Objectives: 1) To evaluate interest, logistics, and content for a curriculum to promote well-being in older adults by gathering data through surveys of nursing home populations. 2) To design a curriculum syllabus that can be carried out and shared by analyzing our survey data and combining it with evidence-based practices from the literature including positive psychiatry approaches and elements of different psychotherapies.

Methods: Long-term and short-term care patients from Budd Terrace and A.G. Rhodes nursing homes were recruited to participate in a survey. Categorical frequency calculations were used to evaluate participant interest and logistical preferences. Ranked scores and distribution columns were used to evaluate course content.

Results: 100 participants completed the survey. 55.1% expressed interest in attending this type of course. For class length, frequency, duration, and size, average preference was for 30 minutes, once a week, 2– 4 weeks, and 6–10 people, respectively. Between pillars, in order of priority, preferences were: meaning in life (ranked score 215), mindfulness (198), and social connection (157). Within the meaning in life pillar, preferences in order of priority were: gratitude for life lived (268), life priorities (249), sources of meaning (235), and goals (188). Within the mindfulness pillar, preferences in order of priority were: emotional stability (272), focusing awareness on the present moment (261), acknowledging and accepting thoughts and feelings (240), and self-compassion (187). Within the social connection pillar, preferences in order of priority were: increasing opportunities for social connections (266), enhancing social support (245), improving social skills (240), and addressing worries about social situations (169).

Conclusions: By combining logistical and content preferences from our population sample with evidence-based practices from the literature, we have developed a psychoeducational course to promote mental health in older adults, centered around three pillars: meaning in life, mindfulness, and social connection. A curriculum syllabus complete with course description, learning Objectives, weekly topics/timelines, materials needed, notes, and handouts will be included with the final manuscript. The handouts can also be selected and distributed outside of a course context, such as outpatient clinics or inpatients settings, and curriculum elements can be incorporated into group or individual therapy.

Background: Older adults may exhibit behavioral disturbance while medically hospitalized. Restlessness, removing medical devices, or wandering may lead to sentinel events including falls, elopements, or violence. The traditional consultation-liaison model addresses challenging or high-risk behaviors but is often reactive and may lead to missed opportunities. The interdisciplinary Behavioral Intervention Team (BIT) was implemented on the campus of Prisma Health Baptist Hospital in Columbia, SC to address and anticipate the need for behavioral health support on medical units.

Methods: A pilot BIT program was implemented in September 2019. Two psychiatric nurses were embedded on med-surg units as a part of medical and psychiatric interdisciplinary teams. After obtaining approval from the Prisma Health Institutional Review Board, a retrospective review was conducted to evaluate the correlation between BIT interventions and patient safety events. Two time periods were examined: six months with early-BIT efforts and six months with expanded-BIT efforts. Medical records and safety reports were reviewed, and statistical analysis was conducted in SAS Enterprise Guide 8.3. Statistical significance was based on associated p- values (p < 0.05).

Results: Of admitted patients during the study period (N = 1413), almost half were age 65+. Pre- existing psychiatric diagnoses were present in 58% of cases with mood, anxiety, and neurocognitive disorders being most common. A majority of patients were on psychotropic medications during both study periods; however, there was a significant decrease in the use of psychotropic medications with expanded-BIT efforts (71.2% vs 61.3%, p < 0.001). In comparing early-BIT efforts to expanded-BIT efforts, significant reductions in workplace aggression (6.7% vs 2.3%, p < 0.001), use of restraints (5.8% vs 3.4%, p = 0.034) and need for security (4.2% vs 0.8%, p < 0.001) were observed. Geriatric subgroup analysis demonstrated a significant decrease in the need for security only (4.6% vs 0.6%, p < 0.001).

Conclusions: Engaging BIT significantly reduced aggression, restraint use, and security interventions. As psychiatric comorbidities continue to impact overall treatment plans, care teams will need to prevent high-risk behaviors and events. Implementing an interdisciplinary BIT is feasible and effective in reducing negative outcomes.

Introduction: This study explores the psychological effects of the COVID-19 pandemic on elderly Chileans, focusing on the role of social isolation (SI), loneliness, depressive symptoms, and pandemic-related concerns. With 150 participants, our cross-sectional descriptive study revealed significant relationships between SI, loneliness, depressive symptoms, and gender differences in their experiences. Despite no longer being in a restrictive phase of the pandemic, the findings highlight the interconnectedness of these factors and their ongoing impact on the mental health of the elderly population.

Methods: Utilizing a cross-sectional descriptive design, this research involved 150 elderly participants from Santiago, Chile. We assessed SI, loneliness, depressive symptoms, and pandemic-related concerns using the Steptoe Social Isolation Index, the Three-item UCLA Loneliness Scale, the Yesavage Geriatric Depression Scale (GDS-15), and a Likert scale for pandemic concern, respectively. Statistical analyses were conducted using JAMOVI 2.36, employing chi-square tests, U-Mann Whitney tests, and Spearman correlations.

Results: Our findings indicate a significant portion of participants experienced SI (42%) and loneliness (26%), with women showing higher frequencies of loneliness and depressive symptoms. Significant correlations were found between SI and loneliness, and both were closely linked to depressive symptoms. Interestingly, a significant negative correlation was observed between pandemic-related concerns and loneliness, suggesting an active coping mechanism among the elderly.

Objectives:

1. 1. Consider the role of Meaning in Life (MIL) in potentially promoting psychological resiliency and well- being and reducing suicide risk among older adults;

2. 2. Describe Online Meaning-Centered Groups (OMG) for older adults experiencing loneliness, social isolation, and/or psychological distress; &

3. 3. Discuss preliminary findings from a study of OMG for Canadian Retirement Home and Community residents 60 and older, both during and following the COVID pandemic.

Key words: Meaning-Centered Groups; Online Interventions; Psychological Well-Being; Upstream Suicide Prevention

Background: The COVID pandemic had a negative impact on the health and well-being of older adults. As older adults additionally have among the highest rates of suicide globally, psychological distress due to lockdowns, fear of infection, and reduced access to mental healthcare and social supports threatened to increase suicide risk, necessitating innovative interventions. Online Meaning-Centered Groups (OMG) were designed to address this concern.

Objectives: To summarize initial findings of an on-going study to adapt, initially evaluate, and disseminate OMG for older adults potentially at-risk for suicide by virtue of loneliness, social isolation, or pandemic-related psychological distress.

Methods: Participants included English-speaking, cognitively-intact, Canadians 60 years and older, experiencing loneliness, social isolation, or psychological distress. Participants of all sexes and genders were recruited primarily via online advertisements for an 8-session, online course of OMG, adapted from Meaning-Centered Men’s Groups (MCMG; Heisel et al., 2020) for men struggling with the retirement transition. Participants completed an online eligibility assessment, and were administered a demographics form, a cognitive screen, and measures of functioning, psychological risk and resiliency factors, and suicide ideation and behaviour. Eligible participants were invited to take part in a course of OMG, and to additionally complete online pre-, mid-, post-group, and 2-month follow-up assessments of psychological risk and resiliency factors and group process.

Results: Two courses of OMG have been delivered to date (n = 15), with a third planned for Spring-Summer 2024. Participants reported high satisfaction with group (M = 44.7, SD = 3.4, on a 0-50 Group Satisfaction scale), a strong working alliance with group facilitators (Working Alliance Inventory-Short Form: M = 5.1/7, SD = 0.8), and experienced significant pre-post reductions in hopelessness (Beck Hopelessness Scale: t(13) = 2.16, p ≤ 0.05) and anxiety (Geriatric Anxiety Scale: t(13) = 2.18, p ≤ 0.05). Improvements in other negative psychological factors and in psychological well-being have not yet reached statistical significance.

Conclusions: Preliminary findings suggest potential benefit in OMG in promoting social connection and reducing psychological distress among older adults experiencing social isolation and/or psychological distress. These and other findings will be discussed in the context of the need for accessible psychological interventions and the importance of promoting meaning in life to enhance psychological well-being among older adults.

Objectives: Loneliness is a modifiable risk factor for depression and dementia in older age. Validated interventions are needed to mitigate the impact of loneliness in older adults. Some evidence suggests that mindfulness meditation may reduce stress, improve mood and cognitive function, and may also impact loneliness per se. Many meditation apps offer an accessible way to meditate at home. However, robust research is needed to assess the benefits of meditation using this technology for older adults. Muse is a meditation app that analyzes brain signals during meditation and provides users with real-time neurofeedback on their level offocus.

Methods: We conducted a pilot, randomized controlled trial to establish the acceptability and feasibility of a remote, mindfulness intervention using Muse in older adults, and to obtain preliminary data on its impact on mood and cognition. Twenty-six adults reporting feeling lonely were enrolled and randomized to an 8-week Muse- based meditation (MM) or a brain- training active control (BT) program. The MM group completed meditation sessions with real- time neurofeedback and guided meditation sessions using Muse. The BT group completed cognitively challenging games on the commercially available Peak app and listened to podcasts. The groups were matched on the amount of interactions with study staff and total program duration. Outcome measures included standardized self-report scales of loneliness, stress, depression, well-being, quality of life, sleep disturbance, resilience, and mindfulness. Staff blinded to program assignment administered cognitive tasks of episodic memory, working memory, and sustained attention, as well as a breath counting task. Assessments were taken at Pre, Mid, and Post intervention, and after a 2-month and 4-month (4M) follow-upperiod.

Results: Participants found both programs engaging and the remote assessments were feasible. The MM group showed a greater improvement in depressive symptoms, and psychological andphysical QOL, compared to the BT group, at Post and at 4M.

Conclusions: A Muse-based mindfulness program is an acceptable and accessible intervention for older adults. A large-scale randomized trial is warranted to evaluate the efficacy of this intervention in this group.

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.

Background: Social connections are important for brain health. We explored the associations between positive and negative social connections and the rate of decline in brain health with ageing.

Methods: We analysed UK Biobank data from 5704 adults aged 40+ (Wave 1 Mage = 54.12, 51.19% female) with brain scans at waves 2 and 3. Predictor variables were positive (current household size, visits to friends/family, community engagement, having a confidante) and negative (loneliness, violence in romantic relationships, or belittling in romantic relationships) social connections at baseline. Outcome variables were brain volumes (total grey & white matter, hippocampus, amygdala) and white matter health (DDF- white matter integrity, white matter hyperintensities, PSMD- a marker of microstructural white matter changes) at waves 2 and 3. We ran linear mixed models controlling for age, sex, intracranial volumes (for brain volume analyses), physical activity, depression, alcohol use, smoking, education, pollution, hearing loss, BMI andhypertension.

Results: Having a greater household size was associated with a slower rate of decline in volumes of total white matter (3160.08, 95% CI: 418.75, 5888.47), right amygdala (43.18, 95% CI: 14.70, 71.02), left hippocampus (62.96, 95% CI: 18.20, 108.04), and right hippocampus (61.02, 95% CI: 15.39, 108.36), and white matter integrity/DDF (0.0014, 95% CI: 0.00047, 0.0022). Loneliness was associated with a slower rate of decline in the left amygdala (81.48, 95% CI: 19.59, 145.91).

Conclusions: In a large UK based sample, we found that living with more people was associated with slower decline in white matter volumes and integrity, and hippocampal volumes. Living with others may promote brain reserve and memory function. Loneliness was associated with slower decline in the left amygdala volume, which is associated with processing of aversive and fearful stimuli. This echoes previous findings indicating that people with depression and anxiety may experience less shrinkage in the amygdala. Our results highlight the importance of encouraging people to live with others, such as in intergenerational households. We also need to address loneliness at a population level to promote healthy brain ageing.

Objectives: People with dementia live with unmet needs due to dementia and other conditions. The EMBED-Care Framework is a co-designed app-delivered intervention involving holistic assessment, evidence-based decision- support tools and resources to support its use. Its intention is to empower people with dementia, family and practitioners to assess, monitor and manage needs. We aimed to explore the feasibility and acceptability of the EMBED-Care Framework and develop its underpinning programme theory.

Methods: A six-month single arm mixed-Methods feasibility and process evaluation, underpinned by an initial programme theory which was iteratively developed from previous studies. The settings were two community teams and two long term care facilities (LTCFs). People with dementia and family were recruited to receive the intervention for 12 weeks. Practitioners were recruited to deliver the intervention for six months. Quantitative data included candidate process and outcome measures. Qualitative data comprised interviews, focus groups and observations with people with dementia, family and practitioners. Qualitative and quantitative data were analysed separately and triangulated at the interpretation phase.

Results: Twenty-six people with dementia, 25 family members and 40 practitioners were recruited. Practitioners in both settings recognized the potential benefit for improving care and outcomes for people with dementia, and to themselves in supporting care provision. Family in both settings perceived a role in informing assessment and decisions about care. Family was integral to the intervention in community teams but had limited involvement in LTCFs. In both settings, embedding the intervention into routine care processes was essential to support its use. In community teams, this required aligning app functionality with care processes, establishing processes to monitor alerts, and clarifying team responsibilities. In LTCFs, duplication of care processes and limited time to integrate the intervention into routine care processes, affected its acceptability.

Conclusions: A theoretically informed co-designed digital intervention has potential to improve care processes and outcomes for people with dementia and family, and is acceptable to practitioners in community teams. Further work is required to strengthen the intervention in LTCFs to support integration into care processes and support family involvement. The programme theory detailing key mechanisms and likely outcomes of the EMBED-Care Framework is presented.

Objectives: Evidence is limited on the comparative impact of specific anesthetic agents used in electroconvulsive therapy (ECT) on outcomes in treatment-resistant depression (TRD). Our study aimed to compare the efficacy of methohexital vs propofol by examining the number of treatment sessions needed to transition from acute to maintenance ECT (NTS) (i.e., change from minimum of two to one or fewer treatments per week), missed treatment sessions, and seizure durations.

Methods: We conducted a retrospective cohort study via chart review of patients with TRD receiving ECT from October 2017 to October 2019. We included adult patients (3 18 years) diagnosed with TRD who received at least six ECT sessions. We analyzed our data using multilevel structural equation modeling(MSEM).

Results: We included 149 patients (36.9% or 55/149 were ³ 65 years): 54 were methohexital-treated (mean age 59 ± 17 years; 41% male) and 95 were propofol-treated (mean age 55 ± 17 years; 36% male). No significant differences between methohexital vs propofol groups were found in NTS (mean ± SD: 12.6 ± 6.6 vs 11.5 ± 6.1; p = 0.3) and missed treatment sessions (0.63 ± 1.2 vs 0.69 ± 1.2; p = 0.75). Patients receiving methohexital manifested longer motor (25.5 ± 10.6s vs 19.9 ± 8.4s; p < .001) and electroencephalographic (EEG) seizure durations (42 ± 17.5s vs .9± 13.1s; p < .001) vs propofol. MSEM revealed that (1) methohexital was associated with longer first-session seizure durations (motor seizure: b = 6.28, p < 0.05; EEG seizure: b = 8.03, p < 0.05) and more rapid decline in motor seizure duration across sessions (b = –.38, p < .05) over propofol, while accounting for relevant covariates; (2) regardless of anesthesia used, faster reductions in seizure durations across sessions predicted fewer NTS; and (3) methohexital was associated with fewer NTS adjusted for covariates which were driven by two indirect effects: (a) sharper decline in motor duration across sessions and (b) the association between a sharper decline in motor duration across sessions with fewer missed treatments. The outcomes were not influenced by age, indicating that the findings are relevant to older adults.

Conclusions: Our findings suggest that methoxexital had fewer NTS and longer seizure durations than propofol, indicating better ECT outcomes using methohexital for TRD. Further research is warranted to verify methohexital’s effects on cognitive and additional recovery outcomes within clinical practice.

Background: Black, Asian and Minority Ethnic (BAME) people continue to present later to specialist care centres and services for memory problems. This poses significant concerns due to implications for poorer treatment outcomes and higher treatment cost among this population. While diverse interventions to support improved help seeking for dementia have been proffered for other BAME communities, there is a paucity of research involving the Black African and Caribbean community. Furthermore, whilst community health professionals like the doctors and community nurses have been involved in such interventions, no previous research has considered the role of the community pharmacist. This research explored opportunities for community pharmacists to support improved help seeking for dementia among the Black African and Caribbean population.

Methods: This research was a multi-stage project involving surveys and interviews with community pharmacists and Black Africans and Caribbeans as participants.

Results: Knowledge, attitude and beliefs around dementia and it’s causes appeared to be major barriers to help seeking among the Black African and Caribbean population. For example, beliefs that dementia is caused by ‘the spirits’ and dementia is a repercussion for past wrongdoing and therefore not amenable to medical intervention. The community pharmacists believe they are well positioned to spot initial signs of dementia among their clients and are therefore willing to offer help seeking support to this population.

Conclusions: To offer intervention for timely help-seeking for dementia, a culturally tailored dementia education for the Black African and Caribbean population should be considered. In addition, training on the impact of cultural beliefs on help seeking for dementia should be considered for the communitypharmacists.

Objectives: To evaluate the relationship between Willis-Ekbom Disease/Restless Legs Syndrome and iron deficiency anemia in older people with dementia.

Methods: A cross-sectional study was conducted with 70 older people diagnosed with dementia and restless leg syndrome in a Psychogeriatric outpatient clinic in a city in the interior of São Paulo, Brazil. The older people filled in instruments of sociodemographic characterization, measures to evaluate the Restless Legs Syndrome, neuropsychiatric symptoms, sleep quality, sleepiness and cognition. Blood data were also collected levels of creatinine, ferritin, red blood cells, hemoglobin and hematocrit, the latter collected in the patients’ medical records.

Results: The sample consists mostly of older people with mixed dementia (i.e., Alzheimer’s disease + Vascular Dementia), with 39% of female patients and mean age of 77.80 years (9.36). This study identified a frequency of 15.7% of Restless Legs Syndrome. Patients with the syndrome present more frequency of neuropsychiatric symptoms, worse sleep quality, higher index of body mass and lower levels of ferritin (p < .05).

Conclusions: A frequency of 15.7% was identified for restless leg syndrome among patients with dementia. In addition, patients with the syndrome have ferritin deficiency.

Objectives: The International Psychogeriatric Association (IPA) definition of agitation in cognitive disorders set standard guidance for recognizing agitation behaviors in research and clinical care. Patients and caregivers were involved in developing a vocabulary to describe these behaviors and, per the IPA, additional studies will offer insights into application of the criteria in diverse cultural and linguistic populations. Based on the IPA criteria, the Agitation in Alzheimer’s Screener for Caregivers (AASC™) was developed in collaboration with clinical experts, patient advocates, and caregivers of individuals with Alzheimer’s dementia to support caregivers and healthcare professionals (HCPs) in communication and recognition of agitation in Alzheimer’s dementia. This study aims to translate and linguistically validate the AASC™ in Spanish, Simplified Chinese, and Traditional Chinese in US populations.

Methods: According to best practices outlined by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) (Figure 1), linguistic validation of the AASC™ includes translation and validation through cognitive debriefing interviews for each target language. This process applies rigorous Methods to obtain translations that are conceptually relevant to the original tool, culturally relevant to each target language, and easily understood by those to whom the tool will be administered. For each target language, lay subjects (n = 5) over 40 years old and representative of the target population (e.g., reside in the US and fluent in Spanish, Traditional Chinese, or Simplified Chinese) will be recruited for cognitive debriefing.

Results: The specific Methods will be used to produce the linguistically validated versions of the AASC™ tool in Spanish, Traditional Chinese, and Simplified Chinese. Translatability review, forward and back translations, clinician and linguist review, harmonization, and cognitive debriefing will ensure the accuracy and consistency of the translated tool. If needed, the original tool language will be updated to account for cultural differences.

Conclusions: The AASC™ is the first screener developed for agitation in Alzheimer’s dementia based on the IPA criteria. Translation and linguistic validation of the AASC™ in Spanish and Traditional and Simplified Chinese aim to ensure clear and culturally relevant translations for each target language. Ongoing and future studies will optimize the effectiveness and cultural acceptance of the AASC™ tool.

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.

Introduction: Resilience is a dynamic process involving the interaction between risk and protective factors that act to modify the effects of adverse life events. Understanding the resilience of caregivers of patients with AD and its predictors is essential for the development of intervention strategies aimed at solutions that can contribute to the improvement of their emotional disorders, such as anxiety, stress, anddepression.

Methods: 93 dyads of patients diagnosed with AD, where 60 (64.5%) dyads had Late-onset AD (LOAD) and 33 (35.5%) dyads had Young-onset AD (YOAD). Patients were assessed for: quality of life (QoL), disease awareness, and depression. Caregivers were assessed for: resilience, depression, anxiety, burden, and QoL. Additionally, caregivers provided information about mood, neuropsychiatric symptoms, dementia severity, and patients’ activities of daily living.

Results: Caregivers showed moderate levels of resilience, with an average score of 140 (SD = 13.20), moderate level of burden 28.94 (SD = 14.74), low level of anxiety 7.56 (SD = 7.44), and low level of depressive symptoms 8.17 (SD = 6.34). Patients had an average cognition score of 18.81, 63.4% had mild dementia, low depression index .2 (SD = 5.78), low index of neuropsychiatric symptoms 16.11 (SD = 14.47), and partially compromised disease awareness 9.06 (SD = 5.12).

Conclusions: No relationship was found between caregivers’ resilience and patients’ clinical condition, indicating that resilience seems to be associated with caregivers’ individual characteristics. Interventions such as psychoeducational groups, behavioral or religious counseling, may stimulate or develop resilience characteristics in caregivers who exhibit avoidance or denial behaviors regarding the patient’s diagnosis.

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.

Introduction: This book aims to help children grasp the concept of Alzheimer’s disease and its impact on our loved ones using simple, accessible language and engaging educational activities.

Methods: The information will be presented using themes that capture children’s interest, such as magic and superheroes, and will be reinforced through activities including word searches, code-based tasks, synonym games, word syllable exercises, planning activities, scrambled words, word puzzles, basic math problems, open-ended questions, and Discussions about grandparents. It will address potential behavioral changes like forgetfulness, confusion, and agitation, and provide suggestions on how to cope, such as remaining calm, offering comfort, paying attention, and communicating clearly and simply. Throughout the book, the significance of family bonds will be emphasized, encouraging care and affection to strengthen connections. Even if a person with Alzheimer’s doesn’t recognize the child, they can still feel the love and support.

Conclusions: This book promotes values of respect, inclusion, and patience in the face of Alzheimer’s disease, underscoring the importance of empathy and understanding regardless of the challenges it presents.

Objectives: Patients with dementia (PWD) benefit from interdisciplinary care. Depression is a well-known risk factor for the progression of neurocognitive impairment and dementia; other psychiatric disorders (i.e. anxiety, post-traumatic stress disorder, bipolar disorder, psychotic disorders) also may confer an increased risk for dementia. PWD may also present with behaviours and psychological symptoms that overlap with psychiatric disorders. Our aim is threefold: (1) Review the current literature on managing psychiatric comorbidities in PWD. (2) Present an illustrative case series of PWD with psychiatric comorbidities. (3) Introduce a model of care on our Behavioural Neurology Unit (BNU) for treating PWD with psychiatric comorbidities.

Methods: Our BNU is a 20-bed quaternary inpatient unit for difficult-to-treat behaviours related to dementia. Psychiatric consultation is readily available to clinicians and often times for PWD with psychiatric comorbidities. We review best practices in managing these patients. We present a case series of PWD with psychiatric comorbidities predating their diagnosis of dementia who have significant behavioural and psychological symptoms and have failed other settings.

Results: Current guidelines for PWD do not discuss the management of psychiatric and neurologic comorbidities in detail. Among 26 cases, we highlight the judicious use of anticonvulsants, lithium, clozapine, and nabilone in PWD. We also demonstrate the importance of interdisciplinary care with primary care, neurology, psychiatry, and allied health support.

Conclusions: Dementia care is challenging and requires individualized attention and interdisciplinary collaboration. These challenges are augmented when dealing with psychiatric comorbidities. We advocate for increased attention and creative solutions to address these complex cases.

Background: The ADI Accreditation Programme, launched in December 2020, aims to support all Alzheimer and dementia associations and other organizations, in improving care for people living with dementia. By providing a standards-based approach to knowledge and skills, ADI establishes benchmarks that program providers must adhere to. Successful completion of an evaluation allows carers, trainers, and program providers to earn ADI Accreditation, indicating that they have reached the required global standard for their training and learning activities, including culturally appropriate context to improve care quality. ADI Accreditation is open to ADI members, as well as other organizations including universities and training colleges.

Activities: Our Global Review Panel (GRP) Members consists of multi-discipline, cultural and regional experts in the global dementia field. Successful completion of an evaluation process: initial application, evaluation report, virtual/in-person or hybrid visit from our Global Review Panel Members, the program or providers can earn ADI Accreditation. The first provider to be accredited was Kiang Wu Nursing College (KWNC) of Macau on January 25, 2021. The pilot project involved Discussions on external and internal governance, trainers and program committees, students, graduates, and other stakeholders. A 3-day virtual visit to KWNC in September, including evaluation, involved carers, trainers, students, and collaboration with other organizations and people living with dementia, followed by a final review by the Global Review Panel in October andNovember.

Silverado Memory Care Communities became the first program to be accredited for their Dementia Care Program on December 22, 2022. In-person visits took place on August 16-17, 2022, involving trainers, stakeholders, family members, caregivers, associates, and staff. University of Bradford in the UK became the first university in UK/Europe to be accredited their Centre for Dementia Applied Science on December 22, 2022. In-person visits took place on June 20-21 June 2023, involving trainers, stakeholders, family members, caregivers, associates, and staff.

Wicking Dementia Research and Education Centre at the University of Tasmania received their accreditation after virtual visit on 29-30 August 2023. involving trainers, stakeholders, associates, andstaff.

As of 2024 Dementia Australia Is currently undergoing the accreditation process along with some new potential opportunities.

Results: In 2 years, Kiang Wu Nursing College of Macau, Silverado Memory Care, University of Bradford and University of Tasmania received ADI Accreditation. Kiang Wu Nursing College of Macau received 5 times more applicant.

Throughout the program, there has been an increase in awareness and understanding of the importance of high- quality culturally contextualized carer training achieved through accreditation.

Introduction: Dementia and cognitive impairment are major causes of admission to Nursing Homes. These conditions also lead to caregiver burden and decrease quality of life. Cognitive Stimulation Therapy (CST) is an evidence-based psychosocial intervention for people with dementia, recommended and implemented in many countries, including Brazil.

Objectives: The aim of the current study is to explore the feasibility and preliminary results of CST protocol in nursing homes for elders with cognitive impairment or dementia in Brazil.

Methods: Older adults with cognitive impairment were invited to participate in this study. Thirteen participants from two nursing homes were assessed at baseline with the Cambridge Cognitive Examination (CAMCOG), Cornell Scale for Depression in Dementia (CSDD), Pfeffer Functional Activities Questionnaire, Katz Activities of Daily Living Scale, Quality of Life in Alzheimer’s Disease (Qol-AD) and Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB). They were assigned to Usual Care/Waiting List and followed up for 7 weeks, being reassessed at the end of this period. Then, they underwent 14 CST sessions throughout 7 weeks and were reassessed at the end of the protocol. Repeated Measures ANOVA was selected to assess differences in time. This study was approved by the Ethics committee of the Federal University of Minas Gerais.

Results: There were no dropouts from the study, the CST protocol has shown to be feasible to be implemented in nursing homes. We found that the CST protocol had no statistically significant impact in CDR-SOB (F = 1.21, p = 0.315), CSDD (F = 1.61, p = 0.221), CAMCOG (F = 0.914, p = 0.414), but showed a statistically significant change in the Qol-AD scale (F = 3.618, p = 0.042). However, Mauchly’s test of sphericity is violated, and since it may lead to increased type I error, it is still premature to define a positive outcome.

Conclusions: These preliminary results are consistent with the previous literature, suggesting that the CST could be a useful psychosocial intervention to improve the quality of life of people with dementia living in nursing homes. Nevertheless, more participants need to be enrolled to address further consistent.

Objectives: Low- and middle-income countries face increasing burden of noncommunicable chronic diseases due to rapid population aging. The Objectives of this study is to estimate the association of co-occurring depression and diabetes with healthcare services utilization in the Brazilian population aged 50 years andolder.

Methods: This is an analysis using baseline data of the ELSI-Brazil study. Measurements used were self-reported previous diagnosis for diabetes and a cut-off point of 4 on the CES-D-8 score for depression. Any medical consultations, specialist consultations and hospitalizations in the previous 12 months were assessed for measuring health services use. Logistic regression was used to estimate the association of having depression, diabetes, or both, compared to having none of the conditions with healthcare services utilization.

Results: In a final sample of 8303 participants, the adjusted odds ratios (95%CI) in the depression only group (27.9%), in the diabetes only group (9.7%), and in the depression and diabetes group (5.8%), for any medical consultations were 1.2 (1.01-1.42), 3.39 (2.4-4.79) and 3.12 (1.82-5.35); for specialist consultations, 1.05 (0.91-1.21), 1.34 (1.07-1.68) and 1.13 (0.86-1.49); and for hospitalizations, 1.42 (1.1-1.84), 1.42 (1.02-1.96) and 3.1 (2.12-4.54), respectively. All models were adjusted for sex, age, education, marital status, insufficient physical activity, current drinking and smoking, obesity and number of other diseases and conditions.

Conclusions: Those with diabetes seemed more likely to have any or specialized medical consultations. However, those with the depression and diabetes comorbidity were more likely than any other group to have been admitted to a hospital in the last year, which is distressing and costly. Screening for depression could be incorporated into diabetes usual care to reduce related complications and hospitalizations.

Funding: This study did not receive any funding. Authors: Ferri and Lima-Costa are recipient of CNPq research productive fellowship.