People with dementia commonly have impaired social functioning and may not recognise this. This lack of insight may result in worse outcomes for the person and their family carers. We aimed to characterise insight into social functioning in dementia, and describe its association with dementia severity.

Observational cross-sectional study of people aged >65 years with clinically diagnosed dementia and their family informants recruited from three sites in Germany, Japan and the United Kingdom. We used the Social Functioning in Dementia scale (SF-DEM), which assesses three domains: “spending time with other people” (domain 1), “communicating with other people” (domain 2), and “sensitivity to other people” (domain 3). We calculated lack of insight into social functioning as the discrepancy between the ratings of the participants with dementia and their informant. We described this discrepancy and the proportion of people with dementia whose rating was overestimated, congruent or underestimated compared to their family informant. We calculated the association between SF-DEM discrepancy score and total mini-mental status examination (MMSE) score and recall and attention/concentration subdomains.

In 108 participants with dementia (50.9% women), mean age = 78.9 (standard deviation, SD 6.5) years, and mean MMSE score = 22.7 (SD 3.7). Ratings of patients and informants for domain 1 did not differ, but patient-rating was higher than carer-rating for domain 2 (patient-rated score 11.2 (2.5), carer-rated score 10.1 (3.4); p = 0.003) and domain 3 (patient-rated score 9.7 (2.4), carer-rated score 8.1 (2.8); p < 0.001). Sixty (55.6%) people with dementia overestimated their overall social functioning, 30 (27.8%) underestimated, and 18 (16.7%) gave ratings congruent with their family informant. Performance on the MMSE, and its sub-domains was not associated with SF-DEM discrepancy score.

We found that insight varies according to subdomains of social functioning, with people with dementia rating their communication and sensitivity differently, and usually higher than their carers. Researchers and clinicians should consider insight into social functioning in dementia as a multidimensional, rather than a unified, concept. Clinicians should help family members understand and adapt by explaining their relative with dementia’s lack of insight about aspects of their social functioning.

Social connection is a basic human need and is important for quality of life and care for residents in long-term care (LTC) homes. Research has established associations between aspects of social connection (e.g., social engagement, social support and loneliness) and mental health outcomes (e.g., depression). Yet, despite living in a congregate setting, those in LTC homes often experience poor social connection. Social connection has unique considerations for LTC homes, including that most residents are living with cognitive impairment or dementia, which requires a customized measurement approach.

The social connection in long-term care home residents (SONNET) study aims to improve measurement of social connection in LTC homes by addressing three specific questions: (1) What existing measures assess social connection in LTC homes and what are their psychometric properties? (2) What do residents, families, staff and clinicians consider to be the important elements of social connection in LTC homes? (3) Can a new measure accurately assess social connection in LTC home residents?

The three study questions will be addressed through: (1) A systematic review of existing measures, where measures will be characterized using content analysis and COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methods; (2) Qualitative interviews with residents, families, staff and clinicians to understand important aspects of social connection, and, (3) Development and testing of a new measure of social connection in Canada and the UK.

Previous research will be discussed, including a scoping review summarizing research evidence linking social connection to mental health outcomes as well as strategies to build and maintain social connection during the COVID-19 pandemic. The SONNET study update will include preliminary findings from the systematic review and qualitative interviews, as well as development of a conceptual model and key considerations for a new measure.

Social connection is an important concept in LTC homes. A robust measure of social connection, developed specifically for this setting, will enable researchers and care settings to test the effects of interventions and to report outcomes at the individual-, home- and system-level.

Aging has traditionally been studied from loss, disease, and dependency, limiting the conceptualization of Quality of Life (QoL) to health. The population group of older people characterize by its heterogeneity in which many older adults experience gains and age with good physical, psychological and social conditions. Ignoring these aspects can lead to ageism. It is necessary to offer a change of perspective in which older adults’ QoL is analyzed from a multidimensional perspective where not only losses are taken into account but also the strengths of the person and the satisfaction of their higher needs (self-fulfillment, control, autonomy and pleasure).

This symposium aims to develop an assessment to improve QoL in older people through the promotion of their strengths.

Four studies from different Spanish and Portuguese universities were presented

Older people have psychological strengths that enhance QoL.

This symposium seeks to promote QoL in older people from a change of perspective based on strengths in a society for all ages, in line with the decade of healthy aging (2021-2030) approved by the World Health Assembly and the United Nations General Assembly. Aging implies a range of personal and material losses to which older people must adapt to maintain adequate levels of QoL. The stress model of Lazarus and Folkman (1984) states that the impact of stress on the person depends on the resources that they use to face the factors associated with stress. Previous research has supported the protective role of reminiscence, personal growth, digital skills, psychological well-being, acceptance, resilience, gratitude, and family functioning in QoL. Likewise, interventions focused on these variables have shown an increase in QoL. However, studies based on a strengths model are still very limited in older people.

The COVID-19 situation could be considered as an uncontrollable stressful life event. It may exert an impact on their quality of life (QoL). Not only COVID related variables, sociodemographic characteristics, health and appraisal but also personal resources could have an impact on QoL.

This study aims to assess the association between QoL and sociodemographic characteristics (sex, age), levels of health (physical health, emotional distress, and psychological well-being), COVID-19 related variables (having got infected, having lost a loved person, being hospitalized or having had a loved one hospitalized), appraisal (fear of COVID-19 outbreak), personal resources (family function, resilience, acceptance and gratitude).

QoL was assessed in all participants using CASP-19. A regression model was tested. 361 older adults in Spain participated in this study. The average age was 68.44 (SD= 5.31) and 62.8% were women (N= 227) and 58.2% were married (N= 210).

The results suggest that the nature of the COVID-19 may not be as relevant for the older adults’ QoL as their levels of health, personal resources for managing COVID related and emotional status. We found that the older adults QoL increased when increased the levels of health, acceptance, gratitude, personal growth, and purpose in life and when there were lower scores in anxiety and depression. This model explained 66.4% of variance. In contrast, COVID-19 variables or appraisal did not show any association with QoL.

A better understanding of the factors associated with QoL could help health professionals to develop interventions that enhance it. Efforts to address older adults’ QoL focusing on older adults’ personal resources, perceived health and emotional status should be considered.

The group population of older adults has suffered the highest number of deaths and impact on health associated with the COVID-19 pandemic. Many older adults can perceive this pandemic as a traumatic experience. However, many older adults may have also experienced positive changes, defined as post-traumatic growth (PTG). Several factors may enhance or hinder this possibility of development.

This study aimed to analyze if the effects of COVID-19 affection (direct and indirect), anxiety and depression on PTG would be mediated by the protective variables life purpose and resilience.

359 older adults over 60 years old completed a web-based survey during the COVID-19 pandemic including sociodemographic data, direct/indirect affectation by COVID-19, anxiety, depression, resilience, life purpose and PTG.

63.2% of the participants were women and 58.2% were married. 89.1% had been infected by COVID-19, 1.7% had been hospitalized, 15.6% had lost a loved one and 17.2% have had a relative hospitalized because of COVID-19. Women (M = 56.77; SD = 18.00) showed higher levels of PTG than men (M = 52.41; SD = 17.84) (t = -2.19; p < .05). Differences in the outcome variables based on direct or indirect COVID-19 affection were not found. The path analysis showed that the effect of COVID-19 symptoms on PTG was mainly mediated by life purpose, and anxiety to a lesser extent. We also confirmed two indirect effects: (1) the negative effect of depression on PTG through resilience and life purpose assessed simultaneously; (2) the positive effect of resilience on PTG through life purpose. Results showed an excellent model fit to this model (χ² = 3.759; χ²/gl = 5; p = .585; GFI = .997; CFI = .999; RMSEA = .001).

The identification of protective and vulnerability variables is essential to protect older adults from mental disorders. This study highlights the need for developing interventions that aim to increase PTG by promoting life purpose and resilience.

New technologies have many benefits for the quality of life of older people, but their use also carries risks and can transforms older people in potential victims of cyber-attacks. The increase of ICT use has caused many older adults to be displaced from these social advances, resulting in greater isolation, negative feelings related to ICTs and less access to services.

Due to the absence of extensive and generalisable studies in this area with this population, we consider it necessary to analyse older people's behaviour in relation to ICT and the psychosocial variables that are related to their adaptation.

To determine the effect of different psychosocial variables that may be related to the adaptation to TIC and protection measures used in cyberspace in older adults.

We have used a mixed research methodology: Firstly, a quantitative pilot study, analysing the variables descriptively; secondly, using qualitative interviews and an exploratory analysis. The next step is to design and validate a questionnaire that will include the 4 factors that we found relevant: victimisation, use of new technologies, fear of cybercrime and use of online protection barriers.

The 84% of the sample uses ICT more than one hour per day and 77%, had not received training in TIC and their perception of online vulnerability is low. The need for social support for the management of these tools was observed. Older people who use ICT less are those who are not digitally literate, perceive themselves as more vulnerable in their use of ICTs and have no one to help them with these tools.

The identification of variables related to the use of TIC, the perception of vulnerability and the online protection of older adults is fundamental for the development of effective interventions. It would be desirable not only to offer them training in digitalisation but also to provide them with the social support they demand.

Although the losses associated with aging activate additional psychological resilience resources, dependency settings, which often require admission to Residential Care Facilities (RCF's), need adequate care so that the person can maintain his/her dignity and quality of life. The activation of mechanisms for regulating losses and the preservation of the identity and autonomy of the person respecting his/her decision-making capacity are central for the preservation of the well-being of people with dependence. Portuguese RCF's are mainly based on care models that are opposed to the models of attention centered on the person, which value the person's potential and decision-making capacity. The COVID-19 pandemic has tested RCF's, highlighting their weaknesses and limitations.

This study aimed to identify ways to improve the provision of care in RCF's during the pandemic.

This is a qualitative study, with data collection through an online questionnaire. Participants were invited to indicate strategies to improve the provision of care to elderly residents in RCF's. The study included 198 RCF ́s workers during the COVID-19 pandemic. Content analysis of the collected data was performed.

Preliminary results on the ongoing study: The results indicate that the strategies that RCF´s workers consider most necessary are at the level of human resources, also highlighting the need for greater proximity, affection and attention to residents, the personalization of care and the valorization of the resident person and his/her opinions. These are considered by the participants as central strategies for the quality of care and satisfaction of RCF ́s workers.

The needs identified are in line with the guiding principles of Person-Centered Care. The use of reminiscence as a strategy for valuing the person and his/her identity, as well as the promotion of self-determination, evaluating and allowing the person to make decisions may be central to meeting the needs identified at the level of care. The necessary transition from RCF's in Portugal to paradigms of centered care is thus reinforced by the results of this study.

Mild Behavioral Impairment (MBI) is a diagnostic construct defined by the later-life emergence of persistent neuropsychiatric symptoms (for example, apathy, anxiety, depression, amongst others) displayed by older adults, with the aim to identify individuals at increasing risk of future dementia. The construct is also related to AD biomarkers including beta-amyloid, tau, and cerebral atrophy. For the assessment of MBI, researchers developed the Mild Behavioral Impairment Checklist (MBI-C) (Ismail et al., 2017) evaluating five domains: decreased motivation, affective dysregulation, impulse dyscontrol, social inappropriateness, and abnormal thought and perception.

The purpose of this symposium is to present four contributions that allow increasing our knowledge of the added value of MBI in clinical diagnosis of neurocognitive disorders.

Firstly, Dr. Maurits Johansson from Lund University (Malmö, Sweden) presents an overview of the role of MBI in the contemporary clinical diagnostic criteria for AD and some perspectives for treatment in the future.

Then, Dr. Sabela C. Mallo from the University of Santiago de Compostela (Spain) and Dr. Byron Creese from the University of Exeter (UK) will talk on methodological issues regarding the MBI-C, the underlying structure of the instrument and the impact of the self and informant ratings in the results of the questionnaire.

Dr. Martin Vyhnalek from the Faculty of Medicine of Prague (Czech Republic) will discuss the MBI profile and severity in a sample of β-amyloid positive individuals with amnestic Mild Cognitive Impairment compared to Cognitively Normal older adults.

Lastly, Dr. Camilla Elefante and Giulio Emilio Brancati from the University of Pisa (Italy) will analyze the relationships and boundaries between MBI and late-life major primary psychiatric disorders in patients who attend to psychogeriatric settings.

The assessment of MBI involves two important issues: 1) to know the underlying structure of the Mild Behavioral Impairment Checklist (MBI-C) a questionnaire designed to evaluates Neuropsychiatric Symptoms (NPS) in pre-dementia states; and 2) to consider self and proxy (i.e., study partner) symptom ratings that may not capture comparable samples. Our objective is to give some answer to these questions: first, to analyze the underlying structure of the MBI-C at baseline and follow-up using Multidimensional Scaling (MDS) and two, to determine how self and proxy ratings and the choice of rating type impact in the results of the MBI-C.

To analyze MBI-C structure, 200 Subjective Cognitive Decline and Mild Cognitive Impairment patients from the CompAS longitudinal study completed baseline and follow-up assessments. Two-step bidimensional weighted dichotomous MDS were performed. All items were included in the first step. Items closely associated with each dimension (1 SD above or below the mean) were selected in a second step to obtain the final models solution.

We will also present a review of the literature on the importance of self and proxy MBI-C ratings. We will also present new empirical evidence based on data from over 10,000 cognitively normal.

Results from baseline and follow-up showed two dimensions: Dimension I (right-left) differentiate high and low emotional activation and Dimension II (top-down) high and low behavioral activation. The combination of both generates 4 quadrants: resistance, restlessness, flattening and desolation. The final models were built considering the most relevant items, with little differences between baseline and follow-up. The good fit of the models, type of two-dimensional solution and group weights were similar in baseline and follow-up.

Regarding our second objective, the results suggest that self and proxy ratings may not capture comparable samples and that the choice of rating type can indeed impact the conclusions drawn from analysis.

The 4 quadrants identified could be the most useful NPS to determine risk factors for predementia patients. Also, the findings suggest that the way of applying the MBI-C has relevant implications.

We aimed to examine the profile and severity of mild behavioral impairment (MBI) in a sample of β-amyloid positive individuals with amnestic mild cognitive impairment (aMCI)compared to cognitively normal older adults (CN). Within aMCI, we further examined the potential influence of APOE and BDN Frisk genetic polymorphisms on MBI severity.

We included 64 β-amyloid positive aMCI participants and 50 CN older adults from the Czech Brain Aging Study. The participants underwent neurological, comprehensive neuropsychological examination, APOE and BDNF genotyping, and magnetic resonance imaging.MBI was diagnosed with the Mild behavioral impairment checklist (MBI-C) developed for MBI case detection, and the diagnosis was based on the MBI-C total score ≥7. Additionally, self-report instruments for anxiety (the Beck Anxiety Inventory) and depressive symptoms (the Geriatric Depression Scale-15) were administered. The participants were stratified based on the presence of at least one risk allele in genes for APOE (i.e., e4 carriers and non-carriers) and BDNF (i.e., Met carriers and non-carriers). We used linear regressions to examine the between-group differences.

MBI symptoms (MBI-C total score ≥1) were present in 28% CN and 83% aMCI. Almost half (48.4%) of the aMCI individuals met the criteria for the MBI syndrome. Compared to the CN, the aMCI group displayed more affective, apathy, and impulse dyscontrol symptoms (p<0.001) but not social inappropriateness or psychotic symptoms. Furthermore, aMCI participants reported more depressive (p<0.01) but similar anxiety symptoms to CN on self-report measures. Within the aMCI group, APOE e4 and BDNF Met carriers did not differ from non-carriers in the severity of NPS in either instrument. However, the results suggested that an interaction between these polymorphisms influenced self-reported anxiety (p=0.034), with Met carriers/e4 non-carriers reporting the highest anxiety levels.

MBI is frequent in prodromal Alzheimer´s disease and characterized by affective, apathy, and impulse dyscontrol symptoms. APOE and BDNF risk genetic polymorphisms did not influence the NPS severity when considered separately; however, their interaction might influence anxiety, which warrants further investigation.

The research has received funding from the EEA/ Norway Grants 2014-2021 and the Technology Agency of the Czech Republic – project number TO01000215, Ministry of Health of the Czech Republic, grant no. 19-04-00560, National Institute for Neurological Research (Programme EXCELES, ID Project No. LX22NPO5107) - funded by the European Union – Next Generation EU and GAČR 22-33968S.

People with dementia can live full and meaningful lives after diagnosis, but still many people with dementia and their family care partners are dissatisfied with the process of getting a diagnosis and may also receive limited, if any, post-diagnostic support. The international COGNISANCE project aims to improve the communication of dementia diagnosis and post-diagnostic support. It is a 3-year project supported by the EU Joint Program for Neurodegenerative Disease Research (JPND), with partners in Australia (lead), Canada, Netherlands, UK, and Poland.

Based on the experiences of people with dementia, family care partners and health care professionals, and in partnership with them, we codesigned a website that provides structured information, resources and tools tailored to empower people with dementia and their family care partners. Effects of the campaign was evaluated using the RE-AIM framework. From our collective experiences, a ‘playbook’ was produced outlining how to deliver similar campaigns in other countries. Through these activities we aimed to improve health care practitioner’s diagnostic habits and provision of support, as well as increase help seeking by people with dementia and care partners.

In this symposium, you will hear about the latest results of four workpackages of this COGNISANCE project:

1. 1. A general overview of the rationale, goals, and design of the project will be presented by the principal investigator

2. 2. Data of a qualitative study will be presented on the experiences of receiving a diagnosis, and the barriers and facilitators towards post-diagnostic support, as well as on the differences and similarities between countries.

3. 3. The development of an online actionable guide Forward with dementia (www.forwardwithdementia.org) using a person-centered approach with target audience groups. The aim of this online guide was to support decision making and to help people find their way forward from a diagnosis of dementia.

4. 4. Data will be presented of the evaluation of the implementation and perceived impact of the Forward With Dementia websites and campaign in the five participating countries

People with dementia and informal caregivers utilize a variety of coping strategies to deal with the consequences of a dementia diagnosis. In the beginning they often rely on informal support, but research shows that they could benefit from formal support. The societal and cultural context may also influence how people deal with dementia. Yet, most research that takes place across countries or cultures provides little detail about cross-country differences or similarities. The purpose of this qualitative study is firstly to describe experiences of receiving a diagnosis and experiences, barriers and facilitators towards post-diagnostic support and secondly, and to examine differences and similarities between countries

A cross-country qualitative study with people with dementia recently diagnosed and their informal caregivers was carried out in Australia, Canada, the Netherlands and Poland between March 2020 and September 2020. A wide range of recruitment strategies and methods was adopted to aid recruitment and participation during the covid pandemic. Participants could participate in (online) Individual and dyadic interviews as well as online focus groups. To examine experiences after diagnosis and support, methods utilized ‘projective techniques’ whereby participants could project their experiences onto two fictional characters (a person with dementia, and her informal caregiver). A multi-step iterative inductive qualitative content analysis was carried out.

23 people with dementia and 53 informal caregivers participated. The following themes were identified; ‘getting a diagnosis, ‘coming to terms with dementia’, ‘support from friends and family’, ‘formal support’, ‘adapting to the role of informal caregiver’ and ‘living well with dementia’. ‘Formal support’ and ‘support from friends and family’ could serve as a barrier, facilitator or both in relation to ‘coming to terms with dementia’ and ‘adapting to the role of informal caregiver’. Coming to terms was a necessity for living well with dementia. ‘Adapting to the role of informal caregiver’ was an ongoing adaption process that was part of ‘coming to terms with dementia’ and extended into ‘living well with dementia’. Similarities of the themes across countries were larger than the differences.

Support should enable the process of coming to terms with dementia in a culturally appropriate manner.

Through a co-design process we set out to improve post diagnostic dementia support as part of a wider international programme. A partnership approach was taken with people living with dementia, carers and healthcare professionals.

A scoping review and thematic analysis of existing national and international dementia policies guidelines and campaigns were undertaken to identify gaps and to create a core evidence base. We established co-design local working groups in each of the five partner countries. A series of 20 objective led iterative workshops, four in each country over a period of six months were held. In this way a prototype website was designed, built, populated, and refined. Evidence based English language content was generated and edited collaboratively, core themes were derived from operationalising national Dementia Clinical Guidelines, utilising current evidence, responding to co-designers’ requests and formative research findings. The website was then adapted regionally through translation, links to local information, and including culturally appropriate images, stories and news items. These adapted sites were then user tested and further refined ahead of awareness raising campaigns.

We co-designed a dementia friendly accessible resource to support people living with dementia, carers and healthcare professionals for the first 12 months following diagnosis. The workshops determined that the resource should be available online, current, practical, and relevant at a regional and individual level. The need for a practical, empathetic and individually tailored resource was identified. Language, tone, and online accessibility were essential, particularly for people living with dementia. It was important that the content be written and presented specifically and discretely for people recently diagnosed with dementia, for care partners and for healthcare professionals.

We set out to improve the dialogue around dementia diagnosis. To empower patients and practitioners through providing information, practical tools, improving awareness of and access to available local supports. Through a person-centred approach with target audience groups together we have developed an online actionable guide Forward with dementia (https://www.forwardwithdementia.org) which supports decision making and to help people find their way forward from a diagnosis of dementia.

The Forward with Dementia (FWD) project is a dementia awareness campaign that was implemented across five countries. The campaign included components such as websites (in four languages – www.forwardwithdementia.org), webinars, newsletters, and social media posts. This campaign is the fourth phase of a three-year longitudinal mixed methods study with five phases in five countries: Canada (New Brunswick, Ontario, Quebec), Australia, the Netherlands, United Kingdom, and Poland. The purpose of this study is to evaluate the implementation and perceived impact of the FWD websites and campaign in the five participating countries.

The RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance) was used to guide the campaign evaluation. The evaluation was drawn from Google Analytics, surveys, individual interviews, and report cards. Data collection occurred between September 2021 and May 2022.

There were approximately 124,945 page views across all FWD websites during the campaign. Participants of the surveys and interviews reported engaging in a range of campaign activities. They read information about receiving a diagnosis, stories from persons with lived experience in dementia, news, and attended webinars (or watched recording). Most participants rated the information that they read on the website moderately, very, or extremely helpful. In addition, the majority of respondents said that they plan to visit the website again. During the interviews, participants shared that the website was easy to navigate, practical, and that it maintains a positive tone related to dementia. The co-design aspect of the campaign was considered a strength.

The findings indicate that the FWD campaign can provide support for people who have recently received a dementia diagnosis and their family or friends. In addition, the campaign may provide health and social care providers with a new source of information and tools to use and share with their clients. These results informed the development of a playbook to guide regions and countries beyond those involved in this project to implement similar initiatives.

The WHO Global Action Plan against Dementia calls for “at least 75% of member states providing carer support and training by 2025”. In response to the global target, WHO has developed iSupport aiming to provide support for caregivers of people living with dementia. The generic WHO iSupport has been translated and adapted in 39 countries and 37 languages so far. The adapted versions of WHO iSupport are now being implemented worldwide, usually as an online program for caregivers. The feasibility, accessibility, effectiveness and sustainability of the iSupport program in different cultural context is now being explored extensively. This symposium aims to share the up-to-date research findings and lessons learned on the adaptation and implementation process and users’ perspectives from diverse cultural background. It will include seven presentation and be divided into sessions: 3 presentations on Session I and 4 presentations on Session II.

Session I: The first presentation will be dedicated to overviewing the development and the progress of adaptation and implementation of WHO iSupport. The second presentation will focus on the adaptation of iSupport in Uganda. The presentation will inform the utility of iSupport in Sub-Sahara Africa. Based on individual semi-structural interview data from Tunisia, the third presentation will highlight that caregivers’ experience and needs are valuable for cultural adaptation of iSupport.

Session II: The first presentation will demonstrate how facilitator-enabled iSupport intervention would change the interaction and engagement in learning among Chinese caregivers living in Australia and Greater China. The second presentation will focus on adapting iSupport in Switzerland using a community-based participatory approach. The third presentation will show the potential benefit of raising awareness of the Russian society about dementia after the implementation of iSupport through digital technologies. The fourth presentation will report on the co-design of an adapted version of iSupport for young caregivers.

The symposium is expected to inform further development, improvement and implementation of WHO iSupport for diverse cultural background. This will be not only valuable information for participants who are interested in iSupport but also for those (interested in) investigating interventions developed in another cultural setting.

In this first presentation, we will present iSupport, WHO’s skills training and support program for caregivers of people living with dementia, and summarize the theoretical and empirical background for its development and cultural specific adaptations, and the lessons learned so far. WHO iSupport consists of 23 sessions in total, covering five modules: (a) what is dementia (one session); (b) being a carer (four sessions); (c) caring for me (three sessions); (d) providing everyday care (five sessions) and (e) dealing with changing behaviour (ten sessions).

The overview that we will present in this session will be based on the fast growing evidence on the adaptation and implementation of iSupport described in the scientific literature.

First steps have been undertaken to translate and adapt WHO iSupport systematically and culturally fair for several countries and specific target groups and first studies on the impact have been carried out. Published results from India, Portugal, Australia and Brazil will be summarized, also discussing some experienced barriers for implementation related to the way the intervention is provided and implemented, also related to cultural issues.

The scaling of programs like WHO iSupport remains challenging. Ongoing research shows that interventions for caregivers of people living with dementia especially in LMICs such as India require further consideration. However, low uptake and adherence help us better understand which barriers caregivers face and how future research might tailor iSupport and other online programs better to carers’ needs.

Support and training programmes such as iSupport, are more important than ever in the context of the ongoing COVID-19 pandemic. They present a real opportunity to help to reach the global target set by WHO that 75% of countries will provide support and training programmes for caregivers of people living with dementia by 2025.

Family caregivers of persons with ADRD face major stressful emotional, social and economic burdens, and the negative consequences associated with caregiving are well documented. Given the projected global increase in the number of people with dementia (82 million by 2030 and 152 million by 2050), plus a current Dementia prevalence among persons 60 years and older in Uganda, ranging from 5.5% to 20%, there is paucity of information regarding the psychotherapeutic management of challenges that family caregivers of persons with ADRD go through in many settings in sub-Sahara Africa, including Uganda. This study will contribute to the cultural adaptation of the WHO-iSupport that is an appropriate intervention for caregivers of persons with ADRD in Uganda.

To investigate the current approaches that caregivers use in the support of persons with ADRD, so as to inform the adaptation of the WHO iSupport intervention for Uganda.

This is a cultural adaptation study involving adaptation and pre-test the WHO-iSupport for family caregivers of persons with ADRD in Wakiso, Uganda. We are using a group consensus method that includes a professional translator and independent groups of bilingual experts. Caregivers of patients with ADRD are being recruited into the study. Data will be collected by the researcher and trained research assistants.

The primary outcome of this study is the adaptation of the WHO-iSupport psychotherapy.

Primary analyses will be based on Intention to treat (ITT) principle to avoid any biases that may occur by subjective choice of ineligible subjects. Summary statistics like age will be given as a mean (SD) while for categorical data will be given as a proportion and summarized in tables and graphs.

The proposed study is instrumental as it will be the first known study in our setting that provides a step-by-step guide in the cultural adaptation of an intervention for care giving of persons with ADRD. The A-iSupport is a caregiver focused intervention, that promises better health and care outcomes for family caregivers of persons with ADRD, thus reducing the health care load on mental health workers.