Summary: The aging of the population poses significant challenges in healthcare, necessitating innovative approaches. Advancements in brain imaging and artificial intelligence now allow for characterizing an individual’s state through their brain age,’’ derived from observable brain features. Exploring an individual’s biological age’’ rather than chronological age is becoming crucial to identify relevant clinical indicators and refine risk models for age-related diseases. However, traditional brain age measurement has limitations, focusing solely on brain structure assessment while neglecting functional efficiency.

Our study focuses on developing neurocognitive ages’’ specific to cognitive systems to enhance the precision of decline estimation. Leveraging international (NKI2, ADNI) and Canadian (CIMA- Q, COMPASS-ND) databases with neuroimaging and neuropsychological data from older adults [control subjects with no cognitive impairment (CON): n = 1811; people living with mild cognitive impairment (MCI): n = 1341; with Alzheimer’s disease (AD): n= 513], we predicted individual brain ages within groups. These estimations were enriched with neuropsychological data to generate specific neurocognitive ages. We used longitudinal statistical models to map evolutionary trajectories. Comparing the accuracy of neurocognitive ages to traditional brain ages involved statistical learning techniques and precision measures.

The results demonstrated that neurocognitive age enhances the prediction of individual brain and cognition change trajectories related to aging and dementia. This promising approach could strengthen diagnostic reliability, facilitate early detection of at-risk profiles, and contribute to the emergence of precision gerontology/geriatrics.

Introduction: Agitation in Alzheimer’s dementia (AAD) confers significant humanistic and economic burden; however, factors, and relationships between them, which drive the extent of this burden are poorly understood. The Objectives of this study was to review and gather evidence on the burden of AAD in order to develop a conceptual framework capturing its effects on patients, their families, clinicians (i.e., care teams), and society, which can then be used to guide further research into how the burden of AAD might be reduced.

Methods: Evidence on the burden of AAD was identified via a targeted literature review. Data were classified into societal, patient/family/care team, and mitigating factors. A conceptual framework (i.e., a visual representation of variables and associations between them) was developed to map the relationships between factors and illustrate the precedents and downstream effects of agitated behaviors on patient and caregiver outcomes, including healthcare resource utilization (HCRU), costs, and admission to long term care(LTC).

Results: Agitated behaviors were found to directly impact caregiving demands in terms of the number of hours required to care for patients. Similarly, levels of caregiver stress (i.e., total caregiver burden, personal strain, role strain, and guilt) were found to be associated with the frequency and intensity of AAD. Burden also extended to care teams via increased HCRU (i.e., pharmacy, outpatient, inpatient, and emergency room visits), and consequently costs, relative to non-agitated patients. Indirectly, through caregiving demands, agitation also affected the rate of placement in formal care and LTC, both of which are associated with incremental costs. Evidence also indicated that mitigating factors such as pharmacological treatment could impact the frequency and intensity of agitated behaviors, potentially affecting downstream HCRU and costs. Limited evidence exists on the optimal means of employing such strategies to limit caregiver demands and stress.

Conclusions: This study demonstrated the complex interplay of factors which drive the burden of AAD and the need which exists for novel ways to improve outcomes for those impacted by the disease. Better insight into the mechanism by which agitated behaviors influence caregiver demands and stress could help improve mitigation strategies both within family units and the larger health system.

Objectives: This study aims to estimate the direct and indirect costs related to dementia in Brazil.

Methods: This study is part of the ReNaDe (National Report on Dementia) project, a domiciliary survey conducted with 140 dyads of people with dementia and their caregivers in 17 municipalities in Brazil. We used the cost of illness study Methods to estimate costs. We collected data from the ReNaDe interviews and national records and presented estimates from societal and SUS perspectives. Our total costs encompassed direct medical costs (hospitalizations, outpatient visits, and others) and indirect costs (for instance, the monetary value of informal caregiving hours) (Table 1). We did not consider direct social costs, given limited or inexistent information about cost and services utilization by people with dementia in Brazil. We used the replacement approach to estimate indirect costs.

Results: The monthly cost of dementia per individual increases with the syndrome’s progression (Table 2). Indirect costs, primarily associated with informal care provided by family or friends, constitute at least 73% of total expenses, irrespective of dementia stage and adopted perspective. For Brazil in 2019, dementia’s total annual cost stood at US$18 billion, with indirect costs comprising 78%.

Conclusions: The average expenses per individual escalate with the advancement of dementia in Brazil. The pronounced prevalence of indirect costs accentuates the pivotal role that family caregivers assume in dementia care. Moreover, estimating the direct and indirect costs related to dementia, considering the reality of Brazil in its geographical diversity, is essential to understanding the reality of health resource allocation and, therefore, (re)direct resources to meet better the needs of people with dementia and their families.

Objectives: To examine pain behaviors and sleep impairment by sex, race/ethnicity, education, and cognition in people living with cognitive impairment (PLwCI).

Methods: Participants (N = 210) in the Healthy Patterns Study, aimed at improving sleep-wake disorders in PLwCI, were included for analysis and were comprised of Black: 135 (64%), Hispanic/Latino: 41(19.5%), white: 34(16%), and primarily female: 140 (67%) individuals. The primary independent variable was PROMIS Pain Behavior 7a. Outcome variables were PROMIS Sleep-Related Impairment 8a, Pittsburgh Sleep Quality Index (PSQI), and actigraphy. Higher scores indicate worse symptoms. Descriptive analysis used t-tests, Mann-Whitney U-tests, and Chi-square tests based on data distribution and variable type. Multiple regression models explored pain behaviors and sleep quality, adjusting for age, gender, education, race, and Clinical Dementia Rating (CDR). Data analysis was conducted using R (v3.5.1).

Results: Descriptive analysis showed those with a high school education had higher pain behaviors than those with some college (p = 0.00703) and individuals with CDR of ≥1 had higher pain behaviors than those with CDR of 0.5 (p < 0.001). For PROMIS Sleep, males had higher scores than females (p = 0.00307), those with CDR of ≥ 1 had higher scores than those with CDR of 0.5 (p < 0.001), and there were race/ethnicity differences (p < 0.001) with Hispanics having higher scores. Individuals with less education had higher PSQI scores (p = 0.0277). For Objectives sleep (actigraphy), total sleep time differed by race/ethnicity (p = 0.0173), with Blacks having slightly shorter sleep. Those with CDR of 0.5 had shorter total sleep time than those with CDR of ≥1 (p = 0.0114). Regression analysis showed PROMIS pain score was associated with PROMIS Sleep score (β = 0.30; SE = 0.06, p < 0.001), indicating that every unit increase in PROMIS pain score increased PROMIS Sleep score by 0.30. PROMIS pain score was also associated with PSQI (β = 1.04; SE = 0.28, p < 0.001), indicating that every unit increase in PROMIS pain score raises PSQI score by 1.04.

Conclusions: This study identified pain behaviors and sleep quality differences by sex, race/ethnicity, education, and cognition, with worse sleep associated with more pain behaviors. This interplay of demographics, pain behaviors, and sleep emphasizes the need for tailored interventions in PLwCI.

Objectives: To highlight the importance of differential diagnosis in the psychogeriatric context, with an emphasis on Lewy Body Dementia (LBD).

Case Report: A 68-year-old woman with 6 years of education presented with symptoms of hypobulia, social withdrawal, sadness, and anhedonia 10 years ago. Concurrently, she experienced delusions and visual hallucinations, believing that armed neighbors were entering her house to kill her. She began psychiatric treatment at the Geriatric Psychiatry department at UNIFESP, where she was diagnosed with depressive disorder with psychotic symptoms and panic disorder. She was started on sertraline, and due to QT interval prolongation with risperidone and quetiapine, clozapine 100mg was introduced, without extrapyramidal signs and symptoms She experienced remission of visual hallucinations but developed apathy but started to exhibit periods of mental confusion. During follow-up, cognitive impairment was noted, and a diagnosis of dementia was made. She began forgetting to turn off the stove, leaving doors open, and getting lost in unfamiliar places. MRI of the brain (2017) showed diffuse bilateral atrophy, and SPECT (2018) showed diffuse (non-localized) hypoperfusion, as per medical records. The attending team referred her for joint evaluation, suspecting frontotemporal dementia and behavioral variant Alzheimer’s disease due to observed apathy and behavioral changes. She was referred for follow-up at the Behavioral Neurology Clinic at UNIFESP. The patient was evaluated by behavioral, sleep, and extrapyramidal neurology clinics. All concurred on the most probable diagnosis of Lewy body dementia (LBD), characterized initially by well- defined visual hallucinations of deceased relatives interacting with her, significant movement during sleep with vocalization and dream enactment, rigidity, gait instability that worsened with antipsychotic treatment, episodes of inattention, and marked apathy. Cognitive fluctuation was noted by her husband and confirmed by the application of the MMSE in different consultations. Galantamine 24mg was prescribed, leading to initial improvement in cognitive complaints at the start of treatment.

Discussion: Lewy Body Dementia is the second most common neurodegenerative disease causing dementia. It is believed to be vastly underdiagnosed, with a significant disparity between the number of clinically diagnosed cases and those diagnosed via neuropathology at postmortem autopsy. According to a study conducted by Auning E et al., which differentiated the presenting complaints of DLB and AD, the most common complaint reported by DLB patients was memory dysfunction, with a prevalence of 57%, followed by visual hallucinations (44%), depression (34%), problem-solving difficulties (33%), gait disturbances (28%), and tremor and stiffness (25%), all features presented by the patient in this case report.

Conclusions: Specificity and diagnostic accuracy in the clinical setting remain challenges in the diagnosis of DLB. In the clinical setting, DLB is often misdiagnosed.

Objectives: General To delineate the epidemiological and clinical profile of elderly individuals diagnosed with dementia who use antidementia drugs and are followed up in the Unified Health System (SUS), comparing them with a group that does not undergo pharmacological treatment, as well as the sociodemographic characteristics of their respective caregivers.

Specific

1. 1. Compare sociodemographic (age, sex, education, marital status, region), clinical (comorbidities, stage of dementia, most common symptoms, dementia medication used, use of other psychotropics) characteristics and caregiver profile (education, age, mental illness, formality of care, caregiver burden) between the group of people receiving pharmacological treatment for dementia and the group, also diagnosed with dementia, but not using medication for it.

2. 2. Test whether the geographic region is a modifying effect of the associations found in specific Objectives item 1.

3. 3. Identify, among individuals using psychotropic drugs for dementia, the type of medication used and at what stage of the disease it was introduced and is being used, and how access to the medication was achieved— purchased or dispensed by the SUS pharmacy.

Methods: This is a retrospective, cross-sectional, observational, case-control, and non- randomized study conducted in the five geopolitical regions of Brazil, including a total of 17 cities of different sizes (small, medium, and large). All 140 people interviewed and diagnosed with dementia, as well as their 140 respective caregivers, were included. The following manuals and scales were used for evaluation: the Clinical Dementia Rating (CDR) - a questionnaire for clinical assessment of dementia, the Neuropsychiatry Inventory-Questionnaire (NPI-Q) - used for assessing neuropsychiatric symptoms, the Johns Hopkins Dementia Care Needs Assessment (JHDCNA 2.0) - an instrument that assesses the care needs of people with dementia and their caregivers, the Montreal Cognitive Assessment (MoCA) - a cognitive screening instrument, and DEMQOL. Data will be grouped for analysis of grouped and cumulative frequency and correlations between variables established using Microsoft Excel software. Statistical data will be processed with the STARTA software.

Results: The present study is under statistical analysis, with completion expected in June. The following hypotheses are intended to be investigated:

1. 1. Patients using pharmacological treatment for dementia with more clinical comorbidities use more anticholinesterase drugs.

2. 2. There is an association between the prescription of pharmacological treatment for dementia and the region of the country.

3. 3. Patients taking anticholinesterase drugs exhibit fewer neuropsychiatric symptoms compared to the population not using such medication and classified at the same stage of dementia.

4. 4. Caregivers of people with dementia using pharmacological treatment for it are less burdened than caregivers of the other group not using pharmacological treatment for it.

Conclusions: The exponential increase in dementia cases, in light of the global aging population, underscores the importance of investigating the factors associated with the pharmacological treatment of elderly people with dementia—to mitigate the obstacles that hinder adequate treatment.

Background: Day care programs for older adults with dementia is an effective strategy that allows prolonging the functionality of the elderly, their support and that of their family reducing home care costs and delaying the institutionalization of patients with cognitive impairment.

Objectives: The aim of the present work is to describe the main goals and the implementation of a multidisciplinary day care program for patients with dementia and their family caregivers in Argentina.

Methods: Design: Prospective cohort study. Subjects: 22 patients and their family caregivers, who attend a day care program in Argentina. Instruments: socio-demographic and psychosocial questionnaire of both patient and caregiver (built ad hoc) Patient: MMSE, GDS, HAD-A, PANAS- VRARG, EQ-5D and instrumental and basic abilities of daily living. Family caregiver: Zarit Burden Interview. Procedure: The intervention for patients consists of two different lines of work, one for the patient, and another for the family member. The activities are coordinated by a multidisciplinary group of professionals. Regarding the caregiver, individual orientation interviews and therapeutic group spaces and psycho-educational material are offered.

Results: Preliminary data of 22 patients and caregivers, who have taken part in the program so far, indicate that: Patient: median age was years 75,27 old (ds = 9,28), % 63,6 of which are woman. The values obtain in the instrument are: MMSE 22,45 (ds = 4,78) GDS 4,47 (ds = 3,73), HAD-A 3,66 (ds = 3,39), (PANAS -E-VRARG) Negative items 7,70 (ds = 3,11) (PANAS -E-VRARG) Positive ítems 18,7 (ds = 3,13), EQ-5D 77,35 (ds = 16,21) and BHDL 93,63 (ds = 13,10), IHDL 9,1 (ds = 3,31). And for family caregivers the mean age was 65,27 old (ds = 11,37), % 66,71 of which are woman. Caregivers Zarit Burden Interview mean score was 40, 18 (ds = 11,35).

Discussion: Our findings concur with those presented in scientific literature and support the WHO recommendations regarding the need to implement multidisciplinary programs for patients with dementia and family caregivers, in order to moderate the impact that providing care for an elderly relative with a neurological disease has on them.

Objectives: To achieve a dementia-friendly society, it is important to understand the attitudes of community- dwelling people toward dementia and those with dementia. Previous studies have reported an association between reduced interpersonal and social interactions and ageism. This may lead to increased prejudice and intolerance toward dementia and people with dementia. This study examined whether a deficiency in social functioning is associated with attitudes toward dementia among community-dwelling older persons.

Methods: We conducted a self-administered questionnaire survey shared by mail with 4,986 community-dwelling older persons (mean age 75.0 ± 6.78; 2,703 women) who were not certified as requiring nursing care in the Tokyo metropolitan urban area. Attitudes toward persons with dementia were assessed using the “Attitudes Toward Dementia Scale” (ATDS; Kim & Kuroda, 2011). ATDS comprises 14 items with scores ranging from 14 to 56; a higher score indicated more positive attitudes. Social functioning was measured by 1) living alone, 2) emotional support, 3) instrumental support, 4) going out less often, 5) visiting friends’ homes, 6) feeling useless, 7) low education, 8) participation in community activities, and 9) economic status. Binomial logistic regression analysis was conducted using these nine social functions as explanatory variables, with sex, age, a subjective sense of health, cognitive decline, mental health, caregiving experience, and the five items of knowledge and awareness of dementia as adjustment variables.

Results: The social functions that were significantly associated (p < .05) with ATDS were a lack of instrumental support (OR = 1.27, 95%CI = 1.01–1.59), not visiting friends’ homes (OR = 1.25, 95%CI = 1.03–1.53), feeling useless (OR = 1.48, 95%CI = 1.12–1.96), and not participating in community activities (OR = 1.27, 95%CI = 1.05–1.54), and all of these were associated with negative attitudes toward people with dementia. Male sex, extremely old age, poor mental health, lack of caregiving experience, and poor knowledge about dementia were also associated with negative attitudes.

Conclusions: Lack of support and connections with friends and neighbors were associated with negative attitudes toward persons with dementia. To achieve a dementia-friendly society, it is crucial to have contact with people with dementia, knowledge about the symptoms of dementia, as well as connections with others in the community.

Objectives: To evaluate the effectiveness of the sleep monitor device, feedback from sleep report, and regular advice for community-dwelling older people.

Methods: Randomized controlled trial and evaluator blinded. Subjects are over 65-year-old who live in the community or living alone or in older households or requiring support under long-term care insurance in Japan. They are divided into three groups: A) For 6 months, send monthly report and conduct telephone intervention; B) For the first 3 months is same intervention as A, then for the next 3 months. only send monthly report; C) For 6 months, send monthly report. A sleep monitoring device: Active Sleep Analyzer is a non-wearable actigraphy device and was used to evaluate Objectives sleep, such as total sleep time, sleep latency, sleep efficiency, wake after sleep onset, number of awakenings. The primary outcome was the subjective sleep quality from Athens Insomnia Scale (AIS). We mainly conducted three analyses. 1) Basic characteristics at baseline 2) Paired t-tests within groups to examine differences in AIS after the intervention from baseline. 3) Repeated measurements to examine differences in AIS between the three groups depending on time. All significance levels were set at p < 0.05. The study was conducted with the approval of the Osaka University Hospital Ethics ReviewCommittee.

Results: We contacted 349 people to participate and randomized 223 people who attended the first seminar and met the eligibility criteria. We analyzed 212 participants (A72, B70, C70), excluding those with dropouts or significant missing data, with the demographic profile of participants being 36% male, mean age 75 years, mean AIS 6.6. Most participants were interested in sleep and wanted to improve their sleep at baseline. As a result of repeated measurements, a significant decrease in AIS was observed in group A and B. For 3month, A decreased 1.8 ± 0.42, p = 0.0013, B decreased 2.4 ± 0.41, p < 0.0001 and for 6month, A decreased 1.5 ± 0.39, p = 0.0072, B decreased 1.4 ± 0.40, p = 0.0188.

Conclusions: Reports using sleep data and feedback from experts over the phone can improve the sleep of older people. This intervention could allow older people to reconsider not only their sleep but also their lifestyle, potentially improving their health.

Introduction and Objectives: Vision plays an important role in theories of cognitive development and language acquisition. Studies on acquired blindness have shown a negative impact on the outcome of semantic and phonological fluency tasks in those who suffer from it. The Objectives of our work was to evaluate the potential effect of visual deficit on the lexical richness (quantity of different words or lexical units) of the work of the Argentine writer Jorge Luis Borges (JLB).

Material and Methods: Verses and prose texts by JLB (complete works of stories and poetry) were analyzed. The total number of words used was counted, and within them, the number of unique words (numbered words without counting their repetitions) was quantified using the Unique Word calculator tool from Planet Calc®. The results obtained after the period in which his blindness prevented him from reading texts were compared with the data obtained from his previous literary production. Statistical results were obtained using SPSS software. Means, standard deviations, and the result of a t-test were calculated.

Results: Data from 3 books of stories and 3 poetry books written between the years 1923 and 1949 (a period in which he still retained his reading ability) were collected, as well as data from 3 books of stories and 10 poetry books from his post-blindness period (starting from 1955). A total of 93446 and 59749 total words were obtained from the pre and post-blindness periods, respectively, with a total of 39887 and 24610 unique words from the mentioned periods. A percentage of unique words over total words was calculated for both periods, and a T-test for related measures was conducted. Although a lower percentage was observed in both the narratives between the pre-blindness stage (M = 45.09%; SD = 6.8%) and post-blindness stage (M = 40.92%; SD = 4.7%), as well as in the poems pre-blindness stage (40.92% SD 4%) and post-blindness stage (32.57% SD 4.5%), this difference was not statisticallysignificant(narrativesp = 0.155;poems p = 0.106).

Conclusions: The analysis of the comparison between pre-and post-blindness stages of lexical richness in JLB’s writing does not align with the fluency deficit reported in the literature. The continuity of his active intellectual life may have influenced his lexical performance through compensatory mechanisms.

Introduction and Objectives: Although new complementary tests have emerged for the diagnosis of cognitive impairment and dementia, due to their high costs and limited availability, it is crucial to find low-cost, simple, and quick tools during the clinical examination that allow the physician to correctly diagnose these diseases. The study aims to evaluate the predictive value of mentioning the year 1900 during temporal orientation in patients presenting with cognitive disorders. No similar studies to the one proposed have beenreported.

Materials and Methods: A prospective cross-sectional observational study was conducted on patients who underwent cognitive evaluation between April and October 2019 and were being followed up in a cognitive neurology service. Within the administration of the Mini-Mental State Examination (MMSE) by Folstein, the reported year during temporal orientation was recorded, considering it positive if the response was between 1900 and 1999. The presence of dementia was determined according to the NIA-AA clinical criteria. Epi Info 7.2.1 was used for statistical analysis.

Results: A total of 192 patients with a mean age of 68.5 ± 13.97 years were included (65.10% women and 34.90% men). 20.31% had dementia (51.28% non-Alzheimer’s dementia and 48.72% Alzheimer’s-type dementia), while 79.69% had other diagnoses (73.6% non-amnestic mild cognitive impairment, 8% subjective complaint, 4% psychiatric disease, 14.4% amnestic mild cognitive impairment). Mentioning the 1900s had a specificity of 95% and a sensitivity of 58% for diagnosing Alzheimer’s-type dementia versus other dementia types (positive and negative predictive values of 92% and 70% respectively). A positive response in the 1900s was associated with a lower MMSE score (Mean 20.5 SD 5.38 vs. Mean 27.1 SD 3.19 in patients with a negative response (p < 0.0001). Additionally, patients without a 1900s response had a higher number of years of education 14.03 SD 4.2 vs. 10 SD 5.3 (p 0.0001).

Conclusions: While this is a preliminary result and a larger sample would be needed, thinking you are in the 1900s seems to be a good dementia indicator, although it remains to be determined if it could be specific to a particular type.

Introduction and Objectives: The affected functional domains in patients with degenerative dementias serve as clues to trace with varying levels of certainty the underlying neuropathology (1) and the negative impact on their autonomy reveals part of the clinical diagnosis of the disease. Healthcare professionals often rely on tools that measure this functionality, allowing them to distinguish between mild cognitive impairment and actual dementia (FAQ (2), CDR(3)).

According to the science fiction author Philip K. Dick, Kipple is a useless object like advertising cards, matchboxes after the last match has been used, yesterday’s newspaper wrapper, etc. Considering that the deterioration in the autonomy of dementia patients negatively impacts their connection with the environment, it is expected that the kipple around them will be few. The aim of this work is to create a low-cost, simple, and quick tool that allows the physician to measure the negative impact of the patient’s cognitive failures on their functionality.

Introduction: Mild behavioral impairment (MBI), and particularly its impulse dyscontrol domain, has been linked to brain alterations suggestive of Alzheimer’s disease (AD) in subjects without dementia. We aimed to analyze the association of impulse dyscontrol with the loss of integrity in white-matter brain tracts in a group of cognitively normal older adults.

Materials and Methods: Using linear regression models, we analyzed the effect of impulse dyscontrol scores (using the MBI-Checklist, MBI-C) on diffusivity metrics (fractional anisotropy, FA; mean diffusivity) controlling for age and sex in five white-matter regions of interest: cingulum, fornix, hippocampus, superior fronto-occipital fasciculus, and uncinate fasciculus. A total of 48 cognitively normal older adults were included in the study.

Results: The mean age of the subjects was 67.5 years, and 28 (58.3%) were female. The mean impulse dyscontrol score was 2.9 (SD: 4.8, Rng: 0 –22). The effect of the impulse dyscontrol score, controlling for age and sex, in the diffusivity measures of regions of interest was only significant in the fornix FA after multiple-comparison correction (weighted least squares model β = –3.65 x 10 –3, SE = 1.27 x 10 –3, corrected p = 0.03, R2 = 0.31).

Discussion: To our knowledge, this is the first time that an MBI domain is linked to MRI diffusivity measures in a group composed exclusively of cognitively normal older adults. Our findings add to the growing understanding of MBI, and particularly the impulse dyscontrol domain, as a potential behavioral marker indicating a higher risk for developing neurocognitive disorders.

Materials and Methods: A prospective cross-sectional observational study was conducted on patients who underwent a cognitive evaluation between May and October 2022 at the memory unit of the Favaloro Foundation (Buenos Aires, Argentina) who had undergone a neuropsychological evaluation during the current year and were under the care of our cognitive neurology service. During the medical interview, patients were asked to show the objects they carry in their pockets (wallet, candy wrapper, cellphone, thread, loose coins, tickets, receipts, etc.). Each item was counted independently. The total number obtained was compared. The total number obtained was compared with the FAQ and CDR values of each patient. A correlation between these data was sought, and it was determined whether this relationship (number of items carried in the pocket/scale value) has predictive value to determine if the patient meets dementia criteria according to functionality (FAQ: 6 or more, CDR: 1 or more).

Results: The sample consisted of 26 male patients (n = 26) with an average age of 69 years and MMSE Mean: 27.73. Within this group, 80.7% had a diagnosis of dementia (of any etiology) and the rest were either healthy patients or patients with mild cognitive impairment. The non- parametric MANN WHITNEY test was performed using the R statistical program. A statistically significant difference was found when comparing the dementia group and objects in the pocket (wilcox_test p 0.00854). When comparing the group of patients with more than three objects and the presence of dementia, significant p values were also found (wilcox_test p 0.0363).

Conclusions: The number of objects in the pocket of patients with cognitive impairment could be a valuable tool for predicting dementia.

The presence of 3 or more objects in the pocket of a patient with cognitive impairment could correlate with a low score on the functionality scales (FAQ less than 6, absence of dementia stage).

Objectives: Various studies described the psychological impact of the mandatory preventive social isolation (lockdown) caused by COVID-19 across different age groups. However, no research had specifically analyzed the effects of lockdown on the cognitive performance of older adults with preexisting cognitive decline. This study aimed to determine the impact of lockdown on the cognitive functions of individuals with cognitive decline.

Methods: Argentina was one of the countries with the longest lockdown periods. Older adults in Argentina experienced extended lockdowns lasting several months, significantly limiting their social interactions and routine activities. Cognitive reevaluations were conducted on 16 patients who had attended a memory clinic with cognitive complaints and were evaluated before the lockdown (group 1). Their progression was compared with 16 patients evaluated and reevaluated over a similar period but without undergoing a lockdown (group 2). To compared the progression of both groups a “change index” (CI) were calculated for each test ((score assessment 1 – score assessment 2)/number of months between assessment 1 and assessment 2))

Results: Patient from group 1 and 2 were paired by age (M group 1 = 77.2, DS group 1 = 6.2, M group2 = 77.3 DS group2 = 6.6, p=.98), yearsof education (M group 1 = 13.6, DS group 1 = 2.8, M group2 = 13.9 DS group2 = 3.0, p=.81), Beck depression inventory score (M group 1 = 12.2, DS group 1 = 7.2, M group2 = 13.9 DS group2 = 7.4, p = .54) and Addenbrooke’s Cognitive Examination (ACE. M group 1 = 76.2, DS group 1 = 14.4, M group2 = 76.0 DS group2 = 20.7, p = .97) score at the first assessment. Group 1 showed a significant and greater increased of false positive than group 2 in Rey Auditory Verbal Learning Test recognition (M CIgroup 1 = –.31, DS CIgroup 1 = .38, M CIgroup 2 = –.1, DS CIgroup 2 = .44, p < .05). Results indicated that patients who experienced the lockdown exhibited a greater cognitive decline compared to the control group.

Conclusions: The findings suggest that the lockdown accelerated cognitive deterioration in individuals with memory complaints.

Objectives: In recent years, there has been an increase in suicide rates in Brazil. From 2015 to 2019 we had a 34% increase in self-inflicted deaths. Are there some subgroups at greater risk of suicide, such as the old people with Alzheimer’s disease?

Methods: The data were obtained by consulting the systems of the Brazilian Institute of Geography and Statistics (IBGE) of the Brazilian Ministry of Health (DataSUS). Population data were measured and compared in the years 2010 and 2022, using the last two censuses.

Results: Between 2010 and 2022, the number of registered deaths of patients with Alzheimer’s increased by 21.93%. Similarly, there was a 100.37% increase in suicides among the elderly population in the same period, compared to a 37.78% increase in the general population.

Conclusions: It is not possible to conclude that the increase in suicide among the elderly is directly linked to Alzheimer’s disease. However, further studies are needed to determine if there is a correlation.

Objectives: The increase in suicidal behavior in patients treated with promising new drugs for Alzheimer’s disease is a dilemma that deserves to be understood. The correlations between suicide and neurodegenerative disorders have been debated for decades in the context of ethics, considering that many people with cognitive decline have opted for euthanasia. The academic community is invited to pay greater attention to issues other than ethics that can improve the quality of life of people with dementia.

Methods: We sought to read the review articles on Pubmed on the topic over the last two decades to identify possible factors that are correlating suicide with Alzheimer’s Disease. The data were grouped and presented to demonstrate possible studies that should be carried out to clarify the topic better.

Results: Depression and the presence of the E4 allele of Apolipoprotein E were the main correlation factors between Alzheimer’s disease and suicide.

Conclusions: Targeted studies are needed to understand better the occurrence of depression in Alzheimer’s disease, as well as the role of the E4 allele in mood disorders and suicidal behavior.

Background: Most individuals with dementia in the UK die in care homes. 70% of these are residential, relying on external healthcare professionals to manage the complex needs. eHealth can help facilitate the delivery of holistic care in care homes, yet adoption has traditionally been faced with resistance. Innovative approaches employing Methods from implementation science are required to promote the uptake of eHealth in care homes.

Aim: To evaluate the feasibility of a theoretically-informed co-designed implementation plan for an eHealth intervention to support holistic assessment and decision making for people with dementia in care homes and their family carers, and to identify opportunities to strengthen it.

Methods: An embedded mixed-Methods study conducted in two residential care homes. Qualitative data comprised non-participant observations of the intervention in use, focus groups and semi-structured interviews with care home staff. Data was analysed using a codebook thematic analysis underpinned by the Normalistion Process Theory. Quantitative data included app usage data and two implementation measures, analysed using descriptive statistics. Patient and public involvement informed development and conduct of the study.

Results: 20 care home staff across two care homes used the intervention with 26 residents. Whilst there was some evidence of adoption, reach within the care home and feasibility of its implementation, usage data indicated that the intervention was largely not utilised as intended. Whilst there was sufficient coherence around the intervention, staff faced barriers related to collective action including workload and incompatibility with practice. Reflexive monitoring was therefore low as individuals could not appraise its impact, which compromised staff cognitive participation. Revisions to the plan related to strategies to provide further staff support, including encouraging family involvement and a more tailored approach to training.

Conclusions: Evaluating feasibility of the implementation plan of the intervention was a vital step in its development. Rapid evaluation and iterative response to barriers to use informed learning and allowed for real- time adjustments to implementation strategies, and a set of updated recommendations for use. Further collaboration on the revised strategies with people living with dementia and their family carers is required.

Objectives: To better understand the unique experience and stigma surrounding Alzheimer’s disease and related neuropsychiatric symptoms. Particularly from the perspective of care partners and individuals living with the disease who are members of the Latino community.

Methods: This project captures stories from individuals representing Latino communities based in the United States. Our qualitative primary research consisted of multiple one-on-one interviews with more than 12 people living with dementia and care partners. Secondary research included a literature review on the community’s experiences. Interviews were led by a member of the Latino community, with our research team on “listen only” mode.

Results: There are notable differences in how communities talk about Alzheimer’s – including identifying early symptoms; conversations with families, communities, and HCPs; and determining pathways for care and treatment. From our conversations with members of the Latino community we heard statements like, “I did not want to tell anybody about my diagnosis. I felt I would be looked upon in a negative way” and “I didn’t know anything about Alzheimer’s. My uncles and aunts from the ranch and ‘said no, no, it doesn’t exist, it’s all in the mind or something like that.” All underscore the sweeping implications of history, stigma, bias, and culture on how diverse communities experience and respond to Alzheimer’s and care. The resulting impact of these perspectives can lead to delayed diagnosis, reluctance to seek treatment, and a lack of a support system for care partners. However, we also heard stories of how individuals are using their unique experiences to educate those around them. For instance, we heard the importance of educating younger family members to break the cycle of stigma; “In the Latino community, households are often multigenerational, so it’s important to educate kids on what’s happening to grandma or grandpa, or even mom or dad.”

Conclusions: It is imperative to understand and bring attention to the realities of diverse and underserved communities who disproportionately experience stigma and discrimination. This will allow for a more nuanced, community centered approach to raise awareness of Alzheimer’s and the related symptoms, ultimately improving access to care and treatment for families.

Introduction: The elderly population presents aggravating factors for the risk of suicide that must be considered. In this sense, it is known that there is a tendency for elderly people not to reveal suicidal ideation and to make highly self-destructive attempts. Furthermore, poorly planned retirement, social isolation, death of a spouse, family and friends can make this situation worse. However, few studies address this topic and public policies regarding suicide among the elderly are still scarce.

Objectives: To analyze the prevalence of suicide among elderly people in different regions of Brazil between 2019 and 2021.

Methods: Quantitative, descriptive and exploratory, cross-sectional study. For collection, the DATASUS database was used, based on information regarding the cause of intentional self- harm codes X60 to X84, based on the 10th revision of the International Statistical Classification of Diseases and Related HealthProblems.

Results: It was observed that in Brazil, among elderly people of both sexes, the highest suicide rates are found in the age group of 60 to 69 years, with the general proportion of suicides being higher in the male population. Furthermore, the Southeast Region had the highest number of notifications, while the North Region of the country had the lowest. The age group equal to or greater than 80 years, presented the highest number of cases in the South Region.

Conclusions: Suicide notifications are an alarm for understanding the risk factors that must be carefully identified through a broader look at issues of mental health in the elderly. This information makes it possible to understand the current scenario of deaths by region to detect populations with a higher incidence and understand the binomial of mental health and aging.

Introduction: Aging is a global phenomenon that can be explained, in short, by improvements in living conditions, which leads to an increase in life expectancy, combined with a reduction in recorded fertility rates. In this sense, it is understood that due to some biopsychosocial determinants, some individuals live much longer than the rest of the population, as is the case of elderly centenarians and this is the focus of this study. It is known that the COVID-19 pandemic scenario was challenging for the elderly population. In this sense, the study aims to analyze the production of national and international knowledge of research articles on the COVID-19 pandemic for centenarian elderly people

Methods: This is an integrative literature review, carried out in six stages: selection of the research question; literature search; categorization of studies; evaluation of studies included in the review; interpretation of results and presentation of the review. The research question was developed according to the PICO strategy. The population refers to elderly centenarians (P); the intervention concerns the COVID-19 pandemic scenario (I); the comparison group is not applicable in this study (C) and the outcome refers to bibliographical productions about elderly centenarians from 2020 onwards (O). The search strategy was carried out on the PubMed/MEDLINE and LILACS platforms. The articles found were exported to the Mendeley Desktop program to exclude duplicates. Soon after, they were transported to a spreadsheet in Microso Excel®. After that, the articles were analyzed, categorized and organized in a table format to facilitate the Discussion of the results found. The data obtained so far is controversial regarding mortality and resilience of centenarians to SARS-CoV-2. These results are justified, in part, due to the uniqueness of each elderly person who can respond in a unique way to SARS- CoV-2. Results: After applying the search criteria, 18 articles were selected for full reading. After that, according to the established inclusion criteria, eight articles were selected for this review. Studies were found from Italy, Germany, Brazil, Belgium, Canada, China and France. The mortality/resilience of centenarians to SARS-CoV-2 was the most discussed topic among the publications. The relationship between the Spanish flu pandemic in 1918 and the COVID-19 pandemic in 2020 was also addressed in three publications. Supercentenarians (>110 years old) were the subject of study in two publications. Analyzes of immunological and/or genetic studies were also found. Supercentenarians appear to possess some kind of resilience against SARS- CoV-2. The most accepted hypothesis to justify this fact is the association between exposure to the Influenza virus, which caused the Spanish flu pandemic in 1918, and resilience to SARS-CoV- 2. Only one of the studies found took place in Brazil.

Conclusions: The topic deserves to be better addressed, as considering the potential increase in the number of centenarians in the future, the lessons learned from the COVID-19 pandemic should help the management and care of this population in the event of a new infectious disease.