The number of elderly populations continues to increase as the advancement in healthcare grows, which is shown by the increase of life expectancy, the declining mortality rates, and the surge of people with dementia (PwD). This mental health issue is barely identifiable by health workers and the elderly themselves especially during COVID-19 pandemic. Therefore, it is important to evaluate and identify the unmet needs of people with dementia, especially mild to moderate dementia.

To describe the unmet needs of people with mild to moderate dementia during COVID- 19 pandemic in 2021 in East Jakarta, Indonesia.

This study is using the CDR (Clinical Dementia Rating Scale) to assess severity level of Dementia, then using the CANE (Camberwell Assessment of Need for the Elderly) instrument to assess the unmet needs of people with mild to moderate dementia.

96 participants were assessed suffer from mild dementia (75%) and moderate dementia (25%). This study procured five substantial unmet needs proportion, which are friendship (26.0%), psychological distress (20.8%), close relationships (19.8%), memory dysfunction (16.7%), and daily activities (10.4%). During interviews in conducting unmet needs assessments, people with mild to moderate dementia and accompanying families expressed their desire for an activity that would be useful to overcome their unmet needs.

The COVID-19 pandemic for the people with mild to moderate dementia has an impact on friendships, psychological distress, memory dysfunction and daily activities so they need meaningful activities to overcome them.

Dementia poses significant and sustained challenges to global society. Diagnosis can lead to increased feelings of loneliness and social isolation. People with dementia living alone are particularly at risk. Considering the growing number of technologies proposed to aid people with dementia address social isolation and loneliness, we reviewed the existing literature.

To collate and summarize current evidence for digital technologies to prevent social isolation and loneliness for people with dementia.

Following the PRISMA guidelines, we systematically searched five databases to identify studies of digital technologies designed to support or prevent social isolation or loneliness for people with dementia. Pre-specified outcomes included social isolation, loneliness, and quality of life. We used deductive thematic analysis to synthesize the major themes emerging from the studies.

Ten studies met our inclusion criteria where all studies reported improvements in quality of life and seven reported benefits regarding social inclusion or a reduction in loneliness. Technologies were varied across purpose, delivery format, theoretical models, and levels of personalization. Two studies clearly described the involvement of people with dementia in the study design and five technologies were available outside the research context.

There is limited—but increasing—evidence that technologies hold potential to improve quality of life and reduce isolation/loneliness for people with dementia. Results presented are largely based in small-scale research studies. Involvement of people with dementia was limited and few research concepts are reaching implementation. Closer collaboration with people with dementia to provide affordable, inclusive, and person-centered solutions is urgently required.

Social distance can be used to measure degrees of prejudice in people towards other members of a diverse social group. The objective of this study was to explore older adults’ perceptions of social distances toward older adults with depression, suicidal ideas, and suicide attempts.

A cross-sectional survey was conducted. Older adults were recruited by convenience from outpatient clinics of three hospitals in Taiwan.

A total of 327 older adults participated in this study. The mean scores of social distances toward older adults with depression, suicidal ideas, and suicide attempts were 20.8 (SD=4.2), 20.8 (SD=4.2), and 26.8 (SD=5.1), respectively. Participants had significantly higher scores on social distance toward older adults with suicide attempters than with depression (p<0.01) and suicidal ideas (p<0.01). Having them care for my family member was rated as the most disliked situation across three target groups. Participants’ social distances toward older adults with depression and suicidal ideas were influenced by their religious beliefs (p=0.02). Their social distance toward suicide attempters was influenced by their education level (p<0.01). Illiterates and college graduates tended to have significantly higher scores on social distance toward suicide attempters than junior high graduates did.

To the best of our knowledge, it was the first study to explore older adults’ perceptions of social distances toward older adults with depression, suicidal ideas, and suicide attempts. The results of this study can be used for further intervention of older adults to decrease prejudice against older adults with mental illness.

The purpose of this research is to review the association between the dementia diagnosis and suicide risk, to debate what to expect on this topic in the future, and to identify some strategies to control suicide risk after dementia diagnosis.

Non-systematic review of the literature with selection of scientific articles published in the last 10 years, using PUBMED as database and the following keywords: «suicide», «dementia» and «dementia diagnosis». Nine studies were included.

Nowadays, suicide account for one million deaths worldwide per year. Suicide rates are up to 8 times higher in the elderly than in general population, in relative numbers. Dementia is an incurable diagnosis and usually result in loss of mental competence. After being diagnosed with dementia, people face emotional challenges and use to feel loss, anger, and uncertainty.

Different studies found dementia as an independent risk factor for suicide. Also, some factors that increase the risk for suicide in dementia are described: the existence of psychiatric comorbidity, such as depression, anxiety, psychosis and substance use; The initial stages of dementia, often within three months of diagnosis, because the person perceive a higher threat to his life, with progressive physical and cognitive impairment, increasingly higher levels of dependence and concern on becoming a burden for their family, and, at the same time, preserving intellectual and volitive capacities to plan and carry out suicide; And younger age at dementia diagnosis, with higher difficulties in adjusting to the diagnosis.

We are moving towards pre-symptomatic and early dementia diagnosis utilizing biomarkers and genetic tests. This implies that the diagnosis is made in younger people, so concerns have been raised about a potential increase for suicidal behavior.

The findings of this research highlight the importance of providing support and paying attention to people with recent dementia diagnosis, particularly in the first year and for patients aged < 75 years. We suggest active management of pre-existing mental disorders, suicide risk evaluation, assessment of patient and caregiver needs and restricting access to lethal means.

Why should you pay attention to personality pathology in geriatric psychiatry? To what extent is mental well-being determined by this? How does that relate to the influence of mental disorders? Does the Alternative Dimensional Model of Personality pathology (AMPD) as proposed by the DSM-5 provide more insight into this than the DSM-IV and DSM-5 categorical diagnoses of personality disorders?

These questions were examined in baseline data of 145 patients included in our randomized controlled trial (RCT) into group Schema therapy enriched with psychomotor therapy in older patients with a personality disorder (see Oude Voshaar in this symposium). Mental well-being was measured by a combination of psychological distress (53-item Brief Symptom Inventory), positive mental health (Warwick-Edinburgh Mental Well-being Scale), assessment of own health (RAND-36), and satisfaction with life (Cantrill’s ladder). Personality pathology was assessed according to the categorical personality model using the Structured Clincal Interview for Personality Disorder (SCID-II) as well as the AMDP DSM-5 model using the Severity Indices of Personality Problems (SIPP-short form) and the Personality Iventory for DSM-5 (PID-25). The relationship between personality pathology and mental well-being was investigated using multivariate regression analysis.

Three quarters of the included people with a personality disorder also had another psychiatric disorder (beyond personality pathology). However, personality pathology was found to be responsible for the bulk of the mental health burden and outweighed the influence of these psychiatric disorders. Personality dimensions were highly predictive of mental well-being. This contrasted with the absence of any influence from categorical personality disorders. Although dimensions of personality functioning – and in particular Identity Integration – were the primary predictors of mental well-being, pathological traits added significant predictive value (particularly Disinhibition and Negative Affectivity).

Personality pathology seriously affects the mental well-being of patients and exceeds the impact of comorbid psychiatric disorders. Contrary to the assumption in the alternative DSM-5 and ICD-10 model, both personality functioning and pathological traits contribute to this impact on mental well-being. Screening and systematic assessment of personality pathology in geriatric psychiatry seems warranted.

Peer support can be very valuable for people with Young Onset Dementia (YOD) (diagnosis before the age of 65). People with YOD often experience stigma, putting them at a higher risk of social isolation. In the United Kingdom, availability of age-appropriate, in-person peer support services is inconsistent, and as a result many people may miss out on the potential benefits. Online peer support could be a solution, as it overcomes geographical barriers, and offers a variety of platforms and modes of communication. This study aimed to explore how people with YOD experience online peer support, identify potential barriers to online peer support, and get insights into how online peer support can be optimized. The findings were used to develop a Best Practice Guidance on online peer support for people with YOD, and specific guidelines for facilitators of online peer support groups.

This study was conducted between October 2019 and December 2022. It followed the Medical Research Council (MRC) guidelines on complex interventions and focused on the development stage. The study consisted of multiple sub-studies, which all contributed to the Best Practice Guidance. The sub-studies included literature reviews, focus groups, an online survey, and interviews. All participants were people living with YOD.

Participants described online peer support as their lifeline which gave them hope and a sense of purpose again, after an often very difficult diagnostic and post-diagnostic period. For people in rural areas or who were unable to travel, online was the only way in which they could connect with their peers. However, many were unaware that online peer support exists, what it entails, and how they could get involved. This indicates a need for better advertisement of and signposting to (online) peer support.

Online peer support can be beneficial for people with YOD. The Best Practice Guidance provides people with YOD with evidence-based information on what online peer support entails, facilitators with guidelines on how to optimize online peer support for people with YOD, and healthcare professionals with an opportunity to signpost people with YOD to online peer support.

Assessment scales for motor symptoms in Parkinson’s disease (PD) lack the sensitivity and resolution to monitor symptoms over time. Wearable sensors in people with PD have shown potential to assess motor symptoms. The DIGI.PARK study explores the use of consumer- and research-grade wearables such as Fitbit Sense (FS), Oura ring (OR) and Empatica E4 (EM) to track behavioral patterns and symptoms of PD over time.

The DIGI.PARK pilot study (12.2021 to 12.2022) included N = 30 participants living in Bergen, Norway (N=15 persons with PD and N=15 controls). Outcome measures: self-reported diary of symptoms and behavior combined with data streams from three wearable devices (FS, OR, EM). Data was collected over 2 weeks: continuously by devices, and diary data every second day consisting of activities, sleep, medication timing (PD) and symptom occurrence (PD). The device data were segmented into 24-hour epochs. Heart rate (HR), heart rate variability (HRV), acceleration, blood volume pulse (BVP), inter-beat interval (IBI), electrodermal activity, metabolic equivalent of task (MET) and hypnogram were visualized as time series. The resulting graphs were annotated with the reported diary data and a manual checking procedure was applied to determine the correlation between sensor outputs and the logged instances of activity, sleep and symptoms.

Self-reported behavior was discernable in the measurements of HR, EDA, BVP, HRV, acceleration, MET and hypnogram. We found considerable differences in device outputs regarding data type, data size, resolution, and periods of active measurements. Tremor symptoms were observable in the raw data provided by EM when worn on the affected hand. Behavioral patterns such as sleep, waking and physical activities were illustrated using aggregated data.

Sensor congruence with diary data support their usefulness for long term monitoring of behavioral patterns and symptoms in PD. For PD research, output from consumer- and research-grade devices have both shown usefulness. The choice of device should be tailored to the purpose and be mindful of the specific strengths and weaknesses of different device types. Aggregated data allow for monitoring behavioral patterns over time, whereas raw data provided the resolution to discern symptoms.

The recognition of dementia as a multifactorial disorder encourages the exploration of new pathways to understand its origins. Social health might play a role in cognitive decline and dementia, but conceptual clarity is lacking and this hinders investigation of associations and mechanisms. Social health might provide a new perspective on social connectedness. The objective is to develop a conceptual framework for social health to advance conceptual clarity in future studies and to identify potentially modifiable risk and protective factors in the “Social Health And Reserve in the Dementia patient journey (SHARED)” project.

The methods include the process of building the conceptual framework. We used the following steps: underpinning for concept advancement, concept advancement by the development of a conceptual model, and exploration of its potential feasibility.

Underpinning of the concept drew from a synthesis of theoretical, conceptual and epidemiological work, and resulted in the definition of social health as well-being that relies on capacities both of the individual and the social environment. In the conceptual framework the abstract definition has been elaborated into more precisely defined domains at both the individual and the social environmental levels. This allowed to identify domain related social health characteristics or markers in epidemiological data bases and to investigate associations between these markers and cognitive decline and dementia. The associated social health markers represent potentially modifiable risk and protective factors. Examples are “social engagement” in the participation domain at the individual level, and “frequency of contact” in the structure domain, “exchange of support” in the function domain and “loneliness” in the appraisal domain at the environmental level. The conceptual framework facilitated identification of domain related markers in the SHARED project, thus showing its potential feasibility.

The conceptual framework provides guidance for future research and facilitates identification of potentially modifiable risk and protective factors. These may shape new avenues for preventive interventions. We highlight the paradigm of social health in dementia as a priority for dementia research.

Lewy body dementia (LBD) is the second most common degenerative dementia in people over 65 (1,2). LBD is underdiagnosed, with only one third of patients correctly diagnosed in daily clinical practice (3); data on the distribution of the disease are scarce. Our study was designed to measure the incidence, prevalence and clinical characteristics of LBD in south-eastern Spain. Healthcare system in Spain is free and universal.

Prospective epidemiological study of LBD in San Vicente del Raspeig between October 18, 2021, and October 17, 2022. The total population aged 60 or over based on the 2019 census was 11445 inhabitants (5227 males, 6218 females). Diagnosis of LBD was based on 2017 McKeith criteria. Only “probable” cases were registered for greater diagnostic certainty. Incidence was studied for the one-year period. Collected data included gender, age, cardinal symptoms for LBD, abnormal biomarkers, neuropsychiatric symptoms, medical treatment, years from diagnosis and GDS score (Reisberg) in the last visit. Protocol was approved by the ethical committee.

Global prevalence was 0.67% among the population over 60. Annual incidence was 3.2/1000 person-year.

Mean age of prevalent cases was 78 years (SD 7.5). 68.8% were studied with at least one biomarker (mainly 123I-ioflupane and less frequent polysomnography or MIBG gammagraphy); most suffered 2 or 3 core symptoms (79.2%) (in descending order: parkinsonism, visual hallucinations, rapid eye movement sleep behavior disorder and fluctuations). Two out of five prevalent cases were in an early phase of the disease: 22.1% in mild cognitive impairment (MCI) and 16.9 % in mild dementia. Mean me of disease was 1.9 years (SD 2.2). Other neuropsychiatric symptoms appeared in up to 74% of patients (apathy 18,2%, anxiety 19,5%, depression 23,4%, minor hallucinations 22%, delusions 17%, auditory and tactile hallucinations 1,2%).

Prevalence is in line with previous reports. Higher incidence than previously reported may be due to high attention on MCI-LBD and our expertise as a referral Memory Unit. We found a wide dominance of aged women and high prevalence of neuropsychiatric symptoms.

It is well known that geriatric patients are at increased risk of developing comorbid medical and psychiatric conditions, and a large proportion of them are admitted to psychiatric liaison units (LPUs). The aim of this study is to determine which clinical differences between age groups (65- 74 years and ≥75 years) are statistically significant to potentially warrant special attention when referring to an LPU.

This is an observational, cross-sectional and comparative multicentre study. We collected data from 165 patients (≥65 years) admitted to 7 Spanish general hospitals and referred to each LPU from different departments. Data were collected over a period of one and a half months. Psychiatric examinations were performed during the patients' stay in the wards. The sample was divided into two age groups of patients and a comparative analysis was done.

We obtained a sample of 165 patients with a mean age of 76.03 years (42.10% < 75 years, 57.83% ≥ 75 years). We analysed several variables between two age groups: the youngest (65- 74 years) and the oldest (≥75 years). In the younger group (mean age 69.87 years), the mean Barthel index before admission was 93.23 (52.1% with independent ambulation) and at the time of our first assessment was 54.62, before 82.71 of the older group (mean age 80.63). The mean Lawton index was 4.44 (6.35 for the older group) and the Charlson index was 6.38 (5.6 for the older group). 21.11% reported falls in the last 6 months, compared to 27.6% in the older group. The most common reason for referral was anxiety/depression symptoms in both groups (52.12% and 56.53%) and agitation (24.46% in the older group). After the LPU visit, the main diagnoses were adjustment disorder in both groups (25.3% and 25.53%) and delirium in the older group (23.4%). Antidepressants and benzodiazepines were the most common psychotropic drugs prescribed before the LPU visit, and benzodiazepines were the most common drugs discontinued after the LPU visit in both groups.

Clinical differences were found between two age groups (65-74 years and ≥75 years) at LPU, which could allow professionals to improve their attention and interventions.

Aging has traditionally been studied from loss, disease, and dependency, limiting the conceptualization of Quality of Life (QoL) to health. The population group of older people characterize by its heterogeneity in which many older adults experience gains and age with good physical, psychological and social conditions. Ignoring these aspects can lead to ageism. It is necessary to offer a change of perspective in which older adults’ QoL is analyzed from a multidimensional perspective where not only losses are taken into account but also the strengths of the person and the satisfaction of their higher needs (self-fulfillment, control, autonomy and pleasure).

This symposium aims to develop an assessment to improve QoL in older people through the promotion of their strengths.

Four studies from different Spanish and Portuguese universities were presented

Older people have psychological strengths that enhance QoL.

This symposium seeks to promote QoL in older people from a change of perspective based on strengths in a society for all ages, in line with the decade of healthy aging (2021-2030) approved by the World Health Assembly and the United Nations General Assembly. Aging implies a range of personal and material losses to which older people must adapt to maintain adequate levels of QoL. The stress model of Lazarus and Folkman (1984) states that the impact of stress on the person depends on the resources that they use to face the factors associated with stress. Previous research has supported the protective role of reminiscence, personal growth, digital skills, psychological well-being, acceptance, resilience, gratitude, and family functioning in QoL. Likewise, interventions focused on these variables have shown an increase in QoL. However, studies based on a strengths model are still very limited in older people.

People are staying in the workforce longer with the employment rates of older adults rising considerably over the years. Particularly, the higher education sector is known to have an aging workforce where a large proportion of staff is older than 55 years. Psychological capital, which refers to an individual’s positive psychological state of development, includes four core dimensions: self-efficacy, hope, optimism and resilience. Understanding of the impact of psychological capital on wellbeing and mental health of working middle-aged to older adults is limited. This paper will present the survey outcomes on psychological capital, wellbeing and mental health of middle-aged and older university staff.

Data were collected using established Psychological Capital Questionnaire (PCQ), Psychological Well-Being Scale (PWBS) and Positive Mental Health (PMH) tool.

The mean age of 29 survey respondents was 55.37 years (SD=4.26) with the majority being female (27; 90%) and, on average, worked at the university for 8.35 years (SD=5.92). Total mean scores for PsyCap, PWBS and PMH were 111.77 (SD=16.15); 231.37 (SD=36.15); and 31.43 (SD=4.58) respectively. PsyCap was moderately correlated with PMH (r=.546) and PWBS (r=.481) as well as PWBS subscales on positive relationships (r=.483), self-acceptance (r=.450) and environmental mastery (r=.558).

While limited by the small sample size, this study provides preliminary evidence that psychological capital can potentially positively influence well-being and mental health and that program focusing on improving psychological capital can be considered to improve well-being and mental health of middle-aged and older staff working in the higher education sector.

Cognitive Reserve (CR) developed from observation that several individuals show fewer cognitive impairment compared to others with the same brain injuries or neuropathology. Cognitive reserve is a potentially modifiable characteristic. Most of studies on cognitive reserve were conducted on chronic progressive diseases such as dementia. This study aims to define the role of cognitive reserve in geriatric delirium cases.

This case-control study was conducted in the acute geriatric inpatient of Cipto Mangunkusumo Hospital, Jakarta, Indonesia on June to September 2019 that consisted of 33 subjects with delirium and 33 controls. The measurement of cognitive reserve was done using the Indonesian adaptation of Cognitive Reserve Index questionnaire (CRIq) with 3 subscales, i.e. Education, Work Activity and Leisure Time.

We found that the CRIq scores of delirium patients were lower compared to the non-delirium controls both on total and each subscores, with a statistically significant mean difference (p<0,01). Patients with low-medium cognitive reserve also more likely to develop delirium compared to those with medium-high cognitive reserve (OR 9; 95% CI 2.86 to 28.22).

Low cognitive reserve may serve as a risk factor for delirium in the elderly. The measure of CRI in the geriatric inpatients unit can be used to determine those at risk of developing delirium. Further research are warranted to elaborate potentially modifiable variables of cognitive reserve to minimize the risk of delirium.

Diabetes Mellitus (DM) is one of the most prevalent chronic diseases, whose incidence has been increasing especially in the elderly, being estimated that over one-quarter of people over the age of 65 years have diabetes. Diabetes implications, whether due to acute or chronic complications, namely cognitive and functional impairments, can be devastating and usually determine the need for more supervision, implying a caregiver. For a better clinical characterization of DM, this study aimed to compare older adults, with and without DM, hospitalized in the Convalescence Units (CUs) of the Portuguese National Network of Integrated Continued Care (RNCCI).

This cross-sectional study included older adults (≥65 years old) admitted into three CUs in northern Portugal. The inability to communicate was considered an exclusion criterion. A comprehensive assessment protocol was used, which comprised the Mini Mental State Examination (cognitive function), the Katz Index, and the Lawton Index (basic and instrumental activities of daily living). A comparative analysis between patients’ groups (with and without DM) was performed using the Mann-Whitney and Chi-Square tests.

The final sample included 202 older adults (99 diabetics and 101 non- diabetics), with a mean age of 77 (±7) years, mostly (69.8%) women. Comparing the patients with and without DM, the first group had more dyslipidemia (97% vs. 62.1%, p<0.001) and osteoporosis (97% vs. 67%; p<0.001), as well as more comorbidities (6 vs. 5; p<0.001) and daily medication (9 vs. 7; p<0.001). Moreover, DM patients had more cognitive impairment (52.5% vs. 34.0%; p=0.008) and greater dependence on instrumental activities of daily living (57.6% vs. 37.6%; p=0.009). A tendency was found regarding the presence of a caregiver for those with diabetes (75.8% vs. 63.1%; p=0.051).

Patients with diabetes had more associated diseases and prescribed medicines, presented more cognitive impairment, greater dependence on instrumental activities of daily living, and were more likely to have a caregiver. This study will contribute to a better knowledge about the clinical and psychosocial characterization of older adults with DM in a specific context, allowing the development of future care plans and the adoption of better strategies for this group’s specificities.