Poster Presentations: P3 diagnosis; or delayed access to the next step in the diagnostic process. While research is ongoing, there is evidence to support the usefulness of a timely diagnosis of dementia. This project is specifically interested in local and international examples of service models which focus on reducing the time lag to diagnosis. Methods: A review of the international literature, including grey literature, was conducted. Contact was made with service providers identified as carrying out relevant activities, even if associated health service research had not already been completed for these activities. Results: Following a search of computerised databases, 34 relevant papers were identified. This was supplemented with some interviews to capture as yet unpublished new service models. A diverse range of countries were identified including: England, Netherlands, America, and Australia Models included: the creation of specialised centres such as memory clinics; use of individual specialists (i.e. psychiatrists, neurologists); multiple component interventions linked to clinical care pathways); practice nursing staff; telehealth. There are key recommendations for the implementation of strategies relevant for Australia and research gaps in relation to knowledge translation (i.e. what additional evidence is required to show the effectiveness of existing implementation strategies). Conclusions: Early/timely diagnosis of dementia is often overlooked as an opportunity for change, given the challenges associated with prevention, treatment and/or cure. This project articulates the potential for translating existing evidence for the task of early/timely diagnosis into clinical practice.
P3-355
A PEER-TO-PEER INTERVENTION TO CHANGE ATTITUDES OF FAMILY PHYSICIANS TOWARD DEMENTIA
Horst Christian Vollmar1, Verena Leve2, Stefan Wilm1, Michael Pentzek1, 1 Institute of General Practice, Medical Faculty, Heinrich-Heine University D€ usseldorf, D€ usseldorf, Germany; 2Institute for General Practice, Medical Faculty, Heinrich-Heine University D€usseldorf, D€usseldorf, Germany. Contact e-mail:
[email protected] Background: Family physicians/general practitioners (FPs) play a central role in caring for persons with dementia. The CADIF project (Changing Attitudes towards Dementia In Family practice) encompasses the development and testing of a complex intervention that is based on a comprehensive understanding of FPs’ attitudes towards dementia. The intervention will be tested in an exploratory trial with FPs in the area of Duesseldorf, Germany. Methods: A systematic review of the literature, a meta-synthesis of qualitative studies and four focus groups with 27 FPs were conducted. As a result, peer-to-peer outreach visits in combination with a toolkit seem to be the most promising approach for a successful intervention. Four experienced FPs (1f, 3 m) were trained as peers in a six hour session. Content of this session was Intention of the project (e.g. eye-to-eye discussions between colleagues);Four key message for the peer visits: a) early perception of dementia symptoms; b) patientcenteredness; c) focus on quality of life ("caring instead of curing"); d) "you are not alone", which means that for FPs (and also for patients and caregivers) there is a wide spectrum of assistance in the local area available;Using and discussing the toolkit (including guideline, slides, addresslists, tests, and patient information leaflets); To address the key messages to different types of FPs ("nihilist", "uncertain", "protector", "time constraint", or "expert") several recommendations were given;Role playing to become familiar with the toolkit and the different roles.To test the peer approach, ten FPs from Duesseldorf were recruited. Qualitative interviews before and 6 month after the intervention were respectively will be conducted. Results: The intervention is still running and the interviews will facilitate some evidence, whether a peer intervention leads to change in FPs’ attitudes towards dementia. The results will be available at the time of the conference. Conclusions: If the results of the exploratory trial are in favor, a cluster-randomized trial to test the intervention will be conducted. This project is funded by the German Federal Ministry of Education and Research (BMBF) as part of the German Research Network on Degenerative Dementia (KNDD) (grant 01GI1011A).
P3-356
P761 ALONE BUT NOT FORGOTTEN: WHO IS LIVING ALONE WITH COGNITIVE IMPAIRMENT?
Allison Gibson, Virginia Richardson, The Ohio State University, Columbus, Ohio, United States. Contact e-mail: gibson.422@buckeyemail. osu.edu Background: In 2012, the Alzheimer’s Association proposed a "call to action" to address the needs of older adults living alone with cognitive impairment (CI). The report concluded that studies of those living alone with dementia are extremely limited– primarily due to the challenges in recruiting participants for research (see Soniat, 2004). While most individuals diagnosed with dementia live with a caregiver, as many as 800,000 of individuals diagnosed with CI live alone-perhaps without any identified caregiver (Alzheimer’s Association, 2012; Webber, Fox & Burnette, 1994; Prescop, Dodge, Morycz & Ganguli, 1999; Nourhashemi et al., 2005). As these individuals may have little or no support for conducting activities of daily living (ADLs) (Nourhashemi et al., 2005), they are likely to be even more isolated from formal sources of support (Miranda-Castillo, Woods & Orrell, 2010; Tierney et al., Tuokko, MacCourt & Heath, 1999; Webber, Fox & Burnette, 1994). Further, research has found this population is more likely to be undiagnosed for their CI (Edwards & Morris, 2007; Waugh, 2009). Methods: A cross-sectional survey design was utilized to better understand the population of persons living alone with CI. The National Health and Aging Trends Study (NHATS, 2011) is a nationally-collected and publicly available dataset which annually collects self-reported measures of CI on study participants sixty and older. A sample of 1,554 individuals, living on their own in a private residence met the criteria for the study (n¼1554). Descriptive statistics were generated to describe the sample of persons living alone with CI. Scale means, standard deviations, and correlations will also be presented. Results: Of those living alone with CI, 73.8% were female. While some individuals had identified formal supports from family, much of the population was utilizing friends and neighbors as care providers. While 49.4% received mild to severely impaired CI scores, only 3.0% reported they had been formally diagnosed with a form of Alzheimer’s and/or dementia. Conclusions: Presentation will conclude with some suggestions on how to possibly alleviate challenges diagnosing CI for persons living alone, as well as recommendations for providing social support services to this unique population. P3-357
IMPACT OF PHYSICAL ACTIVITY AND COGNITION ON ACTIVITIES OF DAILY LIVING IN HOME-DWELLING PATIENTS WITH MILD TO MODERATE ALZHEIMER’S DISEASE
Kristine Hoffmann1, Kristian Steen Frederiksen2, Nanna Aue Sobol3, Nina Beyer4, Asmus Vogel5, Birgitte Bo Andersen6, Annette Lolk7, Hanne Gottrupp8, Gunhild Waldemar9, Steen Gregers Hasselbalch10, 1 The Memory Disorders Reseach Group, Copenhagen, Denmark; 2Danish Dementia Research Group, Copenhagen, Denmark; 3Musculoskeletal Rehabilitation Research Unit & Institute of Sports Medicine, Copenhagen, Bispebjerg, Copenhagen, Denmark; 4Musculoskeletal Rehabilitation Research Unit and Institute of Sports Medicine, Bispebjerg Hospital, Copenhagen, Denmark; 5Danish Dementia Research Center, Copenhagen, Denmark; 6Memory Disorders Research Group, Copenhagen University Hospital, Copenhagen, Denmark; 7Dementia Clinic, Odense, Denmark; 8 Memory Clinic, Aarhus, Denmark; 9Danish Dementia Research Centre, Copenhagen, Denmark; 10Danish Dementia Research Centre, Copenhagen, Denmark. Contact e-mail:
[email protected] Background: InAlzheimer’s disease (AD), the decline in activities of daily living (ADL) is increasingly recognized as a source of considerable social, health, and economic costs. The ability to perform ADL is influenced by dementia severity and by specific neuropsychiatric symptoms, but it is unclear to which extent cognition and physical activity relates to ADL. Two independent metaanalyses have concluded that being physically active at a medium/ high level reduces not only the risk of progression of basic ADL disability but also the risk of cognitive decline in community dwelling adults.
