Behavioral and psychological symptoms of dementia (BPSD) are common in hospitalized older people and challenge acute care delivery.

This study sought to identify available quality indicators (QIs) for BPSD, establish priorities, and explore perceived facilitators and barriers to their use.

We conducted a cross-sectional electronic survey among physicians, nurses, and administrators in Quebec acute care hospitals (January–February 2025). The survey included open-ended questions analysed using Donabedian’s structure–process–outcome model.

Fifty-five respondents generated 677 responses, yielding 59 themes, 44 deemed priorities. Key QIs included delirium screening, restraint and antipsychotic use, length of stay, adverse events, and resource availability. Participants emphasized the need for standardized, clinically meaningful QIs. Reported barriers included staffing shortages, fragmented technological systems, and limited institutional prioritization, while facilitators included leadership commitment, interdisciplinary support, and structured training.

Embedding standardized QIs into electronic health records may enhance benchmarking, guide improvement, and promote safer dementia care.

Neuropsychological (NP) tests are multi-domain in execution. Reliance on a single score representing specific domains obscures the detection of subtle cognitive changes and increases risk of inaccurate assessment. Rooted in the Boston Process Approach (BPA), the Framingham Heart Study (FHS) captures multi-dimensional errors and process features within and across NP tests. We examined these BPA variables in community-dwelling older adults.

We analyzed data from 2363 dementia-free participants aged 60 and above. Exploratory and confirmatory factor analyses used Kemeny covariance structures. Measurement invariance was estimated across age, sex, and education groups. We assessed the impact of demographics on latent factors, and the ability of these factors to predict future conversion to all-cause dementia. We trained machine learning (ML) models to compare NP and BPA data.

Participants were older adults (mean age 71.5 ± 8.7 years), primarily female (54.2%), and non-Hispanic White (96.5%). The bifactor model was the only model with adequate fit (CFI = 0.96, RMSEA = 0.03). General and specific factors captured ability for accurate and strategic responses, test-specific variance, and nuanced executive and semantic processes distributed across tests. Higher general ability and stronger verbatim story recall were associated with a reduced likelihood of developing all-cause dementia (general: OR = 0.15, 95% CI [0.12–0.86]; recall: OR = 0.24, 95% CI [0.23–0.90]) over a median of 5.2 years. With NP/BPA data, ML models identified >99% of 222 converters.

This study highlights the strengths of NP/BPA data. Multidimensional cognitive features may enhance sensitivity to early changes predictive of incipient dementia.

Early-onset frontotemporal dementia (EO-FTD) presents before age 65 and is frequently misdiagnosed as psychiatric or behavioural disorders, delaying care.

This scoping review synthesizes research on EO-FTD’s earliest cognitive symptoms from patients, companions (family and friends), healthcare professionals, and cognitive tests to promote early detection.

A systematic search of six databases (Medline, Embase, CINAHL, PsycInfo, Scopus, and Proquest Dissertations and Theses) identified 2197 studies of which 16 met inclusion criteria, encompassing 663 EO-FTD participants.

A total of 35 unique cognitive symptoms were identified. Memory, attention, and executive dysfunction were most frequently reported. Symptom terminology varied widely, often mirroring cognitive test phrasing, limiting clinical applicability. Many studies relied on cognitive test scores rather than detailed symptom descriptions, with patient and companion reports underrepresented.

The findings underscore the need for standardized nomenclature, improved assessment tools, and greater inclusion of patient and companion perspectives to enhance EO-FTD early diagnosis and intervention strategies.

To evaluate the feasibility and preliminary efficacy of a clinical program designed to teach informal caregivers of older Veterans with pain and mild-to-moderate dementia or mild cognitive impairment (MCI), pain management, pain coping and pain communication skills.

Twenty caregivers of older Veterans with pain and dementia or MCI and the Veterans themselves participated in a 5-session program taught by trained Veterans Affairs (VA) clinicians. All sessions were conducted remotely using video-technology, with caregivers and Veterans. Two sessions were conducted with individual Veteran-caregiver dyads, and three sessions were conducted with caregiver groups. Caregivers and Veterans completed baseline and post-intervention measures. Qualitative interviews of 10 caregivers who completed the program were also conducted and focused on identifying themes related to caregiving for their loved ones with pain and dementia and related to participating in the program.

The program was well received and almost all caregivers identified videoconferencing as the preferred venue for participating in such a program. They most valued learning about dementia and participating with other caregivers. Pre-post analyses revealed significant improvements in perceived caregiving competence and self-efficacy for managing pain. Challenges encountered included scheduling related to caregivers’ multiple competing responsibilities and lack of familiarity with tele-conferencing technology.

Patients with pain and mild to moderate dementia or MCI have been relatively ignored in current literature. Our preliminary findings suggest that a program delivered by trained healthcare professionals to caregivers and Veterans using tele-conferencing could benefit caregivers.

Around 10% of people living with dementia (PLWD) will experience a deterioration in their condition that will require urgent (‘crisis’) community support or an in-patient psychiatric admission. We have previously shown that people at high risk of a crisis event can be identified at the point of diagnosis. How the idea that someone is at increased risk of experiencing a crisis event in their care is best communicated is not known. Here, we describe the analysis of interviews with clinicians and PLWD, to understand their perspective and the co-production of tools designed to support risk communication.

To explore multistakeholder perspectives (healthcare professionals, carers, PLWD; n = 12) on the communication of risk of future in-patient psychiatric admission or enhanced ‘crisis’ community care and develop tools to support communication.

This pilot study used an experience-based, co-design approach. Reflexive thematic analysis was used to analyse transcripts, leading to co-development of draft educational materials.

We identified five themes that inform how risk should be communicated. Participants underlined the importance of timing, setting and follow-up appointments. Digital tools were considered essential, but they were not seen as a substitute to face-to-face appointments. Individual preferences varied, highlighting the need for patient-centred communication. The findings led to the co-development of clinician guidelines and educational materials.

Risk communication in dementia is complex and must be personalised to be most effective. Our findings may have relevance for the communication of other areas of risk in dementia beyond risk of care crises.

This study aimed to make a head-to-head comparison of the diagnostic accuracy and cross-cultural applicability of abbreviated 20-item versions of the Copenhagen Cross-Linguistic Naming Test (C-CLNT20) and Naming Assessment in Multicultural Europe (NAME20).

The present study was conducted in a multicultural and multilingual patient sample from memory clinics across five European countries. Receiver operating characteristic curve analysis was used to assess the diagnostic accuracy of C-CLNT20 and NAME20 in classifying dementia and mild cognitive impairment (MCI). Binary logistic regression analysis was performed to evaluate the influence of demographic and cultural factors on diagnostic accuracy.

C-CLNT20 and NAME20 showed acceptable diagnostic accuracy for dementia with areas under the curve (AUC) of .75 and .82, respectively, but had low accuracy for MCI (AUC of .64 and .62, respectively). Compared to C-CLNT20, NAME20 had slightly higher, but statistically non-significant, AUCs for dementia in both in the full sample and in participants with immigrant background. The diagnostic accuracy of the C-CLNT20 and NAME20 was not significantly influenced by education and immigrant status in the full sample, or by acculturation and use of an interpreter in participants with immigrant background.

Both C-CLNT20 and NAME20 are promising brief alternatives to the full versions of the naming tests when time is limited. They also present a promising alternative to other established naming tests by maintaining diagnostic accuracy while showing minimal cross-cultural and cross-linguistic bias.

Idiopathic normal pressure hydrocephalus (iNPH) is a neurological disorder affecting older adults for which symptoms may improve following shunting; however, the criteria for surgical referral remain unclear. While most studies rely on fixed cut-off scores for cognitive and gait tests, the present study examined decision-making based on clinical judgment to identify which factors influence referral. A secondary objective was to compare pre- and post-CSF tap test (CSF-TT) changes between the shunt and no shunt groups.

This retrospective study included 175 patients assessed at CHU de Québec – Hôpital de l’Enfant-Jésus. Based on a combination of objective test results and clinical judgment, patients were categorized as referred (n = 119) or not referred (n = 56) for shunt surgery. Logistic regression identified the variables influencing referral decisions. Mixed-effects ANOVA models for repeated measures were conducted to compare pre- and post-CSF-TT changes in gait and cognitive performance between shunt and no shunt groups.

Three change indices significantly predicted referral: the 10-Meter Walk Test (normal pace), the Trail Making Test Condition 5 and the Berg Balance Scale. Higher education positively influenced referral. While most gait and balance measures showed significant improvement following CSF-TT, cognitive tests appeared less responsive to the procedure.

Although this study employed a clinically grounded approach based on clinical judgment rather than fixed thresholds, the findings align with prior literature identifying gait and balance as robust indicators. This study reinforces the need to shift from rigid threshold-based criteria toward individualized, clinically grounded decision-making models that can better capture the heterogeneity of iNPH presentations.

People living with dementia (PLWD) want – and have the right – to participate in research that impacts them. However, barriers in legislation, institutional practices, and/or biases may jeopardize inclusion.

Interviews with 33 Canadian dementia researchers were conducted to explore understandings of research consent with regard to dementia, research practices, and approaches in everyday research contexts.

Analysis of these interviews revealed challenges in negotiating the space between best practices and institutional requirements; gaps in knowledge, procedures, and guidelines on inclusion and consent; tensions regarding who should be involved in decision making; and how assumptions of presumed incapacity and/or the ‘protection’ of vulnerable groups create and/or sustain the exclusion of PLWD from research.

Moving forward, findings suggest that advancing the meaningful inclusion of PLWD in Canadian dementia research will require clear, consistent standardized guidelines, flexible and ongoing consent processes, accessibility accommodations, and a stronger focus on rights-based practices.