Objectives: Domestic squalor (DS) is related to physical problems, living alone, problems for their family and neighbors, and mental illness, the most common of which is dementia. Early intervention for DS is important; however, Methods to detect and treat older adults with DS remain unclear. This study aimed to clarify the Methods of early intervention in older adults with DS.

Methods: The Initial-phase Intensive Support Team for Dementia (IPIST) is a multidisciplinary outreach team that provides intensive initial assessment and support for people living at home with suspected dementia in Japan. We distributed a questionnaire to 50 IPISTs that had reported experience of dealing with many complex cases’’ in our previous nationwide survey, asking them to provide detailed information on two complex cases’’ that were extremely difficult to approach or link to medical or long-term care. The questionnaire consisted of questions regarding sociodemographic characteristics, clinical assessments, referral sources, and reasons for complexity. We compared the results of the questionnaire between cases with and without DS (DS+ vs. DS-) and between cases with DS who lived alone and those who lived with family (DS+ living alone vs. DS+ living withfamily).

Results: We received responses from 33 IPISTs and collected data from 70 complex cases. DS was selected as the reason for complexity in 24 cases. Fourteen DS+ cases lived alone. DS+ cases referred by the family (8.3%) were significantly fewer than DS- cases (54.3%). In DS+ cases, the most common referral sources were neighbors and welfare commissioners. The proportion of cases having self-neglect were significantly more in DS+ (87.5%) than in DS- (13.0%). DS+ cases living alone were significantly younger (mean ± SD; 72.9 ± 7.3) than those living with family (80.0 ± 6.7). Family members living with DS+ cases also had issues including mental illness or maltreatment.

Conclusions: This study revealed that most older adults with DS experience self-neglect and a lack of supportive family members. A comprehensive approach to both older adults with DS and their families is important for early intervention, and therefore IPISTs that have a multidisciplinary team with an outreach function would be useful.

Objectives: Family members are the primary source of support for the growing number of people living with dementia (PLWD) worldwide. However, caring for a person living with dementia can have detrimental impacts on the carer quality of life (QoL). This review of systematic reviews was aimed at exploring the factors associated with the QoL of family carers of PLWD and interventions aimed at improving theirQoL.

Methods: Several health-related databases (PUBMED, Psychinfo, Google Scholar and COCHRANE) were consulted in November 2022. Nineteen systematic reviews were included, and their Methodsological quality was assessed via AMSTAR-2.

Results: Nineteen systematic reviews published from 2014 to 2022 were included, of which three assessed the factors associated with the QoL of carers and 16 assessed the impact of interventions on family carer QoL and other outcomes. Several intrinsic and extrinsic factors associated with carer QoL were identified and included dementia symptoms and its care demands, provision of formal support, relationship quality between carer and PLWD, carer physical and mental health, positive psychological traits, and age-specific needs. Systematic reviews of interventions showed promising, yet modest and heterogeneous effects, with no one-fits-all strategy that can improve the QoL of all carers. For this reason, person-centred and outcome-focused approaches have been called for, as well as more qualitative studies exploring the negative as well as positive experiences of QoL among carers. Evidence also points out to the importance of using dementia specific QoL scales instead of generic QoL scales so that relevant caregiving aspects affecting carer QoL can be considered

Conclusions: Evidence suggests the need for a person-centred approach to improving carer QoL, considering individual and contextual needs as well as the continuum and progressive nature of dementia care. Future research should be focused on understanding how to best implement and measure person-centred care approaches to carer QoL, including cost- effectiveness. More qualitative studies are necessary to explore carer negative and positive experiences of QoL.

Background: Most people living with dementia rely on their family members for the care and support they need. However, unpaid care can lead to multiple negative impacts on the wellbeing and mental health of carers.

Objectives: The Objectives of this study was to evaluate the effects of iSupport-Brasil (an online, psychoeducational program) on perceptions of burden and on the mental health of informal caregivers of people living with dementia.

Methods: A randomized controlled trial was carried out from January 2023 to April 2024 in Brazil. A total of 162 individuals were randomly allocated to an intervention group (IG) (n = 77) or a control group (CG) (n = 85). The IG had free access to the iSupport-Brasil platform for three months. Simultaneously, the CG participants were provided with a link to access the Brazilian Alzheimer’s Association website and a copy of the “Care Guide for Older People”, published by the Brazilian Ministry of Health. Pre- and post-intervention assessments were carried out using measures of burden (a single-item Burden Scale and the Zarit Burden Interview – ZBI), and of anxiety and depressive symptoms (Hospital Anxiety and Depression Scale - HADS).

Results: Based on an intention-to-treat analysis, a reduction in anxiety symptoms was observed for the IG (p = 0.02). Based on a per-protocol analysis, significant reductions in burden (p <0.01) and anxiety symptoms (p < 0.01) were found for the IG. No significant effects were found for depressive symptoms, although scores decreased. For the CG, the regression model indicated that, on average, burden and depressive symptoms worsened somewhat, but this result was not statistically significant.

Conclusions: The iSupport-Brasil program was effective in reducing perceptions of burden and anxiety symptoms among informal caregivers in Brazil. Therefore, we recommended that informal caregivers of people living with dementia use this program to help them broaden their interpersonal coping strategies and improve their emotional health, in addition to using mainstream long-term care support services.

Background: There is a dearth of research on the health and psychosocial support needs of unpaid carers in low- and middle-income countries, where approximately 80% of all people living with a disability or functional impairment and who may need support with their activities of daily living currently reside.

Objectives: To explore the variables associated with having the perception of psychosocial or health support needs among a sample of unpaid carers of people living with a disability and/or functional impairment inChile.

Methods: This is a cross-sectional analysis of a nationwide, population-based survey involving sociodemographic, care, and mental health related data of 1,900 individuals aged 13 and older who reported being the primary carer for someone with care needs in their household (adults or older persons). Univariate and multivariate logistic regression analyses were used.

Results: Being widowed/divorced, providing more hours of care, more personal care tasks, with an increased level of perceived difficulty, were independently linked with higher odds of having psychosocial or health support needs. Experiencing (most of the time) low interest/depressive mood, low energy, and anxiety, were associated with 0.6-, 0.9-, and 0.7-times higher odds of having unmet psychosocial and healthcare needs, respectively, compared to experiencing these a few times. Having low sense of control most of the time led to 2.6 higher odds of having psychosocial or health support needs compared to those who felt this way only afewtimes.

Conclusions: Variables related to the care provision and mental health, which could be improved with the receipt of more formal support, were the strongest factors related with unmet psychosocial and healthcare needs.

Objectives: The study aims to: (i) develop a clinical post-fall assessment tool for older adults in long-term care (LTC) settings; (ii) validate the tool’s effectiveness and usability; and (iii) assess the practical application and impact of the tool within LTC units.

Methods: The three-phase study employed a sequential exploratory mixed-Methods framework. Phase I: Tool development comprised a comprehensive literature review and a qualitative study of semi-structured interviews with nine healthcare professionals. Phase II: Validation adopted an embedded design, where qualitative perceptions from 18 professionals through two focus groups informed iterative improvements and a quantitative questionnaire (a Likert scale and open-ended questions) assessed the tool’s effectiveness and user experience. Phase III: Implementation encompassed a retrospective and prospective longitudinal study, focusing on fall incidence, communication efficacy, and usability, to gauge the tool’s real-world impact.

Results: From Phase I, a mnemonic checklist was developed and structured into five sections: patient characteristics, fall description, primary and secondary assessments, and post-fall management—selected for clinical practicality. In Phase II, focus group insights prompted refinements to the tool, while follow-up questionnaires indicated the tool’s substantial utility in enhancing practice (65%), communication (69%), usability (71%), and satisfaction (76%). Responses highlighted key challenges such as resistance to change and workload, contrasting with facilitators like availability and uniformity. The need for training and a period of adaptation were viewed as factors that could compromise use. In Phase III, the tool showed greater utility for identifying fall-related complications and managing falls, with a notable preference among all nurses, regardless of experience level, particularly those with less than 5 years of experience.

Moreover, a comparison of falls over two three-month periods—one without the tool and one with it—revealed that the tool enhanced communication between doctors and nurses. This improvement led to quicker notification of doctors and more efficient transfers of patients to the emergency room when necessary.

Conclusions: Our tool aims to improve comprehensive post-fall assessments for older adults in LTC settings, facilitating improved communication and decision-making among healthcare professionals. With its usability and practical design, this mnemonic checklist shows great potential for wide adoption in enhancing patient care practices.

Objectives: Caregiving can be a daunting and isolating experience, especially when supporting a loved one with Dementia The Objectives 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.

Methods: The Caregiver Literacy Series is a compilation of 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.

Results: 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 caregivers.

Conclusions: 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.

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.