Objectives: Several studies have shown that acetylcholinesterase inhibitors (AChEIs) decrease delta or theta activity, increase alpha activity on Electroencephalography (EEG) in Alzheimer’s disease (AD) patients. The effects of memantine on EEG in AD patients are not as well understood as those of AChEIs. The present study investigated the electrocortical effects of 3 months memantine medication in AD patients.

Methods: EEG was recorded in 28 patients with AD (mean age 83.3 ± 4.6 years, 19 females) before and 3 months after the onset of memantine medication. Source localization was applied to the EEG using exact low-resolution brain electromagnetic tomography (eLORETA) in 8 frequency bands (delta, theta, alpha-1, alpha-2, beta-1, beta- 2, beta-3, gamma). Differences in source strengths from before to after memantine treatment were compared per frequency band using t-statistics (corrected for multiple testing over frequency bands and voxels).

Results: Theta activity significantly decreased in bilateral anterior cingulate gyrus, bilateral posterior cingulate gyrus, right parahippocampal gyrus, right insula, right fusiform gyrus, bilateral precuneus, right uncus and right temporal gyrus. Alpha-1 and alpha-2 activity decreased in the anterior cingulate gyrus. Beta-1 activity significantly decreased in the anterior and posterior cingulate gyrus. There were no areas of increased EEG activity in any frequency bands.

Conclusions: We found that memantine reduced theta activity similarly to AChEIs. This finding may be related to the cognitive improvements of memantine. Whereas the decrease of beta-1, alpha-1 and alpha-2 activity in the anterior cingulate gyrus was different from AChEIs. Further studies are required to elucidate these differences.

Introduction: Brief interventions (BIs) are strategies involving screening for at-risk drinkers, followed by a short intervention providing information about alcohol and personalized feedback. BIs are cost-effective for the general population, but less is known about their potential effectiveness in the older adultpopulation.

Objectives: To conduct a systematic review (SR) on the effects of BI in people aged 50 and above on alcohol consumption (primary outcome), cognitive performance, and depressive symptoms (secondary outcomes).

Methods: Searches were conducted in the MEDLINE, EMBASE, and LILACS databases to identify randomized controlled trials (RCTs) in English, Spanish, and Portuguese, published up to June 2023. A risk of bias assessment (Rob 2.0) was performed, and a direct meta-analysis (RevMan version 5.4.1) was conducted for all available primary outcomes. The SR protocol was registered in PROSPERO (CRD42023436908).

Results: Eight studies were initially identified, and five of them which met the inclusion criteria were included in the meta-analysis. All studies were conducted in high-income countries and varied in relation to the outcome measures. There was a statistically significant reduction (SMD = 0.21; 95% CI: 0.07 – 0 .34) in alcohol consumption among older adults at 3 months follow-up. However, at 6 and 12 months, there was no statistically significant difference between the control and intervention groups. None of the eligible studies presented results on the secondary outcomes, cognition, or mood.

Conclusions: BIs show promise as an intervention for addressing and reducing at-risk drinking in older adults. However, there is limited research in this area, and the lack of standardized Methodsological criteria makes it difficult to compare the results of studies. Therefore, further studies are required, using standardized Methodsologies, to better understand the long-term effects, in respect of both primary and secondary outcomes, of these interventions.

Background: With the aging of the population, alcohol consumption among older adults presents a growing public health concern. Recognizing the prevalence and determinants of at- risk drinking among older adults is crucial for the development of effective interventions and improved healthcare outcomes.

Objectives: To estimate the prevalence of at-risk drinking and associated factors among older adults in primary care in Brazil.

Methods: A cross-sectional study with 1,639 participants aged 60 and above from fourteen primary care units in the city of the state of Sao Paulo, Brazil, between December 2023 and April 2024. At-risk drinkers were defined by the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C scores ≥ 4), and/or binge drinking (≥ 3 drinks on a single occasion). Logistic regression was used to assess the association between sociodemographic characteristics, smoking, depression (PHQ-2 scores ≥ 3), and chronic diseases. A gender interaction test was conducted for all positive associations.

Results: The mean age of the 1,639 participants was 68.6 (SD ± 6,2; range: 60 –95), with 52.6% reporting current alcohol consumption, 21.3% were at-risk drinkers (AUDIT-C plus binge), and 26.8% regular smokers. Men (OR: 2,94; 95% CI: 2.21–3.90), those with high education (OR: 1.53; 95% CI: 1.10–2,14), were employed (OR: 1.50; 95% CI: 1.02-2.19), and current smokers (OR: 2.36; 95% CI: 1.73–3.23) were more likely to be at-risk drinkers. While older participants (70+) (OR: 0.96; 95% CI: 0.93–0,98), and those with depression (PHQ-2) (OR: 0.96; 95% CI: 0.93– 0.98) were less likely to be at-risk drinkers. Having a higher level of education was associated with a greater likelihood of at-risk drinking for men but not for women. Conversely, the presence of chronic diseases was associated with a reduced probability to be an at-risk drinker for women, but not formen.

Conclusions: This study revealed a significant prevalence of alcohol consumption, at-risk drinking, and binge drinking among older adults in primary care. Gender differences were observed in drinking behavior. These findings could aid health professionals in identifying at- risk drinkers and inform the development of targeted interventions for the most vulnerable groups.

Introduction: People with young-onset Alzheimer’s disease (YOAD) are diagnosed when the neurocognitive process begins before the age of 65 and often present with more global impairments and a more rapid course of the disease. In contrast, in late-onset Alzheimer’s disease (LOAD), the loss of short-term memory is most pronounced. Therefore, the age of onset may affect global functioning in different ways.

Objectives: This study examines the relationship between Social Cognition, global cognition, and other clinical variables in young and late-onset people with Alzheimer’s disease and their caregivers.

Methods: Using a cross-sectional design, we included 48 people with YOAD and 118 with LOAD and their carers. We assessed social cognition, global cognition, quality of life, dementia severity, mood, functionality, neuropsychiatric symptoms, and caregiver burden.

Results: Our results showed that the YOAD group had more global cognitive impairment, lower MMSE scores (P = 0.018, d = 0.41), higher Adas cog (P = 0.002, d = 0.06), poorer quality of life (QoL- AD) (P = 0.036, d = 0.36), and more neuropsychiatric symptoms (NPI) (P = 0.044, d = 0.35). However, social cognition showed a stable pattern of impairments in YOAD that did not follow the global deficits. The multifactorial regression analyses further showed that in both groups functionality was significantly related to Social Cognition, YOAD (P = 0.035), and LOAD (P = 0.001).

Conclusions: The significant findings of our study underscore that in YOAD, despite more pronounced global impairment compared to LOAD, social cognition remains stable. This finding is crucial for understanding the patterns of social cognition in YOAD and may potentially guide future interventions and care strategies.

Objectives: Experience of people with dementia falls between attempts to maintain a sense of self and normality and struggle with acceptance in order to integrate the changes within the self (Clare). The need for interventions, including spiritual care, targeting fear and loss of self is reported (Palmer). In Japan, Buddhist temples which hold peer-support café for the caregivers of the people with dementia are emerging, as those needs are not fully covered by the health care system (Okamura). For the better future psychogeriatrics-Buddhist temple collaboration, this study explores the views of the Buddhist priests who work in the secular health care system.

Methods: Consecutive in-depth interviews were conducted with health care professionals such as medical doctors, psychologists, care workers, etc. who work in the secular health care system, and who are at the same time qualified as Buddhist priests. Verbatim transcripts were analyzed using a qualitative descriptive approach. Ethical considerations: The study was approved by the Taisho University ethics committee.

Results: Twenty-four subjects were interviewed. Some medical doctors expressed struggles as Buddhist priests concerning not being able to provide person-centered care in the medical setting, especially in intensive care units in early career training, due to the busyness. However, now that they are specialists, they are able to provide person-centered care. According to care workers, the effects of Buddhist priests in the residential care were; protecting burnout of the care staff; decreasing anxiety of the residents; increasing trust from the family; and making the inclusive care environment. All of them talked that the lack of practical knowledge teaching on aging, dementia, and death in the monk training program is a problem, but that there may be considerable resistance to changing a curriculum with a long history.

Conclusions: Discourses of the professionals of both territories, i.e., scientific care and spiritual care, are worth investigating for the future reform of the education of both territories.

Objectives: To explore how clusters of chronic health problems can impact depression in older adults.

Methods: We performed a latent class analysis using the baseline data from The Brazilian Longitudinal Study of Aging (ELSI-Brazil). Depression was assessed using the Center for Epidemiological Studies Depression Scale (CES- D8). Scores of 4 or higher on the CES-D8 were considered positive for depression. Fourteen self-reported conditions (Diabetes, Systemic Arterial Hypertension, Angina, Myocardial Infarction, Chronic Kidney Disease, Heart Failure, Stroke, Low Back Pain, Arthritis, Osteoporosis, Asthma, Chronic Obstructive Pulmonary Disease, High Cholesterol, and Cancer) were evaluated and combined as a total number of chronic conditions.

Results: The total number of individuals in the sample was 4672. The best resulting model is composed of 4 latent classes. The latent classes were organized as follows: Cardiovascular Multimorbidity (Class1); No multimorbidity (Class 2); Musculoskeletal Multimorbidity (Class 3); and Inflammatory Multimorbidity (Class 4). We identified that, in comparison with class 2, (considered the reference class due to the absence of multimorbidity), the odds ratio for depression was 2.56 for the Cardiovascular Multimorbidity class, 2.86 for the Musculoskeletal Multimorbidity class, and 4.59 for the Inflammatory Multimorbidity class.

Conclusions: We found that various patterns of multimorbidity are associated with depression when compared with a single disease and that Inflammatory Multimorbidity has the greatest impact on depression.

Objective: Uncoupled sleep is a phenomenon characterized by a discrepancy between sleep patterns and sleep complaints. This study aimed to evaluate the effect of sleep report feedback utilizing information and communication technology combined with health guidance on improving subjective and objective sleep outcomes in community-dwelling older people with and without uncoupled sleep.

Methods: This study was conducted in Sakai City, Japan. The Athens Insomnia Scale (AIS) was employed to evaluate subjective sleep outcomes. Participants were categorized as complaining sleepers if they reported their overall sleep quality as markedly or very unsatisfactory, in addition to having a total AIS score ≥10. Non-wearable actigraphy devices were placed under participants’ bedding to continuously measure their objective sleep outcomes. Sleep latency (SL), wake after sleep onset (WASO), and sleep efficiency (SE) parameters were recorded. Participants were classified as poor sleepers if their actigraphy-measured SL was ≥31 min or SE was＜85%, or WASO was ≥31 min. All measurements were taken prior to and following a 3- month intervention program.

Statistical analysis was conducted using SPSS Version 26. This study received approval from the Institutional Review Board of Osaka University.

Results: A total of 105 participants completed the study, with 65 females (62%). Among them, 8 were complaining good sleepers, 12 were complaining poor sleepers, 42 were non-complaining good sleepers, and 43 were non- complaining poor sleepers. Improvements in subjective sleep quality were observed across all sleeper classifications (P < 0.05). Specifically, subjective SL (P = 0.009) and WASO (P = 0.023) improved in complaining poor sleepers without uncoupled sleep. Objective and self-reported changes in sleep parameters were demonstrated in non- complaining poor sleepers with uncoupled sleep, specifically manifested as improvements in objective WASO (P < 0.001), SE (P < 0.001), andsubjective sleep quality (P = 0.038). However, there were no significant changes in objective sleep outcomes among complaining good sleepers, non-complaining good sleepers, and complaining poor sleepers (P > 0.05).

Conclusion: The implementation of sleep report feedback and health guidance intervention for community- dwelling older people has demonstrated improvement in subjective sleep quality across all sleeper classifications. Furthermore, it shows promising effects on non-complaining poor sleepers with uncoupled sleep, as evidenced by both objective and subjective sleep measures.

Objective: Higher intimacy is associated with less behavioral and psychological symptoms of dementia (BPSD) in people with dementia, however, the processes underlying this association remain unclear. This study investigates the role of expressed emotion (EE) and relationship closeness between caregivers and patients with dementia in the manifestation of BPSD.

Methods: We recruited 56 families with dementia and collected 3-month longitudinal data including demographic details of current family caregivers providing care, caregiving relationship closeness (RCS), and BPSD measured using the Neuropsychiatric Questionnaire (NPI-Q). We assessed EE using the validated Family Attitudes Scale (FAS), where higher scores indicate greater intensity of expressed emotion. Correlational and mediation analyses were conducted using baseline and three-month follow-up data to explore the relationships between RCS, EE, and BPSD. Mediation analysis was performed using the SPSS PROCESS Version 4.1 macro. The study received approval from the Institutional Review Board of Osaka University.

Results: Correlation analysis showed that there was significance between RCS and BPSD at baseline and third month (r = –0.301, p < 0.05), and between EE and BPSD (r = 0.378, p < 0.001). Furthermore, mediation analysis demonstrated that caregivers’ EE significantly mediated the association between RCS and BPSD in dementia patients. The indirect effect of RCS on BPSD through caregivers’ EE was found to be significant, with a 95% confidence interval (CI) of (–0.6097, –0.1790), where the CI excludes zero. This indicates that the mediation effect of caregivers’ EE on the relationship between RCS and BPSD is statisticallysignificant.

Conclusions: It suggests that interventions aimed at improving caregiver-patient relationships and managing caregivers’ EE could be crucial in mitigating BPSD, providing a direction for future research and intervention development to support both patients and their families in the dementia care.

Objective: In 2023, the damage caused by “special fraud’’ will amount to approximately US$285 million in Japan, with a marked increase in the number of victims among the older population aged 65 and over, who account for about 86.6% of the total. “Special fraud’’ is a crime in which suspects phone victims and pretend to be police officers, victims’ family members, etc. to have victims transfer cash to the suspects’ bank account. In other cases, a suspect visits a victim’s house after such a phone call and directly receives the victim’s cash and/or cash cards. The purpose of this study is to clarify the factors that contribute to fraud victimization among the elderly and to strengthen measures to prevent victimization.

Methods: The subjects of the analysis were 840 residents of Arakawa Ward, Tokyo, aged 65 years or older, who participated in the Arakawa 65 Years and Older Survey or the Arakawa 85 Years and Older Survey. Data on participants’ fraud experiences, level of caregiving, living environment, and various psychological measures, including the Fraud Vulnerability Score (SVS), the Satisfaction with Life Scale (SWLS), the Resilience Scale (RS), the Mini-Mental State Examination (MMSE), and the Geriatric Depression Scale (GDS) were collected. Multiple logistic regression was used to explore the relationship between these factors and fraud victimization, adjusting for age, gender, level of caregiving, and living situation.

Results: Fraud victims (n = 37) and non-victims (n = 803) differed significantly in terms of SVS and SWLS. Fraud victims had higher fraud vulnerability scores and higher life satisfaction. Logistic regression analysis confirmed that higher SVS and SWLS were significantly associated with a higher likelihood of experiencing fraud (SVS OR = 0.799, CI: 0.720 – 0.887, p < 0.001; SWLS OR = 0.928, CI: 0.870 – 0.989, p = 0.(022).

Conclusion: Given that fraud victimization is correlated with fraud vulnerability and high life satisfaction, it is critical for older adults and their caregivers to implement strategies aimed at reducing fraud risk. This study highlights the need for targeted interventions that address the unique vulnerabilities of the urban elderly population.

Objective: Patients with cognitive disorders such as Alzheimer’s disease (AD) and mild cognitive impairment (MCI) frequently exhibit depressive symptoms. Depressive symptoms can be evaluated with various measures and questionnaires. Geriatric Depression Scale (GDS) is a scale that can be used to measure symptoms in geriatric age. Many questionnaires usually sum up symptom scales. However, core symptoms of depression in these patients and connections between these symptoms have not been fully explored yet. Thus, the objectives of this study were: 1) to determine core symptoms of two cognitive disorders, Alzheimer’s disease and mild cognitive impairment; and 2) to investigate the network structure of depressive symptomatology in individuals with cognitive impairment in comparison with those with Alzheimer’s disease.

Methods: This study encompassed 5,354 patients with cognitive impairments such as Alzheimer’s disease [n = 1,889] and mild cognitive impairment [n = 3,464]. The Geriatric Depression Scale, a self-administered questionnaire, was employed to assess depressive symptomatology. Using exploratory graph analysis (EGA), a network analysis was conducted and the network structure was evaluated through regularized partial correlation models. To determine the centrality of depressive symptoms within each cohort, network parameters such as strength, betweenness, and closeness were examined. Additionally, to explore differences in the network structure between Alzheimer’s disease and mild cognitive impairment groups, a network comparison test was performed.

Results: In the analysis of centrality indices, “worthlessness’’ was identified as the most central symptom in the Geriatric Depression Scale among patients with Alzheimer’s disease, whereas “emptiness’’ was found to be the most central symptom in patients with mild cognitive impairment. Despite these differences in central symptoms, the comparative analysis showed no statistical difference in the overall network structure between Alzheimer’s disease and mild cognitive impairment groups.

Conclusion: Findings of this study could contribute to a better understanding of the manifestation of depressive symptoms in patients with cognitive impairment. These results are expected to aid in identifying and prioritizing core symptoms in these patients. Further research should be conducted to explore potential interventions tailored to these core symptoms in patients with Alzheimer’s disease and mild cognitive impairment. Finding out core symptoms in those groups might have clinical importance in that appropriate treatment for neuropsychiatric symptoms in patients with cognitive impairment could help preclude progression tofurtherimpairment.

Background: Within nursing home care, the role of professional caregivers is paramount. While certain caregiver behaviors, such as personal attention, can positively affect residents’ mood, limited attention has been given to the automatic cognitive processes guiding these behaviors. Automatic cognitive processes refer to mental operations that occur rapidly and effortlessly, often beyond conscious awareness. These processes can impact habits and preferences, thereby influencing behavior.

Objective: This study aimed to develop and evaluate two pictorial Implicit Association Tasks(IATs) to measure nursing home caregivers’ implicit associations with mood-improving behaviors for residents, focusing on implicit valence (liking) and motivation (wanting) regarding these behaviors.

Methods: Study 1 (N = 41) involved developing the Valence towards Behaviors to improve residents’ Mood IAT (VBM-IAT) and the Motivation for Behaviors to improve residents’ Mood IAT (MBM-IAT), and evaluating the content validity of target stimuli representing mood-improving behaviors. Study 2 (N = 230) examined stimulus classification ease (accuracy and speed) for both target and attribute stimuli (representing positive or negative valence, and motivation or demotivation). Additionally, the IATs’ internal consistency was examined. A sub- sample (N = 111) examined test-retest reliability, convergent validity (with self-reported attitude towards depression, altruism, and mood-improving behaviors), and divergent validity (against social desirability).

Results: Content validity was satisfactory (CVI: ≥ .85). Error rates were acceptable for attribute stimuli (4.0%), but above the accepted limit of 10% for target stimuli (12.4%). All stimuli exhibited prolonged response times exceeding the desirable 800 ms threshold. The VBM-IAT and MBM-IAT demonstrated good internal consistency (rsb: .81; .85, respectively) but poor test-retest reliability (ICC: .29; .25). Mixed model analysis showed that both IATs correlated with altruism (estimated effect: .28, 95% CI [.11, .45]; .24 [.07, .42]). The VBM-IAT related to self- reported mood-improving behaviors (.20 [.03,.36]), while the MBM-IAT associated with the behavioral subscale of attitude towards depression (.21 [.03, .39]). The IATs did not significantly correlate with other scales.

Conclusions: The IATs show potential in measuring caregivers’ implicit valence and motivation regarding behaviors to improve residents’ mood, offering an innovative pathway for investigating automatic cognitive processes in caregiving. However, some limitations in psychometric properties were identified, aligning with challenges in similar IATs.