Age-related losses in cognitive control efficiency in the face of response conflict are commonly reported in ageing research. However, it is unclear to what extent this effect reflects changes in actual inhibitory control, or the well-known age-related slowing of processing speed.

We compared young (n = 42; 29 women; mean age = 19.6 years; mean formal education = 13 years) and older adults (n = 42; 27 women; mean age = 68.7 years; mean formal education = 12.8 years) using a spatial Stroop task. Participants responded to the direction of an arrow, ignoring its position. Direction and position could be congruent, incongruent or neutral (respectively low, high and no conflict trials). The level of conflict in trial n-1 (high or no conflict) modulated the level of adaptive control in the nth trial. We used multivariate analyses of variance to probe age-group effects on inhibitory efficiency, adaptive (high conflict n-1 trial) and momentary (no conflict n-1 trial). We analysed accuracy and direct as well as proportional reaction times, which respectively integrate and control for differences in general processing speed.

Older participants showed a larger overall Stroop effect in both direct [Wilks’ λ = .61, F(2,81) = 25.99, p<.001] and proportional reaction times [Wilks’ λ = .79, F(2, 81) = 10.55, p<.001]. Controlling for differences in general processing speed did not impact age-group effects on momentary inhibitory efficiency [F(1,82) = 17.78, p<.001], but eliminated a trend for poorer adaptive inhibitory control in the older group [F(1, 82)=.198, p = .657]. As for accuracy, we unexpectedly found a larger Stroop effect for the younger group [Wilks’ λ = .79, F(2, 81) = 11.07, p=.001].

Older and younger adults are as effective in using previous response conflicts to prepare for current conflict resolution. Older adults' lower momentary inhibitory effectiveness likely reflects age-related slowing of processing speed as well as, to a degree to be determined in future research, larger strategic reaction times investment in accuracy enhancement.

BIAL Foundation (Grant 234/14)

Primary care visits of persons with dementia often bring together triads composed of patients, family carers and general practitioners (GPs), as previously discussed (1). Communication dynamics potentially affect dementia outcomes, not least because primary care is a health setting where these triad encounters often occur naturally. Our aim is to present further data from Portuguese primary care consultations with persons with dementia, their carers and GPs.

We refer to the conclusion of our study ‘Dementia in Primary Care: the Patient, the Carer and the Doctor in the Medical Encounter - Bayer Investigation Grant | NOVAsaúde Ageing 2018’ (1). Fieldwork was interrupted during the COVID-19 pandemic and resumed in 2022. Sixteen consultations with persons with dementia, their carers and GPs (purposive sampling) were audio- recorded and transcribed verbatim. Interactions were thematically analysed using NVIVO® software. The analytical framework combined codes derived from the transcripts with codes from the literature.

Dementia-related content took up less than half of consultations’ time, despite their considerable length (as compared to the average in primary care). Most GPs assessments lacked breadth, although efforts towards positive attitudes were present. Themes specifically related to social health in dementia were not (or were poorly) covered. Frequently, carers facilitated GPs’ assessment of dementia consequences, but their own needs were neglected. Patients’ self-expression tended to be limited.

Our findings suggest that doctor-patient interactions in many GPs’ consultations seemingly compromise patient-centred approaches. There are challenges regarding how to assess the biopsychosocial consequences of dementia in a context of fragmented care (2,3). Given the scarcity of evidence from live-recorded primary care consultations about triadic dynamics, our findings are important to guide further explorations.

There is no cure for dementia due to non-Alzheimer’s disease (non-AD), and current treatments are symptomatic. Noninvasive brain stimulation therapies such as transcranial magnetic stimulation (TMS) are increasingly being investigated to improve cognitive function in dementia. We conducted a systematic review to investigate the effectiveness of TMS on cognition in non-AD dementia.

Comprehensive search of databases (Medline, Embase, Cochrane, APA PsycINFO, Web of Science, and Scopus) from 2000 to February 2023 using keywords related to TMS and dementia (PROSPERO, CRD42022326423). Here we report outcomes from randomized controlled trials (RCTs) of TMS on non-AD dementia populations.

In total, 20 RCTs comprised of 660 patients, mean age 62 years (range 46-71). Diagnostic groups include stroke (n=8), Parkinson’s disease (n=6), Frontotemporal dementia (n=3), Huntington’s disease (n=2) and Progressive non-fluent aphasia (n=1). The most common site of stimulation was left (L) dorsolateral prefrontal cortex (DLPFC, n=13); other sites were primary motor cortex (n=2); Right (R) Broca's area, Brodmann area, Contralesional pars triangularis, R Inferior Frontal Gyrus (IFG) (all n=1); and multiple sites in 1 RCT (L and R IFG, L superior frontal gyrus, L DLPFC, L and R right anterior temporal lobe, supplementary motor area, anterior cingulate, and vertex). Studies used both low (1Hz, n=5) and high (50Hz, n=5) frequencies, or other high (5Hz, 10Hz, 20Hz) or combination low/high frequencies. Frequent duration of treatment was 10 days (n=7), range 1-40. Of 20 studies, 19 (95%) demonstrated improvement of global cognition (on MoCA, MMSE) and specific cognitive domains (learning and memory, language, executive function, problem-solving, attention, reaction time). The only RCT with no effect utilized a single session intermittent theta burst stimulation on the LDLPFC on PD patients. Adverse events in 7 studies included headaches (most common), dull skull pain, dizziness, insomnia, fatigue, anxiety, temporary decrease in hearing, and temporary decreased mental clarity.

There is favorable evidence that rTMS improves global and specific cognitive domains in non-AD dementia. Left DLPFC is the most common stimulation site, both low- and high-frequency are utilized, and 10 sessions is frequently used. Further studies are needed to determine optimal TMS treatments in cognitively impaired populations

Antidepressants are among the most prescribed medications in older adults. In this study we aimed to explore the trends in the use of antidepressants in older Swedish adults between 2006 and 2020.

We conducted a retrospective repeated cross-sectional study, where we included all older adults (65 years and older) registered in the Swedish National Prescribed Drug Register between 2006 and 2020. We estimated the use of antidepressants in older people for each year, across the 21 Swedish regions.

The Swedish population of older adults increased from 1.2 million in 2006 to 1.7 million in 2020. There was an increase in antidepressant use from 12.4% in 2006 to 13.2% in 2019 and 13.8% in 2020. We found that the use of antidepressants varied across age groups, older adults 85+ had a higher use (18.2% in 2006, 18.2% in 2019 and 19.4% in 2020) compared to those 65-74 years of age (9.6% in 2006, 11.7% in 2019 and 12.2% in 2020).

Individuals who used antidepressants were generally older (mean age = 77.7) and more often women, compared to individuals who did not use antidepressants (mean age =75.7). Moreover, individuals who used antidepressants also had a higher use of benzodiazepine compared to non-users (25.1% vs. 6.4% in 2006; 16.0% vs. 2.7% in 2019 and 15.6% vs. 2.5% in 2020), sleeping drugs (27.7% vs. 10.9% in 2006; 25.2% vs. 9.3% in 2019 and 24.6% vs. 8.9% in 2020), first generation antipsychotics (1.1% vs. 4.0% in 2006 and 0.3% vs. 1.3% in 2020) and second-generation antipsychotics (1.0% vs. 6.3% in 2006 and 0.8% vs. 6.3% in 2020).

Citalopram was the most frequently used antidepressant. However, its use declined from 2006 to 2020 and instead we observed an increase in the use of mirtazapine and sertraline. The prescription of tricyclic antidepressants (TCA), selective monoamine-A inhibitors and lithium was relative stable over time.

Overall, antidepressants were prescribed at doses close to the defined daily doses (DDD), except for TCA, mianserin, bupropion and venlafaxine which were often prescribed at lower doses.

We found a slight increase in antidepressant prescription in Sweden between 2006 and 2020, with older adults 85 years and older using more antidepressants compared to those 65-74 years of age. Use of antidepressants was associated with increased use of benzodiazepines, sleeping drugs (zolpidem and zopiclone), as well as first- and second-generation antipsychotics. Citalopram was the most prescribed antidepressant, but its use has declined over time.

Despite the integral role long term residential care staff play in the lives of residents with dementia, the mechanisms for supporting staff to bring about good quality of care (QOC) and quality of life (QOL) are poorly understood. This study focused on establishing the key mechanisms to improve QOC and in turn QOL of residents with dementia.

Over a 10-month period we followed: 247 older adults with dementia from 12 not-for-profit residential care facilities, their families/care partners (n=225), managers (n=12) and staff (n=232). Facilities ranged in size from 10 to 137 beds, located across remote, rural and metropolitan areas of south eastern Australia. Measures included: staff surveys, family member and resident interviews, resident file audits, live resident and staff observations and organisational audits. Multilevel Modelling or Generalised Estimating Equations analyses were conducted for each of the 12 QOC variables, with 22 staff and control variables as the predictors, and for each of the 11 QOL variables, with 20 QOC and control variables as predictors.

Analyses established significant associations between a large number of staff and QOC variables and between QOC and QOL variables.

The quality of the care provided to residents has strong, widespread influences on the QOL of residents. The most promising areas for intervening with staff were: increasing the relevance and applicability of staff training and qualifications, upskilling staff in empathic care provision, communication, and restraint reduction, using a mixture of permanent and rotating shifts, prioritising recreational activity provision by all staff and increasing assistance with meals. patients with cognitive impairment in rural hospitals.

evaluate the clinical outcomes for acute hospital patients with dementia, delirium or at risk for delirium supported by the person-centred volunteer program in australian rural hospitals.

a non-randomised, mixed methods, controlled trial.

older adults admitted to 7 rural acute hospitals. Intervention (n=270) patients were >65 years with a diagnosis of dementia and/or delirium or had risk factors for delirium and received volunteer services. Family carers (n=83) of intervention patients were interviewed. Staff survey and focus groups. Control (n=188) patients were randomly drawn from patients admitted to the same hospital 12 months prior to the volunteer program who would have met program eligibility criteria.

trained volunteers provided 1:1 person centred care with a focus on nutrition and hydration support, hearing and visual aids, activities, and orientation.

medical record audits provided data on volunteer visits, diagnoses, length of stay (los), behavioural incidents, readmission, specialling, mortality, admission to residential care, falls, pressure ulcers and medication use.

across all sites there was a significant reduction in rates of 1:1 specialling (p=.011) and 28 day readmission (p=.006) for patients receiving the volunteer intervention. Los was significantly shorter for the control group (p=.001). All other patient outcomes were equivalent for the intervention and control group (p>.05). Volunteers integrated themselves into the care team providing person-centred care, increased safety and quality of care and were an “extra pair of hands”, reducing care burden for staff and importantly for families: “for me, knowing someone was there … i can't even tell you what a benefit that was”. 98% of staff rated the program as supportive of them in their care

Enablers were clear processes for screening, training and supporting volunteers. Key challenges included initial role delineation, staff/volunteer trust and sustainability.

appropriately trained and supported volunteers are cost effective and can improve the safety and quality of care for hospitalised patients with cognitive impairment in rural hospitals.

Most studies about older adults´ loneliness are related to risk factors that increase the probability of loneliness and its negative consequences. These issues are linked with the negative traditional perspective of aging that focuses on decline, illness, and dependency. Although the probability of these conditions increases with age, current older adults age in better conditions than years ago. Positive Psychology is a new perspective that focuses on people´s strengths as protective factors of mental and physical health, including older people. Considering the negative consequences of loneliness in older adults, knowing the factors that may protect older adults from loneliness is needed.

This study aimed to analyse whether sociodemographics, physical, mental or social characteristics act as protective factors against older adults´ loneliness. Method: 274 Spanish people aged 65 and over completed an online survey that included sociodemographic information (sex, age), perceived health, quality of life, anxiety, depression, family functioning, gratitude, experiential avoidance, purpose of life, personal growth, and resilience. Loneliness was assessed using the Spanish version of the Three-Item Loneliness (Hughes et al., 2004). The average age was 70.46 (SD= 4.42) and 61.7% were women (N= 169) and 55.1% were married (N= 151). A regression model was tested.

The results point out that women show higher scores on loneliness than men. The more loneliness, the lower perceived health, quality of life, family functioning, gratitude, life purpose, personal growth and resilience were. In contrast, the more loneliness the more experiential avoidance, anxiety, and depression. The regression model showed that depression (β = 0.202; p≤ .01), family functioning (β = -0.385; p≤ .001), experiential avoidance (β = 0.318; p≤ .001) and personal growth (β = 0.152; p≤ .01) were the best predictors of loneliness. This model explained 44.3% of variance.

Considering the Positive Psychology perspective when studying older adults´ loneliness is needed. This perspective focuses on older adults´ protective factors and not only on risk factors as a target for prevention and intervention programs that aim to reduce loneliness. Building a more resilient older adults group population may help them to cope with adversities like loneliness.

The aim was to develop a lucidity measure for use with front-line caregivers to describe lucidity episodes among individuals with dementia, neurological and other illnesses and identify associated individual and episodic event characteristics.

Qualitative: An external advisory board reviewed the clarity, breadth, and scope of the conceptual definition and item content. Modified focus groups were conducted with 20 staff and 10 family members who participated using a web-based survey. Data were extracted from Qualtrics for analysis using NVivo. Semi-structured cognitive interviews were conducted with10 health professionals working with older adults with cognitive impairment.

Quantitative: A combined exploratory and confirmatory factor analysis was performed to test for dimensionality. The explained common variance (ECV), calculated as the percent of observed variance was estimated. Estimates of internal consistency such as ordinal alpha and McDonald’s omega were computed in R and Mplus.

Data were collected from 50 staff informants on behalf of 302 residents, 25 with lucidity events. The majority (74%) of those interviewed were certified nursing assistants. Most (58%) of the sample of residents were White and 21% Black or African American. One fourth (25%) were Hispanic or Latino. Most (80% to 90%) of those with lucidity events were reported to have memory deficits and at least 70% required maximal assistance in performing basic tasks such as dressing. Most events (60%) were of short duration (10 minutes or less), and included showing facial expressions (83%) and making eye contact (88%). One half spoke multiple sentences. About half were reported to hold a conversation, and speak coherently to convey needs; 40% were able to remember and mention the name of relatives. Staff reactions were of surprise (60%) shock (52%) and happiness (50%).

Data for item modification derived from the focus groups and cognitive interviews resulted in the final lucidity measure. Internal consistency estimates were high, with most ranging from 0.76 to 0.98. The ECVs were high for most scales, indicative of essential unidimensionality.

The dimensionality and reliability analyses results were strong, and supportive of unidimensional scales with high internal consistency. The feasibility of conducting assessments of lucidity events was established.

Social connection is associated with better health, including reduced risk of dementia. Personality traits are also linked to cognitive outcomes; neuroticism is associated with increased risk of dementia. Personality traits and social connection are also associated with each other. Taken together, evidence suggests the potential impacts of neuroticism and social connection on cognitive outcomes may be linked. However, very few studies have simultaneously examined the relationships between personality, social connection and health.

We tested the association between neuroticism and cognitive measures while exploring the potential mediating roles of aspects of social connection (loneliness and social isolation).

We conducted a cross-sectional study with a secondary analysis of the Canadian Longitudinal Study on Aging (CLSA) Comprehensive Cohort, a sample of Canadians aged 45 to 85 years at baseline. We used only self-reported data collected at the first follow-up, between 2015 and 2018 (n= 27,765). We used structural equation modelling to assess the association between neuroticism (exposure) and six cognitive measures (Rey Auditory Verbal Learning Test immediate recall and delayed recall, Animal Fluency Test, Mental Alternation Test, Controlled Oral Word Association Test and Stroop Test interference ratio), with direct and indirect effects (through social isolation and loneliness). We included age, education and hearing in the models and stratified all analyses by sex, females (n= 14,133) and males (n=13,632).

We found positive, statistically significant associations between neuroticism and social isolation (p<0.05) and loneliness (p<0.05), for both males and females. We also found inverse, statistically significant associations between neuroticism and all cognitive measures (p<0.05), except the Stroop Test interference ratio. In these models, there was consistent evidence of indirect effects (through social isolation and loneliness) and, in some cases, evidence of direct effects. We found sex differences in the model results.

Our findings suggest that the association between neuroticism and cognitive outcomes may be mediated by aspects of social connection and differ by sex. Understanding if and how modifiable risk factors mediate the association between personality and cognitive outcomes would help develop and target intervention strategies that improve social connection and brain health.

Caring for a family member with dementia may have important negative psychological consequences on caregivers. The present study aims to analyze the existence of different profiles in family caregivers of people with dementia according to the levels manifested in different psychosocial variables, which are grouped into psychosocial variables (dysfunctional thoughts, familism, experiential avoidance) and resources (leisure and social support). In addition, it aims to study whether there are differences among those profiles in the levels of distress (depressive, anxious and guilt symptomatology) depending on the relationship of kinship with the cared-for person.

288 family caregivers of people with dementia divided into four kinship groups (wives, husbands, sons and daughters) participated. Face-to-face interviews were conducted assessing sociodemographic variables, familism (family obligations), dysfunctional thoughts, experiential avoidance, leisure activities, perceived social support and depressive, anxious and guilt symptomatology. A hierarchical cluster analysis was performed using Ward's method and contingency tables were run between the clusters obtained and the variable of kinship and distress variables.

Five clusters were obtained: Low psychosocial vulnerability-High resources (mostly daughters), Low psychosocial vulnerability-Low resources (mostly daughters), Mixed (mostly sons), High psychosocial vulnerability-High resources (mostly husbands) and High psychosocial vulnerability-Low resources (mostly wives). Although with nuances, the clusters associated with lower distress are the Low psychosocial vulnerability-High resources profile and the High psychosocial vulnerability-High resources profile, and with higher distress the Low psychosocial vulnerability-Low resources profile and the Mixed profile.

High levels of dysfunctional thoughts, familism and experiential avoidance are not always associated with greater psychological distress. In fact, profile 2 (Low psychosocial vulnerability-Low resources), in which most caregiving daughters are distributed, seems to be particularly vulnerable to presenting higher levels of emotional. Therefore, the identification of profiles of potential protection and vulnerability to psychological distress in family caregivers could help to increase the effectiveness of interventions aimed at this population.

As the world’s population ages, the number of people with dementia is expected to increase. In addition to progressive cognitive and functional deterioration, dementia comprises neuropsychiatric symptoms (NPS). NPS present significant management challenges based on their high frequency and disruptive nature. Against the prevailing guidelines, their treatment is often over-reliant on psychotropic drugs and other restrictive care approaches, frequently without a thorough assessment of underlying and potentially modifiable causes, such as over- and under-stimulating environments, untreated medical illnesses, drug interactions, or unidentified unmet needs. Consistent with the latter, the unmet needs model proposes that these neuropsychiatric phenomena are needs-driven and constitute indicators of identifiable unmet physical, psychological, emotional, or social needs. Despite this backdrop, few studies have investigated this association using standardized and replicable measures. In this context, the present study aims to put the unmet needs model into a practical context in order to disentangle the contribution of the unmet needs, assessed with the Camberwell Assessment of Need for the Elderly (CANE), to the presence of NPS.

A cross-sectional study was conducted. Participants were assessed with validated, accessible, and replicable measures, including the CANE interview and the Neuropsychiatric Inventory (NPI). Other variables collected included residents’ demographic characteristics, cognitive and functional impairment, and daily medication. Multivariate models were used to explore potential risk factors for NPS.

Residents from four nursing homes entered the study. Results found that those with unmet needs assessed using CANE and those taking hypnotic/sedative medications had a higher risk of presenting at least one NPS, even after adjusting for other demographic and clinical-functional covariates.

Built on the main finding that unmet needs assessed with CANE can independently contribute to explaining the presence of NPS, a working model is proposed to find solutions for these symptoms based on uncovering unmet needs. The CANE, as a practical, low-cost, yet clinically relevant assessment of met and unmet needs may be used to signal need areas that can be useful for formulation and intervention purposes and may offer the first step towards individually-tailored non- pharmacological interventions for NPS.

Individual differences in the timing of dementia have been attributed to cognitive reserve (CR), thought to reflect lifelong engagement in stimulating experiences, which provide resilience against brain pathology. In older adults, dementia and depression are closely related, and some studies have linked CR with depression risk in old age. It is unclear if different ways of operationalizing CR exhibit similar association with old-age depression. We examined the association of two measures of CR with depressive burden in older adults: activity-based CR, capturing engagement in stimulating activities using proxy variables, and residual-based CR, indicating residual variance in cognition, not explained by the brain status.

We used data on 354 adults aged 60+ from the Swedish National Study on Aging and Care in Kungsholmen, followed for 15 years. Residual-based reserve was computed from a regression predicting episodic memory with a brain-integrity index incorporating six structural neuroimaging markers (white- matter hyperintensities volume, whole-brain gray matter volume, hippocampal volume, lateral ventricular volume, lacunes, and perivascular spaces), age, and sex. Activity-based reserve incorporated education, work complexity, social network, and leisure activities. Depressive burden was captured over the follow- up with the Montgomery-Åsberg Depression Rating Scale and time until clinically relevant level of symptoms (>6) was modelled using Cox proportional hazard models.

Preliminary results indicate that, upon minimal adjustment (age, sex, brain integrity status), top tertiles (ref: bottom tertile) of both activity-based (HR: 0.77; 95% CI: 0.61-0.98) and residual-based CR (HR: 0.62; 95% CI: 0.44-0.98) were associated with a lower risk of depressive burden onset over 15 years. Upon further adjustment for anthropometrics, health behaviors, and chronic disease burden, the association of activity-based CR was attenuated, whereas residual-based CR preserved its effect on depressive burden (HR [fully adjusted model]: 0.59; 95% CI: 0.40-0.88). Next steps include evaluating the ability of reserve measures to attenuate the association of brain integrity with depressive burden using interaction analysis.

Preliminary findings suggest that CR may be linked with depression development in older adults, although the association may vary depending on measurement of reserve. Association of activity- based reserve may be attributed to somatic disease pathways.

Depression evolves dynamically in old age. Studies of natural history of major depression in older adults suggest that 19–34% recover, 27%–32% remain chronically ill, and approximately 40% experience a fluctuating course. Another way of approaching depression from a longitudinal point of view is by adopting a symptom-based approach, that in addition to the evolution of clinically manifested diagnostic entities, also focuses on transitions involving subclinical/subsyndromal states, although few studies have attempted it. We examined psychosocial, behavioral, and clinical determinants of transitions across states that include no depression, subsyndromal-, and clinical depression.

We used data on 3086 adults aged 60+ from the Swedish National Study on Aging and Care in Kungsholmen, followed for 15 years. Markov-state transition models were used to capture transition patterns, as well as their associated determinants. Death and dropout constituted absorbing states. Depression was diagnosed in accordance with DSM-5; SSD was based on having at least 2 symptoms in the absence of DSM diagnosis. Determinants of transition patterns included index of social connections and support (i.e., psychosocial determinants); smoking, alcohol consumption, and physical activity (behavioral determinants); somatic disease burden and history of depression (clinical determinants).

At baseline, 10% of the study population exhibited clinically relevant levels of depressive symptoms. Over a 15-year period, a total of 11,489 transitions were observed. Preliminary results indicate that behavioral factors (primarily smoking) were mostly associated with transitions from no depression to clinical depression, as well as from clinical depression to death. Mostly the same pattern was seen for clinical determinants, although higher burden of chronic diseases and previous depression also increased the likelihood of transition from no depression to SSD. Notably, of high baseline values of social connection and support were found to: 1) lower the likelihood of transitioning from no depression to either SSD or clinical depression; 2) lower the likelihood of transitioning from SSD to clinical depression; and 3) increase the likelihood of transitioning from clinical depression to no depression.

Clinical and behavioral factors are mostly implicated in lowering the occurrence of depression, whereas psychosocial factors may also be implicated in recovery.

Dementia risk varies along the social gradient, which needs to be considered in risk reduction and prevention strategies. Revealing links of social determinants of health (SDOH) and modifiable health and lifestyle factors for dementia holds clues towards maximizing dementia risk reduction opportunities, especially for vulnerable populations. Therefore, the aim was to investigate associations of SDOH and a dementia risk score in Indigenous Māori and Non-Māori (mainly European descent) in midlife and early late-life.

A subsample of the New Zealand Health, Work and Retirement study completed standardized face-to-face cognitive assessments (adapted ‘Kiwi’ Addenbrooke’s Cognitive Examination/ACE-R) in 2010. We computed the Lifestyle for Brain Health (LIBRA) dementia risk score, comprising 8 risk factors (low/moderate alcohol consumption, heart disease, physical inactivity, chronic kidney disease, diabetes, smoking, hypertension, depression). Higher scores indicate higher dementia risk/poorer lifestyle (range= -1;+9.2). First, we assessed associations of LIBRA and cognition. Second, we performed adjusted regression analysis for area-based (socioeconomic deprivation, health care access, neighbourhood safety) and individual SDOH (education, employment status, net income, social loneliness) with LIBRA stratified for Māori and Non-Māori.

In 918 participants (age: M= 62.9 years, SD= 6.7, range= 48-75; females= 52.8%; Māori= 26.2%), a higher LIBRA score (M= 1.8, SD= 1.6, observed range= -1; +7.4) was associated with lower cognitive functioning (b= -0.30, 95%CI= [-0.48;-0.11], p= .002) and cognitive impairment (OR= 1.41, 95%CI= [1.10;1.81], p= .007), adjusted for age, sex, education, ethnicity and area-based socio- economic deprivation. Higher area-based socio-economic deprivation was associated with higher LIBRA in Māori (b= .10, 95%CI= [0.02;0.18], p= .020), but not in Non-Māori (b= 0.01, 95%CI= [- .03;0.05], p= .677). Employment status and lower neighbourhood safety were associated with higher LIBRA in Non-Māori only. Health care access difficulties and social loneliness were associated with higher LIBRA in both populations, while education and net income were not.

SODH are differentially associated with dementia risk in midlife and early late-life New Zealanders. Area-based socioeconomic deprivation was linked to dementia risk in Indigenous Māori, but not in Non-Māori. This points to systematic inequities in dementia risk, which require equity- focused policy-based public health approaches to risk reduction.

Depression is the most frequent cause of emotional distress in old age and can reduce the quality of life of the elderly. Sarcopenia is a syndrome characterized by the loss of skeletal muscle associated with reduced physical strength/performance. In recent years, some studies have shown correlations between sarcopenia and depression. The aim of the present study is to evaluate the association between depressive symptoms, sarcopenia, functional dependence and comorbidity in the geriatric patient at the first geriatric outpatient evaluation ever performed.

older adults (>=65 years of age) at their first access to the geriatric outpatient clinic of Modena County (Italy) between October 2020 and June 2021 were enrolled in this cross-sectional study. All participants were evaluated validated scales in order to perform a multidimensional geriatric assessment. The symptomatologic diagnosis of depression was performed through the GDS 4-item (cut-off >=2). Frailty was evaluated through the Clinical Frailty Scale (cut-off >=5). The probability of sarcopenia was evaluated through the SARC-F (cutoff >=4). Functional dependence was assessed through the ADL scale and deemed as severe (ADL 0-2), moderate (ADL 3-5), absent (ADL 6). Comorbidity burden was assessed through CIRS.

229 patients (mean age 82.4±7.9 years, 67.6% female) were evaluated. Clinically significant depressive symptoms were found in 173 (75.5%) patients. Probable sarcopenia was reported in 118 (51.5%) patients while 100 (43.7%) and 64 (27.9%) patients were moderately or severely dependent, respectively. At multivariate logistic regression, probable sarcopenia (aOR 2.48, 95%CI 1.09-6.40), moderate functional dependence (aOR 2.62, 95%CI 1.17-5.87) but not severe (aOR 2.72, 95%CI 0.79-9.33) were associated with the presence of depressive symptoms. Conversely, frailty (aOR 0.97, 95%CI 0.39-2.40) was not associated with presence of depressive symptoms, while CIRS (aOR 0.79, 95%CI 0.66-0.96) was found to be protective.

the study showed that a clinically relevant depressive symptomatology is prevalent among older adults and it is associated with higher probability of sarcopenia and moderate, but not severe, functional dependence. On the contrary, there was no association between depressive symptoms and frailty.

The prevalence of depressive symptoms is high among geriatric outpatient and can both be conditioned by and have an impact on the presence of sarcopenia and functional dependence.

Research tends to focus on the issues couples face – i.e., the dyadic relationship between carers and the affected person. This study examined young onset dementia from the broader family systems approach, focusing on the impact on the entire family following a diagnosis.

Public patient involvement was utilised to explore the specific issues of relevance to people with young onset dementia. Participatory workshops with members of the Alzheimer Society of Irelands Dementia Research Advisory Team were held to develop questions for the focus group interviews. Focus group interviews involved people with young onset dementia and their family members. The sample (n = 44) included people with a formal diagnosis of young onset dementia (with various subtypes) living in the community, and their family members including children.

Analysis of the qualitative data uncovered five main themes with related sub-themes including: initial onset of dementia; personal and social impact; behavioural and psychological symptoms of dementia; age-appropriate support and the shifting family roles.

It is clear from the current data that a diagnosis of young onset dementia results in significant challenges for the entire family system. The traditional model of care, which tends to narrow the focus to the person with dementia and primary caregiver, needs to be expanded to include the entire family/caregiving system.

Western countries have a significant cohort of children (≤ 18) and young adults who live with a parent with a life limiting condition. Children and young adults’ perspectives of certain parental illnesses have been well documented. However, the perspectives of children and younger adults of parental young onset dementia tend to be absent from the academic literature. Older adult children have reported on the impact parental young onset dementia, however, there is a necessity for research with younger adult children and children under the age of eighteen in relation to their perspectives of the condition.

Utilizing cultural transmission theory, the current research explored if the social and cultural perspective influences the narratives of children and younger adults of parental young onset dementia.

One-to-one interviews were held with children and younger adults (n = 17: 29·41% male) who currently live with (or have lived with) a parent with a formal diagnosis of young onset dementia (with various subtypes). The participants ranged in age from 14 to 33 years old (x̅ = 21·18 years) with n = 6 eighteen years of age or younger (x̅ = 16·17 years). Participant narratives were analyzed using inductive qualitative thematic analysis.

Detailed thematic analysis of the participant narratives uncovered five main themes (with related subthemes); making sense; lack of representation; threat to the family system; life has completely changed; systemic psycho-social support and education.

It is clear from the current data that the social and cultural perspective can significantly influence the narratives of children and younger adults of parental young onset dementia. Children are faced with more responsibility, shifting roles, changing relationships, and may be forced to postpone educational or employment plans. Furthermore, the social perception of dementia as can act as a barrier to children and young adults accessing and using health and social care providers.

Social health (SH) markers, including marital status, contact frequency, network size, and social support, have been linked with increased cognitive capability. However, the underlying mechanisms remain poorly understood. We aim to investigate whether depression symptoms and inflammatory biomarkers mediate associations between SH and cognitive outcomes.

We used data from waves 1-9 of the English Longitudinal Study of Ageing, involving 7,136 participants aged 50 or older at baseline. First, we examined associations between SH (wave 1) and depression and inflammatory biomarkers (C-reactive protein (CRP) and fibrinogen) (wave 2) using linear regression models. Second, we tested associations between a) SH and b) depression and inflammation with subsequent standardised verbal fluency and memory in wave 3 and change between waves 3-9, indexed using slopes derived from multilevel models. We adjusted for age, sex, socio-economic position, cardiovascular disease, basic and instrumental activities of daily living, health behaviours, and baseline depression symptoms and cognition. We will also conduct causal mediation analysis.

All SH markers, except contact frequency, were associated with lower subsequent depression, but not inflammatory biomarkers. Greater contact frequency (e.g. once-twice a week vs <once per year: β=0.18 [0.01, 0.36]) and less negative support (β=0.02 [0.00, 0.03]) were associated with higher verbal fluency. Larger network size (>6 people vs none: β=0.007SD/year [0.001, 0.012]), less negative (β=0.001SD/year [0.001, 0.002]) and more positive support (β=0.001SD/year [0.000, 0.001]) were linked with slower memory decline, and more positive support predicted slower verbal fluency decline (β=0.001SD/year [0.000, 0.001]). Depression symptoms were associated with lower memory and verbal fluency, and faster memory decline (β=-0.001SD/year [-0.001, -0.000]) and verbal fluency (β=-0.001SD/year [-0.001, -0.000]). CRP was associated with lower verbal fluency (β=-0.02 [-0.04, 0.00]), whereas fibrinogen was linked with faster memory decline (β=-0.001SD/year [-0.003, -0.000]).

Depression symptoms and SH showed associations with subsequent cognitive capability and change. SH was linked with lower depression, but not inflammatory biomarkers. Findings highlight the potential for depression to underpin associations between SH and cognition, a pathway which we will test using causal mediation analysis. We will also examine whether findings replicate in the Swedish National Study of Aging and Care in Kungsholmen.

Reminiscence therapy is the examination of past memories to improve current mood and psychological functioning and is an evidence-based treatment for symptoms of late life psychological distress. Music is sometimes used in such therapy to prompt or enhance the recollection of memories; however, there is limited empirical research on the use and value of using music in reminiscence therapy. This presentation will discuss the findings of two studies exploring the feasibility and use of verbal reminiscence therapy (VRT) and music-assisted reminiscence therapy (MRT) from the perspectives of the older adult and the staff who care for them.

Study one surveyed 110 Australian workers in aged care to explore the extent to which VRT and MRT were used, how such interventions were delivered and viewed, and the benefits. Study two randomly assigned 8 older adults experiencing psychological distress to a single session of VRT or MRT. Pre and post measures of affect, memory experience, and a brief satisfaction interview were collected, along with measures of treatment fidelity.

For staff, simple reminiscence was the most frequently used approach across both VRT and MRT. Staff reported that both VRT and MRT are viewed as successful and regularly used interventions, that occur in spontaneous and creative ways in response to older clients’ needs. Staff reported outcomes such as enhanced social connections, improved affect and mood, and better care practices. Older adults reported that that VRT and MRT were equally acceptable and well tolerated. A pre-post pattern of improvement was observed for affect following VRT, and particularly MRT, suggesting both as promising interventions. MRT resulted in higher scores on memory experience characteristics such as vividness, coherence, and accessibility. The high treatment fidelity achieved in this study indicates that the interventions can be successfully implemented with this population.

VRT and particularly MRT were viewed as successful, feasibility and acceptable interventions by older adults experiencing psychological distress, and direct care staff in Australia. These preliminary findings indicated MRT may provide therapeutic changes above and beyond VRT for older adults, and therefore large-scale clinical trials are warranted.