discharged patients and their carers. To complement the quantitative data, two focus groups involving 9 carers were organized to explore the essential and critical service elements of the discharge program, including their effects on promoting patients’ wellbeing or alleviating caregiver burden.

48 patient-carer dyads were recruited from the discharge program, with 35 pairs (73%) successfully completed both pre-and-post IDSP interviews. 68.6% of the discharged elders had no hospital readmission during the 8-week in IDSP. While there were statistically significant improvement in ADL, IADL (p<0.001), the environment domain of WHOQOL(p<0.05), and 3 other domains measured by the Health Status Questionnaire (HSQ-12), namely social functioning, role limitation due to mental health and level of fatigue (p<0.05) among the patient group, there was only one outcome variable – the environment domain of WHOQOL showed significant improvement (p≤0.01) among carers. Focus group discussions also highlighted the importance of using a family-based approach in providing discharge support.

This Discharge support program which emphasizes hospital-community collaboration seems beneficial to older patients’ timely recovery and smooth transition back to community.

We aimed to examine differences in the severity of neuropsychiatric symptoms (NPS) subsyndromes according to education level among patients with amnestic-mild cognitive impairment (a-MCI) and to identify patient demographics related to NPS subsyndromes.

Overall, 140 patients with a-MCI were included. We divided the patients into three groups according to their educational level (primary education, middle education, and high education) and compared their demographics. To explore the severity of NPS subsyndromes according to educational level, we used the Neuropsychiatric Inventory-Questionnaire (NPI-Q) after adjustments for the Mini-Mental State Examination (MMSE) score. Finally, NPS subsyndromes that were identified as being related to educational level were further explored using a general linear model (GLM).

Significant differences in several demographics were observed among the three groups. Among the NPS subsyndromes, the scores for aggressiveness were significantly higher in the primary and high education groups than in the middle education group, while the apathy/eating problem scores were significantly higher in the primary education group than in the other groups. The GLM analyses showed that aggressiveness was related to marital status and the Zarit Caregiver Burden Interview (ZBI-J) score, while apathy/eating problems was related to the instrumental activities of daily living (IADL) percentage, the ZBI-J score, and the education level in years.

Among NPS subsyndromes, aggressiveness and apathy/eating problems differed according to education level in patients with a-MCI. A GLM analysis suggested that not only education level, but also various other factors should be considered when determining the need for NPS interventions.

The coronavirus disease 2019 (COVID-19) outbreak was declared a public health emergency by the World Health Organization (WHO) on 30 January 2020. COVID-19 circuit breaker (CB) was implemented in our country from April 2020 to June 2020 to curb the outbreak. Healthcare Institutions were tasked to reduce ‘non-essential’ outpatient appointments. This research aimed to capture the responses of elderly patients and caregivers to the deferment of appointments. It also attempted to identify psychiatric symptoms which might be exacerbated during the pandemic.

This retrospective review captured patients’ mental state and caregivers’ responses and preferences for subsequent reviews; reasons for their decisions; as well as mental state findings post CB.

Records of 323 patients with a mean age of 79.24 ± 8.02 were analyzed. 50% were diagnosed with dementia (18% severe, 38% moderate, 44% mild); 23% depression; 11% anxiety and 16% psychosis. 64% documented stable mental state before CB. There was no statistical difference in the diagnoses and stability of mental state or decisions to defer. 77% agreed to defer whereas 7% preferred to retain appointments. Those who brought forward appointments (1%) reported insomnia with increased mood and anxiety symptoms. Post-CB mental state showed 57% of patients remained stable; 15% had increased mood symptoms and 11% reported worsening cognition.

Patients with stable mental state before CB were more agreeable to defer appointments regardless of psychiatric diagnoses. Amongst those with dementia, caregivers reported distress with patients’ inability to comprehend need for safe-distancing measures and closure of day care programs. Some caregivers were concerned about increased food intake, lack of physical and social activity. 11% showed increase forgetfulness and 15% suffered increase in mood and anxiety symptoms post-CB.

Despite the cohort’s advanced age, 57% remained stable during CB. The anticipation of challenges in abiding by the safe-distancing measures with supporting documents of patients with mental illness allowed us to improve our psychoeducation efforts of our community. Cognition, mood and anxiety symptoms were exacerbated as a result of the safe distancing and movement restrictions during the pandemic.

The objective of this study is to describe the diagnostic agreement between physicians and liaison psychiatry units (LPU) in 7 general hospitals of Spain for elderly patients and to analyze possible factors related to it.

This is an observational., cross-sectional, multicenter study. We obtained data from a sample of 165 patients (≥65 years) admitted to 7 general hospitals in Spain referred from different departments to each liaison psychiatry unit. Data was collected for a month and a half period. Psychiatric evaluations were performed while the patients were on wards.

We obtained a sample of 165 patients (78 women, 88 men) with a mean age of 76,03 years old (42.10% <75 years, 57,83% ≥ 75 years). Most of them were married and they lived accompanied (67,27%). Only 5,45% lived in a nursing home.

In 55.15% the main reason to referral was anxiety/depression symptoms. 42,42% had no psychiatry medical background. After LPU visit a new diagnosis was done in 56.96%. Main diagnoses were adjustments disorders (26,66%), delirium (20,6%) and no psychiatric pathology (14,54%)

Cohen’s kappa statistics were used to estimate the agreement between the diagnoses made by LPU and the diagnoses considered by the referring doctors. We obtained a moderate global agreement (kappa= 0,4971) between observers (0,424 for <75 years, 0,557 for ≥65 years) Moderate agreement was found for alcohol or substance abuse (kappa= 0,41) and low agreement was found for affective disorders (kappa= 0,3278) and delirium/ psychological and behavioral symptoms in dementia (Kappa= 0,2341).

We analyzed factors which might affect de agreement between physicians and LPU such is group of age, functional impairment, comorbidity by Charlson index and previous diagnosis of dementia.

Further longitudinal studies might help in the future to analyze the factors related to agreement between doctors and might help to establish educational programs