The literature has shown depression to be associated with an increased risk of dementia. In addition, hormone therapy can be a responsive treatment option for a certain type of depression. In this study, we examined the association between hormone therapy, including lifetime oral contraceptive (OC) use, and hormone replacement therapy (HRT) after menopause with the occurrence of dementia among female patients with depression.

The South Korean national claims data from January 1, 2005, to December 31, 2018, was used. Female subjects aged 40 years or older with depression were included in the analyses. Information on hormone therapy was identifed from health examination data and followed up for the occurrence of dementia during the average follow-up period of 7.72 years.

Among 209,588 subjects, 23,555 were diagnosed with Alzheimer’s disease (AD) and 3023 with vascular dementia (VD). Lifetime OC usage was associated with a decreased risk of AD (OC use for < 1 year: HR, 0.92 [95% CI, 0.88–0.97]; OC use for ≥ 1 year: HR, 0.89 [95% CI, 0.84–0.94]), and HRT after menopause was associated with a decreased risk of AD (HRT for < 2 years: HR, 0.84 [95% CI, 0.79–0.89]; HRT for 2–5 years: HR, 0.80 [95% CI, 0.74–0.88]; and HRT for ≥ 5 years : HR, 0.78 [95% CI, 0.71–0.85]) and VD (HRT < 2 years: HR, 0.82 [95% CI, 0.71–0.96]; HRT for 2–5 years: HR, 0.81 [95% CI, 0.64–1.02]; and HRT for ≥ 5 years: HR, 0.61 [95% CI, 0.47–0.79]).

In this nationwide cohort study, lifetime OC use was associated with a decreased risk of AD, and HRT after menopause was associated with a decreased risk of AD and VD among female patients with depression. However, further studies are needed to establish causality.

The study aimed to examine the effect of social prescribing on improving cognitive performance among community-dwelling older adults, and to explore the potential association between social support and the change of cognitive performance.

One hundred and eighteen older adults from Changtang community participated in the study and were followed up for three months. Cognitive function was assessed with Hong Kong Brief Cognitive test (HKBC) at baseline and 3-month follow-up. Pre- and post-social prescribing difference in cognitive performance was examined with paired t-test. Multivariate regression analysis was used to explore the potential factors of social support associated with the change of cognitive function.

Compared with baseline measurement (25.4±4.1), the total score of HKBC improved significantly after three-month social prescribing (26.5±3.6; t=-3.300，P=0.001). Multivariate regression analysis showed that baseline level of social support utilization was associated with the change of cognitive performance. The lower the utilization of social support at baseline, the more the change of cognitive performance due to social prescribing (β= -0.25, 95%CI = - 0.88 ~ -0.05).

Social prescribing may have a beneficial effect on cognitive function for community older adults. The utilization of social support may be one of the factors associated with its effect on cognitive performance.

Dementia is not an unavoidable consequence of aging, but for most home-dwelling people with dementia (PwD) a result of complex chronic health conditions. About 95% of PwD have multimorbidity, which requires a multicomponent approach and interdisciplinary collaboration to support patients and relatives, and to implement welfare technology and smart solutions.

The LIVE@Home.Path study is a 2-year, mixed-method, stepped-wedged, cluster randomized controlled trial, including home-dwelling PwD and their informal caregivers (N=320 dyads) in Norway (May 2019 – December 2021), to investigate the efficacy of the multicomponent LIVE intervention (LIVE is the acronym for Learning, Innovation, Volunteerism, and Empowerment) on resource utilization and use of welfare technology. The intervention was implemented by a skilled coordinator from the municipality with high focus on use, usefulness, and experiences in welfare technology, both at baseline and during the implementation period.

At baseline, we found that most participants had traditional equipment such as stove guards (43.3%), social alarms (39.5%) or everyday technology (45.3%) (e.g., calendar, door locks). A social alarm was more often available for alone-living elderly women, while tracking devices (14.9%) were associated with lower age. Everyday technology was more often available for women at increased age, higher comorbidity, and poor instrumental activities of daily living (IADL). In people with severe dementia, welfare technology was associated with poor IADL function, children as the main caregiver (61.3%), and having caregivers who contributed 81–100% to their care (49.5%).

We describe unmet potential for communication, tracking, and sensing technology and especially, for devices not offered by the municipalities. In our symposium, we will present early findings on the implementation effect of welfare technology and participants experiences related to usage and awareness.

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.

The relevance of pets in long-term home care is increasingly recognized due to their positive effects on health outcomes in clients, and the growing numbers of pet-owning clients receiving long-term care at home (LTCH). In the Netherlands, there is a lack of supportive materials concerning pet-related issues in LTCH. The aim of this project was to develop materials to support care for LTCH-clients with pets. Using a participatory research approach, LTCH-clients with pets, family caregivers, and professional caregivers collaborated using the Experience-Based Co-Design (EBCD) method that we fine-tuned for frail clients (EBCD+) to create the PET@Home Toolkit.

The project started with a literature review on the roles of pets for older adults. To determine if similar roles were also relevant in LTCH, individual interviews were conducted with LTCH-clients, family caregivers, and professional caregivers. Thereafter, the original EBCD-method was used including group interviews with (1) LTCH-clients and family, (2) professional caregivers (3) mixed groups of (1) and (2). Participants could participate in multiple phases. Professional caregivers preferred online and weekday meetings and LTCH-clients and family caregivers preferred in person and weekend meetings. Therefore, we organized additional interviews, and separate online and in-person groups. Hence, the EBCD+ method included a review, complementary interviews, the original EBCD-method and continuous refinement and testing of instruments.

The review and complementary interviews revealed similar roles related to pets in LTCH (e.g. Relational Aspects, Physical Health, and Social Aspects) to those as in the review on older adults. Based on the results, preliminary tools were developed, e.g., an information brochure. Furthermore, we conducted 14 semi-structured interviews, 6 focus groups, a psychology students workshop, and 4 online meetings with experts in human-animal interaction, education, and animal interest organizations (e.g., a veterinarian). It resulted in the Toolkit with different instruments, e.g., information brochure, e-learning module, and infographic.

We successfully used the EBCD+ method to develop an extensive and practically applicable Toolkit to support caregivers and their pet-owning LTCH-clients. The PET@home Toolkit will be available via the University Knowledge network for Older adult care Nijmegen (www.ukonnetwerk.nl).

The past decade has seen an explosion in the growth of technologies in mental health. Particularly, the scaled adoption of virtual care catalyzed by the COVID-19 pandemic has opened up new frontiers in how digital tools can be incorporated into psychiatry. No area of mental health care is as ripe for digital innovation as psychogeriatrics. In this session, an international group of clinicians and researchers will demonstrate how digital health in psychogeriatrics represents multiple cutting edges of innovation.

Our symposium will include 4 presentations, that represent original research from the USA, Ecuador, Norway, Kosovo and Australia. We will highlight clinical applications of these digital tools and aligned issues such as improved care access in low- and middle-income countries, the ethics of digital data collection and the potential for creating new liabilities.

We will focus on four distinct technologies and applications. Dr. Ipsit Vahia will discuss passive environmental sensing supported by signal processing and artificial intelligence (AI) in guiding treatment decision making, especially in dementia care. His presentation will include discussions on how AI can be incorporated into care while also preserving autonomy. Dr. Kreshnik Hoti will discuss the application of AI on voice-based signals to determine changes in pain levels and psychopathology. His presentation will include research conducted in collaboration between teams based in Australia and Kosovo and through a public-private partnership with a digital health startup. Dr. Ana Trueba will focus on digital interventions, specifically virtual reality (VR). She will present data from two studies, one from McLean hospital In the US, and the other from Ecuador that explore how VR can deliver evidence-based non-pharmacologic interventions. Dr. Bettina Husebø will present data from a project she oversees in Norway. Her talk will discuss how care in nursing homes can be improved by incorporating a range of digital approaches into nursing home care paradigms. A particular focus will be on the relationship between pain and behavior symptoms and dementia among nursing home dwelling older adults.

Thus, the symposium will address diagnostics, treatment and systems level care and how New technologies are shaping the evolution of psychogeriatrics worldwide.

Without intensive practical and emotional support to plan for, and eventually, cease driving, people with dementia are at high risk for depression, anxiety, grief, social isolation, unsafe and unlicensed driving and injury. This study focused on evaluation of a 7-module intensive support program targeted at people living with dementia and their care partners to manage driving cessation (“CarFreeMe”).

Our intervention was person-centered according to geographic location and needs of participants. Participants were encouraged to consider future transport arrangements, plan for lifestyle changes, form realistic expectations of life changes after driving cessation, practice using alternative transport, and supported in their emotional adjustment to the role loss. We collected program evaluation from PWD and care partners via survey, including open and closed questions. Participants reported their satisfaction with content and delivery on a scale of 1-10 (where 1 = not satisfied at all, 10 = extremely satisfied).

We describe our program and report the results of evaluation from 41 participants (PWD = 54%) who completed the survey after program conclusion. There was overall satisfaction with the program, program Content was rated on average 8.6/10, program Presentation and Delivery was rated average 9.1/10. Content analysis identified ‘personalized support’, ‘finding and trying out alternative transports’, ‘psychoeducation’ and ‘a safe space to discuss grief and loss’ as most relevant and helpful to participants.

Findings indicated that PWD and care partners valued the individualized support for the cessation process, and highly valued the psychoeducation components and strategies to address the practical and emotional challenges. Additionally, feedback indicated that for PWD who had involuntarily retired from driving, more focused attention to coping with grief and loss was needed before moving on, accepting support, and finding alternative ways to get out and about.

Reminiscence therapy is an evidence-based treatment for late life depressive symptoms, and has been associated with improvements in cognitive function, loneliness, happiness, and wellbeing for older people. While music is often involved in reminiscence therapy, little is known about how music is used or works in this context. Specifically, we do not know what purpose music serves, or how it works to enhance the experience when combined with reminiscence therapy. This presentation will provide an overview of two studies exploring how music enhances reminiscence therapy.

A narrative literature review was conducted with a structured search strategy to identify all relevant literature. Furthermore, a single-case repeated measures experimental EEG study with 4 older adults experiencing psychological distress was conducted. Participants were randomly assigned to a single session of either verbal reminiscence therapy or music-assisted reminiscence therapy. EEG recordings of resting states (e.g., eyes closed) were taken before and after the session, together with different epochs recorded during the session (e.g., during the start of reminiscence, the problem solving success, and music played). Analysis involved calculating the standardised LORETA (sLORETA) calculations to map regions and sources of EEG activity during these epochs.

The SEED model proposed that music enhances reminiscence through: Summoning autobiographical memories, eliciting physiological responses, evoking emotional reactions and pleasure, and defining and describing self-identity and social connectedness. Findings of the EEG study suggested that for the individual participants, both verbal and music-assisted reminiscence therapy resulted in widespread and lateralised activation. These activations were stronger for music- assisted reminiscence than for verbal reminiscence, particularly in the central and frontal areas. Only participants who received music-assisted reminiscence demonstrated activation in areas associated with emotional regulation and meditation, providing preliminary evidence for the SEED model.

The two presented studies contribute to our understanding of the potential mechanisms for change when applying reminiscence and music-assisted reminiscence therapy interventions to improve wellbeing for older people.

We want to assess the use of a telematics tool against the ordinary follow-up in consultations in the control of Behavioral and Psichological Symptoms of Dementia (BPSD) in a group of patients with dementia.

A randomized prospective clinical study with two parallel intervention groups Unicentro of the Geriatrics service of the General Hospital of Hospitalet (CSI). Two groups of patients/caregivers were compared: a control group (CG) that followed regular controls in the office and another telematic group (TG) that followed controls on the TECUIDE platform. The follow-up has been carried out for one year.

Data on age, gender, comorbidity, treatment received, analytical parameters, and functional, nutritional, and sensory status were collected, as well as the Reisberg GDS scale and the self-administered Cummings Neuropsychiatric Inventory (NPI).

72 CG patients. 76 TG patients. mean GDS of CG: was 4.5, and the mean GDS of TG: was 4.7.

Total group baseline SPCD: Delusions: 48.6%, hallucinations: 43.8%, agitation/aggression: 46.6%, depression 66.4%, anxiety 5.7%, euphoria: 12.3%, apathy: 76%, disinhibition: 39%, irritability: 57.5%, abnormal motor behavior: 43.2%, sleep disorder, 37%, eating disorder: 46.6%.

Mean NPI at the beginning of the study: GC: 5.3, TG: 6. Mean NPI at the end of the study: GC was 4.5 and GT was 4. That is, the average SPCD is higher in the TG than in the GC at the beginning of the study, while at the end of the study, the GC exceeds the TG.

When comparing the BPSD at the beginning and end of the study, a decrease is seen in all in general in the TG and an increase in hallucinations and sleep disturbances in the CG.

In the analysis of drugs, an increase in the consumption of neuroleptics in the CG was observed with a statistically significant difference (p 0.039).

The TECUIDE telematic program is an effective tool for the control of patients with dementia, reducing BPSD and the consumption of drugs (neuroleptics, benzodiazepines, and antidepressants).

INDUCT (Interdisciplinary Network for Dementia Using Current Technology), and DISTINCT (Dementia Inter-sectorial strategy for training and innovation network for current technology) are two Marie Sklodowska-Curie funded International Training Networks that aimed to develop a multi-disciplinary, inter-sectorial educational research framework for Europe to improve technology and care for people with dementia, and to provide the evidence to show how technology can improve the lives of people with dementia.

In INDUCT (2016-2020) 15 Early Stage Researchers worked on projects in the areas of Technology to support everyday life; technology to promote meaningful activities; and healthcare technology. In DISTINCT (2019-2023) 15 Early Stage Researchers worked on technology to promote Social health in three domains: fulfilling ones potential and obligations in society, managing one’s own life, and participation in social and other meaningful activities.

Both networks adopted three transversal objectives: 1) To determine practical, cognitive and social factors needed to make technology more useable for people with dementia; 2) To evaluate the effectiveness of specific contemporary technology; 3) To trace facilitators and barriers for implementation of technology in dementia care.

The main recommendations resulting from all research projects are integrated in a web-based digital Best Practice Guidance on Human Interaction with Technology in Dementia which was recently updated (Dec 2022 and June 2023) and will be presented at the congress. The recommendations are meant for different target groups, i.e. people in different stages of dementia, their (in)formal carers, policy makers, designers and researchers, who can easily find the recommendations relevant to them in the Best Practice Guidance by means of a digital selection tool.

The INDUCT/DISTINCT Best Practice Guidance informs on how to improve the development, usage, impact and implementation of technology for people with dementia in various technology areas. This Best Practice Guidance is the result of intensive collaborative partnership of INDUCT and DISTINCT with academic and non-academic partners as well as the involvement of representatives of the different target groups throughout the projects.

Focus on the capacity and potential of persons with dementia is needed to enable people and their families to adapt to the changes dementia brings in their lives. For those with young onset dementia (YOD), support to remain in work for as long as possible can preserve one’s self-esteem and sense of purpose in life. However, guidance on how to support people with YOD at their workplace is lacking. This study therefore aims to explore experiences, work values, and support needs of people with YOD in the workplace and other stakeholders involved.

In this qualitative study, semi-structured interviews were held with several target groups namely employees with an established dementia diagnosis, relatives of employees with YOD, employers and co-workers, occupational physicians, human resource professionals, and healthcare professionals involved in dementia care. A topic guide was developed, based on recent literature and consultation of experts, and addressed the following themes: experiences regarding the influence of dementia in the workplace, values such as the importance of work, and support needs in the workplace. Themes were explored in the period before and after diagnosis. The interview data were transcribed and analyzed by means of an inductive content analysis.

In total 33 semi-structured interviews were conducted. Eight themes were derived from the interviews in people with YOD, namely 1) difficulties experienced at work, 2) long diagnostic trajectory and involvement of work-and care professionals, 3) Impact of YOD and coping with YOD, 4) Wish to work, 5) Diagnostic disclosure, 6) The role of the work environment, 7) Phasing out work and future perspectives, and 8) Perception and awareness of YOD. Data of the other target groups is currently being analysed. These results are expected in spring 2023.

This study will result into a better understanding of the possibilities of working with YOD. These insights can be used as a starting point to develop practical tools to support and provide guidance to people with YOD and their (work)environment to prevent loss of work or find meaningful alternatives.

Interventions aimed to optimize cognitive function and functionality in individuals at risk of dementia were scarce in validity studies. While some RCTs have been developed in cognitive training interventions, studies of multicomponent interventions (cognitive, social, and behavioral) integrating intervention targeting psychosocial risk factors (social isolation, depression, low cognitive reserve) is absent. Additionally, few efforts have been made to develop such validity studies with individuals at higher risk of dementia who still do not present objective cognitive decline, despite current recommendations in this regard. We aimed to start the validation of a 20-session multicomponent intervention – REMINDER program - with a feasibility test and a preliminary efficacy testing using a comprehensive outcome assessment protocol.

A feasibility randomized controlled trial (RCT) was conducted, recruiting community-dwelling individuals between 60 to 75 years old with increased risk of dementia (LIBRA dementia risk score). Fifteen participants took part in twice-a-week sessions of the REMINDER program, during twelve weeks. Data on the acceptability, satisfaction and adherence to the REMINDER program was collected, and an association between pre and post intervention motivation and knowledge about dementia risk was examined. For the preliminary efficacy testing we considered as primary outcome a performance-based functionality measure (UPSA) and secondary outcomes will include global cognition, emotional status, and lifestyle habits, tested prior and after the intervention.

Rates of satisfaction throughout the REMINDER program sessions were high (75%, mean) as well as the adherences that was superior to the main dementia risk reduction programs referred in literature. (83%). Post-intervention efficacy testing is ongoing, however, levels of knowledge about dementia risk increased 12% compared with pre-intervention (34% pre-intervention, to 46% post intervention; p=.045)

Preliminary data on feasibility and efficacy of the REMINDER program suggests this program is an engaging and motivating tool for dementia risk reduction, justifying the future implementation of a large-scale RCT. We expect that, with a larger efficacy study we can demonstrate the REMINDER program effects in behavior change and in the adoption of protective lifestyles for dementia prevention, and that the comprehensive outcome assessment proves to be effective and, therefore, replicable in further studies.

The amyloid hypothesis suggests that errors in production, accumulation, or disposal of beta-amyloid are the primary causes of Alzheimer's disease (AD). Since this was hypothesized, there has been significant effort in developing treatments that prevent the build-up of amyloid beta (Aβ) plaques in the brain. A disease modifying therapy (DMT) changes the clinical progression of AD by interfering in its pathophysiological mechanisms.

The aim of this article is to review the current literature regarding the role of new DMTs for Alzheimer’s dementia and assess the preparedness of health care systems to implement these treatment options.

Review of the most recent literature regarding the role of new DMTs for Alzheimer’s dementia and the challenges faced by the health care system to implement these treatment options. The research was carried out through the PubMed and UptoDate databases, using the terms “amyloid hypothesis”, “Alzheimer”, “disease modifying treatments” and “dementia”.

Research has been focusing on developing monoclonal antibodies as potential DMTs that target Aβ. Aducanumab, a human antibody, or immunotherapy, is the only disease-modifying medication currently approved to treat AD. It targets the Aβ protein and helps to reduce amyloid plaques and is currently the only FDA approved medication to slow the progression of AD. Lecanemab, a humanized IgG1 monoclonal antibody, binds to Aβ soluble protofibrils with high affinity. Even though there is considerable optimism about its potential, lecanemab will probably be more useful to patients on early stages of the disease.

DMTs administration obeys to certain needs such as a vacancy in Day Hospital for infusion and regular monitorization and for lumbar punction. It demands a complex network involving general practitioner, neurologist, psychiatrist, psychologist, and social services. It also involves a genetic study and complementary diagnosis exams such as PET (Positron emission tomography) scans and MRIs (Magnetic resonance imaging), which are expensive. There is an emerging need to develop enhanced and safer treatments.

Psychotic disorders are not infrequent in late life and involve massive costs to society, affecting individuals and their caregivers. The epidemiology of late-life psychosis remains imprecise and despite its high prevalence, it remains a diagnostic and treatment dilemma. The aim of this article is to review the current literature regarding late-onset psychosis and whether it is recognized as a clinical entity on itself, differing from early-onset psychosis.

Review of the most recent literature regarding late-onset psychosis its clinical and epidemiological particularities. The research was carried out through the PubMed and UptoDate databases, using the terms “late-onset psychosis”, “late-life psychosis”, “dementia” and “elderly”.

Late-life psychotic disorders may originate in an intricate interaction between several biological, psychological, social, and environmental factors. These may include functional status, other physical diseases, hospitalizations, physical activity, and stability of care. Some authors refer that older age, and the presence of suicidal ideation were associated with incident late-life psychosis. Assuming the significant load associated with psychotic disorders in late life, their assessment should identify the potential causes and distinguish predictive factors. Treatment should include a combination of nonpharmacological approaches and psychotropic medications, used cautiously.

Late-life psychosis differs from early-onset psychosis on several characteristics. The treatment must be directed towards the cause and adapted to each individual. Non-pharmacologic interventions are frequently used as first line treatment, and pharmacotherapy must be used carefully. The crescent number of senior population must alert to this entity and the specificity of its approach.