Introduction: Young-onset AD (YOAD) affects people aged 65 years old or younger with greater initial loss of cognitive abilities, more significantly on attention, visuospatial function, motor- executive functions, and language.

Methods: 30 dyads, People with AD – caregivers, were evaluated. People with YOAD were assessed for: disease awareness, and depression. Caregivers were assessed for: depression, anxiety, coping, and burden. Additionally, caregivers provided information about mood, neuropsychiatric symptoms, dementia severity, and patients’ activities of daily living.

Results: Caregivers showed moderate level of burden 38.94 (SD = 14.74), low level of anxiety9.11 (SD = 9.8), moderate level of coping strategies 65.71 (SD = 11.7), and mild level of depressive symptoms 10.72 (SD = 8.8). People with AD had an average cognition score of 15.27, 50% had moderate dementia rating (CDR=2), mild depression index 12.35 (SD = 5.4), moderate index of neuropsychiatric symptoms 36.2 (SD = 23.3), and partially compromised disease awareness 9.06 (SD = 5.12). Coping strategy total score of caregivers was positively correlated with their cognition. Problem-focus is positively correlated with caregivers’ years of education, cognition and inversely correlated anxiety. The coping strategies were not correlated with the clinical variables of people with YOAD. Dysfunctional and emotional- focus did not have significant correlations with the clinical variables of people with YOAD or their caregivers.

Conclusions: Most caregivers, likely experiencing significant disruption in their personal lives, were similar-aged spouses to people with AD. Problem-focused coping strategies appear effective for caregivers, indicating that better cognitive health and higher education levels may enable them to use planning and active coping strategies to manage dysfunctional behaviors. Self-distraction was observed as a dysfunctional coping strategy, suggesting an association with anxiety and depression in caregivers, though our results do not confirm a causal relationship. Future studies with larger dyads samples should explore the relationship between coping strategies, clinical variables in patients with YOAD, and their caregivers, aiming to develop interventions to assist caregivers more effectively.

Noise is a ubiquitous feature for all organisms growing in nature. Noise (defined here as stochastic variation) in the availability of nutrients, water and light profoundly impacts their growth and development. Not only is noise present as an external factor but cellular processes themselves are noisy. Therefore, it is remarkable that organisms can display robust control of growth and development despite noise. To survive, various mechanisms to suppress noise have evolved. However, it is also becoming apparent that noise is not just a nuisance that organisms must suppress but can be beneficial as low noise can facilitate the response of an organism to a sub-threshold input signal in a stochastic resonance mechanism. This review discusses mechanisms capable of noise suppression or noise leveraging that might play a significant role in robust temporal regulation of an organism’s response to their noisy environment.

Expressions in ANCD are viewed as a mode of communication and ascribing meaning for their presence the key step to developing individualized behavioral care plans. Existing dementia care philosophies (PIECES™, GPA™, DementiaAbility and Teepa Snow Dementia Workshops) offer general directions but fail assist in ascribing meaning for the individual or clustering of the constellation of, varied phenotypic presentation of expressions in ANCD. The first step was to establish a biopsychosocial model for the generation of expressions; as all existing models were dichotomized along biological and psychosocial lines. The next step was developing a classification for the various phenotypic manifestations of expressions. This involved collecting ‘alike’ symptoms into individual categories and giving each category title which adequately represented the symptoms therein. Formation of behavioral categories was justified using existing validated psychological theories. Five psychological theories used to justify existence of behavioral categories: Information Processing Theories, Motivational Theories, Emotional Regulation Theories, Developmental Theories and Theories on Compliance and Aggression. These theories were able to ascribe meaning to individual behavioral categories and derived from their lived experiences: their Personhood. The ascribed meaning offers a framework for developing an individualized behavioral care plan for the expressions represented in each behavioral category. This framework, titled, LuBAIR™ Paradigm was structured in the form of an evaluative framework, both quantitative and qualitative, and presented as full day workshops, between 2017 to 2019, to frontline staff trained in existing dementia care philosophies. 92% of the attendees affirmed this paradigm’s ability to offer better assistance in “behavior care planning”. Qualitative thematic analysis: An innovative, simplified, enhanced, and comprehensive approach to understanding the reasons for the occurrence and recognition and labeling of behaviors in PwNCD. This approach offers increased insight into the understanding of “meaning” of behaviors in PwNCD. The Journal of Aging and Social Change: Volume 12, Issue 1, 2021.

Objectives: To clarify that correlation in plasma soluble TREM2 (sTREM2) and cognitive function between mild cognitive impairment (MCI) and normal cognitive function in a Chinese community population, and further to explore whether plasma sTREM2 can be used as a blood biomarker to predict and identify MCI.

Methods: This study included 216 community elderly people in Shijiazhuang and Xingtai City, Hebei Province, including 106 MCI and 110 normal cognitive function (NC) subjects. The Montreal cognitive assessment (MoCA) was used, mini mental state examination (MMSE), Boston naming test (BNT), digit span test (DST) to evaluate the cognitive functions of all subjects. Fasting venous blood was collected at the same time, and ELISA was used to detect Aβ42, Aβ40, P-Tau217, P-Tau231, TREM2, sTREM2 concentration. Use software based on SPSS26.0 to analyze the data.

Results: 1. The level of sTREM2 in the MCI group was higher than that in NC group, and the difference was statistically significant (H = 4312.0, P = 0.001). There was no statistical significance in the difference of the other index between two groups (P > 0.05). 2.Correlation analysis showed that sTREM2 was negatively correlated with P- tau217, education level, MMSE, MoCA, BNT, and DST (P < 0.05). TREM2 was positively correlated with P-tau217 and Aβ42 (P < 0.05). 3. Incorporate whether it was MCI as the dependent variable, gender, age, education level, living style, and the above blood indicators as independent variables in binary logistic regression analysis. The results showed that sTREM2 was a risk factor for MCI (OR = 1.009, 95%CI = 1.002– 1.016, P = 0.015), junior high school education or above was a protective factor for MCI (OR = 6.133, 95 % CI = 2.651–14.189, P < 0.001). 4.The area under the ROC curve of sTREM2 was 0.630 (sensitivity 0.472, specificity 0.782), and the area under the ROC curve of sTREM2 combined with MMSE was 0.849 (sensitivity 0.679, specificity 0.873).

Conclusions: sTREM2 is a risk factor for cognitive function decline in MCI. Plasma sTREM2 levels combined with the cognitive function assessment scale have good clinical value in identifying mild cognitive impairment.

This short article describes some of the archival materials held at Shulbrede Priory, located in West Sussex, England. This private home in Haslemere also serves as an archive containing materials related to the Ponsonby family and presents exciting research opportunities for historians of early twentieth-century Britain. The collection includes material related to the composer Hubert Parry and the diaries of Arthur and Dorothea Ponsonby. Additionally, it contains manuscript and photographic materials related to the Ponsonby's daughter, Elizabeth—particularly her involvement with the so-called Bright Young People of the 1920s and 1930s. As it remains a private home, this archive also compels us to think about the nature of family histories.

Background: The transition from hospital to community for psychiatric patients is often challenging due to difficulties in managing community life after discharge and receiving consistent mental health treatment (Marianne, 2019). Some systematic reviews reported on interventions to improve discharge from acute adult mental health inpatient care to the community (Tyler, 2019) and the effectiveness of crisis resolution/home treatment teams for older people with mental health problems (Toot, 2011). However, these reviews revealed inadequate evidence for nursing interventions in community. In Japan, home-visit nursing is considered to play an important role for people with mental disorders living in community.

This review aims to provide an overview of the effectiveness of home-visit nursing in supporting community life for individuals with mental disorders discharged from psychiatric hospitals.

Methods: We conducted a search in electronic databases including Medline (OVID) and CINAHL (EBSCOhost). The search was conducted using the following keywords: “mental disorders”, “hospitalization”, “patient readmission”, “home visit nursing”, “home nursing”, “home health care”, “home care services”, and “house calls”. The review included original articles and research reports. Conference reports and articles about other professions, and interventions conducted in hospitals or facilities were excluded.

Results: A total of 205 articles were extracted, with 109 from Medline and 96 from CINAHL. We retrieved 13 studies, including three randomized controlled trials, two interventional studies, and eight retrospective studies. Most participants were post-discharge individuals with mental disabilities, but some studies included individuals prior to hospital admission. Most studies reported that home-visit interventions reduced psychiatric rehospitalization, the duration of hospitalization, and medical costs. One study reported that community-based treatment for older persons with severe mental illness decreased depressive symptoms and psychiatric hospitalization at 6 months. Additionally, telephone follow-ups were reported to be more effective than regular interventions in some studies. However, the intervention and effectiveness measurement Methods varied among the studies.

Conclusions: Home-visit interventions appear to be effective in preventing hospitalization for individuals with mental disorders. However, it is difficult to make simple comparisons as the content of home-visit interventions varies according to the background system and the region. Further research and systematic reviews are necessary.

Objectives: Studies in PD have traditionally focused on motor features, however, interest in non-motor manifestations has increased resulting in improved knowledge regarding the prognosis of the disease. Although several studies have explored the incidence of dementia in PD cohorts, these studies have been conducted mainly in reference centers in high-income countries (HIC). In this study we aimed to analyze the prevalence of cognitive impairment in people with parkinsonism and PD and its association with incident dementia in a population- based study, of elderly from six Latin American countries.

Methods: This report consists of the analysis of data from a follow-up of 12,865 elderly people aged 65 years or older, carried out by 10/66 Dementia Research Group. Residents of urban and rural areas, from six low and middle- income countries (Cuba, Dominican Republic, Puerto Rico, Venezuela, Mexico and Peru). Exposures include parkinsonism and PD defined according to the UK Parkinson’s Disease Society Brain Bank diagnostic criteria. Cognitive impairment was the main exposure and dementia was measured through the dementia diagnosis algorithm from 10/66 DRG.

Results: At baseline, the overall prevalence of cognitive impairment was 14% (n = 1,581), in people with parkinsonism and PD, it was of 30.0% and 26.2%, respectively. Parkinsonism and PD were individually associated with prevalent and incident dementia after controlling for age, sex, and education. The pooled odds ratios from a fixed-effects meta-analysis were 2.2 (95% CI: 1.9 – 2.6) for parkinsonism and 1.9 (95% CI: 1.4 – 2.4) for PD. Regarding incident dementia, the pooled sub-Hazard ratio estimated using a competing risk model was 1.5 (95% CI: 1.2 –1.9) for parkinsonism and 1.5 (95% CI: 1.0 – 2.2) forPD.

Conclusions: Parkinsonism and PD were associated cross-sectionally with the presence of cognitive impairment, and prospectively with incident dementia in elderly people in the community population of Latin America studied. Systematic screening for cognitive impairment and dementia with valid tools in PD patients may help with earlier detection of those at highest risk for adverse outcomes. Identifying modifiable risk factors could potentially lead to efficient interventions even in advanced stages of PD.

Summary: Advancing Age-Related Issues Queried through an Exploratory Survey consists of qualitative and quantitative gero-research focusing on volunteers aged seventy and over.

The queries focus on geriatric issues regarding internalized self-discrimination and societally imposed direct and indirect discrimination. The survey Methods applies 2-3 multiple-choice inquiries, while some responses can be expounded upon. As the study is exploratory one of its goals is to lead to more questions on the issue of discrimination.

The study originally aimed at quantitatively collecting and processing response results, harvested through surveys from older adults who reside in The United Kingdom (England), Mexico and in Ireland. With that intention in mind, one of the study’s researchers (Doyle) took to the field but multifactorial logistics, sociocultural incongruencies and other challenges, would increase the time frame which she would need to run the survey as originally constructed as it held a qualitative, comparative component, which was planned for a co-project. She also discovered that a mosaic of distinct subsets of interviewees existed within each of the three survey regions and that would require reworking the original study.

The study-in-the-making was thus simplified to be effectuated with just one group of older adults – those survey participants who reside in Mexico. Reflecting on the challenges of running the original survey would become aa valuable part of the learning overall process.

Objectives: Through the application of an exploratory survey this mixed study seeks to identify patterns related to self-reported and internalized discrimination, and to direct and non-direct discrimination by third parties which impacts older adults. This survey serves as a brief pilot study with a more comprehensive study to thence follow.

Process: This study is being conducted through an anonymous and simple survey which consists of twelve inquiries– some which may be optionally expounded upon.

Methods: Before starting the survey, each prospective participant provides basic demographic data. For ease of comparing response data quantitatively, a 2–3-point multiple-choice format has been established with “yes”, “no” and “non-applicable” or a like-kind concrete response, being the available options. Basic, non-identifying demographic data includes the respondents birth year, type of living arrangement, educational level attained, and mobility level.

Inclusive criteria includes that each prospective participant is seventy years old or older.

All tentative participants are required to voice their express consent to participate. After each survey has been completed (or stopped, by the participant) they will be given a small lapel sticker identifying their participation.

Results: An evaluation of the survey responses will be effectuated, while a scientifically based over-arching reflection of the challenges presented which thwarted the development of the original study will be recognized.

Conclusions: Infographic, bar charts (captioned in English & Spanish) comparing survey responses through the group of survey respondents based in Mexico, will become accessible in poster format, in September of 2024.

Background: The Netherlands allows Medical Assistance in Dying (MAID) based on a diagnosis of dementia under strict legal conditions. The number of dementia MAID cases gradually increase every year up to 288 cases in 2022; 282 were decisionally competent and 6 were decisionally incompetent. In decisionally incompetent patients MAID has been granted based on a written advance directive. To assess decisional competence the Dutch euthanasia review committees, refer to criteria of Appelbaum and Grisso.

Objectives: To examine which factors, and how, influence the judgment of decisional competence for MAID requests of patients with dementia.

Methods: A qualitative analysis was performed of 60 dementia MAID case summaries as published online by the Dutch euthanasia review committees between 2012 and 2021: 20 cases had an advance directive and were decisionally compromised at time of MAID, 40 patients were decisionally competent at time of MAID, of which 20 also had an advance directive (purposive sampling). Two researchers independently coded all text related to decisional competence (thematic analysis). A theoretical framework about the assessment of decisional competence was developed.

Results: The four cognitive criteria of Appelbaum and Grisso were dimensional, and cut-off points were influenced by six factors that also directly impacted on competence assessment, i.e. level of communication, psychiatric comorbidity, personality, presence of an advance directive, consistency of the request, and the patient-physician relationship.

Conclusions: The framework illustrates the complex multidimensional nature of assessment of decisional competence in dementia patients requesting MAID. Subjectivity of the final judgement poses ethical and legal issues and argues for continuous quality improvement processes.

Objectives: Because of the continued transition to older populations, various strategies have been developed to estimate the social impact and burden of health care. Regarding mental health, a strategy in the elderly is the measurement of neuropsychiatric symptoms (NPS), these include a wide range of behavioral and psychological manifestations. These are more frequent in the presence of some diseases, such as neurodegenerative syndromes, among which dementias and Parkinson’s disease (PD) stand out. The present study seeks to analyze the frequency of NPS, its relationship with the presence or absence of neurodegenerative syndromes and some characteristics of the elderly and caregivers.

Methods: This is an analysis of data from 12,865 elderly people evaluated within the protocols of the Dementia Research Group 10/66 in 6 Latin American countries (Cuba, Dominican Republic, Puerto Rico, Mexico, Venezuela and Peru). The presence or absence of parkinsonism, dementia and parkinsonism plus dementia (PDD) was identified through previously validated and published Methods. The NPS were assessed using the 12-symptom questionnaire version of the Neuropsychiatric Inventory. Other characteristics such as age, sex and education, in patients and caregivers; socioeconomic status, disability and comorbidities in the elderly; relationship with the elderly, needs and care-burden were assessed in careers.

Results: The most frequent symptoms were depression and sleep disorders in the four groups (without non-NDS neurodegenerative syndromes, parkinsonism, dementia and PDD, ranging from 23% to 49%. About a third of the elderly with parkinsonism, half of those with dementia, and 3 out of 5 of the elderly with PDD had 3 or more NPS. The odds ratios (OR) of each NPS measure by multivariate logistic regression models shown OR from 1.4 to 1.9 in the presence of parkinsonism; between 1.7 and 9.3 in the presence of dementia; and between 1.9 and 10.2 in the presence of PDD.

Conclusions: From a clinical and public mental health perspective, it is necessary to implement systematic Methods for NPS screening, as well as develop support strategies for families and caregivers, mainly of those with neurodegenerative syndromes.

Limited research exists on preceramic sites in south-central coastal Peru. Systematic survey and excavations at Pampa Lechuza, Ica, now confirm a Late Pleistocene–Early Holocene Paiján (13 000–9000 cal BP) occupation and identify Quispisisa-sourced obsidian Paiján points, which are the only examples currently known to use this raw material.

Introduction: Coping strategies are intentional, cognitive, and behavioral actions aimed at controlling the negative impact of a stressful event or situation.

Objectives: The Objectives of this study was to evaluate the coping strategies used by caregivers of patients with Alzheimer’s disease and the development of strategies to reduce dysfunctional behaviors by patients.

Methods: The sample for this study included 33 caregiver-patient dyads diagnosed with Alzheimer’s disease. Data were collected at the Alzheimer’s Disease Center - ADC, at the Institute of Psychiatry of the Federal University of Rio de Janeiro. Patients were assessed for cognition, quality of life, disease awareness, functionality, and depression. Caregivers were assessed for coping, resilience, depression, anxiety, burden, and locus of control. Caregivers also provided information about mood, neuropsychiatric symptoms, severity of decline, activities of daily living, and quality of life of the patients.

Results: 82% of caregivers were female, with a mean age of 56.36 (SD = 14.31). Caregivers showed high levels of resilience, with an average score of 141.9 (SD = 12.54), moderate level of coping strategies 66.55 (SD = 12.86), moderate level of locus of control 67.4 (SD = 10.3), moderate level of burden 37.61 (SD = 18.1), low level of anxiety .64 (SD = 5.91), and low level of depressive symptoms 8.91 (SD = 8.30). Patients had a mean age of 74 years (SD = 9.4) and 54.5% of patients were male. Patients had an average score of 18.45 on cognition assessment, 60% had mild dementia, low depression index 9.48 (SD = 5.75), moderate levels of neuropsychiatric symptoms 26.45 (SD = 23.63), partially compromised disease awareness 10.8 (SD = 5.31), and high quality of life indices 33.21 (SD = 5.8). The results show a positive correlation between coping strategies and clinical variables. The use of coping strategies associated with high levels of resilience and locus of control may have contributed to the low levels of anxiety, depression, and burden among caregivers.

Conclusions: Coping strategies focused on emotion seem to be more effective for patients with mild dementia, while problem-focused coping strategies yielded better results for patients with moderate dementia.

This study presents an approach to investigate the role of eddy viscosity in linearized mean-field analysis of broadband turbulent flows. The procedure is based on spectral proper orthogonal decomposition (SPOD), resolvent analysis and the energy budget of coherent structures and is demonstrated using the example of a turbulent jet. The focus is on the coherent component of the Reynolds stresses, the nonlinear interaction term of the fluctuating velocity component in frequency space, which appears as an unknown in the derivation of the linearized Navier–Stokes equations and which is the quantity modelled by the Boussinesq approach. For the considered jet the coherent Reynolds stresses are found to have a mostly dissipative effect on the energy budget of the dominant coherent structures. Comparison of the energy budgets of SPOD and resolvent modes demonstrates that dissipation caused by nonlinear energy transfer must be explicitly considered within the linear operator to achieve satisfactory results with resolvent analysis. Non-modelled dissipation distorts the energy balance of the resolvent modes and is not, as often assumed, compensated for by the resolvent forcing vector. A comprehensive analysis, considering different predictive and data-driven eddy viscosities, demonstrates that the Boussinesq model is highly suitable for modelling the dissipation caused by nonlinear energy transfer for the considered flow. Suitable eddy viscosities are analysed with regard to their frequency, azimuthal wavenumber and spatial dependence. In conclusion, the energetic considerations reveal that the role of eddy viscosity is to ensure that the energy the structures receive from the mean-field is dissipated.

Introduction: Early functional changes in women compromise elements such as muscle mass and strength, physical function, and gait speed, leading to a physiological decline that may contribute to frailty in old age.

Objectives: This study aimed to relate strength and physical performance to premature functional decline in women aged 40 years and older.

Methods: A cross-sectional descriptive observational study was conducted, and two groups of women were contrasted (40 to 60 years old and 60 and over), completing a sample of 31 women. Functional decline, lower limb muscle power, prehensile strength, physical performance, gait speed, phenotype of frailty status, level of physical activity, and other sociodemographic factors were contrasted. The UCT internal ethicscommittee.

Results: Preliminary results showed that, among the demographic variables, women over 60 had a lower level of schooling, with 29% having incomplete basic education. Both groups reported a similar number of children: 93% in those under 60 and 100% in those over 60, with an average of 2.3 and 3.06 children, respectively. Statistically significant differences were detected in physical performance, lower limb strength, and gait speed, which were higher in women under 60.

Conclusions: The present report detected that lower limb strength, a determinant of great relevance in the aging population, affects gait speed. Likewise, muscle strength leads to a more rapid decline in older people. In both groups, physical performance played a crucial role in characterizing aging and frailty, particularly at ages over 60, when a decline in performance was evident. Notably, there were no variations in grip strength or physical activity levels, possibly because both groups performed poorly, raising the possibility of functional decline in women who have not yet reached old age.

Introduction: The international demographic data indicates a growth in the population of older people, which is why it is necessary to begin to talk about the process of aging with disabilities from a bio-psycho-socio-functional approach and their socio-family environment according to the pillars of the Decade of Healthy Aging (2021-2030).

Taking into account disability situations in older persons as the guiding thread of concern about the increase on frailties, these presentations will highlight different contributions that open a debate regarding the challenge and the complexity to approach older persons with disabilities in gerontological work, the psychological aspects and the existing legal framework.

Objectives: This Symposium seeks to put on the scientific agenda a topic that make us rethink and reevaluate our intervention practices with a comprehensive approach to older people with disabilities.

Methods: Scientific communications and empirical research.

Results: Empirical data will be provided in reference to each Symposium’s speakers presentations.

Conclusions: It is hoped to raise questions about whether it is possible to achieve the paradigm change from older persons as an object of care to a subject of law.

Keywords: Gerontology, Disability, Autonomy, Legal Framework

Symposium Coordinator: Cecilia Volpe

Speakers

Dr Wanda Gisbert, Geriatrician: Comprehensive approach to frailty as a predictor of disability. Dr Isabel Lovrincevich, Lawyer: Autonomy and dependence in old age. Psychologist Bibiana Kompel: A topic that challenges us: New Psycho Gerontological approach.

The goal of this paper is to show that the theory of curvature invariant, as introduced by Arveson, admits a natural extension to the framework of ${\mathcal U}$-twisted polyballs $B^{\mathcal U}({\mathcal H})$ which consist of k-tuples $(A_1,\ldots, A_k)$ of row contractions $A_i=(A_{i,1},\ldots, A_{i,n_i})$ satisfying certain ${\mathcal U}$-commutation relations with respect to a set ${\mathcal U}$ of unitary commuting operators on a Hilbert space ${\mathcal H}$. Throughout this paper, we will be concerned with the curvature of the elements $A\in B^{\mathcal U}({\mathcal H})$ with positive trace class defect operator $\Delta_A(I)$. We prove the existence of the curvature invariant and present some of its basic properties. A distinguished role as a universal model among the pure elements in ${\mathcal U}$-twisted polyballs is played by the standard $I\otimes{\mathcal U}$-twisted multi-shift S acting on $\ell^2({\mathbb F}_{n_1}^+\times\cdots\times {\mathbb F}_{n_k}^+)\otimes {\mathcal H}$. The curvature invariant $\mathrm{curv} (A)$ can be any non-negative real number and measures the amount by which A deviates from the universal model S. Special attention is given to the $I\otimes {\mathcal U}$-twisted multi-shift S and the invariant subspaces (co-invariant) under S and $I\otimes {\mathcal U}$, due to the fact that any pure element $A\in B^{\mathcal U}({\mathcal H})$ with $\Delta_A(I)\geq 0$ is the compression of S to such a co-invariant subspace.

Summary: Age-related neurocognitive decline is often an irreversible health issue from onset. The concomitant costs could be exponential if left unchecked. There is a need to be able to delay the onset of age-related neurocognitive decline or possibly avoid it altogether. Previous studies have shown that there is a strong positive relationship between the fitness of neurocognitive function and cognitive training. Our laboratory conducted two pilot trials (Lee et al., 2013 & 2015) and one larger scale randomised controlled trial (RCT) (Yeo et al., 2018) investigating the usability and efficacy of a brain-computer interface (BCI) based attention and memory cognitive training system on older adults between ages 60 to 80. The participants across all three trials found the different iterations of our attention-memory training system to be usable and acceptable, with adherence rates surpassing 90%.

Interestingly, a growing number of studies suggest combined cognitive training and physical activity may result in a better neurocognitive outcome as compared to only cognitive training. Combining the insights from those studies and our previous trials, we developed a novel personalized multimodal BCI-based cognitive and physical training system, NeeuroCycle, for neurocognitive protection and enhancement in older adults. NeeuroCycle comprises of a stationary recumbent bicycle and a gamified cognitive training system paired with real-time frontal electroencephalogram (EEG) neurofeedback. The cognitive training program consists of six different tasks that target attention, immediate/working and delayed memory, decision- making, and visuospatial abilities. Certain parts of the gameplay are directly impacted by the partcipant’s own real-time EEG signals. NeeuroCycle has also been designed to include locally relevant stimuli and designs for our Singaporean older adult participants. Evaluation of NeeuroCycle’s efficacy is ongoing. The current study employs a three-arm RCT approach (physical- and-cognitive training [mBCI], cognitive training only [nBCI], and active control [AC] groups). We hypothesise that mBCI par1cipants will perform significantly better on cognitive assessments compared to nBCI and AC participants. Findings of the study will be presented at the IPA Congress. If tested to be effective, we expect NeeuroCycle to be an accessible, safe, and cost-effective way for older adults to maintain or improve cognitive health, which is beneficial for ageing societies.

Objectives: Patients with mild cognitive impairment (MCI) employ compensatory cognitive processes to maintain independence in day-to-day functioning as compared to patients with Alzheimer’s dementia (AD). The dorsolateral prefrontal cortex (DLFPC) supports cognitive compensation in normal aging and MCI. Using Paired Associative Stimulation combined with Electroencephalography (PAS-EEG) we have previously shown that patients with AD have impaired DLPFC plasticity compared to healthy control (HC) individuals. The aim of this study is to examine whether DLPFC plasticity in individuals with MCI is preserved compared to those with AD and HC, serving as a potential mechanism underlying cognitive compensation in MCI.

Methods: We analyzed a combined cross-sectional data of 47 AD, 16 MCI, and 40 HC participants from three different studies that assessed their DLPFC plasticity using PAS-EEG. PAS-EEG assesses DLPFC plasticity via the induction of Long Term Potentiation (LTP)-like activity, thereby referred to as PAS-LTP. Using multiple regression, we compared PAS-LTP in MCI to PAS-LTP in AD and HCs, after adjusting for age andgender.

Results: Among the 47 participants with AD (mean [SD] age = 75.3 [7] years), 29 were women and 18 were men; among the 16 participants with MCI (mean [SD] age = 74.8 [6] years), 11 were women and 5 were men; and among the 40 HCs (mean [SD] age = 76.4 [5.1] years), 22 were women and 18 were men. After adjusting for age and gender, there was an impact of diagnostic group on PAS-LTP [F (2,95) = 4.19, p = 0.018, between-group comparison η2 = 0.81]. Post-hoc comparisons showed that participants with MCI had a higher PAS-LTP (mean [SD] = 1.31 [0.49]) than those with AD (mean [SD] = 1.09 [0.28]) (Bonferroni corrected p = 0.042) but not different from PAS-LTP in HCs (mean [SD] = 1.25 [0.33]) (Bonferroni corrected p = 1.0).

Conclusions: Our findings indicate that plasticity is preserved in the DLPFC among individuals with MCI, supporting the hypothesis that DLPFC plasticity contributes to cognitive compensation towards delaying progression to AD. Thus, further enhancement of longer preservation of DLPFC plasticity in individuals with MCI could further delay the onset of AD in this population.

Objectives: Depression is the second most prevalent mental illness among the elderly. Nonetheless, treatment- resistant depression (TRD) is prevalent among the elderly; one-third of elderly patients with major depressive disorder (MDD) who received antidepressant treatment failed to achieve remission. Although there have been several studies regarding the associations between MDD and increased mortality and suicidal risk, studies between TRD and mortality/suicidal risk in the elderly still remains limited. In this national cohort study, we examined the association between TRD, non-TRD MDD, and non-depression with all-cause mortality, accident mortality, and suicide mortality.

Methods: For this retrospective longitudinal analysis on the entire population, the National Health Insurance Research Database of Taiwan, which comprises claims data from a lifetime insurance program and provided comprehensive medical inpatient and outpatient information categorized by ICD-9-CM and ICD-10. The National Mortality Registry offered information regarding mortality resulting from all causes, natural causes, suicide, and accidents. A cohort of ≥60-year-old patients, including both those with and without MDD, was observed between January 2003 and December 2017. Individuals were classified as TRD if they had undergone aminimum of two distinct antidepressant trials within the current episode’s two-year duration and dose, as documented in the prescribing records. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were calculated for mortality risk utilizing Cox regression models.

Results: Among those >60 years old, after adjusting with sex and comorbidities, TRD was associated with increased risk of suicide (aHR 7.4, 95% CI [5.6-9.8]; MDD without TRD 4.4 [4.1- 4.6], compared with non-MDD group). Simliar risk of accident mortality was observed among three groups (TRD aHR 1.3 [0.9-1.9]; MDD without TRD 0.9 [0.9-1.0], compared with non-MDD group). Surprisely, TRD might presented lower mortality risk of natural mortality than the non- MDD group (TRD aHR 0.8 [0.7-0.8]; MDD without TRD 0.9 [0.8-0.9], compared with non- MDD group).

Conclusions: The suicide mortality among elderly patients with TRD is higher in comparison to non-MDD patients; nevertheless, accident mortality does not appear to have increased and the natural mortality rate is reduced. The lower mortality may reflect patient selection, and the contributing factors need further evaluation.