Greek Association of Alzheimer's Disease and Related Disorders

Apathy is a neuropsychiatric symptom that is present in various disorders, including dementia and Mild Cognitive Impairment (MCI). Patients with MCI who exhibit symptoms of apathy are at a higher risk of progressing to dementia compared to those with depressive symptoms. The aim of the present study was to investigate the psychometric properties of the clinician-rated version of the Apathy Evaluation Scale (AES-C) in a Greek sample of MCI patients and healthy older adults. The translation and adaptation of the scale were conducted using the forward-backward method. The final sample consisted of 100 participants, 14 men (n = 14) and 86 women (n = 86), with a mean age of 72 years. Participants were administered the translated and adapted version of the AES-C, as well as the Greek version of the Beck Depression Inventory. In terms of reliability, Cronbach's alpha was found to be high (α = 0.91), indicating excellent internal consistency. Confirmatory Factor Analysis (CFA) revealed a one-factor solution with a very good model fit (RMSEA = 0.018, CFI = 0.985, TLI = 0.983, SRMR = 0.076). The AES-C can serve as an important addition to neuropsychological assessment for detecting apathy symptoms in patients with MCI, thereby contributing to the early prognosis of dementia.

BackgroundThe paucity of data on the knowledge and attitudes of Deaf people towards dementia is well documented, as is the limited access to dementia services in this population due to lack of interpreters and absence of health professionals who use sign language (SL). Therefore, delivering dementia awareness in Deaf people is assumed as a high priority which is also related to the seeking of relevant diagnostic services. Additionally, till now there are almost no screening tools for detecting early dementia signs which are adapted in national SL.MethodTo address this gap, the current Erasmus+ project aims to identify attitudes and knowledge about dementia among the Deaf population using relevant psychometric tools and subsequently create dementia raising awareness seminars, tailored to the cultural background and norms of the Deaf communities in Austria, Germany, Greece, and Italy. Secondly, the only existing Cognitive Screening Test (CST), originally adapted in British SL from Atkinson et al. (2015) for detecting dementia in Deaf older adults will be also adapted in Austrian and Greek SL.ResultInitially, results from the tools measuring dementia attitudes and knowledge will be presented. Afterwards, the design of the structured seminars delivered in Deaf communities will be also displayed. Finally, the adapted versions of the Austrian and Greek CST administered in Deaf older adults in both countries will be available.ConclusionThe final goal is to increase dementia raising awareness seminars in Deaf people from Austria, Germany, Greece and Italy, as well as achieve dementia detection in this population by providing them with diagnostic and care pathways.

Background/Objectives: Sleep disturbances are increasingly recognized as dynamic biomarkers of cognitive decline; however, longitudinal and multimodal studies directly comparing amnestic (aMCI) and non-amnestic mild cognitive impairment (naMCI) remain limited. Methods: In a three-wave longitudinal design (~24 months), 179 older adults (46 healthy controls [HCs], 75 aMCI, 58 naMCI; mean age = 70.2 years, education = 12.3 years) were assessed with actigraphy and validated questionnaires (Athens Insomnia Scale, Pittsburgh Sleep Quality Index, STOP-BANG). Mixed ANOVAs and structural equation modeling tested group, time and mediation effects. Results: Subjective measures revealed a progressive worsening of insomnia and sleep quality in MCI, with naMCI exhibiting the steepest decline, while HCs remained largely stable. STOP-BANG trajectories indicated increasing sleep-disordered breathing risk across groups, most pronounced in naMCI. Objective indices corroborated these findings: total sleep time (TST) and sleep efficiency (SE) declined significantly in MCI, especially naMCI, while wake after sleep onset (WASO) increased longitudinally. By the third assessment, naMCI consistently showed the shortest TST and lowest SE. Mediation analyses identified SE as a central predictor of future subjective complaints, with indirect contributions from WASO and PSQI. Conclusions: Longitudinal trajectories, rather than cross-sectional comparisons, best differentiated MCI subtypes. NaMCI demonstrated the most aggressive deterioration in both objective and subjective sleep measures, highlighting its heightened vulnerability to sleep dysregulation and potential relevance for neurodegenerative progression. Clinically, sustained monitoring of SE, TST, and sleep-disordered breathing risk may provide prognostic value and inform early, targeted interventions in at-risk populations.

ABSTRACTIntroductionThe literature suggests that the use of creative methods (e.g., art, theatre, and music) in the care of older people can promote interactions and positive experiences. However, there are no studies that have explored the perspectives of nursing programmes internationally regarding their inclusion in the curriculum. Therefore, to expand knowledge from a multinational perspective, this study explored (a) the views and perceptions and (b) the potential barriers to the inclusion of creative approaches in nursing education in the development of competences for the care of people with dementia.MethodsA qualitative descriptive study according to the Consolidated criteria for Reporting Qualitative research checklist. Semi‐structured face‐to‐face and focus group interviews with a purposive sample of 79 participants in four countries (Finland, Greece, Italy, and the Netherlands). Participants were nursing students (n = 32), educators/professors (n = 17), healthcare professionals (n = 13), family members (n = 8), policy makers (n = 6), and people with dementia (n = 3). The interviews were transcribed verbatim and analyzed using thematic analysis.ResultsViews, perceptions, and barriers/advantages related to creative approaches were summarised into four themes: (a) Being already familiar with creative approaches; (b) Perceiving their potentialities; (c) Bolstering the personalised approach in nursing education; and (d) Ensuring preparedness and support.ConclusionsThe inclusion of creative approaches in nursing education appears to be both mature and desired by stakeholders at the international level, given their diverse potentialities. These approaches are also seen as an excellent way to improve the teaching of personalised care. However, resources as well as a particular attitude and the ability of professors to act as role models are required.

Harmonized neuropsychological assessment for neurocognitive disorders (NCDs) is an urgent priority in clinics. Neuropsychology assessments in NCDs seldom include tests exploring social cognitive skills. In 2022, we launched the SIGNATURE initiative to optimize socio-cognitive assessment in NCDs. Here, we report findings from the first initiative phase, including consortium creation and evaluation of the state of the art in socio-cognitive assessment in memory clinics. We developed an ad hoc online survey to explore practices and measures, relevance, and obstacles preventing the use of socio-cognitive testing in clinics. The survey was distributed within the SIGNATURE network. National coordinators were identified to disseminate the survey to local collaborators and scientific societies active in the field of dementia and/or neuropsychology. Data were analysed in aggregate form and stratified by geographical area and variables of interest. Four hundred and thirteen (413) responses from 10 European and Latin American geographical regions were recorded. Responders were balanced between physicians and psychologists. Seventy-eight (78) % of respondents reported no/limited experience with socio-cognitive measures; more than 85% agreed on their relevance in clinics. Ekman-60 faces was the most well-known and/or used task, followed by the Faux-Pas and Reading-the-Mind-in-the-Eyes tests. Lack of clinical measures, assessment time, guidelines, and education/training were reported as main obstacles. Real-life barriers prevent the adoption of socio-cognitive testing in clinics. Bidirectional collaboration between clinicians and researchers is required to address clinical needs and constraints and facilitate consistent socio-cognitive assessment.

Family caregivers of dementia patients experience grief, not only after the death of the patient, but also during the course of the disease. The aim of the present study was to examine the psychometric properties of the Greek version (full and short) of the Marwit–Meuser Caregiver Grief Inventory (MM-CGI and MM-CGI Short Form) before death in a sample of Greek caregivers of persons with dementia. In particular, the study attempts to test the internal consistency reliability as well as the structural and convergent validity of the inventory. The inventory was administered to 515 family caregivers (offsprings and spouses) along with a socio-demographic information form, the Zarit Burden Interview (ZBI), the Beck Depression Inventory II (BDI-II), and the Mini-Mental State Examination (MMSE) exploratively to a subset of dementia patients cared for by survey participants. The application of confirmatory factor analyses revealed a slightly different structure of the Greek version of the MM-CGI, but they fully verified the structure of the Greek version of the MM-CGI-SF. Both the internal consistency reliability and the convergent validity of the subscales of the Greek version of the MM-CGI-SF were good. The findings of the present study indicate that the short version of the Marwit–Meuser Caregiver Grief Inventory is a reliable and valid tool for the early assessment of aspects of grief among the Greek population of family caregivers of dementia patients, in order to potentiate the prevention of their depression and anxiety.

Background/Objectives: Dementia involves the loss of cognitive abilities and impairs functional abilities in daily life. In motor imagery (MI) techniques, motor acts are mentally rehearsed without any overt body movements. The purpose of the randomized controlled trial was to examine the effects of MI on the motor function of older adults with dementia. Methods: Overall, 160 participants (43 men, 117 women, MMSE M = 23.20, SD = 0.15) from an Athens Day Care Center of the Alzheimer Association were randomized to (a) the MI and exercise group (experimental group) (n = 55), (b) the only exercise group (1st control group) (n = 52) and (c) the neither MI nor exercise group (2nd control group) (n = 53). The exercise session comprised 24 physiotherapy exercise sessions, lasting 45 min each, twice a week for 12 weeks. The exercises were selected from the Otago Exercise Program. Three assessments were performed: (a) one week prior to the program, (b) at one and a half months and (c) after the program. The experimental group performed a 30-minute MI with exercise program content after the end of every physiotherapy exercise session. The Multidirectional Reach Test, Five Times Sit-to-Stand Test (FTSST), Timed Up and Go test (TUG), Functional Gait Assessment (FGA) and Berg Balance Scale (BBS) were used to assess participants’ balance and functional status. Results: In the intention to treat analysis (18 participants dropped out), the 3 × 3 repeated measures ANOVA indicated statistically significant results between the three groups on (a) the TUG (F = 3.06, df (2), p = 0.04), (b) the FTSST (F = 3.00, df (2), p = 0.05), (c) the forward direction test (F = 4.14 df (2), p = 0.02), the lateral right and the lateral left direction tests (F = 3.90, df (2), p = 0.02 and F = 7.87, df (2), p = 0.00, respectively), and (d) the FGA (F = 4.35, df (2), p = 0.01). The Friedman test showed significant statistical significant differences among the three groups for BBS (X2 = 7.62, df = 2, p = 0.22), and an effect size of partial η2 coefficient for F-tests was found. Post hoc comparisons using a Bonferroni test for ANOVA and Wilcoxon test for Friedman indicated that the mean scores for the experimental group and the 1st control were significantly better than the 2rd control group in many dependent variables. Conclusions: The study showed a positive effect of MI on balance and the functional status of older adults with early stages of dementia with possible beneficial effects on maintaining independence and reducing physical decline.

Musculoskeletal disorders are a significant global health concern, affecting over 1.71 billion individuals worldwide, with a considerable impact on quality of life and economic burden due to healthcare costs and productivity losses. In the United Kingdom, approximately one-third of the population suffers from musculoskeletal disorders, underscoring the need for effective diagnostic and management strategies. Musculoskeletal ultrasound imaging emerges as a preferred diagnostic modality, offering a balance between technical capabilities and cost-effectiveness, owing to its non-invasive nature, portability and lack of radiation exposure. However, the operator-dependent nature of musculoskeletal ultrasound imaging necessitates specialised training for medical and healthcare professionals. The integration of musculoskeletal ultrasound imaging into traditional clinical examinations, known as ultrasound imaging–assisted clinical examination (UIACE), enhances traditional diagnostic processes by providing immediate visual feedback, facilitating a more accurate and comprehensive assessment of musculoskeletal conditions. This approach not only refines diagnosis in cases with ambiguous symptoms or overlapping signs but also significantly improves patient reassurance and management strategies. In addition, incorporating musculoskeletal ultrasound imaging into medical education through ultrasound imaging–assisted clinical examination offers students a dynamic, interactive learning experience, fostering a deeper understanding of clinical anatomy and examination skills. By advocating for its systematic inclusion in the undergraduate medical curriculum, the study highlights the potential to enhance the competence and confidence of future professionals in utilising ultrasound imaging, ultimately improving patient outcomes in musculoskeletal care.

Background: Dementia involves the loss of cognitive abilities and represents a decline from the prior level of function, which impairs functional abilities in day-to-day life. The purpose of the present study is to examine the effectiveness of an exercise program on the muscle strength and range of motion of the upper limbs, the functional status, and the depression of elderly people with early stage dementia. Methods: The sample consisted of 60 elderly people with early stage dementia who were randomly divided into a control and an experimental group of 30 participants each. The experimental group received a 12-week Otago exercise program with 45 min duration of each session. The control group received usual care without doing exercise. The outcome measures of muscle strength and range of motion of the upper limbs, the functional status, and the depression were assessed by valid instruments and tests at the beginning and at the end of the intervention program. Repeated measures one-way ANOVA and Mann-Whitney tests examined the differences between the two groups at the end of the 12-week exercise program. Results: Statistically significant differences were found between the experimental and control groups in the entire outcome measures (functional ability F = 9.35 p < 0.05; muscle strength right hand F = 32.33, p < 0.05 left hand U = 95.50 p < 0.01; e.g., range of motion shoulder extension U = 104.00 p < 0.01), except depression. Conclusions: Both muscle strength and range of motion of the upper limbs, as well as the functional ability, were improved by the exercise program. Further research is needed to investigate the present results, in particular to explore the long-term cognitive, behavioral, and functional status outcomes of exercise in the early stages of dementia.

The possible relationship between Subjective Cognitive Decline (SCD) and dementia needs further investigation. In the present study, we explored the association between specific biomarkers of Alzheimer's Disease (AD), amyloid-beta 42 (Aβ42) and Tau with the odds of SCD using data from two ongoing studies. In total, 849 cognitively normal (CN) individuals were included in our analyses. Among the participants, 107 had available results regarding cerebrospinal fluid (CSF) Aβ42 and Tau, while 742 had available genetic data to construct polygenic risk scores (PRSs) reflecting their genetic predisposition for CSF Aβ42 and plasma total Tau levels. The associations between AD biomarkers and SCD were tested using logistic regression models adjusted for possible confounders such as age, sex, education, depression, and baseline cognitive test scores. Abnormal values of CSF Aβ42 were related to 2.5-fold higher odds of SCD, while higher polygenic loading for Aβ42 was associated with 1.6-fold higher odds of SCD. CSF Tau, as well as polygenic loading for total Tau, were not associated with SCD. Thus, only cerebral amyloidosis appears to be related to SCD status, either in the form of polygenic risk or actual CSF measurements. The temporal sequence of amyloidosis being followed by tauopathy may partially explain our findings.