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PO6. Post-diagnostic support

Detailed programme and abstracts

PO6.1. Exercise intervention in institutionalized older adults with Alzheimer disease to manage behavioural and psychological symptoms: Effects on caregivers’ distress

SAMPAIO Arnaldina1, MARQUES-ALEIXO Inês1, SEABRA André1, MOTA Jorge1, MARQUES Elisa2, CARVALHO Joana1

1CIAFEL, Porto, Portugal, 2ISMAI, Porto, Portugal

High prevalence of behavioural and psychological symptoms (BPS) in older adults with Alzheimer's disease (AD) can be determinant for formal caregivers’ psychological distress and burden. Developing safe and effective strategies focus on the management of BPS are essential in nursing homes. These strategies can be beneficial for institutionalized older adults with AD, but also important to minimize formal caregiver distress caused by related BPS of this population.

The aim of this study was to analyse the caregivers’ distress caused by BPS of institutionalized older adults with mild to moderate AD after an exercise intervention with the carers.

The EG participated in a 6-month supervised multicomponent exercise program (including aerobic, muscular resistance and strength training and exercises of flexibility) with 50 minutes/session, twice a week, while participants in the CG maintained their regular daily activities during the same period. The caregivers reported their distress related to behavioural and psychological symptoms (NPI) in AD before (M1) and after 6 months of training (M2).

No significant group differences were found at the baseline of the NPI distress variables. A two-way (group and time) factorial ANOVA, with repeated measurements for one factor (time), indicated a significant time effect in hallucinations caregiver distress variable and revealed significant group and time interactions on delusions, apathy/indifference, appetite/eating disturbances, and NPI total score variables. Accordingly, a different response in each group was evident over time for those variables, supported by a significant increased of caregivers distress in delusions, appetite/eating disturbances and NPI total score variables over time (M1vsM2) in CG, whereas a significant decrease of caregivers distress was observed in the same variables from M1 to M2 in EG. 

These results allowed us to verify that multicomponent exercise interventions can be a useful strategy in the management of caregiver distress related to BPS of this population.

Funding reference (CIAFELUID/DTP/00617/2019; B&B - POCI-01-0145-FEDER-031808)

PO6.2. Community based centres for supporting hedonic and eudaimonic well-being of people living with dementia and their care partners

MARINI Zeudi1, PRADELLI Samantha1, BOSELLI Barbara1, BUSA Francesca1, LORICO Fabio1, MARINANGELI Luigi1, MOSELE Marco1, PARISE Giordano1, PERLI Cristina1, SALVAGNIN Daniela1, STEFANI Nilla1, A.M.A.d.2

1AULSS 7 Pedemontana, Bassano del Grappa, Italy, 2Associazione Malattia di Alzheimer e Altre demenze, Bassano del Grappa, Italy

Introduction:At an international level, “living well with dementia” is recognized as a priority (Cook, 2008). For the Italian Dementia Plan, the appropriateness of the interventions and the continuity of care are essential objectives. To promote post-diagnostic support focused on well-being, the local Alzheimer’s Associations (A.M.A.d.), the Local Health System (AULSS 7 Pedemontana) and the Municipalities, thanks to funds provided by Veneto Region, implemented 6 free-of-charge Community Based Centres (CBCs) for PLWD and their care partners on the ideas of Meeting Centres and Cogs Club.

The primary aim of these Centres is to support the hedonic (Diener, 1984) and eudaimonic well-being (Ryan & Deci, 2001) and to allow PLWD and their care partners to “live well with dementia”. 

Materials and methods:A total of 6 CBCs for 75 PLWD and their corresponding care partners were established in 6 different municipalities over 4 years. Satisfaction surveys and focus groups with participants on the domains of eudaimonic and hedonic well-being were conducted.

Results:It emerged that well-being of PLWD and their care partners is supported particularly in the domains of:Hedonic Wellbeing,Connections (positive relations),Scope/meaning, Self-acceptance

Conclusions: Focusing on domains of eudaimonic and hedonic well-being, CBCs can promote a more positive view of PLWD and their care partners, fighting fear, isolation, lack of meaning, and ultimately stigma.

CBCs also help to connect Volunteer sector and the Community with social and health services creating a support network from the diagnosis till the moderate stages of dementia.

In addition, since these CBCs are free-of-charge, they have the potential to reach the most disadvantaged people in the Community.

As future objectives, our group is validating hedonic and eudaimonic outcome measures to quantitatively assess the efficacy of these CBCs.

PO6.3. Codesigning dementia diagnosis and post-diagnostic care (COGNISANCE)

BRODATY Henry1, LOW Lee-Fay2, SWAFFER Kate3

1Centre for Healthy Brain Ageing, UNSW, Sydney, Australia, 2University of Sydney, Sydney, Australia, 3Dementia Alliance International, Adelaide, Australia

Despite many national guidelines for diagnosis and management of dementia, persons diagnosed with dementia and their family carer partners are often dissatisfied with the diagnostic process and receive limited post-diagnostic support.

Our aims are to co-design and deliver in partnership with people with dementia, family care partners and health care professionals, toolkits and campaigns to improve the dementia diagnostic process and post-diagnostic support in Australia, Canada, the Netherlands, the UK and Poland; and to evaluate the campaigns.

Work packages will: (1) explore through surveys and focus groups current experiences, barriers and facilitators to dementia diagnosis and post-diagnosis support from the perspectives of persons with dementia, care partners and health care professionals; (2) develop internationally-applicable toolkits supporting guideline implementation for the at-risk public and health care professionals; (3) devise and deliver campaigns to produce behavioural change using the aforementioned toolkits in selected regions; (4) evaluate the campaigns using the RE-AIM framework including measuring impact on the diagnosis, post-diagnosis experiences, and practitioner attitudes and behavior; (5) develop an implementation playbook outlining how to deliver similar campaigns in other countries

CO-desiGning demeNtia dIagnoSis ANd post-diagnostic CarE (COGNISANCE) will provide a new internationally adaptable set of recommendations, toolkits for persons with dementia, care partners and health care practitioners on how to make the diagnostic process and post-diagnostic care as positive an experience as possible, and a playbook to assist other countries with implementing their own change campaigns.

Funding has been received by partners’ countries national organisations through the JPND.

PO6.5. Evaluation of a service of optimization of pharmacotherapy in a specialized care centre for people with Alzheimer´s disease

MIGUENS Vanesa1, FORNOS PEREZ Jose Antonio2, FERNANDEZ CORDEIRO Marta3, GARCÍA RODRIGUEZ Patricia3, TENORIO SALGUEIRA Lorena3, MERA GALLEGO Ines3, ANDRES RODRIGUEZ Floro3, RODRIGUEZ BERNARDEZ Juan Carlos4

1AFAGA, Vigo, Spain, 2Universidad de Santiago de Compostela, Vigo, Spain, 3Farmacia, Vigo, Spain, 4Director Alzhéimer, Vigo, Spain

Introduction: Interdisciplinary collaboration plays a key role in optimising pharmacotherapy in users of a centre specialising in Alzheimer's disease and other neurodegenerative dementias in which medication can be one of the causes of the increase in falls and fractures, which leads to a great deterioration in people's quality of life and a high health cost.

Objectives: Optimising pharmacotherapy in users with a high risk of falling from a centre specialising in Alzheimer's disease. Specific objectives:

  • Integral evaluation of the patient
  • Detection and resolution of DRP/NOM
  • Medication review according to STOPP/START criteria
  • Medication reconciliation
  • Evaluation and improvement of adherence with Personalized Medication Dispensing Systems (MDS)
  • Evaluating the relationship between pharmacotherapy and fragility in the elderly.

Methodology: Prospective observational study developed in a specialized care centre for people with Alzheimer´s disease in 2019, by a team of pharmacists and physiotherapists, with emphasis on: polymedicated; patients with previous falls and/or non-compliant; those who use narrow therapeutic index drugs or high-risk drugs: anticoagulants, antiplatelets, NSAIDs, etc.

All the requirements of confidentiality and data protection, as established by law, were scrupulously complied with.

Variables:

  • Age, sex, studies
  • Diseases (number and type)
  • Sensory and motor deficits
  • Funded drugs: prescribed (number and type)
  • Scoring of the questionnaire on knowledge of the use of medicines according to the FORO´s protocol
  • Number of DRPs /NOMs and types
  • Pharmaceutical interventions (Number and type).

Procedure:

  • Phase 1: Review of medical records
  • Phase 2: Clinical interviews with patients and/or caregivers
  • Verification of personal data
  • Concerns and health problems
  • Review of medicines
  • Improving medication knowledge/compliance
  • Providing information and/or Health Education
  • Offering Personalized Medication Dispensing Systems (MDS)
  • Medical referral.

Evaluation of the study:

  • Process and outcome indicators.

 

 
 

Last Updated: Thursday 26 September 2019

 

 
  • Acknowledgements

    The 29th AE Conference in The Hague received funding under an operating grant from the European Union’s Health Programme (2014-2020). Alzheimer Europe and Alzheimer Nederlands gratefully acknowledge the support of all conference sponsors.
  • European Union
  • Roche
 
 

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