Cognitive frailty (CF) has been considered as a subtype of frailty characterized by concurrent physical frailty and potentially cognitive impairment (Kelaiditi et al., 2013). Early detection of CF is an important issue in order to implement prevention and intervention to improve quality of life in aging. The aim of this study was to explore the prevalence of cognitive frailty in a sample of Portuguese old people, living in the community, and determine its relationship with sex, age, education and comorbidity.

Two hundred forty nine community-dwelling participants aged over 60 years and without dementia and other neurological and psychiatric diseases were assessed to obtain sociodemographic, functional, health, physical, cognitive and socio-affective measures. Participants were classified with/without mild cognitive impairment using the Montreal cognitive test (MoCa Test), and as physically robust, pre-frail and frail using the criteria of Fried et al. (2001). A cognitive frailty classification variable was created with six groups that were compared on sociodemographic variables and on comorbidity measured with the Charlson Index Scale (ChIS).

A 20.1% of participants were classified as physically robust and cognitively normal (Group 1), a 28.5% as physically pre-frail and cognitively normal (Group 2), a 11.2% as physically frail and cognitively normal (Group 3), a 6.8% as physically robust with cognitive impairment (Group 4), a 14.9% as physically pre-frail with cognitive impairment (Group 5), and a 18.5% as physically frail with cognitive impairment (Group 6). No significant group differences were registered in the distribution by sex. Significant differences were observed between Group 6 and Group 1 and Group 2 in age [F(5, 243)=6.20, p<.01] and in education [F(5, 243)= 6.54, p<.01], being the first older and with lower education level than the two last ones. Regarding comorbidity, Group 6 had significant higher scores in the ChIS [F(5,243)=9.91, p<.01] than all the other groups

The study reveals that a 33.4% of the older adults and with less education level living in community suffer the two more advanced stages of cognitive frailty. Prevention and interventions measures are need to improve their quality of life.

Little is known about the raising number of specialized units for patients with dementia and very severe challenging behavior in the Netherlands. This study describes organizational and treatment characteristics of a sample of these units.

The organizational and treatment characteristics were studied with digital questionnaires completed by the unit managers, interviews with the main physician(s) and observation of the physical environment. The questionnaire consisted of questions about general patient characteristics, unit characteristics and staff characteristics. Furthermore, an interview was held with the main/treating physician often together with another physician or psychologist. The interview guide consisted of questions about admission criteria, the role of staff involved and the treatment process.

Thirteen units participated. Five units were part of a mental health (MH) institution, seven units were part of a nursing home (NH) organization and one unit was a cooperation of MH and NH. Unit sizes ranged from 10 to 28 places. Ten of thirteen units started in 2010 or later. The age of patients admitted was estimated at 75 years. The percentage of involuntary admitted patients was 53% at MH-units and 18% at NH-units. Unit managers mentioned that due to a difference in reimbursement between MH and NH units had difficulty providing the specialized care. Another problem managers faced was recruiting nursing staff. Units strived for expertise in general staffing from both MH and NH. The education level of the nursing staff was comparable between MH and NH. At every unit a physician with background in elderly care medicine or geriatrics and a psychiatrist was involved. Interviewees stressed the role of the nursing staff in the treatment. They were key in providing the care and treatment that, since the main goal of interventions is treatment of and coping with challenging behavior.

The main finding of this study is that units caring for patients with dementia and challenging behavior, despite barriers in regulations and staffing shortage, search for combining expertise from nursing home care and psychiatry in their treatment.

Reminiscence therapy (RT) is a multi-sensory treatment that uses a combination of sight, touch, taste, smell and sound to help people with dementia (PWD) remember events, people and places from their past lives. Currently, digital technologies such as mobile applications and immersive solutions including virtual and augmented reality, are gaining momentum as supplementary tools for RT. This paper presents a usability study of a web-based and virtual reality application to understand the limitations and opportunities of digital platforms for facilitating engaging experiences for PWD towards recalling memories, while easing the therapy process for the caregivers.

A total of fifteen healthcare caregivers were recruited from the Geriatric Dementia Unit and Geriatric Transitional Unit in Ontario Shores Center for Mental Health Sciences, Ontario Canada. Usability feedback from the caregivers were collected from the interviews after the completion of the System Usability Scale (SUS) questionnaire.

Healthcare caregivers found both web-based and virtual reality (VRRT) usable with SUS score above average (68/100), but required improvements related to the onboarding training of caregivers. The interview revealed four overarching themes related to the VRRT: (1) Ease of use; (2) Positive impact on caregiving; (3) Potential reduction in behavioral symptoms; (4) Feasibility of promoting social connection during COVID-19 pandemic.

Next steps will focus on improving the user experience and expanding the application for immersive VR supporting head-mounted displays, hand tracking, and physiological measures, as well as conducting a usability study with PWD to expand our understanding of using RT digital tools with various levels of immersion.

Most studies about older adults´ loneliness are related to risk factors that increase the probability of loneliness and its negative consequences. These issues are linked with the negative traditional perspective of aging that focuses on decline, illness, and dependency. Although the probability of these conditions increases with age, current older adults age in better conditions than years ago. Positive Psychology is a new perspective that focuses on people´s strengths as protective factors of mental and physical health, including older people. Considering the negative consequences of loneliness in older adults, knowing the factors that may protect older adults from loneliness is needed.

This study aimed to analyse whether sociodemographics, physical, mental or social characteristics act as protective factors against older adults´ loneliness. Method: 274 Spanish people aged 65 and over completed an online survey that included sociodemographic information (sex, age), perceived health, quality of life, anxiety, depression, family functioning, gratitude, experiential avoidance, purpose of life, personal growth, and resilience. Loneliness was assessed using the Spanish version of the Three-Item Loneliness (Hughes et al., 2004). The average age was 70.46 (SD= 4.42) and 61.7% were women (N= 169) and 55.1% were married (N= 151). A regression model was tested.

The results point out that women show higher scores on loneliness than men. The more loneliness, the lower perceived health, quality of life, family functioning, gratitude, life purpose, personal growth and resilience were. In contrast, the more loneliness the more experiential avoidance, anxiety, and depression. The regression model showed that depression (β = 0.202; p≤ .01), family functioning (β = -0.385; p≤ .001), experiential avoidance (β = 0.318; p≤ .001) and personal growth (β = 0.152; p≤ .01) were the best predictors of loneliness. This model explained 44.3% of variance.

Considering the Positive Psychology perspective when studying older adults´ loneliness is needed. This perspective focuses on older adults´ protective factors and not only on risk factors as a target for prevention and intervention programs that aim to reduce loneliness. Building a more resilient older adults group population may help them to cope with adversities like loneliness.

Loneliness is a subjective phenomenon. It is experienced a lack of satisfying relationship to others, whether because the subject has too few relationships or because their existing relationships do not provide the desired form of closeness (Svenderson, 2017). As defined by Peplou and Perlman (1982), the definitions of loneliness share the same concept: an unpleasant, subjective experience resulting from inadequate social relationships. Loneliness and rumination are remarkable risk factors of depression among the elderly in the both community and nursing homes (Gan at al.,2015). A Norwegian study found that 56% of nursing home residents are feeling lonely (Dragaset et al.,2011). The study from Poland found that depression was observed in 33.8% long term care facility (Horwath, Scerbinska,2017). Furthermore, another study from China shown that 14.9% residents in long term facility reported suicidal ideation (Zhang at al.,2020). Associated with one being depressed in nursing homes include pain, risk of stroke, risk of heart attack, decreased cognitive function and is also linked to increased morbidity in nursing home residents, a relationship it has been also suggested for medical inpatients (Zammit, Fiorini, 2015).

The scoping review has been selected as the appropriate methodology for this study. The general purpose for conducting scoping reviews is to identify and map the available evidence (Arskley,O’Malley, 2005). Scoping reviews can be useful tools to investigate the design and conduct of research on a particular topic and conducted to review current research an identify knowledge gaps on the topic (Munn at al.,2018). According to Arksey and O’Malley (2005) the scoping review methodology is divided into six steps framework: identifying the research question, searching for relevant studies, selecting studies, charting the data, collecting the data, summarizing and reporting results and consulting with stakeholders to inform or validate study findings.

A total of 27 studies were included in the final synthesis, mixed designed studies (n=7) including questionnaires, surveys, Geriatric depression Scales, Satisfaction with life Scale, Loneliness Scale, face to face interviews and observations. Furthermore, were included quantitative studies (n=10) included one longitudinal study with 6 years follow up. Finally, were also included qualitative studies (n=10), the studies used a mixture of approach of interviews an observation. The majority of the participants were from long-term facilities (n=24), medical students and nurses were included (n=1) study and mixture of participants such as residents, family members and staff were included in (n=1) study. The most of the studies are from Norway (n=7), China (n=3), Finland (n=2), Turkey (n=2), Poland (n=2), US (n=2), Belgium (n=1), Sri Lanka (n=1), South Korea and Japan (n=1), Hong Kong (n=1), Malta (n=1), Taiwan (n=1), Iran (n=1), New Zealand (n=1) and Sweden (n=1). In Table 1, we provide a summary of the individual studies.

This scoping review highlights the importance to continue support residents’ well-being in the long-term care facilities, support their mental health and also to continue educate and support healthcare staff as they have the major impact on resident’s welfare. Previous studies indicated the correlation between loneliness and depression with demographics factors such as being married, unmarried or widowed for that reason it was recommended by Mahammadi et al. (2016) pay more attention on reducing feeling of loneliness and anxiety by increasing their life satisfaction. We found that only one study was focused on resident’s suicidal ideation (Zhang et al., 2020) who concluded from his cross-sectional study with 538 participants, age above 60 years old, from 37 nursing homes in China that 14.9% reported current suicidal ideation but we are worried that this number could be higher and we believe that needs to be done more research for the future to prevent any risk of suicide among elderly. One reason for the lack of information on suicide risk in long term facilities is that prior 2010, universal screening for suicidal ideation in these facilities had not been widely adopted nor recommended as an approach to prevent suicide (Mezuk et al.,2014).