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Considering the adverse outcomes of COVID-19, it is essential to provide adequate support and care for people with dementia and informal carers. Technology can reduce the distress associated with social distancing rules and the decreased access to in-person services. This study aimed to explore the use of technology and its perceived effects across different settings and countries.The sample was composed of 127 informal carers and 15 people with dementia from the UK, Italy, Australia and Poland. Semi-structured interviews explored participants' experiences of using technology and their perceived effects. Transcripts were analysed by researchers in each country using an inductive approach.Three overarching themes were developed: (1) Technology kept us alive during COVID-19; (2) Remote care was anything but easy; (3) Perceived technology limitations. Many similarities emerged between countries supporting the role of technology for being socially engaged, having a routine, and staying active. However, the benefits of technology for health and psychosocial care were more limited. Across countries, barriers to the access and use of technology included lack of digital literacy, dementia severity, and lack of appropriate digital environments. Help and supervision from carers were also necessary and sometimes perceived as an additional burden.Technology can effectively reduce the shrinking world that may be amplified by the pandemic, thus preserving people with dementia's social skills and maintaining family connections. However, for more extensive and well-adapted use of technology in dementia care, actions should be taken to overcome the barriers to the access and use of technology by older and vulnerable people globally.

SARS-CoV-2 stanowi szczególne zagrożenie dla osób w wieku podeszłym oraz z wieloma schorzeniami towarzyszącymi. W przypadku osób żyjących z otępieniem przestrzeganie zaleceń sanitarnych oraz niezbędna fizyczna izolacja mogą mieć daleko idące negatywne konsekwencje związane z ograniczeniem kontynuacji dostosowanej do ich potrzeb opieki, wsparcia oraz leczenia. Zalecenia związane z pandemią SARS-CoV-2 uwzględniać muszą nie tylko medyczne konsekwencje braku dostępu do opieki lekarskiej, lecz również ich długofalowe efekty oraz progresję choroby zgodnie z koncepcją zdrowia społecznego. Potrzebny jest również dopasowany do grupy seniorów, w tym osób z otępieniem, plan postępowania w zakresie psychoedukacji opiekunów nieformalnych. Przedstawione zalecenia, przygotowane pod patronatem PTP, dla osób mieszkających samodzielnie, z rodziną oraz w placówkach opieki długoterminowej mają na celu zwrócenie uwagi na kluczowe kwestie epidemiologiczne możliwe do zaplanowania przez personel medyczny w ramach organizacji opieki nad pacjentem. Równie ważne są jednak potrzeby psychiczne i społeczne pacjentów, których realizacja jest szczególnie istotna w dobie obostrzeń związanych z czynnościami dnia codziennego. Dalsze monitorowanie sytuacji epidemiologicznej oraz doniesień naukowych związanych z pandemią SARS-CoV-2 jest konieczne w celu weryfikacji i aktualizacji wytycznych.

Ocular information was observed during a set of dementia tests involving participants with Alzheimer’s Disease (AD), with a mild level of cognitive impairment (MCI), or in a control group. The number of participants was 26. Features of changes in pupil size and in the central position of both eyes of participants of all three types were compared. There are significant differences in some of the metrics between the types, in earlier test sessions. The possibility of classification was confirmed using the extracted features, and the contributions of some features were examined.

Background: Older people with dementia are particularly at risk of COVID-19, whilst still little is known about the indirect impact of the Pandemic on the lives of those living with and caring for someone with dementia. The aim of this study was to investigate the impact of the Pandemic on the lives of people with dementia and their informal carers in the context of using social and medical services in Poland. Methods: A qualitative thematic analysis of semi-structured interviews with people with dementia (n = 5) and informal carers (n = 21) was performed. Interviews were collected between June and August 2020 via phone after the first wave of COVID-19 in Poland. Data were analysed using NVivo software by four team members. Results: Three overarching themes emerged: (1) Care re-organization; (2) Psychological responses; (3) Emerging needs. The factor underlying all these elements were a reliance on other people. Regardless of the type of support (informal or formal), a sense of presence of others and maintaining mutual contacts displayed as crucial elements influencing the well-being of people with dementia and informal carers. Conclusions: Social support and engagement are vital to the ongoing health and wellbeing of people living with dementia and their informal carers. Services need sustaining to provide ongoing provision to those living with dementia to reach pre-pandemic levels, if not better. Within the post-pandemic environment people with dementia and their informal carers need reassurance that they can rely on external institutional and social support able to meet their need.

Background:Emerging evidence describes impacts of the COVID-19 pandemic upon people living with dementia and their informal carers, however without evidence-based global comparisons to date. The aim of this international study was to explore and compare the impact of COVID-19 and associated public health restrictions on the lives of people living with dementia and informal carers and access to dementia care across five countries.Methods:People with dementia and informal carers from the UK, Australia, Italy, India, and Poland participated in remote semi-structured interviews. Participants were asked about their experiences of the pandemic and how restrictions have impacted on their lives and care. Transcripts were analysed by researchers in each country using thematic analysis, then combined across sites.Results:Fifteen people living with dementia and 111 informal carers participated across the five countries. Four themes emerged: (1) Limited access and support; (2) Technology and issues accessing remote support; (3) Emotional impact; and (4) Decline of cognitive and physical health reported by carers. Whilst variations were noted, the pandemic has indirectly affected people with dementia and carers across all five countries. The pandemic removed access to social support services and thus increased carer burden. Remote services were not always provided and were limited in benefit and usability for those with dementia. Carers frequently described noticeably deteriorating cognitive and physical health in people with dementia.Conclusions:The pandemic has amplified dementia as a global public health problem, and both people affected by the condition ad their carers need support to better access vital support services to live well. This is even more important with emerging new waves and new variants of the virus affecting different countries, in our globally connected world.

Background:Limited access to medical and social services during the coronavirus outbreak has contributed to the exclusion of vulnerable populations, such as people with dementia and older adults. These limitations and the resulting social isolation have highlighted the importance of social relationships and their relationship to the mental health of these people. In the context of dementia, ‘social health’ (SH) can be defined as the role of social abilities for achieving a dynamic balance between opportunities and limitations. The concept encompasses the capacity and independency of an individual to participate in social activities alongside the influences of the surrounding social network.Methods:Using a qualitative and quantitative approach, we will present social health and its determinants of people with dementia related to social care service closures and self-isolation during the SARS-CoV-2 pandemic. We present an analysis of the survey data from the cross-country population- based study and the semi-structured telephone interviews with people with and without dementia from Poland, UK, Australia and Italy aged 65 and over.Results:Measuring the Social Health Index in relation to experiencing self-isolation and changes in the use of services before and during the pandemic among the people with dementia, allow us to identify the level of SH and its determinants. Also, the qualitative results revealed the indirect consequences of the pandemic-related restrictions in the access to social care service and social isolation. Reduction of social support was significantly related to deficits in social health and well-being.Conclusions:Our results highlight the emerging impact of health the current global epidemiological situation upon social health, with a particular focus on those affected by social disadvantage and isolation.

Background:Social distancing rules and the closure of services associated with the COVID-19 pandemic have strongly impacted the physical and mental health of people with dementia. Digital technologies can represent an effective means to compensate for the distress associated with social distancing rules and the decreased use of in-person services. More specifically, technologies such as smartphones, tablets, and smart home systems can minimize the negative effects of social distancing and isolation, and the pressure on health and care systems. Indeed, they can provide a continuity of care and social connectedness, while decreasing exposure to risk. However, barriers such as digital literacy and lower income households can impede the access and use of digital technologies. The aim of this international study was to compare the use of technology by people with dementia from different care settings, and their informal carers across four countries (Italy, UK, Australia, and Poland).Methods:People with dementia and informal carers were invited to participate in semi-structured interviews. Verbatim transcripts were analysed by researchers in each country using inductive thematic analysis.Results:A total of 141 people with dementia and carers (47 in Italy; 50 in the UK; 18 in Australia; 26 in Poland) were interviewed. The analysis identified three overarching themes: 1) different uses of technology (three subthemes); 2) benefits of technology (three subthemes); 3) limitations of technology (three subthemes). Results show that calls, video calls, and group-chats were effectively used across countries to guarantee the continuity of relationships with professionals, families, and small groups of peers. Telemedicine was used with varying levels of satisfaction. Furthermore, the benefits experienced by carers exceeded those for people with dementia. Similar barriers were reported across countries, and were strictly associated with dementia deficits, low level digital literacy, and the need for carer’s supervision.Conclusions:These international findings highlight the importance to maximise the benefits related to the use of technology according to people with dementia’s impairment and care context. Moreover, it should be complementary to in-person care which should be provided, at least to some extent, even during pandemic times.

Introduction Accumulating evidence indicates the effectiveness of cryogenic temperature interventions in rheumatoid arthritis, ankylosing spondylitis, fibromyalgia, multiple sclerosis, and chronic low back pain. The application of whole-body cryotherapy (WBC) in psychiatric aspects of medicine was also noted. Nevertheless, the exact mechanisms explaining the beneficial effect of WBC on mood disorders remain unclear. The study aimed to assess the efficacy of repetitive short exposure to extremely low temperatures (WBC) on mood, quality of life as well as on biochemical measures among people diagnosed with depressive episode undergoing pharmacological treatment. Materials and Methods Prospective randomized, double-blind sham-controlled protocol was used. The study enrolled 92 medically stable adults (aged 20–73 years) with a diagnosis of a depressive episode. The participants were randomly allocated and exposed to 10 whole-body cryotherapy (WBC) sessions (−110°C till −160°C [the experimental group (EG)] or to low, but not cryogenic temperatures −50°C [the control group (CG)]. Thirty participants in the EG and 26 in CG completed the whole study. The primary outcome measures were depressive symptoms evaluated with the Beck Depression Inventory-II (BDI-II) as well as the Hamilton Depression Rating Scale (HAM-D 17). The quality of life, quality of sexual life, acceptance of the disease and self-reported mood, vitality, and sleep quality were assessed as secondary outcome measures. The study was registered at Australian New Zealand Clinical Trials Registry (ACTRN12619001600134). Results The results show evidence for a statistically significant difference in the clinical assessment of depressive symptoms according to HAM-D 17 scale (T4 by group interaction p=0.02), BDI-II (T2 time by group interaction p=0.01), cognitive-affective BDI dimension (T4 by group interaction p=0.00), and somatic BDI dimension (T4 by group interaction p=0.028). Significant improvement was also noticed in life quality (p < 0.05), self-assessed mood (p=0.035), and disease acceptance (p=0.007). There were no statistically significant changes related to sexual satisfaction, self-assessed vitality, and sleep (p > 0.05). Conclusions Whole-body cryotherapy is a useful method to improve standard pharmacological treatment. The WBC intervention reduces mental health deterioration, especially in mood disorders, such as depression, and can be beneficial for well-being and quality of life.

The paper assessed psychological response of LTCF personnel to the SARS-CoV-2 crisis. Results show that access to PPE, safety guidelines and psychological support at workplace may reduce psychological distress.

Background Whole-body cryotherapy (WBC) - a repetitive, short-term exposure to extremely low temperatures – may become an effective early intervention for mild cognitive impairment (MCI). It is a heterogeneous group of symptoms associated with cognitive dysfunction which is estimated to transform into dementia in 50% cases. Study design The prospective randomised double-blind sham-controlled study aimed to determine the efficacy of WBC on cognitive functioning and biological mechanisms. The study was registered with Australian New Zealand Clinical Trials Registry (ACTRN12619001627145). Methods Participants with MCI (n = 62; (20 26) were randomly allocated to cryogenic temperatures (−110 °C till −160 °C) (EG, n = 33) or placebo-controlled group (CG, n = 29). Cognitive functions were measured at baseline (T1), after the 10th WBC session (T2) and after 2 week-break (T3) with DemTect, SLUMS and Test Your Memory (TYM). Secondary outcome measures included quality of life (WHOQoL–BREF), self-reported well-being (VAS) and depressive symptoms (GDS). Whole blood samples (10 ml) were collected at T1 and T2 to evaluate levels of cytokines, neurotrophins, NO and biochemical parameters CRP total cholesterol, prolactin). Results There were significant differences between groups measured at T2 in immediate recall (DemTect) and in orientation (TYM) in favour of WBC group. Improvement in mood was detected in self-reported depressive symptoms level (WHOQoL-26; T2 p = 0.04; VAS mood T2 p = 0.02; T3 p = 0.07). The significant reduction of BDNF level was observed (p Conclusions WBC may increase the performance of cognitive functions. It seems promising to combine WBC with existing behavioural and cognitive trainings in the future studies investigating early interventions methods in MCI.

IntroductionThe high COVID-19 morbidity and mortality are observed among residents in long-term care facilities (LTCF) worldwide. Employees of LTCF, who are facing a critical epidemiological situation endangering the vulnerable residents, are exposed to pandemic’s psychological consequences daily.Objectives The main aim of this study was to assess psychological consequences (somatic symptoms, anxiety and insomnia, social dysfunction, and depression) among LTCF employees exposed to the SARS-CoV-2 pandemic crisis. Moreover, we investigated if factors such as: personal protective equipment (PPE) availability, safety guidelines or access to psychiatric and psychological support at the workplace, correlated with the level of psychological distress experienced by personnel.MethodsA cross-sectional study was conducted among personnel of LTCF in Poland. The survey consisted of the sociodemographic section, the authors’ questionnaire with questions related to COVID-19 exposure, working conditions, access to PPE and mental health services, GHQ Questionnaire-28.Results show that access to PPE (P= .018), to workplace safety guidelines (P= .031), psychological support at workplace (PConclusions The study indicates an evidence that LTCF personnel are susceptible to the development of anxiety, depression, insomnia and social dysfunction during the pandemic crisis. However, these can be modified by: access to PPE, safety guidelines and psychological support. Findings from this study lay a basis for effective interventions aiming to support psychological health within this group.

Introduction: Day care centres (DCC) aim to support older adults living in their own homes by providing a variety of activities to promote the independence of those people and reduce the caregiver&rsquo, s burden. In Poland, there are no standards for providing this form of care. The provided care is delivered by different organisations, and there is a lack of quality control in the majority of places. Regrettably, in Poland, there is a paucity of research on the holistic needs of the elderly attending DCC. Aim of this study: This is the first study which has aimed to identify the Polish day care centres attendees&rsquo, needs to ensure that the increasing number of older people receive the best possible care, and as a part of the quality improvement process for recommendation development of the new day care services model in Poland within the &lsquo, Homely Marina&rsquo, project. Methods and Materials: A representative sample (n = 269) was randomly selected from day care centres attendees (estimated as 10,688) in Poland. An anonymous survey for the assessment of needs was developed by the authors. Results: The respondents assessed the level of provided services as very good or good. Best rated services included meals, supportive and welfare services (occupational therapy, music therapy, art therapy, cognitive training). Almost half of the participants indicated the need for company as the main reason to attend a DCC. This research reveals a lack of support with regard to additional staff: e.g., a nurse. Conclusions: In Poland, the services offered in DCC should focus on social isolation and sense of loneliness prevention, and maintenance of social activity of the elderly. The presented analysis of needs in Polish day care centres suggests a need for changes which may improve the quality of services. There is a great need to find a balance between home-based care and in-patient care, using better integration of available services and strengthening support for informal caregivers. Robust research with a collection of meaningful outcomes is required to ensure that in Poland, the increasing number of older people is enabled to access high-quality day care service provision.

Background: Urinary incontinence (UI) is a serious medical and social problem for about one-third of women in the world population. It is one of the most common chronic diseases of women. Despite significant improvement in the diagnosis and treatment of this illness, women continue to struggle with the stigma associated with incontinence. Research conducted in the last few years shows the importance of social support in respect of the illness. Aim: The purpose of this study was to determine how people perceive the disease and the influence of social support to deal with UI. Materials and Methods: The study involved 200 women in the age range of 34-78 with a diagnosis of incontinence. All women agreed to fill out an anonymous questionnaire, Acceptance of Illness Scale (AIS) and Disease-Related Social Support Scale (DSRSS). The obtained results were subject to statistical analysis. Results: The greater the social support, the lesser the tendencies to judge the condition in terms of harm. Material support among respondents makes it easier for them to distance themselves from UI. Women having a sense of spiritual, emotional, and global support information found it easier to come in terms with UI. Conclusion: There is a relationship between the perception of disease for women, and social support received by women. Awareness of the availability support in disease allows peaceful thinking about a situation as difficult as UI.

BACKGROUND The posterior cingulate region is an area of the earliest pathological changes in amnestic mild cognitive impairment (aMCI). The utility of FDG-PET imaging in dementia is already well established. OBJECTIVES The aim of the study was to compare FDG-PET with advanced MR measurements: MR spectroscopy (MRS), perfusion weighted imaging (PWI), and diffusion tensor imaging (DTI) within the posterior cingulate region in patients with aMCI. METHODS Fifty-five patients diagnosed with aMCI (66.5 y) and 20 age-matched controls (69 y) underwent MR examination including MRS, PWI, and DTI followed by FDG-PET scanning. Values of MRS metabolite ratios (NAA/Cr, Cho/Cr, mI/Cr), PWI cerebral blood volume (rCBV), and DTI fractional anisotropy (FA) were compared to the FDG-PET rates of glucose metabolism. RESULTS Compared to controls, aMCI patients showed significant (p < 0.05) glucose hypometabolism, and lower rCBV and FA values. FDG-PET results correlated significantly with rCBV values. Compared to FDG-PET, PWI showed similar and DTI greater accuracy in distinguishing aMCI from controls. According to FDG-PET findings, two groups of aMCI patients were established: those with lower (PET-positive) and normal (PET-negative) glucose uptake. PET-positive aMCI subjects showed normal MRS findings, lower rCBV and FA values, while PET-negative patients revealed normal MRS and PWI results but significantly lower FA values. CONCLUSIONS Advanced MR techniques such as PWI and particularly DTI may be regarded as competitive techniques to FDG-PET. DTI was the only method to show alterations in aMCI patients with normal FDG-PET, PWI, and MRS findings. DTI seems to be a very sensitive biomarker of early degeneration in aMCI.

The brain of patients with Alzheimer disease (AD) showed the evidence of reduced expression of insulin and neuronal insulin receptors, as compared with those of age-matched controls. This event gradually and certainly leads to a breakdown of the entire insulin-signaling pathway, which manifests insulin resistance. This in turn affects brain metabolism and cognitive functions, which are the bestdocumented abnormalities in AD. These observations led Dr. de la Monte and her colleagues to suggest that AD is actually a neuroendocrine disorder that resembles type 2 diabetes mellitus. The truth would be more complex with understanding the role of low-density lipoprotein receptor-related protein 1, Aβ derived diffusible ligands, and advanced glycation end products. However, now it known as "brain diabetes" and is called type 3 diabetes mellitus (T3DM). This review provides an overview of "brain diabetes" focusing on the reason why the phenomenon is called T3DM.

A number of biological and clinical characteristics typical of late life depression (LLD) have been suggested by recent research findings. The close association of LLD with cognitive impairment is now well documented and evidenced. However, it is still not clear whether it is depression that leads to cognitive decline, and in more severe cases, to dementia. The work presented in this review article suggests that depression and dementia frequently and strongly copresent, even if the causality remains largely opaque.

This study evaluated the damage to the extensive range of white matter tracts in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Thirty-four patients with AD (mean age 71.5 yrs, MMSE 17.6), 23 patients with MCI (mean age 66 yrs, MMSE 27.4) and 15 normal controls (mean age 69 yrs, MMSE 29.8) were enrolled. Diffusion tensor imaging (DTI) was performed in 25 directions on 1.5 T MR scanner. Fractional anisotropy (FA) values were obtained with a small ROI method in several association tracts including posterior cingulum fibers, in commissural tracts (genu and splenium of corpus callosum) and projection tracts (middle cerebellar peduncles and posterior limbs of internal capsules). In MCI significant reductions of FA were found in the inferior longitudinal fascicles, left superior longitudinal fascicle and posterior cingulum fibers compared to normal controls. In AD significantly decreased FA values were detected in the same fascicles as in MCI and additionally in inferior fronto-occipital tracts and commissural tracts. In both AD and MCI the most severe changes were found within posterior cingulum fibers. No abnormalities were detected in projection tracts in both groups. Accuracy of DTI in detecting AD and MCI reached 0.95 and 0.79, respectively. FA measurements strongly correlated with neuropsychological tests. DTI is capable of depicting microstructural changes within white matter fiber tracts in dementia and may aid the differential diagnosis of AD and MCI.

IntroductionCognitive impairment is considered to be a result of oxidative stress and disturbances in inflammatory status. Whole-body cryotherapy (WBC), which is a short exposure to extremely low temperatures, probably regulates the release of cytokines and nitric oxide. The hypothesis is that WBC may be useful in the therapy of mild cognitive impairments (MCI).AimsThe effect of the whole-body cryotherapy (WBC) on cognitive impairments was investigated.ObjectivesIn this study the observation of several biological factors and cognitive functions were conducted to analyse the WBC influence on cognitive deficits.MethodsPeople with MCI participated in 10 WBC sessions divided for experimental group (−110 °C till −160 °C) or control group (−10 °C till −20 °C). The MoCa test (scores 26 and lower) was used for inclusion criteria. Cognitive functions were measured with: TYM, DemTect and SLUMS at baseline and in follow-up. Biological factors (cytokines, BDNF, NO) were also assessed.ResultsIt was shown that memory domains in experimental group improved after WBC sessions. Also modulatory effect on inflammatory mediators in plasma was shown. The results of this study consist of the comparison of experimental and control groups regarding to cognitive functions as well as biological factors.ConclusionsWhole-body cryotherapy may be supposed to improve cognitive functions in MCI patients. The modulatory effect of WBC on immunological response may be considered as one of possible mechanisms of its action. However, there is no confirmation how long the effects resist so further investigations are needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The paper presents the case report of a patient diagnosed with borderline personality disorder, treated with carbamazepine. During the treatment symptoms of the infection of upper respiratory tract appeared, which evolved to allergic symptoms and then to morbilli-like and mumps-like symptoms. The patient was hospitalized due to this disorder for two weeks, in the beginning on an isolation ward and then was diagnosed and treated on a dermatological ward. The diagnosis of the disorder was doubtful due to polymorphic symptoms and their evolution. Detailed course of the disease, diagnostic process and laboratory results were presented in the case report. The authors also attempt to classify these symptoms and to analyse the relationship between the observed symptoms and drugs used during the treatment.

The purpose of the study was to evaluate the usefulness of perfusion CT (pCT) in differentiating Alzheimer's disease (AD) from vascular dementia (VaD) and mixed dementia (MixD). pCT was performed in 41 patients (mean age, 68.3 years): 24 with AD, 8 with VaD, and 9 with MixD. Regional perfusion parameters (rCBF, rCBV, and rMTT) were calculated from 31 ROIs in the grey and white matter of the frontal and temporal lobes, basal ganglia, and internal capsules bilaterally. The obtained data for the subgroups of AD, VaD, and MixD patients were compared statistically. Conclusions On the basis of rCBF and rCBV values, pCT may be a valuable method of distinguishing between AD and VaD but it seems to be of little significance in differentiating MixD from VaD and of no usefulness in distinguishing between AD and MixD.

Introduction Although the original diagnostic criteria for mild cognitive impairment (MCI) highlighted the importance of memory impairment, more recently the MCI classification was expanded to encompass other cognitive domains, allowing the diagnosis of amnestic or non-amnestic MCI. Objective The primary aim of this study was to identify cognitive tests and illustrate a neuropsychological profile of cognitive subtests of persons with amnestic MCI (aMCI) and non-amnestic MCI (naMCI). Material and Methods: The study used a cross-sectional design. The study group consisted of 35 aMCI and 16 naMCI subjects matched for age, sex and years of education. The groups did not differ according to CDR. All subjects underwent a wide range of psychological tests including MMSE, TYM, DemTect, FAS, CDT, IADL and GDS. The following tests were completed to measure episodic memory, working memory, executive functions, perception and language. The analysis of variance (ANOVA) was used to analyze the differences between group means. Results The statistical analysis illustrated that total scores of MMSE, TYM, DemTect and FAS to differentiate the aMCI from naMCI subjects. Compared to naMCI, aMCI subjects scored lower in MMSE (p=0.0104) and in DemTect (p=0.0002) while they had higher scores in TYM (p=0.0067) and FAS (p=0.0427). Conclusions This study shows that cognitive screening tests provide valuable information regarding the differential diagnosis of aMCI versus naMCI. MMSE and DemTect may be seen as superior screening tests in aMCI, while TYM and FAS in naMCI subjects.

Background The aim of the study was to search for correlations between the results of psychological tests and FDG-PET as well as spectroscopic metabolites from the posterior cingulate gyrus (PCG) in patients with amnestic (aMCI) and non-amnestic MCI (naMCI). Material and Methods The study group consisted of 35 aMCI, 16 naMCI and 20 control subjects matched for age, sex and years of education. All subjects underwent a wide range of psychological tests including MMSE, CDR, TYM, DEMTEC, CDR, FAS, IADL and GDS as well neuroimaging brain studies including FDG-PET with the evaluation of glucose metabolism and magnetic resonance spectroscopy (MRS) with the evaluation of several metabolites such as NAA (neuronal marker), choline (marker of myelin turnover) and myoinositol (marker of gliosis). The results of FDG-PET and the levels of MRS metabolites obtained from PCG were compared between the subject groups and then correlated with the scores of psychological tests using Pearson’s coefficient. Results Compared to CG, both aMCI and naMCI subjects showed significantly lower levels of glucose metabolism and NAA within PCG. In the aMCI subgroup the results of FDG-PET studies revealed significant negative correlations with the scores of TYM (p=0.17, r= -0.48) while in the naMCI subgroup lower levels of NAA correlated with lower scores in DEMTEC. Conclusions In both aMCI and naMCI metabolic changes within PCG such as glucose hipometabolism and decreased neuronal activity correlate with the results of single psychological test.

The development of science allows us to take up new investigative challenges. Interpretations of results can be difficult if there is no adequate and complete information about investigative methods applied, course of trial and statistical analyses. The CONSORT group proposed a standardized diagram facilitating an accurate presentation of the randomised trial. The EDEN study is an example of the application of this method, where the studied groups, number of participants, and all procedures can be presented. It is helpful to prepare reports and find necessary data. The first part of the diagram describes the course of recruitment, the second part presents data necessary to estimate the course of the study and data about numbers of patients in each timepoint whilst the third part shows the assessment of caregivers.The analysis of the course and correctness of the study is legible if the flow diagram is used. It is useful to find the necessary data for statistical analyses at every stage of study. Permanent control of the study allow to avoid bias upsetting the course of the study and influencing its quality. It introduces comprehensible and straight forward presentation of the results.

The survey was aimed at describing the characteristics and therapeutic means offered and the organizational structure of Polish day hospitals for adults as well the as characteristics of patients treated there. It was part of a wider international project carried out within a 5 EC Framework Program and focused on evaluation of costs and effectiveness of day hospital treatment when set against conventional stationary treatment in different European health care systems.Data concerning the year 2000 were gathered using a self-designed questionnaire sent to respondents by post. The response ratio reached 65.2%.Based on the cluster analysis, three main types of day hospitals were recognized: 1. day hospitals focused on rehabilitation of chronic mental disturbances, improvement of social functioning and support, 2. day hospitals being alternative to stationary inpatient treatment, 3. day hospitals intended to continue out-patient treatment and psychotherapy. The number of treatment places, working hours and work-days in a week in polled institutions was constant. Most frequent reasons for not admitting a patient to a day hospital were: intensive suicidal tendencies and acute psychotic decompensation. The most numerous diagnostic groups of patients treated there were schizophrenia (32.2%) and affective disorder (17.4%). Only 18.6% of day hospitals employed a qualified psychotherapist, and 32.6% had a social worker. On the average, one treatment place was offered to 5 patients during a year.The profile of patients admitted to Polish day hospitals for adults is not arbitrarily defined with respect to diagnosis and severity of disorder. However, it is possible to distinguish day hospitals, which have their preferences: more to rehabilitate or more to treat patients. In the last 16 years there was a threefold increase of the number of patients treated in day hospitals due to affective disturbances.

An increase of interest of cost-effectiveness begins from 1999 when act about general insurance was in force. The same situation was observed a few years ago in Europe. It was the reason why created and standardized questionnaire: European Service of Mapping Schedule--(ESMS)--for describing mental health system, European Socio--Demographic Schedule--(ESDS)--for presentation sociodemographic situation, The International Classification of Mental Health Care--(ICMHC)--questionnaire used to assess therapeutic process and Client Service Receipt Inventory--(CSRI)--for estimate cost-effectiveness. These questionnaires are used in clinical trial "European of Day Hospital Evaluation" conduct in Wrocław.

There is many changes in psychiatric service last years. In deinstitutionalization process arising new diversified and wide integrated psychiatric services. Traditional names lose significance for example: open or stationary care. Moreover the same names, have different meaning in different centers or countries. Because of that processes in year 1997 EPCAT group with funding from European Commission Biomed grant developed ESMS instrument by Sonia Johnson and Robert Kuhlmann, to modern description and classification of psychiatric services. Instrument is based on standardizing classification accessible services, with different care models in Europe. In this work authors presented structure of questionnaire and typical applications in catchment areas. That compatible with European standards of psychiatric service instrument, portray gaps in old standards system and indicate developmental trends new psychiatric health service in medical care. Instrument ESMS indicates another possibilities in service study area for example analysis and comparison individual service components and helps in planning local development of psychiatric care services.

We changed our postgraduate training system from 1999, but from 2001in addition to previous statements there existed only one degree of specialization. The hole system became comparable to Western Europe. It was included - psychotherapy, day hospital, forensic psychiatry and other additional forms of treatment." We need to create the net of hospital with the best specialist and all forms of psychiatric care." It is still problem to coordinate all practices with the free places in accredited hospital." The supervision in psychotherapy should be provided by qualified therapist and should be performed at the training institution during the working hours and be founded by the institution." It should increase the salary." It could be improve the connections between young psychiatrist from different country to can learn more about the diversity and richness of the current training of psychiatrist throughout Europe.

Introduction DemTect is a short screening scale designed to differentiate between mild cognitive impairments and dementia patients, first developed und published in 2000 in Germany. DemTect provides cutoff scores for dementia and for mild cognitive impairments. Cognitive performance is adequate for age. Objective To evaluate the diagnostic utility in Polish clinical practice a cross-sectional study was undertaken. Methods The analysis was conducted on data from 224 patients diagnosed as patients with AD (n=109), MCI (n=85) and healthy controls (n=30). Subjects ranged in age from 55 to 94 with a mean age of 71,42 ± 9,86 (SD). All patients underwent detailed neuropsychological and psychiatric examinations including TK, MRI. The diagnostic utility of DemTect was compared with MMSE. All patients underwent the DemTect, MMSE, CDT, FAS, CDR conducted by a trained psychometrist. Results 1. The average of total DemTect score was 16.93 (SD+/−1,68) in HC, 13.40 (SD+/−2,52) in MCI patients and 6.10 (SD+/− 3,04) in AD patients. 2. There was a significant difference in DemTect performance between the AD and MCI (p Conclusion The Polish version of DemTect scale is a useful screening test in clinical practice patients with dementia and MCI. It may be seen as superior cognitive instrument tool in day-to-day practice as it achieves more accurate differentiation between AD and HC as well between MCI and HC compared to MMSE.

Introduction The aging of the world population implies challenges in the area of diagnosis in geriatric psychiatry. Objectives The Test Your Memory (TYM) is a short cognitive instrument designed for the detection of Alzheimer’s disease (AD). Its diagnostic utility for application in Polish clinical practice was evaluated in the study. Aims The Polish version of TYM as a screening instrument in AD and MCI patients versus healthy control subjects were evaluated. Methods In this study 66 patients with probable AD (mean age 74,4 ± 9,1), 71 patients with MCI (mean age 66,3 ± 10) and 94 healthy controls (mean age 71,6 ± 8,3) were assessed. The Polish version of TYM was used after receiving permission from the author and conducting translation and validation process. Results The average total TYM score were 45.4 in healthy controls, 41.1 in MCI patients and 23.4 in AD patients. The statistical analysis illustrated that TYM differentiate the AD patients from MCI patients, as well as from healthy control group. Nevertheless, it was found that the tool was not useful in conducting the differential diagnosis between MCI patients and healthy controls. Post hoc testing showed significant impairment in performance for participants aged ≥ 75 and educated in primary level between those educated in secondary and higher level. Conclusions The Polish version of the TYM is a useful instrument and is seen as a superior screening test in clinical practice. However the age and the level of education of respondents should be considered as important factors affecting the interpretation of the final score.