ORAL PRESENTATION ABSTRACTS NO CONTENT ONS1 AUTHOR(S) O MIYUKI - - PDF document

21ST ASIA PACIFIC REGIONAL CONFERENCE OF ALZHEIMER’S DISEASE INTERNATIONAL

ORAL PRESENTATION ABSTRACTS

NO CONTENT ONS1 AUTHOR(S) O MIYUKI Hakodate University, Japan TITLE Problems of post-retirement migration in Japan BACKGROUND As for the elderly population in Japan, there are movements from the metropolitan area to the rural area because of retirement in the young-elderly, and from the rural area to the metropolitan area because of health problem and living with children in the

• ld-elderly. Why do elderly people migrate? Can elderly people continue to live where

they want to live? METHODOLOGY Subjects were 11 migrated elderly people (male 4, female 7, 60-64: 1, 65-69: 6, 70- 74: 2, 75-: 2) after retirement, from the metropolitan area to Hokkaido (the northernmost rural area in Japan). Semi-structured interview was conducted. RESULTS Reason for migration: Retirement made it possible to choose a place to live. Migration to Hokkaido was a longing for the elderly. Lifestyle after migration: Both the young- and old-elderly people were busy every day for sports such as softball, tennis and golf, handmade life such as furniture-making and kimono remaking, and interaction such as local festival, lifelong learning and part- time job in university. Settlement intention: Elderly people wanted to continue living in Hokkaido. Health problems did not matter, because hospitals are available. However, they, especially female, were worried about the future, such as driving a car, continuing the lifestyle after losing their spouse. And elderly people were thinking that the need for care makes it impossible for them to choose a place to live, and metropolitan area children would choose. Care services are available in Hokkaido, however, the right to choose a place to live is taken away from the elderly by the need for care. CONCLUSION Need of care = choosing is impossible. This recognition makes the elderly people who chose a place to live post-retirement leave the rural area where they want to continue living using hospital and care services by their children's choosing in metropolitan area. ONS3 AUTHOR(S) YN LIM Alzheimer’s Disease Association, Singapore TITLE Memories Café: Breaking through Dementia Stigma with Community Arts DESCRIPTION Facing stigma is often a primary concern of persons living with dementia and their

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ORAL PRESENTATION ABSTRACTS

care partners. The topic of dementia is often a taboo even among family members; the lack of knowledge and conversations prevents people from living the best quality

• f life possible and developing a support system in the community.

In early 2014, Alzheimer’s Disease Association (ADA), Singapore piloted the Memories Café programme to raise awareness about dementia. Modelled after Dr Bere Miesen’s “Alzheimer’s Café”, the programme is for persons living with dementia and their care partners. The programme provides a normalised café setting for participants to interact through activities and conversations in a safe, supportive and conducive environment. Memories Café aims at minimising the societal stigma on persons living with dementia and to encourage social acceptance through the engagements in a café within a community setting. The programme provides an alternative platform for social interactions and respite to persons living with dementia and their care partners, moving away from long-term care environments and their homes. With organised activities for persons living with dementia and their care partners, Memories Café aims to improve their bonding with each other. Memories Café is a two-hour programme, designed with various engagement activities such as sing-alongs, drumming, movement, storytelling and craftwork that are led by community artistes, volunteers and staff. The programme encourages all participants to mingle and interact among the group and members of the public while enjoying light refreshments. A programme evaluation questionnaire was conducted to gather feedback from persons living with dementia and care partners. At Memories Café, persons living with dementia are empowered to be creative and express themselves through music, movements and artwork. ONS4 AUTHOR(S) T LEE, SC WONG Alzheimer’s Disease Association, Singapore TITLE A Reminiscence Programme For Persons With Dementia - Arts, Culture And Heritage DESCRIPTION The Arts and Dementia Programme at the Alzheimer’s Disease Association (ADA) involves persons with dementia from ADA’s dementia day care centres, the New Horizon Centres and the Family of Wisdom Centres, artistes, volunteers, care partners and the community. The programme adopts the person-centred care approach for persons with dementia to express themselves through the arts which comprises heritage culture tours to the Peranakan Museum, National Museum, Malay Heritage Centre and Chinatown Heritage Centre. The use of creative arts and cultural places for dementia care is a valuable tool in enriching their lives. The arts provide a non-pharmacological approach to dementia care offering a platform for persons with dementia to connect with their past experiences and memories, increase their self-esteem, enhance creativity and motivate them in gaining new skills. Using photography at the Chinatown Heritage Centre programme, for example, provide opportunities for persons with dementia to apply their photography skills to explore, to discover and to be creative. Photos taken by persons with dementia provide subjects for discussion through storytelling and an opportunity to exchange personal stories, thoughts and feelings whilst enjoying social activities together.

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Programme evaluation tools such as Dementia Care Mapping (DCM) and a questionnaire for all participants are conducted for each programme. DCM was conducted to document the behaviours and moods of the clients during activities to assess their well-being whilst the questionnaire was used to gather feedback from person with dementia, care partners, docents, volunteers and staff. The presentation will provide an overview of ADA’s reminiscence programme for persons with dementia - Arts, Culture and Heritage, describe how the programme is conducted and the impact of the programme on persons with dementia, their care partners, volunteers and staff. ADA was awarded with a programme grant from the National Arts Council for the Arts and Dementia Programme. ONS9 AUTHOR(S) R LASRADO University of Manchester, Manchester, United Kingdom TITLE Feasibility And Acceptability Of Dempower: A Home-Based Couple Management Guide For Couples Where One Partner Has Dementia BACKGROUND The increasing rate of dementia and high health and social care costs call for effective measures to improve public health and enhance the wellbeing of people living with dementia and their relational networks. Most post-diagnostic services focus

• n the condition and the person with dementia with limited attention to the spouse or

partner caregiver. The key focus of the study is to develop a guide for couples where

• ne partner has a diagnosis of dementia. This couple management guide is delivered

in the form of an app, DemPower. The study aimed to investigate the feasibility and acceptability of DemPower app. METHODOLOGY The study used a non-randomized feasibility design. The study recruited 25 couples in the United Kingdom and 19 couples in Sweden. The suggested timeline for completion of the app was 3 months and the usage data were gathered from the devices at the end of the study. A set of outcome measures were obtained at baseline and post-intervention. RESULTS The overall study completion rate was 55% (UK=9/25, Sweden=12/19). A total of 18 (86%) couples completed all parts of the app and an average of 15 days. 33 minutes per day were spent on the app over the course of the study period. Among the four chapters, ‘Home and Neighbourhood’ (chapter 1) received the most visits (average 223 visits) while chapter on ‘Communication and Emotions’ received average110 visits over the course of the study. Participants visited the activity pages more frequently than the core contents pages, for example taking pictures, physical exercise, talking to each other, walking, music and home adaptation need assessment checklist. There was no significant difference between the baseline and post intervention outcomes results. CONCLUSION The DemPower app was considered as useful resource by most couples and is best

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delivered through memory clinics at the stage of diagnosis. ONS10 AUTHOR(S) PK LOH1,2

• 1. Royal Perth Hospital, Perth, Australia
• 2. Edith Cowan University, Perth, Australia

TITLE General Practice Hubs For Management Of Dementia In The Community BACKGROUND Vulnerable older people with dementia have difficulty accessing hospitals and are unable to attend hospital clinics without assistance from family, friends and non- government organisations (NGO) providing care services. General Practitioners (GP), family, professional carers often contact the Aged Care departments to request help for dementia clients. Physicians who have home visits and multidisciplinary team (MDT) meetings in community hubs based in GP settings provide client centred care close to home. METHODOLOGY Review of hospital physicians visiting GP community hubs to support the delivery of medical and dementia health services close to home after a 4-month trial. There were 2 models of GP hubs: firstly, Integrum, in a nursing NGO and secondly, a GP model with a group of solo GPs who supported each other’s dementia and frail patients. RESULTS The Integrum model had weekly clinical assessments on Wednesdays followed by MDT meetings on Fridays. 4 patients a week were seen in the Integrum by a physician at the purpose-built NGO assessment facility then discussed at MDT. The GPs presented to a MDT at a GP clinic. The physician did not initially see the cases but decided whether they needed a review after presentation by GP. CONCLUSION Community based services help to deal with a shrinking hospital bed stock in aged care, and increasing cost of hospital care. Community dementia care outside of hospitals help to direct and manage dementia care in the community. GP hub visits and discussions by geriatric medicine physicians allow medical teams to engage town councils, local NGO service providers and GPs involved in the care of dementia. These GP hubs allow the development of an environment that fosters creative holistic and innovative care that enables better dementia health service delivery in the community. OS1 AUTHOR(S) JW WU, SL CHE, SM LIANG, YC CHUANG, IK VAN Kiang Wu Nursing College of Macao, Macao, People’s Republic of China TITLE Differences Of Knowledge And Attitudes Towards Dementia Between Students And

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Older Adults In Macao: Preliminary Results BACKGROUND The prevalence of dementia worldwide is rapidly increasing and raising awareness and friendliness has been identified as a key priority for global action plans on

• dementia. In response to the increasingly aging population, the Macao SAR

government is proposing to build a dementia friendly community. However, knowledge deficit and social stigma against dementia remain as barriers to dementia friendly communities in Macao. Studies related to this topic in Macao is very limited. The current study therefore aimed to explore the knowledge level and attitudes towards dementia amongst general public in Macao. This paper sets to report the initial research findings from the participant group of students and older adults. METHODOLOGY A cross-sectional survey by paper or online questionnaires was performed amongst 2 high schools, 3 colleges and 2 community centers in Macao. Data was collected from January to April in 2019. The research instruments were translated and validated; measured items included basic knowledge, symptoms and risk factors of dementia, and attitudes towards dementia. Quota sampling method was used to recruit n=293 participants, including 151 high school students, 83 college students and 59 older

• adults. All the collected data were eligible for analysis.

RESULTS The average correct rate of basic knowledge, symptoms and risk factors of dementia was 61.6%, 69.5% and 43.2% respectively. The score for risk factors knowledge was significantly higher in older adults than high school and college students (F(2, 290)=34.17, p=<0.001). Respondents’ attitudes towards dementia was generally positive (average score was 3.30±0.49, above the median 3). However, older adults were found to be less positive than the student group (F(2,290)=58.89, p=<0.001). CONCLUSION Findings indicated that respondents’ knowledge with respect to risk factors for dementia was limited in Macao, especially amongst the student group. Further, older adults in Macao seemed to be relatively negative towards dementia, despite respondents’ attitudes was generally positive. Thus, appropriate education in terms of dementia and target population should be developed. OS2 AUTHOR(S) WC HUANG, HJ LEE, DW YU, YC CHANG, RW ZHANG, LY TANG Taiwan Alzheimer Disease Association, Taipei, Taiwan, Republic of China TITLE Seeing And Being Seen: Helping People With Young Onset Dementia To Rebuild Their Sense Of Self In Dramatherapy BACKGROUND It is estimated that there are more than 12,000 young people with dementia in

• Taiwan. People with early dementia encounter a huge change of their life and are

forced to confront with the feeling of loss, chaos, depression, confusion, panic and worry (Kitwood, 1997). As dementia patients are not able to express the feelings

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precisely, they often feel "invisible" to the extent of losing the sense of self. However, in Taiwan, most of the treatments of dementia are focusing on physical and behaviour, instead of psychological mind. Dramatherapy is a form of psychological therapy in which all of the performance arts are utilized within the therapeutic relationship. Utilizing these media instead of talking helps them to visualize, concretize and embody their feelings, reconnecting with their inner-self without boundaries and enhancing their personhood as well as their sense

• f self.

METHODOLOGY This research had a qualitatively hermeneutical design based on five cases. These five cases were closed dramatherapy group took place in the Home for Young Onset Dementia of Taiwan Alzheimer Disease Association(TADA) from 2017-2019. It was a 12-weeks program, 2 hours per session with mix genders. Data collected within this research consist of clients’ medical records, therapy notes, supervision notes and hand over notes from TADA. Data were analysed in two steps: (1) inductive analysis with an interpretive approach and (2) deductive analysis, applying a theoretical framework for dramatherapy. RESULTS Findings revealed that members in the groups were more willing to express their feelings with significant support from the group. There were more positive feelings expressed by the members as well. According to their reflection, they felt “useful and recognized by the others again”. Caregivers pointed out that members were more stable and expressed more sense of humour after each session. CONCLUSION Overall, the results highlight significant benefits on expressions, emotions and interaction, which enable the members to reconnect with others and their inner-self as well as rebuild their sense of self. OS3 AUTHOR(S) JA LIM 1, KY LEE2, J LEE1, EC LEE2, JY LEE 1

• 1. Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of

Korea

• 2. Department of Computer Science, Sangmyung University, Seoul, Republic of

Korea TITLE Facial Expressivity In Alzheimer’s Disease BACKGROUND The purpose of this study was to investigate whether there is a difference in an ability

• f posing six basic facial emotions (happiness, fear, surprise, anger, sadness, and

disgust) between Alzheimer’s disease (AD) patients and normal controls (NCs) METHODOLOGY

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A total of 28 participants (AD N=14, mean age=74.65; NC N=14, mean age=72.15) were enrolled. Tasks were as follows: a series of a photo that containing six basic emotions + neutral on facial expression was presented to participants. Then, they were asked to pose perceived emotions for 15s, the responses were recorded via DSLR camera (60 fps). Videos of participants’ posed facial expressions of 6 basic emotions where facial action units (AUs) combinations were used to interpret automated emotion intensity scoring (range from 0-5). The extent of movement for each muscle landmark by an automated face analyzing tool “OpenFace”, based on facial action coding system (FACS) was used to interpret AU and automated emotion intensity scoring. Facial differences were analyzed by ANOVA. P-values <.05 were regarded as statistically significant. RESULTS Male patients with AD showed the decreased emotional facial expression on happiness or fear than male NCs. No differences were observed in female patients with AD compared to female NC. CONCLUSION Current preliminary study provide evidences that AD brain change may have contributed to the decrease in facial expression that involved happiness or fear in men with AD. OS4 AUTHOR(S) SM KIM, SA LEE* Department of Big Data Analytics, Ewha Womans University, Republic of Korea *Department of Occupational Therapy, College of Medical Science, Soonchunhyang University, Republic of Korea *Korean Association for Dementia, Republic of Korea TITLE Factors Affecting Falls of Demented Inpatients BACKGROUND The study aimed to identify risk factors for falls as well as hospitalization status according to disease characteristics and demographic characteristics of demented inpatients by investigating the in-depth Injury Patient Surveillance System data by Korea Centers for Disease Control and Prevention (KCDC). METHODOLOGY Older adults over 60 years old who were diagnosed with dementia were included (n=1,732). Their data were analyzed after being assigned to either a fall group or a non-fall group. STATA was used for statistical analyses, such as frequency analysis, Chi-square (χ2) test, and logistics regression. RESULTS It was found that 8.0% of the demented inpatients experienced falls. According to the analysis on category of fall and non-fall group were statistically significant difference in age and Charlson Comorbidity Index (CCI) and bone density deficiency. Based on the logistic regression analysis of factors affecting falls, older adults over 80 are 2.386 times more likely to fall and based on a target with a CCI of 0, the risk of falls is 0.421 times lower, finally based on those without bone density disorder, the fall risk for

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those with bone density disorder was 3.581 times higher. CONCLUSION As a result of this study, the number of patients over 80 years of age may be about 2.3 times higher and patients of bone density disorders are the higher 3.5 times than dementia patients who do not have it. On the other hand, if the CCI is 3 points, the fall may be about 0.4 times lower. Therefore, we hope that the factors related to fall- related effects of patients with dementia who are hospitalized based on the results of this study not only does the present findings have important implications for helping decision-makings of clinical professionals and preventing falls in demented inpatients, but also they can be served as evidence when fall prevent learning adults with dementia and dementia patients care staffs. OS6 AUTHOR(S) M FRANCISE XAVIER, WN WAN ZAINAL ABIDIN, NI MAT ZAIN, A HASHIM, N NORDIN Geriatric Unit, Hospital Sungai Buloh, Malaysia TITLE Cognitive Stimulation Therapy In Mild To Moderate Dementia BACKGROUND As the global population ages, the number of people living with dementia is expected to triple from 50 million to 152 million by 2050. CST emerged as an established proven non-pharmacological approach benefiting mild to moderate dementia. The aim of CST is to actively stimulate and engage people with dementia, whilst providing an optimal learning environment and social benefits of a group. This program is

• ffered as part of the Geriatric Day-care Services in Hospital Sungai Buloh since

August 2018. This cross-sectional study aims to evaluate the efficacy of CST in our setting. METHODOLOGY The CST treatment involved 14 sessions of themed activities over a period of 7 weeks; led by an occupational therapist and trained nurses. The clinical effectiveness

• f CST were assessed in 3 different aspects ie: cognitive, functional as well as
• behavourial. These include Mini-Mental State Examination (MMSE), Holden

Ccommunication Scale (HCS), Quality of Life in Alzheimer’s Disease (QOL-AD), Geriatric Depression Scale (GDS), Modified Barthel Index (MBI), Lawton, and Neuropsychiatric Inventory (NPI). Data were analysed via SPSS version 23. RESULTS 24 participants (60% males) were recruited, with a mean age of 71.6 years old. 46% were Malays, 29% Indians and 25% were Chinese. No difference in MMSE seen upon completion of programme. However, there was a significant improvement in quality of life (p<0.00), overall NPI (p<0.004), and the HCS [(p<0.00): conversation (p<0.00), awareness and knowledge (p<0.001); and communication (p<0.00)]. No improvement seen in GDS, MBI or even Lawton. CONCLUSION

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CST appeared to benefit communication, dementia behavioural functioning, and quality of life in the older persons with mild to moderate dementia. This provides evidence to support the use of CST as a routine program to complement patients with mild to moderate dementia in Hospital Sungai Buloh. OS7 AUTHOR(S) AD SAIFULLAH, S MULYANI Universitas Gadjah Mada, Indonesia TITLE Informatics Technology-Based Dementia Elective Course for Nursing Student in Indonesia BACKGROUND The growth of people with dementia is increasing, even in developing countries. There were 1 to 2 people aged more than 65 who got dementia. Moreover, people with dementia tend to be hospitalized even more due to its progression. So that, any healthcare worker, including nurse student need to be taught and experiencing caring for people with dementia. In terms of education, current student were coming from a very different generation compared to the elders. So that, innovation in delivering dementia care course is needed. The aim of this research is to test the feasibility of implementing blended learning in the dementia care course. METHODOLOGY The one group quasi-experiment research was performed by integration of schedule, assignment, material were provided in the learning management system (LMS), eLOK (Moodle based) and applied it in the actual class. A number of 42 students voluntarily join the course. RESULTS The result of this study showed that 100% of students easy to access, satisfied with the eLOK, and felt that the eLOK help them in learning. Even better, 100% of the students relatively willing to use eLOK in the future. In terms of the topic was covered in the course, sign and symptoms of dementia, and behavioral and psychological symptoms of dementia were the students’ favourite (73% and 70.3%) both topics were delivered online. The students also favour quiz provided in the eLOK (51.4%). Lastly, even though the online meeting was “exciting” for the students, there are still room for improvement. Online meeting was facilitated in zoom.us apps, which not most, of the student familiar with. Signal reception on was reported to vary in the student’s dorm, audio quality also depends on the signal reception, which made few students experience a bit trouble. We solve this problem by also provide a meeting script to all students, after the meeting. CONCLUSION It is concluded that blended learning is feasible to perform in our school, the system is well developed and the students are pretty much ready. We suggest to improve the content provided in the eLOK with some videos and articles to improve the learning experience of the students. Familiarizing the students through the online meeting platforms may be useful too.

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OS8 AUTHOR(S) SM WANG1, G SON2, DW KANG3, HR NAH1, C MOON2, HK LIM1

• 1. Department of Psychiatry, Yeouido St. Mar's Hospital, College of Medicine, The

Catholic University of Korea, Republic of Korea

• 2. Department of Brain and Cognitive Sciences, Graduate School, Daegu Gyeungbuk

Institute of Science and Technology, Daegu, Republic of Korea

• 3. Department of Psychiatry, The Seoul Saint Mary’s Hospital, Seoul, The Catholic

University of Korea, Republic of Korea BACKGROUND Although soluble Aβ oligomer (AβO) might play a pivotal role in pathogenesis of Alzheimer’s disease (AD), development of biomarker using detection of AβO might be limited due to its structural heterogeneity. Recently, we found the 56kDa soluble Aβ*56(Aβ*56) which is known to be involved in a very early state of AD in human nasal secretion. The aim of this study is to explore diagnostic validity of Aβ*56 in nasal secretions in discriminating AD pathology. METHODOLOGY A total of 28 patients [normal control (NC)=9, amnestic mild cognitive impairment (aMCI)=10, and AD=9] were included in the study. They were dichotomized using 18F-flutemetamol amyloid positron emission tomography (PET) into with and without detectable amyloid burden. Level of Aβ*56 in nasal secretions were measured using immune blotting. Group differences in nasal Aβ*56 level were analyzed and correlation between nasal Aβ*56 level and mean standardized uptake value ratio were also conducted. RESULTS There were no group differences in age, gender, and education. The nasal Aβ*56 level were significantly higher in aMCI and AD than NC group, but no group differences were found between aMCI and dementia. The nasal Aβ*56 level also had a positive correlation with cortical Aβ deposition on 18F-flutemetamol PET. CONCLUSION These results demonstrate that the nasal Aβ*56 level can be easily measured, and it may be utilized as a biomarker for the diagnosis of early AD including aMCI. The study also suggests that nasal Aβ*56 level may predict cortical deposition of Aβ. OS9 AUTHOR(S) S MAT1, MH JAAFAR1, SB KAMARUZZAMAN2, AV CHIN2, MP TAN1,2

• 1. Ageing and Age-associated Disorder Research Group, Faculty of Medicine,

University of Malaya, Malaysia

• 2. Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine.

University of Malaya, Malaysia TITLE Determinants Of Impaired Cognitive Function In Malaysian Older Adults Age 55 And Above: Results From Malaysian Elders Longitudinal Research. BACKGROUND Cognitive function declines with age. Considering the ageing population which brings increasing burden and costs to individuals and society, health problems related to cognitive performance should be prevented at earlier stage. However, the lack of

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ideal diagnostic tools which are universal or culturally sensitive has hampered the

• process. Therefore, this study aims to identify the determinants of poor cognitive

performance in older people in multi-racial nation. METHODOLOGY Data from the first waves of the Malaysian Elders Longitudinal Research study which consisted of individuals aged ≥ 55years selected from electoral rolls in the Klang Valley were utilized. Cognitive performance was tested using Montreal Cognitive Assessment (MoCA) score. Data on demographic such age, gender, education and ethnicity were also collected. RESULTS Of 1322 participants with mean (SD) age 68.42 (7.23), 57.2% female, 422 (31.9%) is belongs to Malay ethnics, 36.4% is Chinese, and remaining 31.7% is Indians. Mean MOCA scores for overall population was 22.23 (4.4). Linear regression model suggests that advancing age (β=-0.125, SE=0.015, p-value<0.001), being in ethnic Malay (β=-3.024, SE=0.266, p-value<0.001) or Indian (β=-1.635, SE=0.265, p- value<0.001) compared to Chinese, had education less than 12 years (β=-2.199, SE=0.239, p-value<0.001), and were the independent significant determinants for low MoCA score while increased social engagement (β=0.065, SE=0.017, p-value<0.001) and ADL (Lawton score) (β=0.634, SE=0.150, p-value<0.001) was significantly associated with higher MoCA score. CONCLUSION This study has identified the significant determinants for poor cognitive performance in Malaysian older people. Considering that ethnicity plays big role in determining cognitive function, current acceptance on MOCA score cut off for mild cognitive impairment (<25) should be revised. Ethnic-specific MoCA score cut off is therefore should be introduced. OS10 AUTHOR(S) M SAIFUDDIN1, K INDAH SARI2, P ANAM ONG3, S TAUFIK4 Dago Disrict, Bandung, West Jawa, Indonesia TITLE Description Of Food Selection (Protein Intake, Vitamin B 12 Intake And Food Texture) On Cognitive Function BACKGROUND Nutritional content plays an important role in the elderly population because it affects the quality of life. Food selection can affect cognitive function. This is a preliminary study to provide an overview of food selection (protein intake, vitamin B12 intake and food texture) in the elderly on cognitive function in Bandung, Indonesia. METHODOLOGY The population consists of 42 elderly people aged 60 years and over. The sampling method used was cross-sectional in Dago District, Bandung. The food selection (protein intake, vitamin B12 intake and food texture) uses a semi-quantitative food frequency questionnaire. Cognitive functions were assessed using MMSE forms with score categories: normal (26-30) and cognitive impairment (25-0). The data was then described in proportion.

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RESULTS The results showed that 58.62% of the elderly with normal cognition had adequate daily protein intake. About 92.31% of the elderly with cognitive impairment have insufficient daily protein intake. A total of 89.66% of elderly with normal cognition and 76.92% of elderly cognitive impairment had inadequate daily vitamin B12 intake. Elderly with normal cognition, 82.76% preferred hard food texture while 69.23% of elderly people with cognitive impairment preferred soft food texture. CONCLUSION The elderly with cognitive impairment have inadequate daily protein intake and tend to prefer soft food texture. Vitamin B12 intake among the elderly with normal cognitive functions and the elderly with cognitive impairment was resulted to be inadequate. OS11 AUTHOR(S) EWL CHAN1, PS YAP1, ZF KHALAF2

• 1. Institute for Research, Development and Innovation, International Medical

University, Malaysia

• 2. Department of Psychology, International Medical University, Malaysia

TITLE Factors associated with high strain in caregivers of Alzheimer's disease (AD) in Malaysia DESCRIPTION A cross-sectional study design involving a total of 230 participants, recruited through Alzheimer's Disease Foundation Malaysia (ADFM), was adopted to access and correlate caregiver strain index (CSI) and resilience (RES) levels of the AD caregivers with various patients’ and caregivers’ factors. Findings revealed that 77.7% of caregivers had a high level of stress, and there was a significant negative correlation between RES and CSI (p<0.001). Care recipients’ physical function was negatively associated with CSI level. Caregivers’ gender and employment status were not directly associated with CSI but were significantly associated with caregivers’ RES

• level. Among the mediator variables, years of care was related to increase CSI and

adult-children of AD patients experienced a higher level of caregiver strain compared to the other caregiver groups (p=0.025). Thus, interventions to improve the family caregivers’ RES level, and support for AD patients will be helpful in lowering the strains of AD caregivers OS12 AUTHOR(S): ROSMALIAH ALIAS1, NUR AQILAH BINTI ZAINUL RASHID2, LEE FATT SOONC, RIZAH MAZZUIN3, HAMID FAUZI2

1Pharmacy Department, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia 2Faculty of Pharmacy, Univerisiti Teknologi MARA, Puncak Alam, Selangor, Malaysia 3Geriatric Unit, Medical Department, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia

TITLE Influence of cyp2d6*3, cyp2d6*9 and cyp2d6*14 polymorphism on donepezil metabolism among dementia patient in Memory clinic, Hospital Kuala Lumpur

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INTRODUCTION In Malaysia, Donepezil is used to treat mild to moderate Alzheimer’s disease (MOH, 2009) and is a preferred agent as compared to Rivastigmine oral and Galantamine as it has less side effects and better bioavailability. However, the drug respond will depends on metabolism process whereby Donepezil is hepatically metabolized by CYP2D6 isoenzyme which is highly polymorphic and the prevalence of polymorphism is reported to be different according to ethnicity in Malaysia. OBJECTIVE The main objectives of this study is to identify genotype-phenotype correlation and clinical implication of Donepezil metabolism in dementia due to influence of polymorphism CYP2D6*3, CYP2D6*9 and CYP2D6*14 allele. METHOD This is a subanalysis from subjects recruited from one centre that include patient who had exposure to the treatment of Donepezil. We draw 3ml of blood from 21 patients who has been given consent during study period for genotyping of to look at polymorphism of CYP2D6*3, CYP2D6*9 and CYP2D6*14. The clinical implication of treatment is looking at the MMSE score before and after started Donepezil. The patient profile is reviewed starting from 2014 to 2016 that still actively followed up at Memory Clinic HKL. RESULT In our subject population, 52.4% are male. The mean age are 76.14±7.492 years old. Chinese dominated by 47.6% follow by Malay (28.6%) and Indian (23.6%). The analysis on CYP2D6 genotyping showed that 48% from total population were homozygous wild type inherited CYP2D6*9 and 19% inherited CYP2D6*3 which are non-functioning allele. The reduced function allele found to be heterozygous allele of CYP2D6*14 were 5% from population . The overall phenotyping analysis found that 50% are Extensive metabolizer while ultrarapid metabolizer (UM) is 30% and the remaining are Intermediate metabolizer. The MMSE value among CYP2D6-UM showed changes from -7 to 7 (n=6). CONCLUSION Seventy-seven of subjects inherited non-functional allele that may affect the activity of CYP2D6 to metabolized Donepezil. It shows that genotyping-phenotyping is one of the way towards personalized medicine that may help in optimizing treatment without causing harm. Eventhough the sample size is small and results cannot be generalized, it shows that this study group proved that the existence of different polymorphism between each subjects should alarm us that treatment should be personalized. OS13 AUTHOR(S) WC LIM, JN KENG, WK YAU, RM RAZALI Geriatric Unit, Medical Department, Hospital Kuala Lumpur, Malaysia TITLE Relationship Between Cognitive Impairment, Mortality And Length Of Hospital Stay In Older Adults Admitted To Acute Medical Wards: A Prospective Observational Study

21ST ASIA PACIFIC REGIONAL CONFERENCE OF ALZHEIMER’S DISEASE INTERNATIONAL

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BACKGROUND Cognitive impairment is common among older adults, but it frequently goes unrecognised and undiagnosed in the acute medical wards. In this study, we aim to describe the incidence of cognitive impairment among older adults and its effects on length of stay and mortality METHODOLOGY A prospective observational study involved all male older adults aged ≥ 60 years old with unscheduled admission to acute medical wards in a tertiary public hospital. Subjects were screened for cognitive impairment with Abbreviated Mental Test 4 (AMT 4) score, functional assessment using Barthel Index, and frailty screening using Vulnerable Elders Survey (VES-13). Basic demographics, inpatient mortality rates and length of stay were compared between patients with and without cognitive impairment RESULTS A total of 204 patients were included in this analysis with mean age of 70.5±7 years

• ld. There were 28 (13.7%) patients who lived alone. 44 (21.6%) had cognitive

impairment with AMT 4 score < 4.The prevalence of cognitive impairment increased significantly with age (p<0.05), comprising of 14.7% in patients aged 60-74 years, 31% in those aged 75-84 years, and 75% in patients aged ≥85. Patients with cognitive impairment were more likely to have prolonged length of stay (41.7% vs 18.7%, p=0.003). In-hospital mortality rate was also higher in patients with cognitive impairment (OR 3.98; 95% CI, 2.4-6.7). A history of ≥3 cardiovascular co-morbidities was associated with increased risk of cognitive impairment (OR 1.4; 95% confidence interval 1.1-1.7). Patients with cognitive impairment also had a lower Barthel Index (mean 54.8 vs 95.7, p<0.05), and a higher VES-13 score (mean 6.4 vs 2.4, p<0.05). CONCLUSION Presence of cognitive impairment in older adults admitted to acute medical wards is significantly associated with increased mortality and length of hospital stay. Routine screening for cognitive impairment enables prognostication and better strategies for efficient management for the older adults. OS14 AUTHOR(S)

• E. JULAIDA1, FS LEE2 , WK YAU2 L.K.LIM1 ,S.RAJADURAI1,A.FADZIL NUR AIN1 ,

B.M.KAMIS3, M.NORSIHA3, EGM CHONG2, RM RAZALI2, WK POK2

1Physiotherapy Department, Kuala Lumpur Hospital 2Unit Geriatric, Department of Medicine, Kuala Lumpur Hospital 3Occupational Therapy Department, Kuala Lumpur Hospital o

TITLE Effect of cognition on physical parameters in the 12 weeks intervention study at Geriatric Day Care Clinic, Hospital Kuala Lumpur Medicine, Hospital Kuala Lumpur INTRODUCTION Increase aging population in Malaysia can lead with increase of functional impairment and cognitive impairment. When patient have both the problem increase of fall, poor prognosis and more difficulties in care of non-communicable disease. Functional

21ST ASIA PACIFIC REGIONAL CONFERENCE OF ALZHEIMER’S DISEASE INTERNATIONAL

ORAL PRESENTATION ABSTRACTS

capacity, balance performance and mobility deteriorate with increasing age, (Liubicich et al., 2012). Aim of this study was to assess effects on the parameters among older patient after complete 12 weeks intervention programme. METHOD 12 weeks intervention study with a Physiotherapy and Occupational Therapy exercise programme and the assessment on cognitive and physical function will do on 1st assessment and 12th weeks assessment. Physical Parameters use for this study was Timed Up and Go Test, Dual task tug cognitive and Sitt To stand Test and the was is to measure the functional outcome. This study was conducted at Geriatric Clinic, Hospital Kuala Lumpur. Occupational Therapy will do the cognitive assessment as Mini Mental State Examination. RESULT Older patient (N=200) were studied (mean age, 73.2y) all of the was assessed by Mini Mental State Examination. The MMSE of the control group 25.8-25.82/30 and the cognitive impaired group 18.3-18.9/30 on the assessment week and 12th week. The Timed and Go Test of the control group was 13.05 sec, 14.09 sec and cognitive impaired group 12.5 sec and 15.3 sec on the 1st assessment and 12th weeks. There are show no significant difference between the groups. CONCLUSION The above findings could be due to the possibility that both groups are maintaining their physical performance or there is a possible improvement with increased caution in mobility leading to no change of TUG. On the other hand the cognitive impaired group who may be expected to deteriorate more, may actually be doing better as they are able to keep up with the cognitively intact group. These are however speculative and will need to be explored further with a bigger sample for a longer periods of time. OS15 AURTHOR(S) HL TEH, MH YAHAYA, R AHMAD Medical Department, Hospital Sultanah Bahiyah, Kedah, Malaysia TITLE Correlation of Muslim Prayer Performance with Stages of Dementia INTRODUCTION Dementia is a common disease for older population, Malaysia is moving towards ageing country and our Dementia disease burden is getting higher. Malaysia is unique by its own because of multi-racial, multi-religious and multi-cultural social background, it makes the manifestation of Dementia varies among different ethnic

• population. From clinical experience, we noticed the inability to perform prayers

among Muslims can be a sign of cognitive impairment and it seems to be correlated with stages of Dementia. However, until now we don’t have any objective assessment method to assess it. Islam is Malaysia’s national religion, vast majority of Malaysians are Muslims and they have been practising 5 times prayers a day since young as their daily routine. Muslim prayer involved complex cognitive process which required the individual to pray at the correct timing, correct sequence of actions and reciting the prayer verses. There was

• ne study showed engagement with prayers among Muslim females was associated

21ST ASIA PACIFIC REGIONAL CONFERENCE OF ALZHEIMER’S DISEASE INTERNATIONAL

ORAL PRESENTATION ABSTRACTS

with significant lower risk of cognitive impairment [Rivka Inzelberg etal, Curr Alzheimer Res. 2013 March]. We believe continue to encourage or engaging Muslims with Dementia in their routine prayers can be one of the effective non pharmacological management for them. Further research and evidence is needed to guide us on this research topic, hence the first step as pilot project we would like to analyse the correlation of the ability to perform prayers among Muslims and stages of Dementia. OBJECTIVE To study the correlation of Muslim prayer performance with stages of Dementia To establish an objective assessment tool for Muslim prayer performance in Person with Dementia METHODOLOGY This is a cross sectional study took place in Memory Clinic Hospital Sultanah Bahiyah, started from June 2019, where all Muslims with Dementia or Mild Cognitive Impairment who attended Memory Clinic were included in the study. We have created a scoring system (Dementia Solat Score - DSS) to assess the prayer performance after discussed with Hospital Ustaz. DSS consists of 5 components, 0-2 marks was given for each component, minimum score is 0, maximum score is 10, higher score indicates worse prayer performance. The main caregiver of the subject was interviewed about the prayer performance by using DSS. At the same time, Clinical Dementia Rating (CDR) and Modified Barthel Index (MBI) were also performed to decide on stages of Dementia. Data entry and analysis was done with SPSS 21. RESULTS To date, we have recruited 12 subjects, age range 53 to 80, consists of one case of Mild Cognitive Impairment, 6 cases of early stage (CDR 1), 3 cases of moderate stage (CDR 2) and 2 cases of severe stage (CDR 3). Pearson correlation test showed significant positive correlation 0.971 of DSS with CDR, p-value < 0.001. On the other hand, Pearson correlation test showed significant negative correlation -0.916 of DSS with MBI, p-value <0.001. The data collection is still in progress. CONCLUSION This pilot project showed that Dementia Solat Score showed strong correlation with Dementia Stages and MBI. Hence, DSS can be used as one of the objective assessment for instrumental activity of daily living for Muslims with Dementia.

21ST ASIA PACIFIC REGIONAL CONFERENCE OF ALZHEIMER’S DISEASE INTERNATIONAL

ORAL PRESENTATION ABSTRACTS

DATE : SATURDAY, 17TH AUGUST 2019 TIME : 11:00am – 13:00pm VENUE : Safir I PLEASE ARRIVE 10 MINUTES BEFORE SESSION BEGINS. NO CONTENT ONS3 YN LIM Memories Café: Breaking through Dementia Stigma with Community Arts ONS4 T LEE A Reminiscence Programme For Persons With Dementia - Arts, Culture And Heritage OS12 R ALIAS Influence of cyp2d6*3, cyp2d6*9 and cyp2d6*14 polymorphism on Donepezil metabolism among dementia patient in Memory Clinic, Hospital Kuala Lumpur OS13 WC LIM Relationship between cognitive impairment, mortality and length of hospital stay in

• lder adults admitted to acute medical wards: a prospective observational study

OS14 J EMBONG Effect of Cognition on Physical Parameters in a 12 Week Intervention Study at the Geriatric Day Care Clinic, Hospital Kuala Lumpur OS15 HL TEH Correlation of Muslim Prayer Performance with Stages of Dementia

21ST ASIA PACIFIC REGIONAL CONFERENCE OF ALZHEIMER’S DISEASE INTERNATIONAL

ORAL PRESENTATION ABSTRACTS

DATE : SATURDAY, 17TH AUGUST 2019 TIME : 14:00 - 15:15 PM VENUE : SAFIR 1 PLEASE ARRIVE 10 MINUTES BEFORE SESSION BEGINS. NO CONTENT OS1 JW WU Differences of knowledge and attitudes towards dementia between students and older adults in Macao: preliminary results OS2 WC HUANG Seeing And Being Seen: Helping People With Young Onset Dementia To Rebuild Their Sense Of Self In Dramatherapy OS3 JY LEE Facial Expressivity In Alzheimer’s Disease OS4 SA LEE Factors Affecting Falls of Demented Inpatients OS6 MF XAVIER Cognitive Stimulation Therapy In Mild To Moderate Dementia OS7 AD SAIFULLAH Informatics Technology-Based Dementia Elective Course for Nursing Student in Indonesia

21ST ASIA PACIFIC REGIONAL CONFERENCE OF ALZHEIMER’S DISEASE INTERNATIONAL

ORAL PRESENTATION ABSTRACTS

DATE : SATURDAY, 17TH AUGUST 2019 TIME : 1545 - 17:00PM VENUE : SAFIR 1 PLEASE ARRIVE 10 MINUTES BEFORE SESSION BEGINS. NO CONTENT ONS9 R LASRADO Feasibility And Acceptability Of Dempower: A Home-Based Couple Management Guide For Couples Where One Partner Has Dementia ONS10 PK LOH General Practice Hubs For Management Of Dementia In The Community OS8 SM WANG Aβ*56 in nasal secretions in Dementia OS9 S MAT Determinants Of Impaired Cognitive Function In Malaysian Older Adults Age 55 And Above: Results From Malaysian Elders Longitudinal Research. OS10 M SAIFUDDIN Description Of Food Selection (Protein Intake, Vitamin B 12 Intake And Food Texture) On Cognitive Function OS11 Z KHALAF Factors associated with high strain in caregivers of Alzheimer's disease (AD) in Malaysia