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Background and Objectives: In the accompanying paper (Part 1), it was reported that forced convection roasting of wheat before milling can be directed to tailor the viscosifying properties of flour. The objective of the present work was to examine the effect of prior wheat roasting on flour proteins. Findings: Effective control of wheat roasting conditions proved to be essential to avoid the irreversible loss of flour functionality as deduced from the flour ethanol and lactic acid solvent retention capacity and mixography data. Response surface models predicted roasting at 108°C and 80 Hz (135 s) to maintain protein integrity. The microstructure of flour and isolated starch as well as X‐ray diffraction patterns revealed starch to be relatively unaffected by this heat treatment. Conclusions: Flour produced from roasted wheat can still be used for products that require the formation of a gluten network. Significance and Novelty: Protein is more sensitive to roasting conditions than starch. [ABSTRACT FROM AUTHOR]

Gastrointestinal helminth parasites undergo part of their life cycle outside their host, such that developmental stages interact with the soil and dung fauna. These interactions are capable of affecting parasite transmission on pastures yet are generally ignored in current models, empirical studies and practical management. Dominant methods of parasite control, which rely on anthelmintic medications for livestock, are becoming increasingly ineffective due to the emergence of drug‐resistant parasite populations. Furthermore, consumer and regulatory pressure on decreased chemical use in agriculture and the consequential disruption of biological processes in the dung through nontarget effects exacerbates issues with anthelmintic reliance. This presents a need for the application and enhancement of nature‐based solutions and biocontrol methods. However, successfully harnessing these options relies on advanced understanding of the ecological system and interacting effects among biotic factors and with immature parasite stages. Here, we develop a framework linking three key groups of dung and soil fauna—fungi, earthworms, and dung beetles—with each other and developmental stages of helminths parasitic in farmed cattle, sheep, and goats in temperate grazing systems. We populate this framework from existing published studies and highlight the interplay between faunal groups and documented ecological outcomes. Of 1756 papers addressing abiotic drivers of populations of these organisms and helminth parasites, only 112 considered interactions between taxa and 36 presented data on interactions between more than two taxonomic groups. Results suggest that fungi reduce parasite abundance and earthworms may enhance fungal communities, while competition between dung taxa may reduce their individual effect on parasite transmission. Dung beetles were found to impact fungal populations and parasite transmission variably, possibly tied to the prevailing climate within a specific ecological context. By exploring combinations of biotic factors, we consider how interactions between species may be fundamental to the ecological consequences of biocontrol strategies and nontarget impacts of anthelmintics on dung and soil fauna and how pasture management alterations to promote invertebrates might help limit parasite transmission. With further development and parameterization the framework could be applied quantitatively to guide, prioritize, and interpret hypothesis‐driven experiments and integrate biotic factors into established models of parasite transmission dynamics. [ABSTRACT FROM AUTHOR]

This paper proposes a surveillance model for plant pests that can optimally allocate resources among survey tools with varying properties. While some survey tools are highly specific for the detection of a single pest species, others are more generalized. There is considerable variation in the cost and sensitivity of these tools, but there are no guidelines or frameworks for identifying which tools are most cost‐effective when used in surveillance programs that target the detection of newly invaded populations. To address this gap, we applied our model to design a trapping surveillance program in New Zealand for bark‐ and wood‐boring insects, some of the most serious forest pests worldwide. Our findings show that exclusively utilizing generalized traps (GTs) proves to be highly cost‐effective across a wide range of scenarios, particularly when they are capable of capturing all pest species. Implementing surveillance programs that only employ specialized traps (ST) is cost‐effective only when these traps can detect highly damaging pests. However, even in such cases, they significantly lag in cost‐effectiveness compared to GT‐only programs due to their restricted coverage. When both GTs and STs are used in an integrated surveillance program, the total expected cost (TEC) generally diminishes when compared to programs relying on a single type of trap. However, this relative reduction in TEC is only marginally larger than that achieved with GT‐only programs, as long as highly damaging species can be detected by GTs. The proportion of STs among the optimal required traps fluctuates based on several factors, including the relative pricing of GTs and STs, pest arrival rates, potential damage, and, more prominently, the coverage capacity of GTs. Our analysis suggests that deploying GTs extensively across landscapes appears to be more cost‐effective in areas with either very high or very low levels of relative risk density, potential damage, and arrival rate. Finally, STs are less likely to be required when the pests that are detected by those tools have a higher likelihood of successful eradication because delaying detection becomes less costly for these species. [ABSTRACT FROM AUTHOR]

This paper presents the performance evaluation of an amplify‐and‐forward (AF) relay‐assisted multiuser multiple input–multiple output (MU–MIMO) downlink transmission system for correlated fading channels. The overall system performance was improved by incorporating a double‐quadrature spatial modulation (DQSM) scheme. The bit error rate (BER) performance and detection complexity of the AF–MU–MIMO–DQSM system were analyzed and compared with those of a conventional AF–MU–MIMO system under the same conditions and parameters. The results showed that the correlated fading channel severely affected the performance of systems with higher spectral efficiency (SE). Considering an SE of 12 bpcu/user, the AF–MU–MIMO–DQSM system yielded a gain of up to 3 dB in BER performance compared with that of its conventional counterpart for the analyzed cases. In terms of detection complexity, the AF–MU–MIMO–DQSM system showed a reduction of up to 56 % compared with that of the conventional system for the optimal maximum likelihood detection criterion. [ABSTRACT FROM AUTHOR]

This paper presents a novel circular fractal ring monopole antenna for ultra‐wideband (UWB) hardware with dual band‐notched properties. The proposed antenna consists of four crescent‐shaped nested rings, a tapered feeding line at the front of the dielectric material, and a semicircular ground plane on the backside. In this design, the nested rings are used both as a radiation element and a band rejection element. The proposed antenna has a bandwidth of 9.03 GHz, which works efficiently in the range of 2.63 GHz–11.66 GHz with the dual notched bands of Worldwide Interoperability for Microwave Access (WiMAX) at 3.15 GHz–3.66 GHz and wireless local area network (WLAN) at 4.9 GHz–5.9 GHz, respectively. The antenna has a compact size of 20 mm × 30 mm × 1 mm (0.177 × 0.265 × 0.0084 λ0) and is implemented using a flame‐retardant type 4 (FR4) material. It has a maximum gain of approximately 4 dB in its operating range, and experimental results support the simulation predictions with high accuracy. The findings of this study imply that the designed antenna can be utilized in UWB applications. [ABSTRACT FROM AUTHOR]

In this paper, we describe a neural network‐based application that recommends multiple items using dialog context input and simultaneously outputs a response sentence. Further, we describe a multi‐item recommendation by specifying it as a set of clothing recommendations. For this, a multimodal fusion approach that can process both cloth‐related text and images is required. We also examine achieving the requirements of downstream models using a pretrained language model. Moreover, we propose a gate‐based multimodal fusion and multiprompt learning based on a pretrained language model. Specifically, we propose an automatic evaluation technique to solve the one‐to‐many mapping problem of multi‐item recommendations. A fashion‐domain multimodal dataset based on Koreans is constructed and tested. Various experimental environment settings are verified using an automatic evaluation method. The results show that our proposed method can be used to obtain confidence scores for multi‐item recommendation results, which is different from traditional accuracy evaluation. [ABSTRACT FROM AUTHOR]

To treat the novel COronaVIrus Disease (COVID), comparatively fewer medicines have been approved. Due to the global pandemic status of COVID, several medicines are being developed to treat patients. The modern COVID medicines development process has various challenges, including predicting and detecting hazardous COVID medicine responses. Moreover, correctly predicting harmful COVID medicine reactions is essential for health safety. Significant developments in computational models in medicine development can make it possible to identify adverse COVID medicine reactions. Since the beginning of the COVID pandemic, there has been significant demand for developing COVID medicines. Therefore, this paper presents the transfer‐learning methodology and a multilabel convolutional neural network for COVID (MLCNN‐COV) medicines development model to identify negative responses of COVID medicines. For analysis, a framework is proposed with five multilabel transfer‐learning models, namely, MobileNetv2, ResNet50, VGG19, DenseNet201, and Inceptionv3, and an MLCNN‐COV model is designed with an image augmentation (IA) technique and validated through experiments on the image of three‐dimensional chemical conformer of 17 number of COVID medicines. The RGB color channel is utilized to represent the feature of the image, and image features are extracted by employing the Convolution2D and MaxPooling2D layer. The findings of the current MLCNN‐COV are promising, and it can identify individual adverse reactions of medicines, with the accuracy ranging from 88.24% to 100%, which outperformed the transfer‐learning model's performance. It shows that three‐dimensional conformers adequately identify negative COVID medicine responses. [ABSTRACT FROM AUTHOR]

Despite its high prevalence among dementias, Lewy body dementia (LBD) remains poorly understood with a limited, albeit growing, evidence base. The public‐health burden that LBD imposes is worsened by overlapping pathologies, which contribute to misdiagnosis, and lack of treatments. For this report, we gathered and analyzed public‐domain information on advocacy, funding, research outputs, and the therapeutic pipeline to identify gaps in each of these key elements. To further understand the current gaps, we also conducted interviews with leading experts in regulatory/governmental agencies, LBD advocacy, academic research, and biopharmaceutical research, as well as with funding sources. We identified wide gaps across the entire landscape, the most critical being in research. Many of the experts participated in a workshop to discuss the prioritization of research areas with a view to accelerating therapeutic development and improving patient care. This white paper outlines the opportunities for bridging the major LBD gaps and creates the framework for collaboration in that endeavor. Highlights: A group representing academia, government, industry, and consulting expertise was convened to discuss current progress in Dementia with Lewy Body care and research.Consideration of expert opinion,natural language processing of the literature as well as publicly available data bases, and Delphi inspired discussion led to a proposed consensus document of priorities for the field. [ABSTRACT FROM AUTHOR]

Background and Objectives: Proso millet is a traditional grain that can be divided into waxy and nonwaxy varieties based on amylose content. However, research on different varieties of cooked proso millet is limited, especially as a whole grain. This paper investigated the quality properties and aroma characterization of cooked nonwaxy proso millet (NPM) and waxy proso millet (WPM). Findings: Scanning electron microscopy images showed that cooked NPM exhibited a more compact structure, whereas cooked WPM displayed a porous structure. Cooked NPM presented higher water absorption ratio, expansion ratio, hardness, and better chewiness than cooked WPM. Correlation analysis indicated that the texture properties were positively correlated with the cooking characteristics as well as the amylose and protein contents. The resistant starch content of cooked NPM (35.97%) was higher than that of cooked WPM (28.85%). Aroma analysis revealed that cooked NPM and WPM contained 56 and 67 volatile substances, respectively. Conclusion: Cooked NPM and WPM exhibited different properties mainly attributed to the various amylose and protein contents. Significance and Novelty: These findings may provide a theoretical basis for the processing and commercial development of the proso millet resource. [ABSTRACT FROM AUTHOR]

Creativity researchers are increasingly interested in understanding when, how, and for whom creativity can be beneficial. Previous reviews have demonstrated that creativity research largely ignores the study of its impact on factors that promote health, and well‐being among populations of adults. It is unclear, in fact, whether this gap in research also extends to creativity research among young children. This paper addresses this issue. Early childhood is a crucial stage for the cognitive development of young children who remain highly sensitive to stress, and adversity. It is therefore essential to identify and promote factors that are beneficial to early childhood resilience, thereby contributing to documenting more of the effects of creative activities on positive outcomes. This paper presents a review with a bibliometric analysis of 1000 randomly selected articles from the Web of Science, without bias towards any specific peer‐reviewed journal. The analysis of 454 included articles shows that approximately 80% of the included studies focus on creativity as an outcome (replicating previous findings with a larger sample), with only 3.78% investigating creative activities as predictors among young children. In this small percentage, most of the studies addressed creative activities in young children related to resilience outcomes. [ABSTRACT FROM AUTHOR]

The above article, published online on 29 April 2016 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor‐in‐Chief, Kevin Ryan, FEBS Press, and John Wiley and Sons Ltd. The retraction has been agreed due to several image duplications in Figures 4B,E,G, and 5C,D, and inconsistencies between tumour luminescence images and the quantification in Figure 4K. Compelling raw data images were not available from the authors. The editors consider the conclusions substantially compromised and are therefore retracting the paper. Corresponding author Pritha Ray agrees to this retraction, since the raw data are no longer available for analysis and validation. Reference 1 Thakur B, Ray P. p53 loses grip on PIK3CA expression leading to enhanced cell survival during platinum resistance. Mol Oncol. 2016;10(8):1283–1295. https://doi.org/10.1016/j.molonc.2016.06.006 [ABSTRACT FROM AUTHOR]

The article discusses recent advancements in artificial intelligence (AI) and their impact on speech and language comprehension. It highlights the emergence of speech and language technologies as major topics in AI research, enabling computers to interpret human language in both written and spoken forms. The article also provides summaries of 12 papers included in a special issue on speech and language technologies, covering topics such as question answering, coreference resolution, essay grading, named entity recognition, morphological analysis, code generation, Alzheimer's disease recognition, backchannel prediction, spoken-to-written text conversion, multimodal speech recognition, and language tutoring systems. The authors express their gratitude to the contributors and emphasize the importance of these studies for the future design and implementation of AI systems. [Extracted from the article]

This paper presents the development of language tutoring systems for non‐native speakers by leveraging advanced end‐to‐end automatic speech recognition (ASR) and proficiency evaluation. Given the frequent errors in non‐native speech, high‐performance spontaneous speech recognition must be applied. Our systems accurately evaluate pronunciation and speaking fluency and provide feedback on errors by relying on precise transcriptions. End‐to‐end ASR is implemented and enhanced by using diverse non‐native speaker speech data for model training. For performance enhancement, we combine semisupervised and transfer learning techniques using labeled and unlabeled speech data. Automatic proficiency evaluation is performed by a model trained to maximize the statistical correlation between the fluency score manually determined by a human expert and a calculated fluency score. We developed an English tutoring system for Korean elementary students called EBS AI PengTalk and a Korean tutoring system for foreigners called KSI Korean AI Tutor. Both systems were deployed by South Korean government agencies. [ABSTRACT FROM AUTHOR]

Objective: The geoduck show‐factor is the probability an individual geoduck is detectable to a diver during a stock assessment survey. It is one of the values used to estimate the abundance of geoducks. This paper presents estimates of show‐factor according to data collected during 21 approximately monthly surveys over a 32‐month period. The new estimates are compared against other long‐term studies of show‐factor and against estimates made from shorter term (approximately daily surveys over a period of approximately 1 week) studies. Methods: Data were collected from three plots near Marina Island, British Columbia, and three novel methods were used for the analysis. Two of the methods estimate show‐factors at the time of data collection, while the third method treats show‐factor as a function of the time of year. All three methods generate probabilistic results. Result: Each method of show‐factor analysis indicated a strong seasonal effect. Show‐factors were highest from March to June and lowest from October to December. The difference between the high and low show‐factors was at least a factor of two. The three methods generated estimates of show‐factor that are generally lower than the values previously used as part of stock assessment on the coast of British Columbia. Conclusion: If this difference between long‐ and short‐term show‐factor can be generalized to the many commercial beds on the coast of British Columbia, the abundance of geoducks has been underestimated and the fishery is even more cautious than currently believed. As of yet, long‐term data have not been collected on a coastwide basis and conclusions cannot be more definitive. Impact statementBased upon data collected from a single location, over 32 months, under a new protocol, there are likely more undetected geoducks than previously expected. The geoduck fishery is likely even more sustainable than previously believed. [ABSTRACT FROM AUTHOR]

Recurrent selection is an effective breeding method for improving complex traits in wheat (Triticum aestivum L.) breeding. In this study, we propose a genitor selection strategy, employing a multi‐trait selection approach and genetic diversity analysis. To evaluate our proposed method, we conducted a lattice design trial during the winter seasons of 2020 and 2021 in Viçosa, MG, Brazil, comprising 87 lines and 13 commercial cultivars. It assessed various traits such as plant height, days to heading, wheat leaf rust, tan spot of wheat, a hundred grain mass, hectoliter weight, and grain yield, and the best linear unbiased predictor (BLUP) was obtained for each trait via restricted maximum likelihood. Next, a genotypic distance matrix, derived from principal component analysis using the BLUP values, was computed to perform hierarchical clustering via the unweighted pair group method with arithmetic mean. The selection of superior genotypes was made utilizing the multi‐trait genotype‐ideotype distance index, resulting in the identification of eight lines and two commercial cultivars as candidates. Furthermore, the genetic diversity analysis revealed distinct clusters among the selected genotypes. To assess the divergence of the chosen genitors, this study proposes a complementarity matrix using factor analysis. Our results indicate that this selection strategy effectively directed the identification of the best and divergent genitors. The complementarity matrix developed in this paper to evaluate the crossings proposal can also be used to evaluate combinations in any panel selected via a multi‐trait approach and can be easily applied and interpreted by breeders of various programs. Core Ideas: Novel strategy to select divergent genitors for cycle zero of recurrent selection program is presented.Multi‐trait selection and genetic diversity analysis of tropical wheat on phenotypic data is presented.A complementarity index based on a factor analysis is presented to evaluate the proposed crossings. [ABSTRACT FROM AUTHOR]

This article discusses the management of invasive alien species (IAS) in China. It highlights the negative impacts of biological invasions on ecosystems, the environment, and the economy. The article presents 24 papers that cover a wide range of topics related to IAS management, including risk analysis, mechanisms of invasion success, performance of successful IAS, and impact and control of invasive species. The studies use various methods such as field surveys, experiments, ecological modeling, and molecular techniques to assess invasion risks, investigate mechanisms, and develop control strategies. The article emphasizes the importance of interdisciplinary research and effective management strategies to address the increasing threat of IAS in China. [Extracted from the article]

Background: Racial/ethnic minority groups and those with lower socioeconomic status suffer greater prevalence of cognitive health problems. For example, older Black Americans are about twice as likely to develop ADRD as older Whites (Lennon et al., 2022). Rates of ADRD are unknown among Middle Eastern/Arab Americans (MENA). Throughout the COVID‐19 pandemic, racial/ethnic disparities existed such that COVID‐19 prevalence and mortality were greater among Black and MENA populations compared to Whites (Dallo et al., 2022). This paper characterizes COVID‐19 stress prevalence and cognitive health in metro‐Detroit among three racial‐ethnic groups. Method: In the recently completed U.S.‐based Detroit Area Wellness Network – COVID‐19 Supplement (DAWN‐CS) project (N = 606), participants were recruited from an existing longitudinal cohort study (i.e., Social Relations Study; Antonucci & Akiyama, 1994), supplemented by address‐based and respondent‐driven sampling in order to obtain a racially/ethnically balanced sample of MENA, Black, and White older adults. Eligible persons (aged 65+) within screened households were selected with probability to allow appropriate inference to the target population. Inclusion criteria for DAWN‐CS were: age 65+, fluency in English or Arabic, and identifying as MENA, Black, or White. Psychosocial questionnaires and cognitive measures were administered via telephone. Global cognition was a composite score of episodic memory, language, attention, and working memory tests. Result: MENA older adults reported more COVID‐19 stress and demonstrated lower cognitive health than White older adults, aligning more with profiles observed among Black older adults. The influence of COVID‐19 stress did not vary by race‐ethnicity or predict cognitive health in the whole sample. COVID‐19 stress predicted better cognitive health only for Whites. Conclusion: Including underrepresented populations in the study of stress and cognitive health advances science and addresses societal health in its entirety. Disaggregating MENA from Whites demonstrates an unrecognized disparity (MENA versus White older adults), and improves estimates of other disparities (Black versus White older adults). The benefit of stress on cognitive health for Whites reflect that stress may have health benefits when experienced in small doses. [ABSTRACT FROM AUTHOR]

Background: One of the great challenges facing clinical trial recruitment is to have a representative sample reflective of the diversity of the US population. While racial and ethnic minorities compromise 39% of the United States population, they only account for 2%‐16% of clinical trial participants.1 The aim of the FOCUS study was to collect cognitive testing data from a diverse population and develop normative ranges for Cognivue, the first FDA‐cleared computerized cognitive assessment device based on modern cognitive neuroscience. Cognivue Thrive provides a 5‐minute cognitive screen while Cognivue Clarity provides a 10‐minute comprehensive assessment, allowing both physicians and non‐physician clinicians to objectively and quantitatively access brain health beyond traditional paper and pencil cognitive tests. Method: Cognivue partnered with Velocity Clinical Research to lead the recruitment efforts for the FOCUS study. The enrollment goal included an objective to enroll a group resembling the racial, ethnic, gender, and educational makeup recorded in the 2020 U.S. census data. Study subjects were recruited through local community outreach, participant referrals, and advertising. Recruitment was stopped once goals for specific sub‐groups were reached, to model real‐world outcomes. Cognivue Thrive and Clarity were administered to assess scoring and normative ranges and compared against performance on other neuropsychological test batteries within the diverse study cohort. Result: The Cognivue/Velocity partnership resulted in recruitment of more than 1,500 subjects from 14 sites in 11 states with a mean age of 50.2±16.3y (range 18‐89), 59.2% female, and 51.8% with 12 years or less of education. Over 28% of subjects identified their race as Black or African American, American Indian or Alaska Native, Asian, Native Hawaiian or Pacific Islander, or other non‐white, and over 12% of participants identified as Hispanic or Latino. Conclusion: Working in collaboration with Velocity, a clinical research partner with study sites throughout the United States, Cognivue was able to reach a 37% research participation rate of historically underserved and underrepresented populations in the national FOCUS study. 1Clin Pharmacol Ther. 2015 Mar;97(3):263‐73. https://doi.org/10.1002/cpt.61. [ABSTRACT FROM AUTHOR]

Background: Early detection of Mild Cognitive Impairment (MCI) and Alzheimer's Disease and Related Dementias (ADRD) is key to optimal management. Digital tests allow for the reliable capture of meaningful, process‐based neuropsychological test parameters that traditional paper/pencil measures fail to detect, thus enabling earlier detection. We assessed how subtle functional decline relates to process features extracted from the digital Clock Drawing Test (dCDT) and the digital Trail Making Test‐Part B (dTrB). Methods: 629 community dwelling participants (58.5% female) were assessed with the Functional Assessment Questionnaire (FAQ), the MMSE, the digital clock drawing test (dCDT) and the digital Trail Making Test‐Part B (dTrB). Three FAQ groups were constructed: FAQ = 0‐2 (minimal functional disability, n = 490); FAQ = 3‐5 (subtle functional disability, n = 90); FAQ = 6‐8 (mild functional disability, n = 49). Results: Participants with minimal functional disability were younger (p = 0.027) and scored better on the MMSE (p = 0.001) than other groups. Groups were equated for education. dCDT command/copy component placement was more accurate among participants with minimal functional disability compared to other groups (command dCDT p = 0.001 versus mild functional disability; copy dCDT p = 0.006 versus both subtle and mild functional disability). On the dTrB, participants with minimal disability drew faster than those with subtle or mild disability (mean stroke velocity, p = 0.001). Analyses for percent pen lift time found no difference between participants with minimal versus subtle disability; however, both groups differed from participants with mild disability (p = 0.001). Optimal group classification using stepwise nominal regression with the minimal functional disability group as the reference was achieved using dCDT copy component placement and dTrB mean stroke velocity (X2 = 28.37, p = 0.001), where dTrB mean velocity entered first (X2 = 17.73, p = 0.001) followed by dCDT copy component placement (X2 = 11.19, p = 0.004). Both variables contributed comparably to group classification (Wald statistic range 5.82‐8.88, p = 0.012, respectively). Conclusions: The digital assessment described above, targeting executive, scanning, visuoconstructional and motor domains, captures highly nuanced, discrete behaviors with precision/ operationalism heretofore unattainable. Consequently, it is reasonable to posit that digital cognitive assessments leveraging the Boston Process Approach can both objectively detect emergent cognitive impairment and infer its likely impact on functional activities, critical for practical assessment in clinical care. [ABSTRACT FROM AUTHOR]

Background: Currently, there is a search for timely care and intervention on patients with dementia, which have reasonable costs and allow the sustainability and efficiency of national health and social care systems (Livingston et al., 2017). Cognitive interventions delivered in the patient's home can be an excellent alternative, due to their feasibility(Jang et al., 2021) and accessibility (Rai et al., 2021) to the intervention. The aim of this paper is to describe the evidence on cognitive intervention performed at home for patients with MCI and mild dementia. To describe its characteristics and outcomes, and to address its feasibility and usability. Method: A systematic review was performed using the PRISMA recommendations. We reviewed 190 records from four databases: PubMed, CINAHL, Web of Science, and PsycInfo.The quality of the studies was assessed using the tool "Assessment (mERA) checklist7" (World Health Organization, 2016) Result: Ten papers were included. With a mean quality score of 0.76/1 (91.7% agreement). The sample contains (N = 777) patients (MA 75.9). 80% have an education >7 years. 87.1% have a diagnosis of mild dementia. There are (N = 628) caregivers (MA 64.8). Seventy percent (n = 440) are women. Positive results were found in: 71% of studies that looked for results on cognition. 66% of the studies that looked for results on mood and behavioral symptoms. 83% of studies that looked for results on functionality/quality of life. 100% of the studies that looked feasibility, and 75% of the studies that looked for results on the caregiver. Conclusion: Cognitive intervention in the home of patients with MCI and early dementia showed positive results at a cognitive, emotional and behavioral levels. Likewise, in the caregiving relationship, emotional health and quality of life of caregivers. The use of assistive technologies in the home has some benefits over face‐to‐face care. Outcome‐cost ratio can be a cost‐effective solution for the sustainability and efficiency of national health and social care systems. [ABSTRACT FROM AUTHOR]

Background: Experimental, clinical, and genetic epidemiological studies continue clarifying important aspects of Alzheimer's disease (AD) pathological development. Despite this progress the genetic mechanisms of AD regulation remain unclear. One problem that may contribute to slowing further progress in better understanding of these mechanisms deals with difficulties in replication of the results of genetic association studies. To overcome this problem the idea of using a gene‐based analysis in which all common variation within a candidate gene is considered jointly has been suggested. In this paper we investigate to what extent the use of gene‐based analyses resolves the non‐replication problem. Method: We performed gene‐level and meta‐analysis association studies for two cohorts: Cardiovascular Heart Study (CHS) and Framingham (FRAM) using Alzheimer's disease as a primary outcome. To support our findings, we also performed meta‐analysis following gene‐enrichment study for both cohorts. Analysis was performed separately for males and females and for both sexes. Additional covariates were age, smoking. Gene‐level analysis was performed with fastBAT and enrichment analysis with ClusterProfiler on KEGG database. Result: Our analysis identified a list of highly significant genes, such as TOMM40, APOC1 (all with FDR‐adjusted p‐value < 0.05) and pathways, such as Cholesterol metabolism, Fluid shear stress and atherosclerosis, Proteoglycans in cancer, Lipid and atherosclerosis showed statistically significant associations (FDR‐adjusted p‐value < 0.05) in both datasets and sexes. Meta‐analysis revealed TOMM40 (p‐value = 2.35E‐16), APOC1 (p‐value 4.46E‐13), ENSG00000259648 (p‐value = 8.88E‐06), PEX7 (p‐value = 4.40E‐05), ENSG00000287274 (p‐value = 5.38E‐05) genes for men and women combined; men exclusively revealed ENSG00000259648, TOMM40, and APOC1 (p‐value<1.75E‐05) and women TOMM40 and APOC1 (p‐value<6E‐08). Gene‐enrichment meta‐analysis revealed NOD‐like receptor signaling pathway (adjusted p‐value 3.23E‐07), Lipid and atherosclerosis (p‐value = 5.93E‐05), Yersinia (p‐value = 1.17E‐04) for men and women combined; for men only the pathways are Lipid and atherosclerosis (p‐value = 3.61E‐03), TGF‐beta signaling pathway (p‐value = 3.61E‐03), AGE‐RAGE signaling pathway in diabetic complications (p‐value = 5.18E‐03); and for women Cholesterol metabolism (p‐value = 3.49E‐07), Fatty acid degradation (p‐value = 1.04E‐06), PPAR signaling pathway (p‐value = 1.23E‐05). Conclusion: In this work we were able to identify statistically significant genes and pathways showed replication across the studies and are potentially useful for uncovering genetic mechanisms of AD. However, other things such as genetic heterogeneity may influence disease developing and needed further exploration. [ABSTRACT FROM AUTHOR]

Background: Globally, a rapid demographic transition is occurring with a significant increment in the proportion of older individuals. For the first time in history, individuals aged 65 and above outnumber that of children under five years of age. Method: A mini review was conducted to assess the burden and types of dementia risk factors in Ethiopia. Results: In Ethiopia, the life expectancy has shown dramatic improvements in the past few decades and is expected to reach 74 years by mid‐century. Older age is considered the most important non‐modifiable risk factor for dementia. Likewise, other modifiable diseases such as infectious diseases, non‐communicable diseases, particularly cardiovascular diseases, and traumatic brain injuries are associated with dementia. Despite, the high prevalence of dementia risk factors and impending economic and health impact from dementia, no country in the sub‐Saharan Africa (SSA), including Ethiopia, has developed a standalone national dementia strategic plan to guide the overall effort to improve dementia care in the country. It is vital to design and develop a national dementia plan in line with a framework outlined by the 2017 World Health Organization (WHO) global action plan. The health, social, & economic burden from dementia is expected to be high to the developing countries such as Ethiopia unless clear prevention and management strategies are designed at a national level to cascade the care to the primary care level. The planned strategic policy may focus on improving the knowledge and skills of health care professionals. Translation and cultural adaptation of cognitive, functional, and behavioral assessment batteries is of paramount importance in improving the diagnostic accuracy along with availability of advanced imaging, biomarkers, and dementia treatment. Conclusion: In summary, this call for action paper recommends developing a tailored stand‐alone or an integrated national dementia prevention and care plan which is in congruent with the seven WHO global action plan. [ABSTRACT FROM AUTHOR]

Background: Subjective cognitive decline is a self‐reported experience of declining cognitive function showing normal performance in cognitive assessments, which is a known risk factor for dementia. Recent studies highlight the importance of nonpharmacological multidomain interventions that can target multiple risk factors of dementia in older adults. We investigated the efficacy of the Silvia program, a mobile‐based multidomain intervention, to improve cognitive function and health‐related outcomes of older adults with a high risk of dementia. Additionally, we compared its effects to a conventional paper‐based multidomain program on various health indicators related to risk factors of dementia. Method: This prospective randomized controlled trial involved 77 older adults with a high risk of dementia recruited from the Dementia Prevention and Management Center in Gwangju, South Korea during May to October 2022. Participants were randomly assigned to either the mobile‐ or paper‐based group. Interventions were administered for 12 weeks, where pre‐ and post‐assessments were conducted. Result: The Korean version of the Repeatable Battery for the Assessment of Neuropsychological status (K‐RBANS) total score did not show significant differences between groups. The mobile group showed better improvement in K‐PRMQ scores and PSS scores than the paper group. Differences within groups showed that mobile‐based interventions significantly improved the Korean version of the prospective and retrospective memory questionnaire (K‐PRMQ), State‐Trait Anxiety Inventory‐X‐1 (STAI‐X‐1), Perceived Stress Scale (PSS), and e EuroQoL 5‐Dimension 5‐Level (EQ‐5D‐5L) scores, while paper‐based interventions significantly improved PSS, and EQ‐5D‐5L scores. Conclusion: The Silvia program was more effective than paper‐based intervention in improving self‐reported memory failures, stress, anxiety, and health‐related quality of life. However, longer periods of administration for more than 12 weeks may be needed to achieve significant improvements in cognitive function by objective measures [ABSTRACT FROM AUTHOR]

Background: Physical inactivity significantly contributes to chronic disease burden, including increasing dementia risk. Physical activity (PA) can benefit cognitive health for groups at high‐risk of dementia, such as people experiencing cognitive concerns (including mild cognitive impairment and subjective cognitive decline), and mental health symptoms. However, understanding how to best enable people with co‐occurring cognitive and mental health concerns to increase PA for dementia risk reduction (DRR) remains challenging for researchers, resulting in lower adherence in clinical trials and limiting the impact of implementation in clinical practice. The EXCEL PA implementation study incorporated design approaches from behavioral science that were novel to DRR, to improve intervention tailoring and engagement. We report findings from the first phase of EXCEL, which aimed to understand PA behavior change needs in this population and identify unique intervention tailoring requirements to enable more effective engagement. Method: The study used the Capability, Opportunity and Motivation (COM‐B) model of behavior change as an organizing framework. Middle‐aged and older people (aged 45 – 85 years) experiencing subjective cognitive decline (SCD) or mild cognitive impairment (MCI) and mild‐moderate depression or anxiety were interviewed. Themes from semi‐structured interviews examining PA and DRR perspectives were triangulated with findings from published PA intervention trials to identify convergent and complementary themes. Integrated findings were mapped to the study framework to develop a specified, contextualized model of key factors influencing PA behavior change and matched intervention approaches. Result: Data from 21 interviews and 24 relevant papers were included. Identified areas requiring behavior change support in the target population that have not been emphasized in theory or previous interventions included: • Emotional regulation • Turning intentions into action despite distractions or barriers • Confidence in existing skills, including to overcome barriers and regulate emotion These aligned with and extended COM‐B and provided a model to guide the EXCEL intervention. Conclusion: This novel model used behavioral science methods to tailor an intervention for people experiencing cognitive concerns and depression or anxiety, supporting improved PA engagement and impact for an at‐risk population (see Ellis et al. AAIC‐23, submitted, for trial results). [ABSTRACT FROM AUTHOR]

Background: Existing studies have shown the importance of marital status and quality on later‐life cognitive health, including dementia risk and likelihood of timely dementia diagnosis. Yet, much evidence comes from different‐sex couples' experiences, for whom marriage remains the norm and unmarried persons face social and material costs. In contrast, where same‐same marriage is legal in North America and Europe, marriage has not yet become the norm: same‐sex couples (SSCs) have lower marriage rates than different‐sex couples. SSCs also tend to structure their relationships differently across a range of domains, from household labor to sexual nonmonogamy. Throughout Europe and North America, older lesbian and gay people are also more likely to be single, to live alone, and to have no living children than straight or bisexual people; as a result, the former tend to rely less on partners or biological family to meet their social needs. Unlike straight men, for example, gay and bisexual men tend to rely less on their partners or daughters to forge and maintain social and community connections, instead relying on "chosen families". Method: Given their unique prominence for sexual minorities, this paper uses population‐based surveys from the US (HRS) and Europe (ELSA and SHARE) to investigate measures of non‐biologically familial social bonds, including whether measures of friendship, social connectedness, and community involvement function similarly to marital status. Result: In the US, which has the highest marriage rates and a deeply entrenched "marriage culture", LGB participants in the HRS (1998‐2018; n = 23,035) who indicate having never been married perform better cognitively at baseline than married LGB people (β = 1.5; p = 0.05), while never‐married straights perform worse (β = ‐0.9; p <0.01). Conclusion: Relationship factors have a different association with cognitive health for LGB people than straight people, yet these remain unexplored in their effects on cognitive aging and queerer pathways to good cognitive health. [ABSTRACT FROM AUTHOR]

Background: Dementia in people with Intellectual Disability (ID) has a prevalence three times greater (Strydom et al., 2007) and with an earlier onset (Dodd et al., 2015) than in the general population. Despite the fact that virtually all adults with ID display neuropathology consistent with dementia by the age of 40, many of them never show the clinical symptoms (Strydom et al., 2009): there is no linear link between degree of brain damage and severity of the symptomatology (Arvio & Bjelogrlic‐Laakso, 2021). This discrepancy could be attributed to a difference in Cognitive Reserve (CR, Stern, 2009). However, CR has never been systematically studied specifically in relation to ID. To fill this gap, we aimed to identify potential indicators ("proxies") of CR specifically relevant for people with ID to be included in future instruments. Indeed, activities potentially promoting and enhancing CR in people with ID may not overlap with those considered by the instruments for the general population (see CRIq, Nucci et al., 2012). Method: A Scoping Review was conducted in PubMed and Scopus. N = 1239 potentially relevant papers were identified, 104 papers were assessed for eligibility and 17 studies matched our inclusion criteria. Result: We consider as proxies of CR all lifestyle factors and life experiences proven in past studies to be positively correlated with the cognitive performance or with the everyday functioning of adults with ID, even if not explicitly labeled as proxies of CR. Some proxies found are partly overlapping with the ones used to quantify CR in the general population: Education, Occupation, Leisure and Physical activity. Yet, others are uniquely suitable for the population with ID: Type of schooling, Parental educational level, Environmental stimulation and Living place. Those should be incorporated within the instruments developed and validated in the future to assess the CR of people with ID. Conclusion: This Review is the first step toward the development of the first instrument to measure CR in people with ID. The hope is that it will be integrated among the instruments routine used in the clinical practice and assure people with ID an early and accurate diagnosis of dementia. [ABSTRACT FROM AUTHOR]

Background: Researchers are expected to manage various responsibilities whilst staying up‐to date with developments in their field. This is an arduous and time‐consuming task. In Alzheimer's disease research alone, an average of 350 research articles are appearing every week on PubMed. We present the podcast AMiNDR (A Month in Neurodegenerative Disease Research), as a means of easing the burden on scientists. We offer an accessible channel where one can find all the primary papers sorted by topic in distinct episodes and summarised in an audio friendly format, complete with a bibliography of the papers covered as well as those not featured on the podcast. Methods: We assess the success of this initiative on three levels: 1) We track our listenership and reach through podcast analytics on Simplecast including unique listeners, countries reached, and number of downloads per episode. 2) We evaluate the utility of our podcast based on listener retention, growth through time, and feedback collected through surveys and engagement indicators on social media. 3) We also consider the sustainability of our project through episode output, team growth, and internal interviews with volunteers to assess satisfaction. Results: Since the launch of AMiNDR in June 2020, we have published over 350 episodes with accompanying bibliographies in 40 categories pertaining to Alzheimer's disease research. Our podcast benefited from the contribution of 51 scientists worldwide at various stages of their training and reached over 6500 unique listeners in 91 countries. We present the results of the ongoing assessment of this initiative and measures we took to continue to refine our tool over the past three years, with a list of recommendations for digital knowledge dissemination tools like the AMiNDR podcast. Conclusion: Based on our program evaluation, we find that AMiNDR is garnering a growing listenership worldwide and proving to be useful and accessible to researchers. [ABSTRACT FROM AUTHOR]

Background: National‐health‐registry based data demonstrates Psychosocial support & treatment‐availability are major issues for Alzheimer's ‐sufferers in resource‐poor‐nations. Hence our Non‐Government‐Organisation analysed & made this public health‐policy paper recommendation's. NGO's are close to rural/tribal‐communities. Cost of running NGO is economical than medical‐institution. Medical treatment cost is prohibitive and inaccessible for majority patients in Asia. Government‐Health‐Departments need to workout strategy to increase access to care. In resource‐poor‐setting unaffordable cost leads to poor‐therapeutic‐compliance & therefore high mortality. We developed training program to evolve sound /sustainable Alzheimer's‐care for rural communities Methods: No national‐program for financial help to Alzheimer's patients exists in india. Treatment programs designed towards rural/tribal population needed. Since four years we offer guidance for drug‐therapy‐funding. This project is unique, as we are training NGO health workers to assist patients community in improving access to care. Depending on support given by donors, we provide financial‐assistance for treatment. We improved access to governmental hospitals. Initially we started with two towns & intend to offer our services to 23 villages by 2025. Results: We did face hiccups in mobilising volunteers/resources. Our strategy has minimum maintenance‐cost & high‐acceptability. Forums like AAIC‐2023 conference must support NGO‐activists to form workgroups with AAIC conference‐participants to further develop this concept on larger scale. Conclusion: Economical‐factors/access to therapy changes out‐come of treatment. With little training, few resources our community NGO in rural/tribal India formed well knit volunteers‐group who are giving free part‐time dedicated service. psychosocial‐support improves QOL reducing difficulties faces by resource‐poor‐southern countries. We urge participants to share views/expertise on this burning‐issue at AAIC‐2023‐venue to come out with sustainable policy paper for Asian nations. [ABSTRACT FROM AUTHOR]

Background: It is crucial to identify patients with Alzheimer's disease (AD). To do so, various attempts have been made to develop AI and non‐AI assessments, among which some focus on developing acoustic‐ and linguistic‐based classifiers. They are based on the detection of impairments in their language and speech, which can manifest years before other cognitive impairments associated with AD appear. The fact is that most of the current vocal and language classifiers of AD have been trained using the Pitt corpus, which is an imbalanced class and gender dataset. These two characteristics could be enough to bias such classifiers making them untrustworthy and unsuitable for integration into AD care settings. This paper presents a novel method for collecting vocal data to reduce the impact of potential sources of bias on acoustic and linguistic classifiers for AD. Method: We will use a data collection approach that collects voices from participants (i.e., patients with AD and healthy controls) with diversity in race, gender, educational, socioeconomic, and cultural backgrounds. Participants will be asked to perform diverse language tasks, including word association, verbal fluency, and grammaticality judgment tasks. Following such an approach can ensure we collect oral data that wouldn't be affected by selection, recruitment, sociolinguistics, and gender biases. Results: The main result of this study is the creation of a benchmark vocal dataset from diverse gender and racial groups and ensuring that the data is representative of the population with AD. We expect such data to be used for evaluating and validating and help AI developers to successfully develop fair acoustic and linguistic classifiers of AD. It, in its turn, can motivate healthcare professionals to employ these systems as assistants to identify patients with AD from their voices quickly. Conclusion: The Pitt corpus is a biased data set. Thus, acoustic and linguistic classifiers trained upon it can not be considered trustworthy AI systems. The AI developers that aim to deploy vocal systems into Alzheimer's disease care settings would need unbiased vocal data. This study proposed a method to collect such verbal data. [ABSTRACT FROM AUTHOR]

Background: Palliative care (PC) aims to provide dignified and self‐determined life for dying individuals. While the integration of PC for tumor diseases in health care is established in case of progressive course and unfavorable prognosis, PC is surprisingly not mentioned in the German S3‐guideline for dementia. PC is mainly used by older people, with proximity to death rather than age being the determining factor. However, more people are dying at older ages. Moreover, as the elderly population increases, the number of dementia patients also increases. The aim of this paper is to examine the utilization of PC at the end of life and to explore whether a dementia diagnosis is among the top factors that predict PC utilization. Method: We developed predictive models using discrete survival conditional inference trees (ctrees) and discrete survival conditional inference forests (cforests). We used randomly drawn claims data from a German health insurer from 2014 aged 50+ (N = 250.000), and followed them quarterly until 2019. We analyzed the last eight quarters of life of 13,628 individuals who had died in the observation period and used outpatient (OPC) and inpatient (IPC) PC as outcomes. We included medical history, care measures, medications, comorbidities and patient status (diagnosis of dementia or cancer, combinations of both diagnoses, and diagnosis‐free patients) as possible predictors. Dementia was defined by ICD‐10 codes F00‐F03,F05.1,G23.1,G30,G31.0 and G31.82 and cancer by C00‐C26,C30‐C41,C45‐C58,C60‐C97 and D00‐D09. For evaluation we used concordance‐index (C‐Index) and calibration plots. We identified the most important predictors by using a permutation variable importance approach. Result: The models for OPC and IPC had a discriminatory power of more than 0.7 (C‐Index) on the test data. The calibration plots showed well calibrated ctrees, but the cforests require further tuning (Figure 1). Among the top 20 predictors of OPC were proximity to death as well as cancer and dementia diagnoses, and their combinations. Neither cancer nor dementia diagnoses were important predictors of IPC. Conclusion: We found that a dementia diagnosis has comparably predictive power for OPC as a cancer diagnosis. This issue should be addressed by including appropriate measures in dementia care guidelines. [ABSTRACT FROM AUTHOR]

Background: The relationship between socio‐economic status (SES) and length of life after dementia diagnosis may vary by specific aspects of SES. Education and wealth, two widely used measures of SES, may extend life expectancy via greater efficiency of health investment and better access to care. However, according to the cognitive reserve hypothesis, education protects against dementia pathology and thus when dementia symptoms manifest, individuals with higher education have more advanced atrophy, likely shortening their post‐dementia life expectancy. This paper examined education and wealth disparities in 1) timing of dementia diagnosis, 2) length of life after diagnosis, and 3) use of healthcare after diagnosis as a potential mechanism through which education and wealth differentially influence survival. Method: Data was extracted from the Health and Retirement Study (HRS) linked to Medicare claims. From claims we identified 2,377 individuals with incident dementia diagnosis between 2000 and 2016 and followed them for up to 18 years. Using Cox proportional hazard models, we estimated relationships between education, household wealth, and mortality, adjusting for demographics, comorbidity, function, and cognition at the time of dementia diagnosis. To test whether SES disparities were driven by healthcare utilization, we ran linear regressions on the number of emergency room (ER) visits, inpatient admissions, and office visits after diagnosis with the same set of predictors. Result: Individuals with higher education and wealth exhibited less functional and cognitive impairment at dementia diagnosis. The protective effect of higher education on mortality was absorbed by controlling for wealth. In the fully adjusted model, ranking in the top quartile of wealth was associated with a 17% reduction in mortality risk (HR = 0.83, 95% CI: 0.72‐0.96), relative to the bottom quartile. Wealth was not associated with ER visits, hospitalization, or office visits. Conclusion: More intact function and cognition at incident diagnosis did not confer longer survival for the highly educated. In contrast, the most affluent experienced a lower mortality risk, which was unrelated to healthcare utilization. While more research is warranted to understand pathways, these disparities inform opportunities for achieving health equities among persons living with dementia, by targeting at those with limited financial resources. [ABSTRACT FROM AUTHOR]

Background: NICOLA, the largest public health cohort study of ageing in Northern Ireland, commenced in 2013 with a representative sample of ∼8500 individuals aged 50 years and over living across Northern Ireland. HCAP is a National Institute on Ageing (NIA) funded sub‐study designed to assess prevalence of cognitive impairment and dementia in a sample of 1000 participants aged 65 years and older. A dress rehearsal was carried out prior to the main study to implement the study as per the HCAP study protocol. This, ensured any issues could be identified prior to the main phase and the Standard Operating Procedures (SOP) could be amended accordingly. Method: 14 participant interviews and 14 informant interviews were completed between December 2021 and January 2022. The HCAP dress rehearsal sample was selected from the NICOLA research advisory panel, which included NICOLA participants and individuals from the charity group AgeNI. The study consisted of a face‐to‐face participant interview, comprising nineteen different measures of memory and thinking. During the informant interview a family member or friend was asked about participant's ability to perform daily tasks and their social and cognitive activities. During the HCAP dress rehearsal, fieldwork staff conducted home visits in pairs: one conducting the interview while the other observed. Staff completed feedback forms which provided opportunities to comment on the use of computer software, consent processes and the administration of memory and thinking assessments. Result: Several areas for improvement were highlighted: Pre‐Visit Documentation: Fieldwork staff reflected on the complexities of test administration and the transition between computer and paper assessments. Pre‐visit protocols were revised to include preparation processes. Test Administration: Queries were raised on the logistics of test administration and scoring. These were resolved through contact with the Health and Retirement Study (HRS) team. Study Administration Processes: Additional administration databases were created and SOPs amended to ease the flow of recruitment and home visit bookings. Conclusion: The HCAP dress rehearsal highlighted the importance of pre‐visit preparation and staff training, combined with clear procedures and protocols to allow for the collection of high quality data and enhancement of the study experience for participants and researchers. [ABSTRACT FROM AUTHOR]

Background: Meaning and purpose in life (M&P) represents goal direction and meaning for an individual. Literature has shown associations between higher M&P and better global cognition. However, papers included either predominantly White or Black samples. We aim to replicate these results in a sample with roughly equal Black and White participants and assess racial differences in the association between M&P and markers of brain health (global cognition and amyloid). We hypothesize that higher M&P scores will be associated with better markers of brain health and that the association will be stronger among Black compared to White individuals. Methods: 263 adults aged 50‐89 years (Table 1) from the Pittsburgh Human Connectome Project were included. M&P was measured by the NIH Toolbox questionnaire. Brain health was characterized as general cognitive function by the Montreal Cognitive Assessment (MoCA) and amyloid burden from positron emission tomography with Pittsburgh compound B (PiB) using a global region of interest. Race was self‐reported as either White or Black/African American; individuals of other races (n = 6) were not included in these analyses. The association of M&P with brain outcomes was assessed by linear regression adjusted for years of education, sex, and age. Effect modification by race was assessed with inclusion of an interaction term in the models. Analyses were conducted in the whole sample and then again, in only those considered cognitively normal. Results: There was no association between M&P and either marker of brain health (global amyloid: β = 0.0008, p = 0.52; cognition: β = 0.019, p = 0.28). There was no statistically significant effect modification by race for either outcome (all p for interaction>0.1). When restricting to those considered cognitively normal, results remained the same. Conclusion: In contrast to prior findings, we found no association between M&P and markers of brain health in contrast to other studies. This difference is not likely due to racial composition as we found no differences by race but may be due to differences in measurements used. Further research should explore potential differences in associations based on cognitive domain. [ABSTRACT FROM AUTHOR]

Background: Elective care is defined as care that is planned in advance for those that require a procedure or treatment for an existing condition. Elective surgery aims to improve the physical or psychological quality of life for a patient and may extend the life of an individual. Evidence has shown that surgery in people with dementia (PwD) carry even more risk than those in the general ageing population particularly in terms of post‐operative complications and mortality rates. Whilst thousands of elective surgeries take place every year, it is unclear how many of these are conducted on PwD. This study explores the types and rates of elective surgery in PwD in Northern Ireland and the contributing factors to patient referral for elective surgery. Method: Data was accessed through the Honest Broker Service (NI) and was retrospectively analysed. Dementia was defined in people who received one or more dementia medications (as outlined in the British National Formulary (BNF)) or when dementia was identified as a primary or secondary cause of death. Elective surgeries were identified by elective surgery referrals (Patient Administration System) (dementia cohort: n = 26,780; control: n = 24,056). Result: Overall, significantly less PwD were referred for an elective surgery compared to controls. Within the PwD group those who had higher odds to undergo an elective surgery were male, of younger age, lived in rural areas, did not transition to a care home, and were married instead of single or widowed. PwD were less likely to have an elective surgery if they received antipsychotics, but they were more likely to have a surgery if they received lipid lowering drugs, antihypertensives, hypnotics and anxiolytics, antidepressants, or antiarrhythmics. The most common surgeries from both PwD and controls were surgeries for lens, bladder and skin. Having an elective surgery was associated with lower odds of death for PwD and controls compared to people who did not undergo a surgery. Conclusion: This paper can inform health policy through insight into factors contributing to the rate and types of elective surgery referrals for PwD to ensure PwD are afforded the same care when it comes to elective surgery compared with the general population. [ABSTRACT FROM AUTHOR]

Background: Drug development is a complex, expensive, lengthy, and multifaceted process. Patient recruitment tends to be a considerable and underestimated variable when it comes to planning and implementing a study. More information about evaluating patient sources and resource allocation will allow sites and sponsors to use their resources more effectively and to complete clinical projects earlier. Method: This paper reviews the sourcing of patients and resource utilisation in hours for 6 pivotal Cognitive Disorder studies by gathering all patients contacted in various phases of a project: pre‐screening, screening, and randomization. Result: Sourcing of patients was tracked for pre‐screening, screening and randomisation and are compared in number of calls, resource utilisation (hours), and number of randomized patients A total of 1 726 patients were pre‐screened, which represents 575 hours of resources, the largest proportion of pre‐screened calls, 43%, was generated from internal database of patients resulting in 46% of randomized patients. The second largest proportion of pre‐screened patients originated from newspapers with 18% of contacts that required 13% of resources and resulted in 14% of randomized patients. Additional sources of pre‐screened calls were conferences (8%), canvassing (7%), friends (4%), medical references (3%), memory day (9%), radio (2%) and web site (2%). Conclusion: We report a pre‐screened/screened/randomized ratio of 23:5:1 indicating that pre‐screening is important to secure patient enrolment though largely underestimated and rarely if ever accounted for in budget assessments. Given the current decline in the use of paper media, alternate solutions must be developed to replace this otherwise successful communication tool. More information is required to better characterize each recruitment method and to determine to which extent the randomization ratio is favorable with each initial source of patients. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease is the second most common neurodegenerative disease and affects the lives of people around the world. Approximately 30% to 40% of people with Parkinson's disease also develop cognitive symptoms. Most notably impairments are observed in executive function, visuospatial abilities and memory are observed. An effective alternative to treat these symptoms is cognitive rehabilitation, but there are still too few publications presenting cognitive rehabilitation protocols for this population. The aim of the present study was to develop a rehabilitation protocol focused on cognitive symptoms in people with Parkinson's disease. Methods: A free search was conducted for publications on the topic of cognitive rehabilitation for people with Parkinson's disease and cognitive symptoms. From the reading of these studies, a set of exercises aimed at training executive functions, visuospatial skills and memory was then developed. Result: The elaborated protocol includes nine sessions of 60 minutes each. It should be used by appropriately trained healthcare professionals. The protocol consists of activities using paper and pencil, as essential materials, which means low application costs. The protocol includes activities aimed at training visuospatial skills (Figure 1), memory (Figure 2) and executive functions (working memory, reasoning, mental flexibility, problem solving and planning) (Figure 3) with an increasing level of difficulty. Conclusion: This study presents the formulation and scientific dissemination of a protocol that is easy to use, inexpensive and effective in the rehabilitation of these individuals. References: Aarsland, D., Batzu, L., Halliday, G. M., Geurtsen, G. J., Ballard, C., Ray Chaudhuri, K., & Weintraub, D. (2021). Parkinson disease‐associated cognitive impairment. Nature Reviews. Disease Primers, 7(1), 47. https://doi.org/10.1038/s41572‐021‐00280‐3 Balestrino, R., & Schapira, A. H. V. (2020). Parkinson disease. European Journal of Neurology, 27(1), 27‐42. https://doi.org/10.1111/ene.14108 [ABSTRACT FROM AUTHOR]

Background: Dementia Care Navigators (DCNs) are professionals without clinical training, who provide individualised emotional and practical support to people living with dementia, working alongside clinical services. Navigator services have been implemented widely but the service offered vary without a consistent overview provided. The aim of this narrative systematic review was to describe and compare existing models, and to synthesise evidence regarding their implementation and impacts. Methods: The review was registered on PROSPERO [CRD42021292518]. Three electronic databases were searched and included studies reported on a DCN model, defined as a service in which non‐clinically trained workers provide personalised advice and support to people with dementia and/or carers in the community. Two independent reviewers screened abstracts and titles and read through full papers for inclusion. Risk of bias was assessed using the Standard Quality Assessment QualSyst. Results: We included 13 papers (six studies). All models were US‐based and only varied by integration and training provided. Studies reported different degrees of impact on service utilisation and on symptoms and mental well‐being of people with dementia and their carers, with too little evidence to draw substantial/meaningful conclusions. One study evidenced greater impacts on people with more advanced dementia compared to earlier stages. Conclusions: DCN models have the potential to effectively provide non‐clinical support to people with dementia and carers from the point of diagnosis. Further research from countries other than the USA, focusing on the impact on social care and social support service access and utilisation, and utilising similar stablished outcome measures are required. [ABSTRACT FROM AUTHOR]

Introduction: People living with vascular dementia (VaD) have an altered neuropsychological profile, including visuospatial deficits, decreased attention, altered colour perception and executive function problems. Because of this, they perceive and interpret information differently, thus we cannot assume that they read and absorb information in the same format as cognitively healthy individuals. This paper reviews current infographics available for patients with VaD and the appropriateness of information delivery within these documents. Methods: A literature review identified the ideal features of infographic design that allow people living with VaD to engage with the infographic. Many of these ideal infographic features are not found within existing VaD resources. We developed a rating scale for the construction of future infographics, and infographic examples to ensure optimal accessibility and understanding for people living with VaD. A questionnaire was distributed to dementia clinicians across the UK to validate the scoring system and assess their views on current infographics available. A focus group of people living with dementia and their carers reviewed prototype infographics and fed back to the research team about how best to use infographics in dementia care. Results: The literature review suggested the most important factor that determines ability of an infographic to transfer information to people living with VaD was text formatting. Of 164 clinicians the questionnaire was distributed too, we had 36 respondents (22% response rate) across 9 health care occupations. 35 (97%) believed that infographic material is useful in the memory clinic setting but only 21(58%) use these resources. Care providers felt that the most important feature of infographic design is the use of graphics (56.3%), followed by language (37.5%). The general consensus was that information should be kept simple, concise and complemented by pictures, and patients should be involved in infographic development to incorporate their opinions. Patient groups identified that having infographic information that evolved in complexity as the disease progressed would be best for patients. Conclusion: We have developed a framework for infographic design specifically aimed at those living with VaD. This framework can be used to develop infographics best suited to the altered neuropsychological profile in VaD. [ABSTRACT FROM AUTHOR]

Electronic cognitive assessment tools are essential in screening and managing patients' disease progression in clinical practices. Neurocognitive disorders, particularly mild cognitive impairment (MCI) and Alzheimer's Dementia (AD), can be assessed using the Montreal Cognitive Assessment (MoCA) [1, 2]. A digital version of the MoCA could help reduce the burden on healthcare providers, increase accessibility, and maximize its utility, especially in countries that lack medical staff such as Thailand. This pilot study aimed to establish the concurrent validity between the electronic version of the MoCA‐Thai (eMoCA‐Thai), developed by the authors of this paper, to the original paper‐and‐pencil version (MoCA‐Thai) in adults who are cognitively normal (CN), have MCI, and have AD. 54 adults between the ages of 60 to 90 attending a dementia clinic were administered both the eMoCA‐Thai and the standard MoCA‐Thai one week apart. The primary outcome measures include the total scores and all subscale scores of the two test versions. Correlations and differences between scores were analyzed using concordance correlation coefficients (CCC) and various parametric t‐tests. Results show that there is high correlation for total MoCA scores with a CCC of 0.919 and a mean difference of ‐0.204 (‐6.311, 5.904). All the cognitive subdomain scores had moderate to high CCC of more than 0.4. The differences in average total score (22.81±7.49 for the MoCA‐Thai and 23.02±7.99 for the eMoCA‐Thai) were not statistically significant (p = 0.633), indicating no differences between the MoCA scores of both versions. When comparing total MoCA scores between participant groups, both CN and MCI had acceptable correlations (CCC >0.2) with a mean difference of 0.355 (‐4.720, 5.429) and ‐1.643 (9.001, 5.715), respectively, whilst AD had excellent correlation (CC >0.8) with a mean difference of 0.111 (‐6.496, 6.717). Subdomain scores between participant groups were not statistically significantly different except for Delayed Recall for all participants combined (p<0.05). In conclusion, there is adequate concurrent validity between the MoCA‐Thai and eMoCA‐Thai, making it a useful tool to help improve workflow and increase accessibility. [ABSTRACT FROM AUTHOR]

Introduction: It is well established that older adults with cognitive impairment are more likely to fall. Injurious falls lead to functional decline and higher level of mortality. The Centers for Disease Control and Prevention, USA further concluded 20% falls resulted in serious injuries which were either fractures and/or head injuries. Methodology: This paper aimed to evaluate the relationship between characteristics of fallers with moderate cognitive impairment and osteoporosis. A single center cross sectional study with universal sampling was performed for all patients who attended the transdisciplinary falls clinic in a large tertiary center in Klang Valley from January 2015 till January 2023. Anonymised data was collected from the existing falls database. Subjects with MMSE score 0‐18 were categorised as having moderate‐severe cognitive impairment. Results: During the study period, a total of 185 older adults were assessed with 96 females (51.9%) and 35 (18.9%) with moderate‐severe cognitive impairment. They were all community dwellers. All those with moderate‐severe cognitive impairment had previous history of falls. 91.3% subjects with mild or no cognitive impairment had fallen before. Those who stayed alone (0 out of 21 subjects) were less likely to have moderate‐severe cognitive impairment (p value 0.037). Subjects with moderate‐severe cognitive impairment had lower hip T‐score (mean ‐2.23, SD1.93, p = 0.026), Mechanisms were more likely due to slipping (25.7%, p = 0.03) and less likely because of losing balance (22.9%, p = 0.006). The Berg Balance Scores were numerically higher 42.2 (SD32.3) but did not achieve statistical significance (p = 0.652). These fallers were less likely to fall out of home (11.4%, p = 0.017). 34.3% fallers with moderate‐severe cognitive impairment required assistance to ambulate (p = 0.034). There was no difference for the following parameters: age, gender, ethinicity, multi‐morbidities, polypharmacy, sensory impairment, history of falls, recurrent falls, frequencies of any injuries sustained including fractures or intracranial hemorrhage, admission for falls and presence of osteoporosis. Conclusion: This study suggested that community dwelling older adults with moderate‐severe cognitive impairment had similar falls risk profile comparing to their counterparts. Clinicians should be more vigilant in screening for falls risk in this population and be proactive in managing their bone health. [ABSTRACT FROM AUTHOR]

Background: The Memory Keepers Medical Discovery Team (MK‐MDT) was established in 2016 to address brain health equity for Indigenous and rural populations. Indigenous populations are under‐represented in Alzheimer's disease and related dementias (ADRD) research studies and clinical trials, yet there is a dire need to address ADRD disparities in this population. In this paper we outline our research approach and studies underway at the MK‐MDT that are designed to address the ADRD disparity in Indigenous populations in the US and Canada. We highlight our flagship study "Indigenous Cultural Understandings of Alzheimer's Disease and Dementia – Research and Engagement" (ICARE) as a key foundational ethnographic study necessary to advance the field. Method: The MK‐MDT incorporates a community‐based participatory research (CBPR) approach with two‐eyed seeing. Two‐eyed seeing ensures the inclusion and valuing of Indigenous knowledge throughout the research process. In ICARE, we maintain a consistent focus on ethnographic research with Indigenous communities to ensure deep understanding of how culture and context shape the dementia experience. Interviews, sequential focus groups, participant observation and fieldnotes are used to populate an ethnographic database on the lived experience of dementia in Indigenous populations. We incorporate a diversity perspective by working with multiple Indigenous communities for each study. We invest in community engagement infrastructure such as community advisory committees, elder advisors, community‐based researchers and outreach workers to ensure our methods follow local ethical protocols, is culturally safe, and community controlled. Result: We have successfully initiated NIH‐funded programs of research aimed at reducing dementia disparities. ICARE was launched in 2018 and included 54 interviews and 14 sequential focus group sessions (n = 17) in four diverse Indigenous communities, establishing the first stage of a robust ethnographic database. Findings support the existence of an Indigenous specific understanding of dementia that impacts the dementia care experience. Conclusion: The CBPR approach coupled with two‐eyed seeing has allowed for authentic engagement with multiple Indigenous communities and has supported the collection of ethnographic data that can be used to develop culturally appropriate health promotion materials and interventions. The community‐based infrastructure that has been established is currently supporting multiple projects, including clinical research. [ABSTRACT FROM AUTHOR]

Backgrounds: Although the effectiveness of cognitive training has previously been established, adherence or maintenance to these program is difficult to achieve due to the lack of validated and convenient tools and programs. Furthermore, presenile dementia patients are usually physically no impairment but their welfare systems are overlooked compared to senile patients. The aims of this study are to evaluate the effects of home‐based cognitive training and usefulness of workbook (e.g. regular paper book) and tablet personal computer (e.g. GALAXY pad) focusing on presenile dementia patients. Materials and Methods: We enrolled 48 dementia patients who met the predefined inclusion criteria from two dementia outpatient clinics. Finally, 34 presenile dementia patients (age; 63.03±4.58, 16 men and 18 women, educational attainment; 10.03±4.30 years, CDR sum of box; 3.21±1.97, MMSE; 21.74±5.24, ADAS‐Cog_total; 20.12±8.13, K‐IADL; 0.43±0.36) were randomly assigned to a 12‐week scheduled cognitive training program using either an workbook (W‐group, age; 62.53±4.03, 9 men and 10 women, educational attainment: 10.05±3.05, CDR_SOB; 3.68±2.07, MMSE; 21.42±5.46, ADAS‐Cog_total 20.95±8.49, K‐IADL; 0.50±0.40) or tablet personal computer (T‐group, age; 63.67±5.26, men 7 and women 8, Education; 10.00±5.63, CDR_SOB; 2.60±1.71, MMSE; 22.13±5.11, ADAS‐Cog_tatal; 19.07±7.81, K‐IADL; 0.33±0.29). All patients underwent 1 hour/day for 5 days/week of training with support with their caregiver. During the program, levels of difficulties were adjusted according to rater's measurement at regular visits. Before and after the training program, all patients were tested for MMSE, CDR‐SB, IADL and ADAS‐Cog. Results: On ADAS‐cog tests, patients showed improvement post training (p = 0.021). T‐group showed more improvement in CDR‐SB than W‐group (P = 0.01). In subgroup analyses including subdomain, there were no significant differences between pre and post tests. All patients and caregivers were well‐tolerated for 12 weeks. Conclusion: We suggest that cognitive training using workbook and tablet personal computer is a well‐tolerated and comparable tool for presenile dementia patients and their caregivers. [ABSTRACT FROM AUTHOR]

Background: Dementia Trials Ireland (DTI) is a newly developed national network to increase capacity and capability to deliver clinical trials for dementia in Ireland. DTI activities are informed by a panel of people with lived experience of dementia and their care partners, following principles of 'patient and public involvement and engagement (PPIE). Method: People with lived experience of dementia joined the DTI panel to provide consultation on the design and conduct of industry‐sponsored and investigator‐led clinical trials, providing insight into the lived experience of dementia. Monthly meetings and consultation workshops enable panel members to provide feedback to the DTI trial teams. Result: Thirteen PPI panel members represented lived and care partner experience of FTD, AD, LBD, VaD have informed the following DTI network activities: (1) Advising on appropriate language use for trial Participant Information Sheets; (2) Co‐developing the logo for DTI; (3) Advising on our website and video content; (4) Representing DTI at online conferences and workshops; and (5) Providing researchers and clinicians with feedback on the lay summaries of scientific papers. Conclusion: The panel has made meaningful changes to various outputs and activities of the trials' network, ensuring that the perspectives of people with lived or caregiver experience of dementia are included. [ABSTRACT FROM AUTHOR]

Background: Assessing patients for cognitive impairment is a required element of Medicare's Annual Wellness Visit (AWV). Variability exist in the type of cognitive assessment methods used to assess patients for cognitive impairment during such visits. Paper and pencil tests such as the Mini‐Cog are commonly used in such visits, as they are easy to administer and interpret. Our study aims to assess acceptance of Mini‐Cog use in primary care and conversion of Mini‐Cog from normal to abnormal in the older adults visiting primary care for repeat AWV. Methods: Cleveland Clinic implanted Mini‐Cog as a cognitive screening tool in Primary Care Institute in 2019. Inclusion criteria were Age 65+, AWV, no preexisting diagnosis of dementia, normal Mini‐Cog in previous year. Since this process was established, primary care providers were educated about use of Mini‐Cog by internal continuous quality improvement (CQI) platform. Use of Mini‐Cog in AWV within the Primary Care Institute was registered during the study period from January 2021 ‐ December 2022. The number of repeated tests, the rates of conversion of normal (3‐5) to abnormal (0‐2) and the total proportion of abnormal scores overall were recorded. Results: Total number of Mini‐Cog during the study period was 46094 out of which 2843 (6.2%) were abnormal.16644 were repeat tests and out of these 507 were abnormal suggesting a 3% conversion rate when testing was repeated on previously normal subjects. An upward trend and 1.7 fold increase was observed in the total number of tests on year to year basis (2021 vs 2022). (Figure 1) Conclusion: Currently, variability exists in the type of cognitive assessments methods used during the AWV in primary care. Consistent use of Mini‐Cog combined with CQI over the period of two years have shown to increase usability and acceptance within Primary Care community. As the repeat assessment have increase over period of time; now we have the opportunity to identify a narrow subset of converted patient (3%) who could benefit from urgent comprehensive cognitive assessment to confirm a diagnosis of dementia and can subsequently close examination of the risk factors that could have contributed to measurable cognitive decline. [ABSTRACT FROM AUTHOR]

Background: Primary Care Providers (PCPs) are critical for case finding of Mild Cognitive Impairment to provide management, referrals, and treatments. Conducting cognitive assessments are time consuming and difficult to incorporate into time‐limited visits. The Self‐Administered Gerocognitive Examination (SAGE) is a reliable and valid, pen and paper, cognitive assessment tool easily incorporated into a PCP visit without time required for staff to administer. Accurate scoring by PCP or staff is critical to interpreting the degree of impairments and any changes over time. Methods: Patients over 64 years‐old without a diagnosed cognitive disorder, presented for a non‐acute care visit with their PCP and were given a SAGE test during their appointment. The SAGE was administered as part of the provider's standardized method for screening for cognitive impairment. Detailed scoring instructions were provided to the PCP office before subject enrollment. Differences in SAGE scoring between the PCP office and the Ohio State University Memory Disorders Research Center (MDRC) were evaluated. Paired t test and 95% confidence interval were used to compare the mean SAGE scores. Results: Of the 110 potential recruits, 93 SAGE tests were graded by the PCP office and by MDRC. Scoring discrepancies, the MDRC scored SAGE minus PCP office scored SAGE, ranged from ‐7 points to +3 points with a total of 80% of the SAGE tests resulting in a scoring error by the PCP office; 74% of the total score discrepancies were within ± 2 points. The mean difference was ‐1.49 with a 95% CI (‐1.82, ‐1.17) and p<0.0001 with PCPs scores tending about 1.5 points higher. The largest discrepancies between the scores occurred with the problem‐solving question (40%) and the 3‐D figure question (29%). Conclusions: The PCP office provided an incorrect score (typically higher) 80% of the time which downplays cognitive deficits. When scoring mistakes are made, accuracy is diminished, impacting the interpretation of the test results and perceived changes over time. PCP offices need to emphasize accurate scoring or consider utilizing the digital format of SAGE, called eSAGE or BrainTest® (available at https://braintest.com). It can send HIPPA compliant automatically scored results to the PCP office. [ABSTRACT FROM AUTHOR]

Background: Alzheimer's disease is a universal medical and public health challenge. A timely identification of this ailment can enhance both the standard of care and the patient's quality of life. Alzheimer's diagnosis includes a critical component called cognitive assessment. These examinations have been carried out by neurologists, manually and digitally since the development of clinical neurological tests. But it's obvious that integrating AI technologies into such assessments has many advantages. This research paper describes the implementation of a 3‐Dimensional Embodied Conversational Agent to support Neurologists in conducting cognitive assessments in Alzheimer patients. Method: Twenty‐two questions are included in the assessment. The assessment checks different mental abilities of patients such as time orientation, place orientation, ability to recall things, concentration skills, language skills, ability to follow written and oral instructions, visual interpretation skills, etc. A score is given for each correct answer. A normal score must be higher than 24. A score of 24 or less is typically seen as abnormal and indicative of possible cognitive impairment further subject to detailed analysis of a neurologist as the result may occasionally be impacted by certain physical impairments, language or speech barriers, education level, or cultural differences. The 3D agent was created using software such as Blender, iclone7, Adobe Photoshop, JavaScript, and MIT App Inventor. Text‐to‐speech synthesis algorithms were used to convert the questions to speech. The answers given by the user will be recognized using Natural Language Processing (NLP) algorithms. Correspondingly, a score will be awarded. TinyDB is used for local storage and CloudDB for web storage. Result: The 3D agent receives the speech input, analyzes the input, and provides a vocal response. As per the total score, it will suggest suitable recommendations vocally. Also, an assessment report with the AI impression is generated. Conclusion: The implementation of a 3‐D Embodied Conversational Agent to support Neurologists in conducting cognitive assessment is portrayed in this research. Instead of trying to replace clinicians, Artificial Intelligence aims to help them and make their tasks simpler. [ABSTRACT FROM AUTHOR]

Background: A core outcome set (COS) is a minimum set of health outcomes to be measured for a given condition. COS can be developed for specific populations, interventions, or settings, so several COS may exist for a condition e.g., dementia. Comparison of the outcomes and measurement tools informs which outcomes should be considered by stakeholders when assessing quality of care. Method: COS developed for people living with any type of dementia were identified through the COMET database1 and handsearching references of eligible papers. Data was extracted on COS scope (population, intervention), stakeholders, development methods, and the outcomes and tools recommended within each COS. Recommended outcomes were classified against COMET's taxonomy2 and tools were grouped by outcome across COS. Result: Ten papers outlining 14 COS were identified (Table 1). Nine included people living with dementia, carers or care organisations in the consensus process. Eleven specified use for a disease stage or intervention. Eleven COS were for research use, one for routine care, and two for both settings. 87 outcomes covering a range of domains were recommended (Table 2). Function/Activities of Daily Living, Cognition, Patient behaviour/ neuropsychiatric symptoms, QoL, and Family Carer QoL were all recommended by at least four COS. Eight COS included recommendations of how to measure the outcomes, but tools differed across the COS. Conclusion: Multiple COS for dementia have been identified. Most of these have been developed for research, specific interventions, or stages of dementia. Although the majority involved people with dementia or their carers, further quality assessment is needed. Evaluation of recommended outcomes and quality of COS development is required where multiple COS exist, or COS scope does not directly match the proposed area of application. This information can be used by stakeholders from the intended setting to select or ratify the most pertinent outcomes instead of creating additional COS. 1https://www.comet‐initiative.org/ 2Dodd S et al. A taxonomy has been developed for outcomes in medical research to help improve knowledge discovery. J Clin Epidemiol. 2018;96:84‐92. [ABSTRACT FROM AUTHOR]

Background: Promoting habitual physical activity (HPA; e.g. walking) may help decelerate dependency and disability in people with dementia (PwD). HPA refers to any movement the skeletal muscles make which requires energy expenditure, including daily tasks (e.g. gardening/housework). Research regarding physical activity in PwD mainly focuses on exercise‐based activities, which may not be feasible for people with chronic health conditions or frailty, or who cannot afford or travel to exercise classes. Promoting participation in HPA may be an inclusive, accessible strategy to support PwD to remain physically active and mobile. PwD participate in less HPA than recommended and disease‐specific factors (e.g. cognition) do not sufficiently explain this. In healthy ageing, HPA participation is associated with multiple socio‐ecological factors (e.g. psychosocial wellbeing/social support/environment) but this has not been explored in dementia. The ActivDem study aims to identify key socio‐ecological influences on HPA change over time in community‐dwellers with dementia. Figure 1 presents ActivDem's core objectives. Method: PwD and their carers will be recruited from the ongoing cohort study, DETERMIND, they will participate in a continuous seven‐day HPA assessment. This involves wearing an inertial measurement unit on their lower back at baseline and one‐year follow up. Digital mobility outcomes relating to volume (e.g. steps per day), pattern (e.g. mean ambulatory bout length), and variability (i.e. of bout length) will be derived via validated algorithms. PwD will also complete the LASA Physical Activity Questionnaire and Falls Efficacy Scale. Carers will complete the Dementia Management Strategies Scale. Demographic, clinical and psychosocial characteristics and information on care support will be assessed as part of the DETERMIND study (1). Result: Longitudinal statistical methods will identify key predictors of HPA change in PwD, and examine the relationship between HPA and independence Conclusion: The ActivDem study will identify key socio‐ecological predictors of HPA change, these will inform key interventional components to support PwD to remain physically active and mobile following diagnosis of dementia. References 1. Farina et al., 2020. DETERMinants of quality of life, care and costs, and consequences of INequalities in people with Dementia and their carers (DETERMIND): A protocol paper. Int. J. Geriatr. [ABSTRACT FROM AUTHOR]

Background: There is good evidence that cognition‐oriented treatments (COTs) including cognitive training and rehabilitation benefit older adults, including those with mild cognitive impairment or dementia. Despite this, there remains a research‐to‐practice gap where these interventions are not readily available in clinical practice. This paper will describe the protocol for a pilot/feasibility implementation study of rolling out COTs for people with MCI in the Australian Memory Clinic Network. Method: The Australian Dementia Network (ADNeT) Working Group on Cognitive Interventions is tasked with bridging the evidence‐practice gap in Australian Memory Clinics. We have conducted a scoping review of COT implementation efforts around the world, a multi stakeholder survey to understand needs in gaps, have developed an online clinician‐training toolkit for choosing and delivering interventions, and are conducting an implementation study in 2023 using the RE‐AIM Implementation Framework (Glasgow et al. 2019; www.re‐aim.org), assessing Reach, Efficacy, Adoption, Implementation, and Maintenance of COTs in six participating clinics throughout Australia. Result: Our scoping review identified 29 eligible studies but only four have used formal implementation frameworks. Cognitive stimulation was the most frequent approach in these studies, and only a small proportion investigated cost‐effectiveness and maintenance parameters. The stakeholder survey confirmed that clinicians believe it is very important to offer interventions as part of routine clinical practice, and that more training was required. Progress of our implementation study to date will be described including the clinician training tool. Conclusion: This is the first study in Australia to address the evidence‐practice gap in COT research, and will inform the development of a larger implementation study to continue building the evidence base for the costs and benefits associated with incorporating these evidence‐based approaches in clinical practice. [ABSTRACT FROM AUTHOR]

Background: One in three Medicare beneficiaries dies with dementia. COVID‐19 has disproportionately increased death rates among: persons living with dementia (PLWD), those in nursing homes, and members racially/ethnically minoritized groups. Simultaneously, COVID‐19 led to a mass exodus of nursing home staff, creating a perfect storm for abuse and neglect, especially of those most often historically and systematically disadvantaged. Reports of abuse and neglect in nursing homes, especially among PLWD are not new. But, the primary focus has been residents being abused or neglected. In the present paper we present the implications of abuse and neglect for the family and friends who provide care for PLWD in nursing homes. Method: Together with community partners we explored experiences of dementia‐related bereavement with a 15‐member community advisory board over two years. Our authorship team includes experts in long‐term care, healthcare system administrators, nurses who have worked within healthcare systems, and those with lived experience. Lived experience perspectives come from caregivers who cared for parents and grandparents with dementia, identify with different racial/ethnic groups, are of different ages, and have had between 2 and 12 years since the death of the PLWD they cared for. Result: As one community member stated, "there's all kinds of ways that a facility could potentially kill someone, whether it be through like a willful act or just neglect." We present the experiences of community partners who attribute the deaths of PLWD they cared for to such abuse and neglect and explore the ways that abuse and neglect manifested, potential precipitating events, and how those deaths continue to affect family members years or even decades after a PLWD's death. Conclusion: We explore and share these experiences to amplify the voices of these bereaved dementia caregivers and raise a call for the research and clinical communities to seek ways to aid former caregivers and nursing home staff. Community partners also made clear that interactions between each person with dementia and nursing home staff were exceedingly challenging and that those staff deserve additional support to help them prepare for and cope with those events. [ABSTRACT FROM AUTHOR]