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Background: Mobility‐related ambulatory activity (e.g., walking) is essential to healthy cognitive and functional ageing. Wearable technology (e.g., accelerometers/inertial measurement units; IMUs) allows us to objectively and continuously capture digital mobility outcomes (DMOs), e.g. volume, pattern and variability of walking activities. Continuous digital mobility assessment has been shown as feasible and acceptable to older adults with and without dementia. However, interpretation of DMOs is limited as we do not yet understand the impact of different social and environmental contexts on walking activity. For example, DMOs may be influenced by the volume of walking that one's partner participates in, or by the walkability of their local area. Understanding the impact of social and environmental contexts on DMOs will support development of socio‐ecological strategies to support mobility in ageing. We aim to conduct a feasibility study in older adults with the following objectives: (1). Objectively assess DMOs in older adult dyads using digital mobility tools (i.e., IMUs/GPS); (2). Identify key social and environmental influences on DMOs through mixed‐methods exploration; (3). Develop a novel analytical approach combining DMOs with GPS data to assess independence/interdependence in dyads' walking activities. Method: We will recruit 20 older adult dyads in North‐East England for an observational cross‐sectional study. Walking activities will be recorded continuously for seven days using an IMU attached to participants' lower backs. DMOs include volume (e.g., daily steps), pattern (e.g. mean bout length) and variability (of bout length) of walking activities. Simultaneously, participants will carry a GPS device (i.e., smartphone) to monitor excursions outside the home. Questionnaires will capture information on cognition, function, falls risk, exercise motivation, wellbeing, relationship mutuality, spatial navigation, and walkability of local area. Participants will complete a "mobility diary" for the assessment period (e.g., daily journeys, motivations/perceptions/familiarity of journeys). Result: Preliminary results will be presented regarding associations between social/environmental contexts with DMOs via flexible Bayesian statistical models and thematic qualitative analysis. Conclusion: This study will assess the feasibility of the protocol and analysis strategies, with intentions of developing further research to examine the impact of social and environmental influences on DMOs in people with dementia and their carers. [ABSTRACT FROM AUTHOR]

Background: Primary health care providers face the challenge of making timely dementia diagnosis due to limited time available to interact with patients resulting in stigma, neglect and abuse. With training, these providers can collaborate with Community Health Workers (CHWs) to improve dementia detection and articulate the needs of communities whilst mobilizing resources that are salient in decision‐making, care coordination and service delivery processes. In this study, we outline the process that led to integration of a Community Level Dementia Screening Program in Rural Kenya (DEM‐SKY). Method: As part of the Strengthening Responses to Dementia in Developing Countries (STRiDE) project, ten CHWs were trained to deliver a dementia anti‐stigma intervention to 59 members of the general public in rural Kenya, through four bi‐weekly psycho‐education sessions. This led to increased number of people turning up for dementia screening at a county referral hospital. However, due to lack of knowledge and busy waiting lines at the hospital, discussions on how to integrate dementia screening within the hospital began. Result: Findings from the STRiDE project formed the basis of integrating a community‐level dementia screening programme in Makueni County Referral Hospital in Kenya, a program that has seen more than 600 adults aged 60 and above screened for dementia by CHWs in a period of one month. Through partnership and collaboration with the hospital, a recording and reporting system for people living with dementia was established to provide an indication of the number of dementia cases and individuals referred from the community. This was made possible through: (i) training formal and informal providers on importance of dementia screening, (ii) continued awareness in communities to change existing negative dementia perceptions and (iii) motivating CHWs through project visibility materials and recognizing them in community events. Conclusion: Public awareness and stigma reduction using CHWs can be a precursor to strengthening health care systems through routine dementia screening for older people in community settings. This integration process also requires using task‐sharing approaches in order to promote timely detection and improve care coordination at all levels of care, thus forming a basis for formulation, implementation of policy and service planning. [ABSTRACT FROM AUTHOR]

Background: Sub‐Saharan African countries have the fastest growing rates of older people, yet little is known about the number of cases of dementia. In Kenya, the little we know about dementia is derived from studies involving the few individuals who receive a diagnosis, but typically in the more advanced stages of the condition when carers have reached a crisis point. Effective and routine data screening is important for the early detection of dementia, but also provides insights into the number of people living with cognitive and functional impairment associated with dementia. We aimed to describe the number of people screening positive for dementia within rural Kenya, and identify factors associated with screening positive. Method: Community Health Workers conducted an opportunistic household survey among community‐dwelling residents aged 60 and above in rural Kenya. The brief Community Screening Instrument for Dementia (CSID), which allows for potential cases of dementia to be identified without the need for specialist tools or intensive training was used to identify number of people living with dementia and socio‐demographic information collected. This is an interim analysis of the data. Result: 672 older adults (M = 71.0 years old; SD = 8.96) were screened for dementia. Participants were predominantly Kamba (n = 664, 98.8%) and from Makueni county (n = 617, 91.8%). 209 people screened positive for dementia (31.1% (95%CIs 27.6 to 34.8). Males (OR = 0.67, 95%CIs 0.52 to 0.87) and people who were literate (OR = 0.51, 95%CIs 0.41 to 0.64) were less likely to screen positive for dementia. Screening positive for dementia was also associated with old age, with the oldest age group (90 years+) being 3.7 times more likely to screen positive for dementia than the youngest group (60‐64 years) (OR = 3.67, 95%CIs 2.54 to 5.37). Conclusion: These findings form the first‐ever dementia screening programme in rural Kenya and highlight the numbers of people living with cognitive and functional impairment, potentially indicating dementia. Although such cases need to be clinically confirmed, these data can support the planning, policy development and inclusion of dementia care within policy discussions. [ABSTRACT FROM AUTHOR]

Background: Within Kenya, dementia is commonly under‐recognised and under‐diagnosed. As a result, many people living with dementia do so without any formal support. The DEM‐SKY project seeks to address this gap by implementing a dementia screening program in Kenya using Community Health Volunteers. The aim of this study is to understand some of the consequences of living with cognitive and functional impairment. Methods: Older adults (aged 60 years and older) were opportunistically screened for dementia using the Brief Community Screening Instrument for Dementia (CSID) within Makueni County, Kenya. Secondary outcomes included Quality of life (EUROHIS‐8) and loneliness (UCLA). Regression models were created to understand how quality of life and loneliness outcomes differ between those who screen positive and negative for dementia. Results: Of the 672 older adults screened, 31.1% (n = 209) screened positive for dementia. People who screen positive for dementia reported to have poorer quality of life (p = 0.01) and were also lonelier (p = 0.03) than those who screened negative. Quality of life (b = ‐0.93, 95%CIs = ‐1.83 to ‐0.02; p = 0.04) and loneliness (b = 0.34, 95%CIs = 0.03 to 0.65; p = 0.03) outcomes remained statistically significant after controlling for age, sex, ethnicity, geographic location, and social status. Conclusion: The findings indicate that people who experience cognitive and functional impairment (indicative of dementia) in Kenya are more likely to be lonely and have poorer quality of life. Further research is needed to understand the underlying mechanisms within a Kenyan context, but our findings are indicative that even without a diagnosis the impact of dementia can be felt by people living with it. [ABSTRACT FROM AUTHOR]

Background: Dementia related stigma is a key barrier to people living well with dementia. The global action plan on the public health response to dementia outlines the need to tackle the stigma towards dementia among the general population (WHO, 2017). Adolescents represent an under researched group among the general population but may already have experience of dementia and will become future carers or healthcare workers. Adolescents are ideal targets for anti‐stigma initiatives since the adolescence period has a key role in attitude formation. Understanding the factors involved in dementia attitude formation is useful when developing anti‐stigma initiatives. This study aims to identify predictors of dementia attitudes in adolescents. Method: This is a cross‐sectional study using secondary data analysis. 470 participants aged 12‐15 years old from secondary schools in the Southeast of England, United Kingdom completed validated questionnaires relating to dementia attitudes (KIDS and Brief A‐ADS) as well as demographic information. A path analysis via a structural equation model was used to test for direct and mediatory effects between dementia attitudes, contact, career interest, empathy and sex. Result: The overall fit of the model was very good, χ2(16) = 16.913, p =.15, CFI =.99, GFI =.99, AGFI =.97, TLI =.98, RMSEA =.03, Pclose =.82. There was a significant direct effect observed between the following paths; sex to dementia attitudes (p =.001), attitudes to willingness to work with people with dementia, (p < 0.001), empathy to dementia attitudes (p =.01), contact to empathy (p =.01), and empathy to contact (p < 0.001). Within the final structural equation model, empathy was a key mediator between contact and dementia attitudes. Conclusion: This study highlights the pivotal role that contact with dementia can have in influencing dementia attitudes in adolescents with empathy a key mediator between contact and dementia attitudes. The translational significance of this work is that it provides organizations with the knowledge needed to create effective policy and interventions. Interventions that use contact should consider stimulating empathetic responses to shape dementia attitudes. [ABSTRACT FROM AUTHOR]

Background: The suspension of memory services during the COVID‐19 pandemic delayed dementia diagnosis and access to early intervention. Some services responded to the challenge by developing a remote memory assessment pathway to comply with reduced social contact measures to protect vulnerable patients. The aim of the study was to establish whether remote model is considered a satisfactory experience within the context of the COVID‐19 pandemic and to understand the factors associated with patient and carer satisfaction of remote pathway. Method: 73 participants recruited from patients referred to memory clinic in West Sussex, who were assessed over a video or telephone. Participants completed an 11‐item questionnaire capturing satisfaction across a range of elements, contextual items (the impact of the pandemic, loneliness, previous experience of using teleconference technology and diagnosis), as well as 3 dimensions from Patient Experience Questionnaire. Descriptive statistics are reported at a whole sample level, separated by patient and carer status. A hypothesis driven set of bivariate analyses (Spearman's rank) was used to understand the association between overall satisfaction and key independent factors across the whole sample. Results: 73 participants were typically older adults (M=68.5, SD=13.3) and female (n=40, 54.8%). The patient was more likely to be older, feel lonely within the past week and to have used video call software when compared to the carer (p> 0.05). Participants were generally satisfied with the remote pathway with 95.8% (n=69) agreeing or strongly agreeing with the statement "Overall, I was satisfied with the assessment". Patients and carers did not significantly differ on any satisfaction response, apart from the ease of use of technology, in which carers were more likely to find the technology easy to use (U= 432.5; p=0.01). Worry about contracting COVID and communication experience was positively associated with overall satisfaction, whilst perceived communication barriers were significantly negatively associated with overall satisfaction. Conclusions: Remote memory assessment was a positive and satisfactory experience for most patient and carers. The remote pathway should be considered as an option available during and beyond the pandemic to improve access and patient choice of assessment modality. [ABSTRACT FROM AUTHOR]