Objectives: This study evaluates the use of sleep monitoring to discontinue sleeping pills in a patient with insomnia and neurodegenerative conditions, presenting a non-pharmacological approach to managing sleepdisorders.

Methods: This case report involves a 72-year-old woman with Progressive Supranuclear Palsy who was unable to sleep without sleeping pills. The patient lived alone, had some trouble speaking, and her MMSE score was 25/30. Medical records were reviewed from her initial visit to Hospital A until the cessation of sleeping pill use. Sleep was monitored using a non-wearable sheet-type device (Nemuri SCAN, Paramount Bed Co., Ltd.) placed under the mattress, providing long-term data. The study was conducted with approval from the Osaka University Hospital Ethics Review Committee.

Results: The patient had been unable to sleep since visiting her previous doctor and had tried various medications, including Suvorexant, Brotizolam, and Triazolam, none of which were effective. On her first visit to Hospital A, she was prescribed 8 mg of Ramelteon but still could not sleep. One week later, 15 mg of Brotizolam was added, allowing her to sleep with the combination of the two medications. A few months later, she experienced insomnia again due to daytime napping. Despite efforts to curb her naps, her condition persisted. Consequently, 0.25 mg of Clonazepam was added, and she was able to sleep with the three medications. After that, the patient began sleep monitoring using the Nemuri SCAN device and the monitoring indicated a consistent sleep rhythm with few awakenings, prompting her doctor to consider reducing her medication. A few months after starting sleep monitoring, the sleep monitoring results remained stable, with a constant sleep rhythm and few awakenings, leading to the discontinuation of 0.25 mg of Clonazepam and 15 mg of Brotizolam. Subsequent sleep monitoring continued to show stable results, allowing the discontinuation of 8 mg of Ramelteon six months after starting sleep monitoring.

Conclusions: This case highlights the importance of cautious sleep medication use in older and neurodegenerative patients, demonstrating benefits of alternative strategies like using non- wearable sleep monitoring device.

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

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

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

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

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

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

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

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

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

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

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

Objectives: The relationship between cognitive decline and life satisfaction in older adults remains unclear. This study aimed to examine whether older adults with normal cognition at baseline, who developed cognitive decline (i.e., mild cognitive impairment or dementia) over a five-year period, experience lower life satisfaction compared to those who remained cognitively intact.

Methods: The present longitudinal study was conducted in the Arakawa Ward, Tokyo, Japan. Among the initial 1,099 community-dwelling older adults who were between 65 to 84 years old in 2016, we analyzed data from 628 participants who were cognitively intact at baseline and remained in the study at follow-up (2022–2023) with complete data. The effect of developing cognitive decline on life satisfaction, measured by the Satisfaction with Life Scale (SWLS), was examined using a linear mixed model. In addition to developing cognitive decline, fixed effects included time, sex, age, education, depression (indicated by the Geriatric Depression Scale scores above 5), living status (living alone), and frequency of social interactions. The intercept and participants were treated as random effects.

Results: At follow-up, 87 participants were diagnosed with mild cognitive impairment and 7 with dementia. Overall, the mean SWLS score experienced a slight but statistically significant decrease over the five-year period (18.14 ± 5.27 at baseline and 17.75 ± 5.27 at follow-up, p = 0.02 as determined by a paired t-test). The linear mixed model analysis revealed that developing cognitive decline was not significantly associated with life satisfaction (p = 0.93). Notably, living alone and being in a depressive state were significantly associated with higher SWLS scores (p = 0.003 and p < 0.001, respectively).

Conclusions: Life satisfaction did not significantly decline in older adults who developed cognitive decline compared to those who remained cognitively intact. The unexpected findings that individuals living alone and those experiencing depressive states reported higher life satisfaction may indicate potential adaptive mechanisms, whereby these individuals might have developed strategies to find joy in everyday life. Further research is warranted to replicate these results and to explore the underlying factors or potential resilience mechanisms contributing to these findings.

Objectives: With a rapidly aging population in Singapore, late-life depression and anxiety become increasingly relevant as they impact on quality of life, disability and healthcare costs. BRIGHT initiative begins as a group coaching programme with the aim to empower at risk elderly to self-manage physical and mental health ailments. This poster aims to present the latest findings and updates from BRIGHT as we embark on to the next phase, BRIGHT Train the Trainers (BRIGHT T3) programme to ensure long term sustainability of theseinterventions.

Methods: BRIGHT consists of three two-hour workshops facilitated by a multidisciplinary team (MDT) comprising psychiatrists, psychologists, and medical social workers. Two virtual runs were conducted over zoom while five physical runs were conducted on site at the local senior activity centres. Scales of GDS, GAI, HCS and SF 12 were administered pre and post intervention to capture 1) reduction in depressive and anxiety symptoms, 2) quality of life, 3) improvement in health confidence, and 4) participant satisfaction.

This intervention is supplemented by a mobile wellness application nested within Singhealth Healthbuddy application, providing seniors access to an application with self-monitoring, inbuilt reward systems to reinforce positive behaviours and self-help mental health resources.

BRIGHT T3 programme aims to promote mental wellness and create sustainable impact by establishing a self- sustaining model through peers, volunteers and grassroot leaders who will continue to deliver the programme in their respective communities. Eligible trainers identified will be pre-screened by the BRIGHT team and a baseline assessment of mental health literacy will be administered. The comprehensive training regimen comprises of training modules in didactic and experiential format which will be led by the BRIGHT MDT. As trainees gain competence, they will progress to leading sessions under close supervision.

Results: Average participant satisfaction was 85% with positive verbal reviews from community partners as well. GDS, GAI, HCS, and SF 12 PCS scores improved by an average of 1.8, 1.7, 1.6 and 1.8 respectively. On the other hand, SF-12 MCS scores decreased by an average of 1.8.

Conclusions: By focusing on a train-the-trainer model, the programme ensures long-term sustainability of these interventions.

Objectives: Activities that require active thinking, like occupations, may influence cognitive function and its change over time. Associations between retirement and dementia risk have been reported, however the role of retirement age in these associations is unclear. We assessed associations of occupation and retirement age with cognitive decline in the US community-based Atherosclerosis Risk in Communities (ARIC)cohort.

Methods: We included 14,090 ARIC participants, followed for changes in cognition during up to 21 years. Information on current or most recent occupation was collected at ARIC baseline (1987–1989; participants aged 45–64 years) and categorized according to the 1980 US Census protocols and the Nam-Powers-Boyd occupational status score. Follow-up data on retirement was collected during 1999–2007 and classified as retired versus not retired at age 70. Trajectories of global cognitive factor scores from ARIC visit 2 (1990–1992) to visit 5 (2011–2013) were presented, and associations with occupation and age at retirement were studied using generalized estimating equation models, stratified by race and sex, and adjusted for demographics andcomorbidities.

Results: Mean age (SD) at first cognitive assessment was 57.0 (5.72) years. Higher occupational status and white- collar occupations were significantly associated with higher cognitive function at baseline. Occupation was associated with cognitive decline over 21 years only in women, and the direction of the effect on cognitive function differed between black and white women: in white women, the decline in cognitive function was greater in homemakers and low status occupations, whereas in black women, less decline was found in homemakers and low (compared to high) occupational status. Interestingly, retirement on or before age 70 was associated with less 21-year cognitive decline in all race-sex strata, except for blackwomen.

Conclusions: Associations between occupation, retirement age and cognitive function substantially differed by race and sex. Further research should explore reasons for the observed associations and race-sex differences.

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

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

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

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

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

Objectives: 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.