Eating-related problems are common in people with dementia, and may have many adverse consequences. To provide a comprehensive assessment and understanding of these issues, we validated the Chinese version of the Abnormal Eating Behavior Questionnaire (AEBQ), and investigated the prevalence of and factors related to eating-related problems in people with dementia.

A total of 129 people with dementia were recruited from a nursing home and a psychiatric hospital for a cross -sectional study. Internal consistency and test–retest reliability were tested using Cronbach’s α and intra-class correlation coefficient. Dimensionality was evaluated by principal component analysis. Concurrent validity was assessed using Spearman’s correlation coefficient to compare scores for AEBQ and the eating-related items in the Neuropsychiatric Inventory. Factors affecting the prevalence of eating-related problems were identified using logistic regression analysis.

The Chinese version of the AEBQ showed acceptable internal consistency, time stability, dimensionality, and concurrent validity. Overall, 86.8% of the participants showed eating-related problems. “Needs supervision” was the most common one, followed by “swallowing problems”. History of stroke (OR: 12.62, 95% CI: 1.58–101.06) and Clinical Dementia Rating (OR: 1.82, 95% CI: 1.02–3.24) were risk factors for “swallowing problems”. Use of antipsychotics protected against “decline in table manners” (OR: 0.21, 95% CI: 0.06–0.74), but was a risk factor for “decrease in appetite” (OR: 3.15, 95% CI: 1.35–7.38). Clinical Dementia Rating (OR: 9.27, 95% CI: 4.13–20.79) independently predicted “needs supervision”.

The Chinese version of the AEBQ is a reliable and valid tool. People with dementia had a high prevalence of eating-related problems. Clinical assessment of eating-related problems in this group needs to screen for secondary causes or risk factors, such as psychotropic medications and comorbidities. Targeted interventions should be used to manage reversible eating-related problems among people with dementia.

Best practice in dementia care is support in the home. Yet, crisis is common and can result in hospital admission. Home-treatment of crisis is an alternative to hospital admission that can have better outcomes and is the preference of people living with dementia.

To report an investigation of the management of crisis for people with dementia living at home and managed by a Home Treatment Crisis Team.

To identify critical factors for successful resolution of crisis and avoidance of hospital admission

The research was mixed-methods case study design. It was an in depth investigation of what happens during crisis in people with dementia and how it is managed by a home treatment crisis team to resolution and outcome at six weeks and six months. Methods were observation of the management of crisis in the home setting for 15 people with dementia (max 3 per person, total 41 observations), interviews with people with dementia (n=5), carers (n=13), and 14 professionals (range 1 to 6 per person, total 29), a focus group with professionals (n=9) and extraction from medical records of demographics and medical history.

The analysis focused on the identification of key treatments, behaviours, education and context important for home treatment to prevent hospital admission.

The study recruited 15 of the 88 accepted referrals to the service for management of a crisis in a person with dementia.

Factors key for crisis resolution were

• a systems approach with embedded respect for personhood,

• attention to carer needs independently of the person with dementia,

• review and monitoring of the effect of medications,

• awareness and promotion of potential benefits with treatment at home,

• education of the health and social care workforce in dementia care,

• local availability of respite and other social care services.

The Home Treatment Crisis Team created a ‘Safe Dementia Space’ for the person with dementia in crisis. In the first instance, this was immediate but temporary with on-going assessment and intervention until negotiated permanent support was in place coproduced and agreed by stakeholders to be a sustainable dementia space with acceptable risk of harm to the person with dementia or others. The approach enabled avoidance of hospital admission in more than 80% of referrals.

This is the first study to collect data during crisis at home for people with dementia and to investigate process and management. It reveals the Home Treatment Crisis Team created sustainable ‘Safe Dementia Space’ to enable the person with dementia to continue to live in the community during and after crisis, thus avoiding hospital admission. The identified key components of the management approach for crisis resolution are important considerations in the design and delivery of home treatment services for people with dementia in the UK and beyond.

The prevalence of loneliness increases with age. The presence of loneliness in older adults has been found to be associated with health problems such as depression, decreased cognitive functioning, increases in systolic blood pressure and increased mortality. The underlying mechanisms of the higher mortality risk are largely unknown.

Meta-analysis to investigate the present evidence for the associations between loneliness and mortality. Cross-sectional studies investigating the associations between loneliness and cardiovascular disease and between loneliness and cortisol in 378 depressed and 132 non-depressed older adults.

Loneliness appears to be associated with increased mortality, although when only studies are included that consider depression as a covariate, the association is not significant. Therefore it seems likely that depression plays a mediating role in the higher mortality risk.

We did not find a significant association between loneliness and cardiovascular disease. In contrast, loneliness was significantly associated with lower cortisol output and decreased dexamethasone suppression.

The results and their implications for prevention and treatment will be discussed from a clinical perspective as well as a general health perspective. Is loneliness as potentially dangerous as depression?

Most studies about nursing homes staff are based on deficit models and focused on risks factors, however, when appealing to protective factors or individual strengths the publications are scarce. People differ in individual characteristics, abilities or skills which may be protective when managing adversities. Engaging and resolving positively stressors and other adversities gives people a sense of achievement, satisfaction, and helps to their personal growth, being this expressed through a major tolerance, compassion, forgiveness, and hope.

The aim of this study was to assess whether variables associated to the professionals (resilience, purpose in life, job content, job satisfaction and burnout) had a significant role in the personal growth of nursing homes staff in different job context situations (person-directed care and person-centred care).

187 professionals working in nursing homes participated in this study.

The results showed that personal growth was explained by purpose in life, person-centred care, burnout self-realization, personhood, management and resilience, predicting 66% of variance (F= 23,22; p≤.01).

Individual variables of the staff predict personal growth, especially in person centred care. Personal growth has positive consequences on the caregiver but also on the care receiver. These results are consistent with the Person-Centered Care model that stresses the need of considering the humanistic aspects not only of the care-receiver but also of the caregiver.

This work was funded by the Spanish Ministry of Economy and Competitiveness (grant number PSI2016-79803-R).

People with dementia depend on a relative to be able to stay at home longer However, being a caregiver has shown to influence on their quality of life (QoL). Depression is the most common factor associated with low caregiver QoL, while relational factors have shown to be a protective factor. Less is known about how female and male caregivers approve to the caregiving demands, and thus how these demands influence their QoL. In this study, we aimed at investigating what factors influenced on QoL related to gender and how these fluctuated with time.

In this longitudinal design, a total of 208 caregivers, 158 female mean age 62.5 and 50 male caregivers, mean age 67.9 were assessed for Quality of Life-Alzheimer Disease (QoL). In addition, depression, family relationship and caregivers’ burden of care were assessed. Linear regression analyses were applied to explore the bivariate and multivariate associations between the dependent variable QoL and potential explanatory variables.

The same questionnaires were completed at one-year follow-up, and the results from the remaining 176 caregivers were compared with their baseline scorings.

Caregivers’ depressive feelings were the strongest predictors of caregivers’ QoL. What differed in the explained perceived QoL was feeling of social isolation in female caregivers, and male caregivers’ perception of their care receivers’ emotionally overinvolved attitude towards them. Additionally, female caregivers expressed a higher burden and cared for a relative more affected by their dementia. After one year, their QoL declined, more for male than female, while their level of depressive feelings, distress and level of EOI remained unchanged.

The study revealed that except for depressive feelings, female and male caregivers faced their caring experience, differently. The implication of these findings is that gender must be considered when planning for interventions. While female caregivers might need more time for leisure activities, male caregivers need ways to deal with their emotional relationship with their care receivers. Treatment of their depressive feelings seems to be crucial. They would also need approaches specifically targeting the different stages as dementia develop.

Nursing staff play an important role in the care of people with dementia (pwd), both at home and in residential care. Communication is essential in providing person centered care to people with dementia. However, symptoms of the disease, such as deterioration in memory, concentration, thought and speech, make communication with pwd more challenging. Therefore, at the request of nursing staff, we started to developed tools to support nursing staff to better communicate with pwd.

First, we identified bottlenecks in communication experienced by nursing staff, informal carers and pwd both through online questionnaires among nursing staff (n=1.070) and informal caregivers (n=446), and through face-to-face interviews with informal carers (n=7) and pwd (n=5). Next, we set up a working group (n=15) consisting out of nurses, nurse practitioners, a caregivers, a psychologist, an elderly care physician and a representative of the Dutch Alzheimer’s Association to support us with the development of the tools. Besides scientific literature, their practical experience form the basis of the tools. Finally, a field-test was conducted, in which nursing staff (n=45) used the developed tools for three month in daily practice, to help improve the tools even more and learn about enhancing and hampering factors in using them. All this is done to match the tools with the needs in practice as good as possible.

Identification of the bottlenecks showed that for person centered care, not only communication between nursing staff and pwd themselves needed to improve, but also between nursing staff and the informal carers and other involved professionals. Therefore, the tools serve as a handle for enhancing communication with all three groups. A guide incorporates recommendations how to communicate within these groups. It is specified whether the recommendations are based on literature, or practical experience by the working group. The recommendations are enriched with practical examples, to make them more tangible. Furthermore, reflection tools and short animations are developed to enhance practical use. In this session the steps in development and the tools themselves will be presented.

The Dutch professional nurses organization, called V&VN, is owner of the tools and they will implement them on a nationwide level.

Burden of care might be highly dependent of specific characteristics of the disease (Lee et al., 2019). Uncertainties remain about factors that influence burden of care in Parkinson Disease (PD).

To identify a list of ICF-related domains identified by caregivers of older patients with PD.

Caregivers of people with PD were recruited in Portugal Parkinson Foundation, if they take care of someone with PD older than 65 yrs, and for more than 6 hours/day. A focus group was video recorded, based on the following questions: Can you please tell us how did you spent your day before you're a caregiver; there are any differences in your daily routine now? How do you feel or think when you're caring for a relative? Can you tell us if there is any kind of daily activity more pleasant or more embarrassing? Verbal interactions during focus group were transcribed and codified using International Classification of Functioning and Disability (ICF) domains.

Seven caregivers (5 females; 40-73 yrs; 5 were spousal) were enrolled. Thirty-six caregivers’ references were about body functions and structures (91.67% - mental functions: “I feel tired…it is a constant monotony”); fifty-seven references were about activities and participation (“I need to assist him with bathing”; “when he wants to standing from his favourite chair, he always need help…and his body is very stiff”);eleven references were about environmental factors, mostly about medication and family/health professionals assistance.

Our results demonstrated that caregivers are worried about their mental health and routine preservation, which is in accordance with previous studies in this topic (Tessitore et al.,2018). However, new caregivers’ perceptions were found in our study, which are very specific domains in PD: body motion rigidity and medication for patients’ psychomotor agitation. A previous study stated that control of mental symptoms in PD are the most powerful predictors of caregivers' burden (Hooker et al., 2000), but do not consider the importance of Parkinson’s motor symptoms.

Burden of care in PD is mostly associated with the need of preservation in daily routines, but also with management of mental and motor symptoms in PD.

There is a significant difficulty in the engagement of people with dementia in therapeutic activities. Considering that stimulus attributes (e.g., content of a specific activity) seem to be determinant to achieve an expected engagement, innovative approaches are required.

characterise the engagement of people with dementia in serious traditional multidimensional games (sTMG), comparing with conventional therapy (CT) sessions.

Subjects with dementia were recruited in Alzheimer’s Portugal Foundation. Sociodemographic and clinical participants’ characteristics were collected, including classification of dementia severity using Mini-mental State Examination (MSE) and walking independence classification (dependent - someone needs supervision or human support to walk). Gerontologist, psychologist, occupational therapist and physiotherapist were invited to classify patients’ engagement in routine CT (i.e., cognitive therapy and exercise classes), according to 0 -10 scale (10 – successful engagement). Serious adaptations in TMG were implemented in 3 consecutive sessions (1 per week/ 45 min./session) and patient s engagement was rated in each session. Success index (number of subjects showing higher engagement in TMG/total participants) was calculated.

Thirteen participants (5 males; 79.23±8.39yrs; 15.76±9.22 MSE; 9 walk independently) were enrolled. Success index was 38%; comparing TMG with cognitive therapy and 31%, comparing to movement classes. Two patients with severe dementia and walking independency were more engaged in sTMG sessions (sTMG - 4;4; Cognitive therapy - 2;1; Exercises Classes). Four patients with moderate dementia and walking independency obtained worse engagement (sTMG –3;6;2;7; Cognitive therapy – 6;7;8;8 Exercises Classes – 4;6;7;9).

Our results showed that sTMG sessions had a positive impact in people with dementia, specifically in advanced/severe cases. In this respect, a previous study of Natalie et al., (2017) concluded that engagement was lower in cognitive activities for people with severe dementia, which can explain the higher engagement in sTMG sessions. Furthermore, Bier et al. (2008) enlightened that people with dementia in a moderate stage are characterised by emergent behavioural changes, which might difficult patients’ integration in new activities.

sTMG had a positive impact in the engagement of people with dementia. Specifically, for patients at middle stage of dementia, future studies include longer sTMG protocols, possibly providing better patients’ integration.

The generation of people getting older has become a public health concern worldwide. People aged 65 and above are the most at risk for Alzheimer’s disease which is associated with physical and behavioral changes. This nurtures informal support needs for people living with dementia where their families together with other community members are the core providers of day to day care for them in the rural setting. Despite global concern around this issue, information is still lacking on informal support delivered to these people with dementia.

Our study aimed at establishing the nature of informal support provided for people with dementia (PWDs) and its perceived usefulness in rural communities in South Western Uganda.

This was a qualitative study that adopted a descriptive design and conducted among 22 caregivers and 8 opinion leaders in rural communities of Kabale, Mbarara and Ibanda districts in South Western Uganda. The study included dementia caregivers who had been in that role for a period of at least six months and opinion leaders in the community. We excluded trained health workers.

The study highlights important forms of informal support offered to PWDs such as support in activities of daily living, enabling access to medical attention, recovering misplaced items, provision of herbal remedy, informal counseling, and sourcing caregivers from other families to offer presence and support in the hope to impact positively on behavioral outbursts and the frustration of living with dementia.

The study revealed various forms of informal support that are available for PWDs in South Western Uganda and stressed the role of caregivers and the perceived usefulness of the care provided.

Identifying effective treatments is a critical issue for Alzheimer’s dementia (AD). The pathological amyloid deposits of AD result in disruption of the balance between long-term potentiation (LTP) and long-term depression (LTD) of neuronal cells and synaptic plasticity. Brain stimulation in dementia research, especially with relatively safe tDCS, has been taken seriously recently. In theory, tDCS affects long-term synaptic plasticity through LTP and LTD, thereby improving cognitive ability. Recently, an increasing number of studies have been conducted to evaluate the efficacy of tDCS in AD and concluded a positive therapeutic effect. Currently, there are no studies of tDCS for AD in Taiwan. In this study, we investigate the effects of tDCS in AD.

Using a double-blind, randomized and sham- controlled trial design, Sixteen AD aged 55-90 years (8 active, mean age 73.88 and 8 sham, mean age 74.75) were included in the study. AD diagnostics is according to DSM-5 criteria. The CDR ratings of AD participants ranged from 0.5 to 2. All subjects completed ten consecutive daily sessions in which they received either an active or a sham tDCS over the left dorsal lateral prefrontal cortex (anodal) and a cathodal electrode on the right supraorbital area. In each session, we applied a current intensity of 2 mA and an electrode size of 35 cm2 for 30 min in the active group. All subjects received a series of neuropsychological tests, which included CDR, MMSE, CASI and WCST, before and after these treatment sessions on the first day and 4 weeks later. Chi- square test, Wilcoxon signed ranks test and Mann-Whitney U test were used to assess the differences in participant demographic characteristics and to compare the differences among groups.

The active group showed significant improvement in total correct item, Conceptual level Responses (reflecting insight into the correct sorting principles), Categories Completed (reflecting overall success), and Trials to complete first categories (reflecting initial conceptual ability) of WCST 4 weeks later after the final stimulation. There were no statistically significant differences between before and after the 10-session course for the sham group.

tDCS stimulation improves cognitive operation and Conceptual Ability of AD.