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 increase in suicidal behavior in patients treated with promising new drugs for Alzheimer’s disease is a dilemma that deserves to be understood. The correlations between suicide and neurodegenerative disorders have been debated for decades in the context of ethics, considering that many people with cognitive decline have opted for euthanasia. The academic community is invited to pay greater attention to issues other than ethics that can improve the quality of life of people with dementia.

Methods: We sought to read the review articles on Pubmed on the topic over the last two decades to identify possible factors that are correlating suicide with Alzheimer’s Disease. The data were grouped and presented to demonstrate possible studies that should be carried out to clarify the topic better.

Results: Depression and the presence of the E4 allele of Apolipoprotein E were the main correlation factors between Alzheimer’s disease and suicide.

Conclusions: Targeted studies are needed to understand better the occurrence of depression in Alzheimer’s disease, as well as the role of the E4 allele in mood disorders and suicidal behavior.

The injuries that occurred in earthquakes caused an accumulation in hospitals and the need for health services increased. The most needed human resource in the provision of health services in disasters is nurses. The aim of this study is to determine the scope of nursing services in earthquakes and to identify the service needs in hospitals during the February 6 earthquakes in Turkey. In this study, Delphi technique was used for needs analysis. The managers of health institutions in 11 provinces that experienced the earthquake were interviewed to determine how nursing services are carried out during earthquakes. As a result of this study, it was determined that there were inadequacies in triage, identification of earthquake victims, medical intervention and keeping records, identification of deceased earthquake victims, storage of personal belongings, communication with relatives of earthquake victims, and psychosocial support services in disasters such as earthquakes where many people were seriously injured. It has been observed that there is a need for disaster nurses and forensic nurses to work in these areas and it is thought that these 2 nursing fields should be taken into consideration in the planning of health professional resources in disasters.

Background: Most people living with dementia rely on their family members for the care and support they need. However, unpaid care can lead to multiple negative impacts on the wellbeing and mental health of carers.

Objectives: The Objectives of this study was to evaluate the effects of iSupport-Brasil (an online, psychoeducational program) on perceptions of burden and on the mental health of informal caregivers of people living with dementia.

Methods: A randomized controlled trial was carried out from January 2023 to April 2024 in Brazil. A total of 162 individuals were randomly allocated to an intervention group (IG) (n = 77) or a control group (CG) (n = 85). The IG had free access to the iSupport-Brasil platform for three months. Simultaneously, the CG participants were provided with a link to access the Brazilian Alzheimer’s Association website and a copy of the “Care Guide for Older People”, published by the Brazilian Ministry of Health. Pre- and post-intervention assessments were carried out using measures of burden (a single-item Burden Scale and the Zarit Burden Interview – ZBI), and of anxiety and depressive symptoms (Hospital Anxiety and Depression Scale - HADS).

Results: Based on an intention-to-treat analysis, a reduction in anxiety symptoms was observed for the IG (p = 0.02). Based on a per-protocol analysis, significant reductions in burden (p <0.01) and anxiety symptoms (p < 0.01) were found for the IG. No significant effects were found for depressive symptoms, although scores decreased. For the CG, the regression model indicated that, on average, burden and depressive symptoms worsened somewhat, but this result was not statistically significant.

Conclusions: The iSupport-Brasil program was effective in reducing perceptions of burden and anxiety symptoms among informal caregivers in Brazil. Therefore, we recommended that informal caregivers of people living with dementia use this program to help them broaden their interpersonal coping strategies and improve their emotional health, in addition to using mainstream long-term care support services.

Cultural heritage preservation and protection are increasingly tethered to an international security agenda constituted across multilateral agencies. UNESCO and other organizations have securitized heritage, engaging in military training and peacekeeping, international law and prosecution, and cultural property protection. Following the events in Iraq and Syria, UN Security Council resolutions have instantiated norms of heritage violence, risk, and threat, while the Global War on Terror also interpolated looting, trafficking, and terror financing into a heritage-protection agenda. We compare these developments with our large-scale public opinion survey of Mosul and Aleppo residents’ experiences of heritage violence and the implications for security and reconstruction. While our results display potential overlaps with UNSC concerns, we suggest that site destruction and broader security concerns are understood differently on the ground, shaped by political and economic factors. We argue for a more humanitarian focus if any relationship between heritage, security, and, indeed, peacebuilding is to be forged.

Resource partitioning is a critical mechanism underlying the coexistence of close relative species that feed on similar resources. Based on foraging data, we built a plant–seedeater interaction network for three sympatric species of Neotropical seedeaters – namely Tropeiro Seedeater Sporophila beltoni, Black-bellied Seedeater Sporophila melanogaster, and Tawny-bellied Seedeater Sporophila hypoxantha, and tested to what extent the three species shared resources. The interaction network was non-nested and modular, forming three modules, each one comprising one seedeater species and their most consumed plants, indicating the existence of resource partitioning. Modules may result from multiple non-exclusive factors, including differences among seedeater species in habitat use, bill sizes, feeding habits, structure of vegetation for nesting, and abiotic factors that influence plant composition. Our results indicate that the effective conservation of these species requires the protection of areas that include the three distinct subsets of plants used by these birds during the breeding season and also indicates which plants may be used for the restoration of grasslands in the region.

Objectives: To evaluate the effectiveness of the sleep monitor device, feedback from sleep report, and regular advice for community-dwelling older people.

Methods: Randomized controlled trial and evaluator blinded. Subjects are over 65-year-old who live in the community or living alone or in older households or requiring support under long-term care insurance in Japan. They are divided into three groups: A) For 6 months, send monthly report and conduct telephone intervention; B) For the first 3 months is same intervention as A, then for the next 3 months. only send monthly report; C) For 6 months, send monthly report. A sleep monitoring device: Active Sleep Analyzer is a non-wearable actigraphy device and was used to evaluate Objectives sleep, such as total sleep time, sleep latency, sleep efficiency, wake after sleep onset, number of awakenings. The primary outcome was the subjective sleep quality from Athens Insomnia Scale (AIS). We mainly conducted three analyses. 1) Basic characteristics at baseline 2) Paired t-tests within groups to examine differences in AIS after the intervention from baseline. 3) Repeated measurements to examine differences in AIS between the three groups depending on time. All significance levels were set at p < 0.05. The study was conducted with the approval of the Osaka University Hospital Ethics ReviewCommittee.

Results: We contacted 349 people to participate and randomized 223 people who attended the first seminar and met the eligibility criteria. We analyzed 212 participants (A72, B70, C70), excluding those with dropouts or significant missing data, with the demographic profile of participants being 36% male, mean age 75 years, mean AIS 6.6. Most participants were interested in sleep and wanted to improve their sleep at baseline. As a result of repeated measurements, a significant decrease in AIS was observed in group A and B. For 3month, A decreased 1.8 ± 0.42, p = 0.0013, B decreased 2.4 ± 0.41, p < 0.0001 and for 6month, A decreased 1.5 ± 0.39, p = 0.0072, B decreased 1.4 ± 0.40, p = 0.0188.

Conclusions: Reports using sleep data and feedback from experts over the phone can improve the sleep of older people. This intervention could allow older people to reconsider not only their sleep but also their lifestyle, potentially improving their health.

Introduction: Transcranial Direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) are neuromodulatory techniques capable of modifying the altered cerebral hyperexcitability in amnestic mild cognitive impairment (aMCI). Cortical excitability can be estimated with motor evoked potentials (MEPs) and synaptic plasticity can be induced with a 5 Hz rTMS paradigm applied to the motor cortex (M1). An increase in MEP amplitude reflects a better capacity for plasticity in M1, and these measures can, in turn, be associated with cognitive performance. Cognitive stimulation (CS) and tDCS in aMCI can modify excitability and improve cognition.

Objectives: Study the effect of the combination of CS and tDCS (real vs. placebo) on cognitive performance and cortical excitability.

Methods: Randomized, double-blind, placebo-controlled clinical trial in aMCI. The diagnosis was established through a clinical evaluation by a psychogeriatrician and a neuropsychological assessment. To determine the effect of the interventions, evaluations were conducted at two time points: before (T0) and after administering 9 sessions of CS and 15 sessions of tDCS over three weeks (T1). The evaluations included: MEP amplitude, Montreal Cognitive Assessment (MoCA), and Screening for Cognitive Impairment in Psychiatry (SCIP-S). For data analysis, ARTool in RStudio was used to perform aligned rank transformation for non-parametric analysis of variance in factorial models with fixed and random effects, applying a factorial ANOVA for each response variable.

Results: A total of 18 participants were enrolled (real n = 8 and placebo n = 10). Comparing T0 and T1, differences were found in both groups in MEP amplitude after applying the paradigm (F = 5.479; p = 0.032) as well as in the total MoCA score (F = 4.808; p = 0.043). When comparing the groups, differences were found in the delayed verbal learning domain assessed with SCIP-S (F = 6.038; p = 0.025) and in MEP amplitude (F = 6.165; p = 0.024). No differences were found in any of the evaluations when studying the effect of the GroupxTimeinteraction.

Conclusions: Both groups benefit from cognitive stimulation, and the use of tDCS does not appear to enhance the cognitive effect or the MEPs. It seems that cognitive stimulation alone is capable of modifying cortical excitability and improving cognitive performance.

Attempts to develop high yielding varieties in Ghana have mostly relied on the introduction of new clones to broaden the range of planting materials for yield improvement. The objective of this study was to estimate the genetic variation and heritability for bean yield of six recommended cocoa clones using these as males in crosses with five seed garden parents. Twenty-four families obtained from a 5 × 6 North Carolina II (NC II) incomplete factorial mating design together with 19 high yielding single crosses, of which four were standard mixed hybrids, were planted in a randomized complete block design with four replications and evaluated for bean yield over 6 years. To account for the serial correlation among yield data collected from the same plants over years, six models with different covariance structures were tested. The general covariance model emerged appropriate based on Akaike information criterion values with significant (P < 0.01) family × year interaction. Average bean yield was highest in the NC II families followed by the specific crosses then the standard mixed hybrids. Combining ability analysis among the NC II was significant for female, male and female × male interaction along with a narrow-sense heritability of 0.26. Clone CRG 6035 among the males which had good general combining ability could be added to the seed garden parents, while the promising hybrids (NA 33 × SCA 9, SCA 6 × Pound 10, T60/887 × PA 121 and T79/501 × CRG 6035/103) undergo stability tests before release.

We examine whether the “privileged coordinates” of a geometric space encode its “amount of structure.” In doing so, we compare this coordinate approach to comparing amounts of structure to the more familiar automorphism approach. We first show that on a natural understanding of the former, it faces one of the same well-known problems as the latter. We then capture a precise sense in which the two approaches are closely related to one another, and we conclude by discussing whether they might still prove useful in cases of philosophical interest, despite their shortcomings.

Introduction: Young and older adults with bipolar disorder (BD) commonly present with cognitive deficits. Many also report subjective or perceived cognitive failures.

Objectives: For this study, we identified four distinct clusters of adults with BD on the basis of both BD symptoms (depression and hypo/mania) and perceived cognitive errors (i.e., forgetfulness, distractibility, false triggering). We hypothesized that participants reporting more BD symptoms and cognitive errors would report lower psychological well-being (i.e., self-efficacy, life scheme, life satisfaction).

Methods: From the BADAS (Bipolar Affective Disorder and older Adults) Study, we identified 281 adults with BD (M = 44.27 years of age, range 19–81), recruited via micro-targeted social media advertising (vs. mass marketing to general samples). All clusters significantly differed across all grouping variables except symptoms of hypo/mania due to low frequency.

Results: Across clusters, perceived cognitive failures and BD symptoms increased in lockstep; that is, those reporting more cognitive errors also reported significantly higher symptoms of both depression and hypo/mania. As hypothesized, they also reported significantly lower psychological well-being.

Conclusions: Of note, age did not significantly differ across clusters in contrast to existing research in which cognition is Objectivesly measured. That is, perceived cognitive errors are significantly associated with lower psychological well-being for both young and older adults with BD.

Objectives: The aim of this study was to analyze the impact of maintaining professional activity on cognitive functioning at advanced ages.

Methods: The sample comprised 131 people aged 60 years-old and older (M = 68,15 years) of whom 41 were still working (30 women and 11 men, Mage = 65.24), and 89 retired (74 women and 15 men Mage = 69.48). To assess participants’ cognitive functioning the following instruments were used: Rey-Osterrieth Complex Figure Test, Digit Span Test, Trail Making Test (TMT), Verbal Fluency Test and Boston Naming Test (Short Form). Since age differences among participants of the two groups were found an ANCOVA test was used, and age was included as a covariable.

Results: Statistically significant differences were found between the two groups in the Part A of TMT (F = 7.383, p < 0.05) and the Boston Naming Test (Short Form) (F = 3.495, p < 0.05). Compared with retired participants those who were still active had better scores on both measures.

Conclusions: Work-related activity in old age has a positive influence on cognitive functioning and can contribute to older people’s cognitive reserve and to maintaining better attention, naming or word retrieval performance. Thus, in order to maintain good cognitive functioning, when older adults retire, they may need to substitute work with stimulating and challenging activities.

Objectives: In recent years, there has been an increase in suicide rates in Brazil. From 2015 to 2019 we had a 34% increase in self-inflicted deaths. Are there some subgroups at greater risk of suicide, such as the old people with Alzheimer’s disease?

Methods: The data were obtained by consulting the systems of the Brazilian Institute of Geography and Statistics (IBGE) of the Brazilian Ministry of Health (DataSUS). Population data were measured and compared in the years 2010 and 2022, using the last two censuses.

Results: Between 2010 and 2022, the number of registered deaths of patients with Alzheimer’s increased by 21.93%. Similarly, there was a 100.37% increase in suicides among the elderly population in the same period, compared to a 37.78% increase in the general population.

Conclusions: It is not possible to conclude that the increase in suicide among the elderly is directly linked to Alzheimer’s disease. However, further studies are needed to determine if there is a correlation.

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.

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: As life expectancy continues to rise globally, the prevalence of dementia is also increasing. However, there is a lack of studies in Latin American countries that describe the sociodemographic and clinical characteristics of dementia patients and their caregivers, potentially overlooking important differences that could impact diagnosis in a diverse population. This study aims to elucidate the sociodemographic characteristics of patients with Behavioral Variant Frontotemporal Dementia (bvFTD) and Early-Onset Alzheimer’s Disease (AD), as well as their primary caregivers in Colombia, while also examining the clinical presentation ofdementia.

Methods: A total of 83 Colombian participants were included in the study, consisting of 40 healthy controls and 43 individuals previously diagnosed with bvFTD (n = 20) and early-onset AD (n = 23). Diagnoses were established based on the current diagnostic criteria for both conditions. Participants underwent sociodemographic assessments, and a clinical evaluation was conducted. Additionally, caregivers were characterized sociodemographically.

Results: Most participants were female (67%) with a mean age of 63 years. Educational levels were comparable between the dementia group (12.4 years) and the control group (12.9 years). A higher proportion of dementia cases were observed in lower socioeconomic status categories (1 to 3). Past medical history of hypertension, type 2 diabetes, and traumatic brain injury was more prevalent in the bvFTD group, whereas coronary disease was more common in the AD group. Initial psychiatric misdiagnosis occurred more frequently in bvFTD (50%) compared to AD (26%), with depression being the most common misdiagnosis in both groups (37.5%), followed by bipolar disorder (25%) and anxiety (25%). Most caregivers were female (70%) with a mean age of 50 years. The most common caregiver-patient relationships were daughter (25.6%) and husband (25.6%), followed by wife (23.3%). The mean educational level of bvFTD caregivers (13.95) was higher than that of AD caregivers (12.87).

Conclusions: These findings provide valuable insights into the sociodemographic characteristics of dementia patients and their caregivers in Latin America, a population that is often underrepresented in research. Further exploration of diagnostic variations may be warranted, given the high prevalence of misdiagnosis in this region.

Introduction: Previous studies have shown that people with low socioeconomic status have more white matter hyperintensities (WMH) when they get older. In this study, we wanted to analyze to what extent education and income explain differences in WMH. Further, we wanted to identify lifestyle risk factors that are associated with WMH among people with low and high education or income.

Methods: A total of n = 1,185 dementia-free participants aged 40–80 years from the population-based study of the Leipzig Research Centre for Civilization Diseases (LIFE) in Leipzig, Germany, were analyzed. Information was obtained in standardized interviews. WMH (including the derived Fazekas scores) were assessed using automated segmentation of high- resolution T1-weighted anatomical and fluid-attenuated inversion recovery (FLAIR) MRI.

Results: Income and WMH were significantly associated in univariate analyses but did not remain statistically significant after adjusting for age, gender, arterial hypertension, heart disease, and APOE e4 allele. Education was significantly associated with Fazekas scores but not with WMH and not after Bonferroni correction. After combining the lifestyle risk factors in a factor analysis, results from adjusted models indicated only statistically significant associations between higher distress and more WMH as well as between obesity and deeper WMH.

Discussion: Differences in WMH between individuals with low and high education or income may be the result form differences in risk factors. Further research needs to explore the potential pathways.

Objectives: Population ageing will lead to a dramatic increase in dementia prevalence globally. Recent evidence suggests a decline in dementia incidence in HIC due to increasing education levels and improvements in cardiovascular health. Although, most of the increase will occur in low and middle-income countries (LMICs), there are no recent estimates of dementia prevalence and incidence in LMICs. The present study aimed to examine new trends on dementia prevalence and incidence in Latin-America and associations of socioeconomic determinants and cardiovascular risk factors.

Methods: Sample size included older adults from Latin America (Cuba, Dominican Republic [DR], Puerto Rico [PR], and Mexico) drawn from the 10/66 Dementia Research Group study. We compare wave 1 (2003–2006) with wave 3 (2016 – 2019) of 10/66 studies. The main outcome was dementia prevalence relative to previous waves. Dementia diagnosis was determined according to the 10/66 dementia criteria. All the 10/66 waves used the same standardized assessments and protocols.

Results: Comparing the first wave (2003 - 2006) with the third wave (2016 - 2019) in four Latin American countries – Cuba, the Dominican Republic, Mexico, and Peru – reveals significant trends in dementia prevalence. Preliminary data suggest an increase in the Dominican Republic, Mexico, and Peru, while Cuba slightly declined, from 12.4 percent in Wave 1 to 10.1 percent in Wave 3. In contrast, the Dominican Republic’s age-adjusted prevalence rose from 11.5 percent to 13.6 percent, Peru from 9.2 percent to 16.8 percent, and Mexico from 8.3 percent to 17.1 percent. Despite, improvements in levels of education, increases in dementia prevalence were associated with higher rates of cardiovascular disease and cardiovascular risk factors, including diabetes, hypertension, obesity and heart disease in the later-born cohorts. Self-reported stroke is also rising.

Conclusions: The increasing prevalence of dementia in LAC underscores the urgent need for targeted health interventions. Prevention strategies should emerge as a key focus in the battle against dementia in Latin America. Addressing modifiable risk factors can significantly impact the incidence and prevalence ofdementia.