Given any unital, finite, classifiable $\mathrm{C}^*$-algebra A with real rank zero and any compact simplex bundle with the fibre at zero being homeomorphic to the space of tracial states on A, we show that there exists a flow on A realizing this simplex. Moreover, we show that given any unital $\mathrm{UCT}$ Kirchberg algebra A and any proper simplex bundle with empty fibre at zero, there exists a flow on A realizing this simplex.

Objectives: Geriatric abuse, a grave violation of human right affecting older adults, remains a silent epidemic in India. This study provides an insight into the prevalence, manifestation, contributing factors and societal implications of geriatric abuse within the Indian context. Drawing from scholarly research and empirical evidence it aims to illuminate the multifaceted nature of this phenomenon and advocate for urgent attention from policy makers, healthcare professional, and society at large Despite its pervasive nature, geriatric abuse in India often goes unnoticed and unaddressed due to cultural norms, family secrecy and systemic neglect. The abuse may take various forms including physical, psychological, financial and neglect perpetrated by family members, care givers or institutional staff. Factors such as socio- economic disparities, gender inequalities and cultural attitudes towards aging intersect to exacerbate the vulnerability of older adults to abuse. Understanding the socio cultural dynamics shaping geriatric abuse its essential for effective intervention and prevention strategies, traditional values emphasizing familial duty and respect for elders coexist with modern challenges such as urbanization, migration, and changing family structures impacting elder care and support networks furthermore, inadequate legal protections, limited access to healthcare, and stigma surrounding aging compound the challenges faced by older adults experiencing abuse. Addressing geriatric abuse in India requires a comprehensive approach encompassing legislative reforms community mobilization and capacity building initiatives strengthening reforms legal frame works to protect elder rights tailored to the needs of older adults and promoting awareness campaigns to challenge ageism and stigma are critical steps to creating a society where older adults age with dignity and safety.

Methods: We used interview and survey Methods to derive a representative sample (based on race gender education) in order to measure elder abuse in west Rajasthan (India) based population. Participants undergone interviewed via in OPD, IPD by taken case history, about a variety of abuse/mistreatment types and mistreatment risk factors in addition to question regarding health, social support and demographic. Specific elder abuse categories included emotional, physical, sexual, financial and neglect.

Results: Results of this study will be discussed during my presentation at the conference.

Conclusions: In consistent, geriatric abuse in India represents a profound violation of human rights and a moral imperative for action by acknowledging the complexities of this issue and fostering collaboration among stake holders, India can strive towards a future where older adults are respected, empowered and free from abuse and neglect.

The World Health Organization (WHO) proclaimed September 21 as World Alzheimer’s Disease Awareness Day and extended the observance to the entire month. Various awareness campaigns are being conducted around the world, with special emphasis on the importance of education to improve the quality of life for patients, families, and the community at large, and to eliminate stigma and ageism.

It is estimated that there are approximately 44 million people worldwide with some form of dementia, while in the United States it reaches 5.4 million. In Puerto Rico, it is estimated that there are approximately 60,000 people with Alzheimer’s disease. An AARP study (2021) showed that there are over 500,000 caregivers of older adults, making Puerto Rico one of the top three countries with the largest aging population and the 6th country in the world. While in Latin America and the Caribbean there is a prevalence between 6.2 and 6.5 per 100 adults aged 60 years or older (WHO).

This health and social situation require an educated and empowered society to meet the challenges. Muñoz et. al (2023) conducted a qualitative study with caregivers and found that 91% of the participants stated that training would help them provide better care to the elderly. Social work is one of the main disciplines dealing with this social phenomenon and should therefore play a leading role in education and therapeutic intervention.

For the past five years, the Department of Social Work at Inter-American University, Metro Campus, has joined and supported the cause through the celebration of the Alzheimer’s Symposium: A Perspective from the Academy. This event involves the entire university community, as well as the community at large, which includes caregivers, government and non- profit agencies, and professionals from various disciplines. There will be concurrent lectures, Discussions among local and international professionals, a film forum, poster presentations, artistic expressions, and educational tables. The 6th Symposium will be held on September 20, 2024. The Symposium is promoted through various media. This activity has generated alliances, recommendations and new educational projects that contribute to the well-being of older adults.

This study presents surveillance data from 1 July 2003 to 30 June 2023 for community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) notified in the Kimberley region of Western Australia (WA) and describes the region’s changing CA-MRSA epidemiology over this period. A subset of CA-MRSA notifications from 1 July 2003 to 30 June 2015 were linked to inpatient and emergency department records. Episodes of care (EOC) during which a positive CA-MRSA specimen was collected within the first 48 hours of admission and emergency presentations (EP) during which a positive CA-MRSA specimen was collected on the same day as presentation were selected and analysed further. Notification rates of CA-MRSA in the Kimberley region of WA increased from 250 cases per 100,000 populations in 2003/2004 to 3,625 cases per 100,000 in 2022/2023, peaking at 6,255 cases per 100,000 in 2016/2017. Since 2010, there has been an increase in notifications of Panton-Valentine leucocidin positive (PVL+) CA-MRSA, predominantly due to the ‘Queensland Clone’. PVL+ CA-MRSA infections disproportionately affect younger, Aboriginal people and are associated with an increasing burden on hospital services, particularly emergency departments. It is unclear from this study if PVL+ MRSA are associated with more severe skin and soft-tissue infections, and further investigation is needed.

Objectives: With the global growth of the population of older adults, the prevalence of mental health disorders in this age group is also increasing. Despite the high demand for prompt access to specialized care, referrals to geriatric psychiatry are still disproportionately low, as suggested by the review of current epidemiological studies. Research data evaluating referral patterns to geriatric specialists are limited and indicate that primary care providers play a key role in the referral process.

Methods: As a part of a year-long Archstone Learning Collaborative, a group of geriatric psychiatrists has had monthly meetings discussing various contemporary issues in geriatric psychiatry. One of the projects was to clarify a decision-making process for medical professionals and caregivers, to help them determine when to refer to geriatric specialists, including geriatric psychiatrists.

Results: We reviewed the most common criteria for referral to geriatric psychiatrists and other specialists with overlapping expertise in geriatric mental health care. We have worked on a diagram and a flowchart to help navigate the referral process. To empower primary care providers and other medical professionals, we created a flyer for caregivers, educating them on what signs and symptoms may indicate the need for seeking a referral to geriatric psychiatrists.

Discussion: Encouraging interdisciplinary collaboration and streamlining referral processes are crucial to fulfilling the increasing demand for geriatric psychiatry services. To guarantee older adults receive the specialized care they need, it is important to raise awareness among various medical professionals regarding the referral criteria and the roles of different geriatric specialty providers. Caregivers are essential to the referral process because they can identify warning signs and symptoms and seek referrals. Overall, this presentation offers insightful information about the referral process to geriatric psychiatry, intending to enhance access to mental health care for older adults with mental health disorders.

Many efforts to persuade others politically employ interpersonal conversations. A recurring question is whether the participants in such conversations are more readily persuaded by others who share their demographic characteristics. Echoing concerns that individuals have difficulties communicating across differences, research finds that individuals perceive demographically similar people as more trustworthy, suggesting shared demographics could facilitate persuasion. In a survey of practitioners and scholars, we find many share these expectations. However, dual-process theories suggest that messenger attributes are typically peripheral cues that should not influence persuasion when individuals are effortfully thinking, such as during interpersonal conversations. Supporting this view, we analyze data from eight experiments on interpersonal conversations across four topics (total N = 6, 139) and find that shared demographics (age, gender, or race) do not meaningfully increase their effects. These results are encouraging for the scalability of conversation interventions, and suggest voters can persuade each other across differences.

Objectives: To identify the characteristics and principals’ diagnosis of the older patients of a mental service in order to design the basis of an intervention plan.

Methods: Retrospective longitudinal observational study based on a secondary database provided by Mentalitat. Results: On a year 30% of the attention were over 60 years old, 70% of them was women with anxiety disorder, mixed anxiety-depression disorder, and mayor neurocognitive disorder. Almost half of the dementias had not reported etiology despite the repeat attentions.

Conclusions: In order to improve the mental state and reduce hospitalization interventions should be focused on women with anxiety or/and depression and brain health to influence the incidence of neurocognitive impairment and the quality of life; emphasizing dementia training for mental health care.

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: Compare the psychometric characteristics of three brief screening instruments - Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and its basic version (MoCA basic), for early detecting mild and major neurocognitive disorder (NCD), discriminating from normal elders and provide MoCA and MoCA basic norms and accuracy data for seniors with a lower education level, including illiterates.

Methods: Cross-sectional study, with 60 years or older community dwelling individuals, submitted to diagnostic interviews (according to DSM-5) and screening tests. Of a total of 271 elderly interviewed, 59 had mild and 32 had major NCD. A sum of 266 MMSE; 104 MoCA and 81 MoCA basic were applied. Area under the ROC curve (AUC) was determined for all three tests, and sensitivity (S), specificity (E) and cutoff score (CS) for the last two were determined.

Results: The total scores varied significantly according to age and education (p < 0.01). MMSE had a high discriminative validity – AUC for normal vs major NCD = 0,915 (p < 0.001; 95% CI 0,868– 0,963) and regular for normal vs mild NCD = 0,706 (p < 0.001; 95% CI 0,631–0,781). MoCA demonstrated excellent discriminative validity – AUC for normal vs major NCD = 0.932 (p < 0.001; 95% CI 0.842–1.000) and regular for mild NCD – AUC = 0.753 (p < 0.001; 95% CI: 0.654– 0.853). CS was 9 (S = 83% E = 95%) and 16 (S = 83% E = 68%). MoCA basic showed excellent discriminative validity for major NCD vs normal AUC = 0.910 (p < 0.001; 95% CI 0.818–1.002) and good for mild NCD vs normal AUC = 0.834 (p < 0.001; 95% CI: 0.742 –0.927). CS was 21 for both conditions (S = 100% E = 72%; S = 89% E = 72%).

Conclusions: The MoCA and MoCA basic are valid screening instruments for cognitive assessment of low-schooled elderly people from the community, but we found different cut-off from the original and other studies. The MMSE still remains a good and useful tool. These results provide information about psychometric characteristics of the instruments for elderly with low schooling in Brazil.

Objectives: There is a lack of research on differences between decision-making capacity and awareness according to age at onset of dementia. We investigated the relationship between decision-making capacity and awareness domains in people with young-(YOAD) and late-onset Alzheimer´s Disease (LOAD).

Methods: A cross-sectional study included 169 consecutively selected people with AD and their caregivers (124 people with LOAD and 45 people with YOAD). Decision-making capacity was assessed with the MacCAT-T and awareness with the ASPIDD scale.

Results: People with YOAD were more cognitively impaired, but more aware of their cognitive deficits and health condition, with moderate effect sizes. We did not find any other significant differences between the groups in the other domains of awareness. In addition, there were no significant differences in the domains of decision-making capacity between groups. All PwAD presented deficits in the domains of decision-making capacity with a greater impairment in the understanding domain (YOAD = mean 3.67, SD 1.57; LOAD = mean 3.80, SD 1.22). Understanding was the domain of MacCAT-T most significantly associated with awareness domains: ASPIDD Total (p < 0.001), awareness of cognitive deficits and health condition (p < 0.001), awareness of emotional state (p < 0.008), awareness of social functioning and relationships (p < 0.001), and awareness of impaired functional activity (p < 0.001). However, age at onset only impacted total ASPIDD (p < 0.013) and awareness of cognitive deficits and health condition (p < 0.001).

Conclusions: Better awareness involved better understanding in the YOAD group. Clinically, our findings shed light on the need to consider the differences in the domains of awareness and their relationship with other clinical aspects such as decision-making capacity according to age at onset of AD.

Introduction: Recurrent major depressive disorder (MDD) has been associated with cognitive impairment and hippocampus atrophy. Additionally, in older adults it is related to increased dementia risk, as well as being dementia’s prodromal syndrome.

Case Report: A 68-year-old female patient, with a history of MDD beginning in 2014, has been under the care of the Psychogeriatrics service at HC-UFMG. In 2015, she was 60-year-old and underwent her first MRI scan. At that time, the Medial Temporal Atrophy Score (MTA) was 2 and she had a treatment resistant depression (TRD). She began multimodal treatments, including ECT, achieving only partial remission. Since then, the patient had recurrences of depression without the remission of cognitive impairment. In 2021, her MTA Score was still 2 with TDR symptoms. Currently, she is on Venlafaxine 150mg, Mirtazapine 30mg, Lithium 300mg, Olanzapine 5mg, Clonazepam 0.25mg and maintenance ECT every 45 days. The patient remains with cognitive impairment that leads to disabilities but had not significantly progressed. On the other hand, the main impact in functionality is related to depressive symptoms, especially to the loss of interest and apathy.

Discussion: This case stands out due to the combination of hippocampal atrophy at a relatively young age and severe depression with cognitive impairment that has not progressed to dementia in 9 years. Severe depression can lead to significant cognitive deficits, as well as, hippocampus atrophy. While depression is related to hippocampus atrophy, it has not been related to TRD in a review study with Voxel-Based Morphometry. Conversely, Alzheimer’s Disease is related to MTA ≥2 scores, as well as depressive symptoms. MTA 2 in a person of 60 years of age is not considered normal. When combined with cognitive impairment, these findings are generally related to neurodegeneration. Since both MTA and cognitive deficits were relatively stable, the hypothesis of a cognitive impairment and hippocampus atrophy due to depression were more likely.

Conclusions: MDD leads to cognitive impairment in older adults, as well as hippocampus atrophy. Nevertheless, depression and age are important risk factors for dementia and, therefore, a progression to dementia due to a neurodegenerative disease is still possible.

This article serves as the introduction to a Special Issue of the European Journal of International Security titled ‘What the War on Terror Leaves Behind’. In it, we seek to contextualise and summarise the diverse contributions of this collection, which is animated by four overarching questions: (i) More than 20 years after the attacks of 11 October 2023, is the War on Terror now, finally, over? (ii) What, if any, legacies remain from the post-9/11 way of thinking and doing counterterrorism? (iii) What is the significance of the War on Terror’s legacies or absence thereof? and, (iv) How do the War on Terror’s impacts and effects sit within other historical contexts and (dis)continuities? The article begins with a brief overview of some of the conceptual and political ambiguities of the War on Terror itself, before situating the issue in relation to issues of continuity and change anticipated by the four questions above. A second section then explores the urgency of these questions for academic debate, and in the ‘real world’ of international security as experienced by states, communities, and other subjects. A third section then summarises the argument and contributions of the articles in the issue –highlighting the lack of agreement on key issues within these debates.

Introduction: Frailty is a common condition among older individuals and is associated with increased vulnerability to adverse health outcomes. The COVID-19 pandemic has further highlighted the impact of viral infections on frail individuals.

Objectives: This study assessed the functional and clinical analysis changes in frail patients before and after SARS- CoV-2. This study evaluated the functional and clinical changes in frailty patients before and after SARS-CoV-2 infection in a cohort of 20 frailty patients of a long-stay facility.

Methods: Demographic, clinical, and functional data, including the Barthel index, Katz index, and Mini-Mental Examination, were collected. Clinical analyses were also conducted, including a complete blood count and biochemical profile. The functional and clinical analyses were compared before and after SARS-CoV-2 infection using t-tests. Pearson’s correlation was used to analyze the relationship between functionality, frailty, and clinical biomarkers.

Results: The cohort had a mean age of 84 ± 2.42 years, with 80% female. The most common comorbidities were Arterial Hypertension, Diabetes Mellitus type II, and Alzheimer’s disease. The functional assessment showed a significant increase in functional dependence on basic activities of daily living after the SARS-CoV-2 infection. Significant differences were also observed in grooming, bowel, and bladder control. Clinicals biomarkers, such as albumin, showed substantial changes post-infection.

Conclusions: The findings indicate worsening functional dependence and changes in clinical biomarkers after an illness. These results emphasize the need for targeted interventions and support for frail individuals during viral outbreaks. Further research is warranted to explore the long-term consequences of COVID-19 on frailty and develop strategies to mitigate its impact.

Background: There are no approved treatments for Alzheimer’s disease psychosis (ADP). Xanomeline, a brain- penetrant M1/M4 preferring muscarinic receptor agonist, showed antipsychotic efficacy in placebo-controlled trials in subjects with AD [Bodick NC et al. 1997; DOI: 10.1001/archneur.1997.00550160091022]. Despite promising efficacy, further development of xanomeline was limited by cholinergic adverse events. The investigational antipsychotic xanomeline and trospium combines xanomeline with trospium, an FDA-approved muscarinic receptor antagonist that does not measurably cross the blood-brain barrier. Trospium acts to mitigate the peripheral procholinergic side effects of xanomeline, providing a strategy for using xanomeline to stimulate brain muscarinic receptors with a decreased side effect burden. Unlike available antipsychotics, xanomeline and trospium have no direct dopamine D2-blocking activity, and as such, its safety and tolerability profile is different.

Methods: The phase 3 ADEPT-1 trial is a double-blind, flexible-dose, placebo-controlled randomized withdrawal study to evaluate the safety and efficacy of xanomeline and trospium in decreasing the risk of relapse in subjects with ADP. Subjects aged 55-90 years with moderate to severe psychosis associated with mild to severe AD (Mini- Mental State Exam score range 8-22) will be enrolled into the study. Subjects will receive single-blind xanomeline and trospium for 12 weeks. Each subject will be flexibly titrated to the maximum dose of xanomeline and trospium 200 mg xanomeline/20 mg trospium/day. At the end of the single-blind treatment, eligible responders will be randomized to either continue xanomeline and trospium or be switched to matched placebo for a 26-week double- blind treatment period. A responder is defined as a subject with a ≥40% decrease (improvement) on the Neuropsychiatric Inventory- Clinician: Hallucinations + Delusions (NPI-C: H+D) score compared with baseline (day 1) and a Clinician Global Impression–Change (CGI-C) score of 1 or 2 (very much improved or improved).

Results: The primary endpoint of the study, time from randomization to relapse during the double-blind, randomized withdrawal treatment, will be evaluated by survival analysis using Kaplan-Meier Methods. The study started in August 2022 and will randomize approximately 200 subjects.

Conclusions: The trial design of the ADEPT-1 study is an efficient way to assess the potential for xanomeline and trospium to provide clinically meaningful benefit in preventing the return of ADP in patients who have responded to xanomeline and trospium.

Substance use disorders (SUDs) among older adults represent a growing but often overlooked public health crisis. This presentation explores the prevalence, impact, and management of SUDs in later life, focusing on alcohol, cannabis, and opiate use, as well as misuse of over the counter (OTC) medications.

Aging populations are increasingly at risk of developing SUDs due to factors such as chronic pain, mental health disorders, and social isolation. The physiological changes associated with aging also alter drug metabolism and increase susceptibility to adverse effects. Despite being the most common SUD in older adults, alcohol misuse often goes undetected. Cannabis use is rising among seniors due to changing legal landscapes, presenting both potential therapeutic benefits and risks. Opiate dependency often stems from chronic pain management, necessitating best practices for opiate use and alternatives. Additionally, misuse of OTC medications, such as sleep aids and pain relievers, is a growing concern.

Effective management of SUDs in older adults requires a multidisciplinary approach, integrating medical, psychological, and social support. Key principles include comprehensive assessment, personalized treatment plans considering comorbidities and polypharmacy, behavioral interventions, and ongoing education for healthcare providers on age-specific SUD challenges and management. Addressing SUDs in older adults is crucial for improving quality of life and reducing healthcare costs. This presentation aims to highlight the significance of early detection, appropriate intervention, and the importance of a holistic approach to managing SUDs in the aging population.

The Clinical descriptions and diagnostic requirements for ICD-11 mental, behavioural and neurodevelopmental disorders (CDDR) and Non-Substance Uses Addictions in Old Age (NSUAOA)- Carlos Augusto de Mendonça Lima, M.D., MSci., DSci.

The Eleventh Revision of the World Health Organization’s International Classification of Diseases (ICD-11) represents major, comprehensive revision of the ICD in the last 30 years, and incorporates major advances in scientific evidence, best clinical practices and health information systems The Clinical descriptions and diagnostic requirements for ICD-11 mental, behavioural and neurodevelopmental disorders (CDDR), led by the WHO Department of Mental Health and Substance Use, constitutes the most broadly international, multilingual, multidisciplinary and participative revision process ever implemented for a classification of mental disorders.

The CDDR are an integral part of ICD-11, and have been developed specifically for the ICD-11 mental, behavioural and neurodevelopmental disorders chapter, providing substantially more detailed information needed to understand and apply this part of the classification.

A major improvement in the ICD-11 CDDR is the consistency of structure and information across major categories. The information provided for the main disorder categories in the CDDR is organized under the following headings:

• Essential features

• Additional clinical features

• Boundary with normality

• Course features

• Developmental presentations

• Culture-related features

• Sex- and/or gender-related features

• Boundaries with other disorders and conditions (differential diagnosis).

Yet we regret thar age was not considered in this list of headings. This is a missing opportunity to provide specific care for older persons and develop research to study the potential influence of the ageing process on the clinical features of mental health conditions. This is particularly true in the case of NSUAOA, an area that has been particularly neglected besides the increase of the number of older adults in the global population.

At this lecture, it will be presented the CDDR criteria to classify the NSUAOA.

Non-Substance Addictions in Later Life in Emerging Crisis Dr. M.S. Renuka Prasad, BSc, MBBS, FRC Psych. (UK), DGM (UK), FRCPC, DFCPA, DFAPA

The generation known as “baby boomers” is the fastest growing segment of our society globally. Substance Use Disorders among this group is a growing health problem universally. Non-Substance Use Addiction is not far behind, but is getting far less attention, in spite of its impact on these individuals and their families, which could be devastating, but cannot be underestimated. This presentation aims to assess the epidemiology, impact and treatment of Non-Substance Use Addictions, like Gambling, Internet addiction in Later Life. Evaluated studies, indicate this cohort of these individuals are at higher risk of substantial negative impact socially, along with other medical and psychiatric comorbidities.

The current treatment models to address this new wave of older individuals, with Non- Substance Use Addiction behavior, are inadequate. The field of Geriatric Psychiatry, Geriatric Addiction Medicine, Social Services all must come together to address this emerging health concern.

The genus Maculabatis is a group of batoid rays from the Dasyatidae family, consisting of two main complexes: the gerrardi (spotted species) and the pastinacoides (plain species). This study investigated the diversity within the Maculabatis gerrardi complex, revealing the presence of two distinct geographical lineages, with a potential new species captured off the coast of Mozambique. Molecular analysis showed a significant divergence: COI sequences from Mozambique specimens exhibited over 99% similarity with M. gerrardi from South Africa but more than 2% divergence from those in the Indo-Pacific. Phylogenetic analysis identified two distinct subclades, suggesting at least two hidden lineages within the genus Maculabatis and consequently possible new undescribed species within M. gerrardi complex. These findings emphasize the importance of conducting additional research that integrates both morphological and molecular methods to better understand the group's diversity and evolutionary dynamics, ultimately supporting the development of effective conservation strategies.

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: Hospital-related negative outcomes such as reduced functional ability and mortality are significantly more frequent in people with dementia compared to other groups. Although these can result from preventable adverse events (AE) related to care standards (e.g., in-hospital falls or infection), researchers usually link such outcomes with the dementia itself. To date, it is unclear whether and the extent to which negative outcomes in hospitalised people with dementia are partly or fully due to the occurrence of AE.

Aim: To explore the AE endured by people with dementia in hospital settings and to determine whether and the extent to which these are associated with negative outcomes.

Methods: A scoping review was undertaken in line with Arksey and O’Malley’s framework in PUBMED, Web of Science, CINAHL, and Scopus in October 2023. Primary studies in English, Spanish, or Portuguese published in peer-reviewed journals were eligible.

Results: Of the 1,976 retrieved documents, 16 were included. Considering all studies and AE together, people with dementia had between 2.8 to 5.2 times higher risk of having an AE compared to people without dementia. In non- surgical settings, the most frequently reported AE were falls, delirium, and infections, while in surgical settings, these included postoperative delirium, infections, and other complications. Longer hospital stay, increased healthcare costs, higher risk of discharge to residential care (vs. home), and increased mortality were significantly more frequent in people with dementia. The link between the AE and negative outcomes was explored in three studies: longer hospital stay was linked to having endured a fall, delirium, or pneumonia as AE; higher risk of 90- day readmission was linked to having had delirium, and higher mortality was found in those with a hip fracture due to an in-hospital fall.

Conclusions: AE are more common in people with dementia compared to other hospitalised groups and may be largely responsible for the negative outcomes found in this population. However, current evidence is limited and does not allow for this relationship to be confidently established. Future research should further explore such associations with the goal to improve care and safety for people with dementia in hospital settings.