Effects of foreign language learning on executive functions in healthy older adults: study protocol for a randomised controlled trial.

BACKGROUND: With age, most cognitive functions decline. As the number of people aged 60 years and older is expected to rise rapidly within the next decades, identifying interventions that promote healthy cognitive ageing is of utmost importance. Promising research on bilingualism has led to the notion that learning a foreign language could protect against cognitive decline. Foreign language learning likely promotes executive functions, which are higher-order cognitive abilities particularly affected by age-related cognitive decline. However, evidence is still sparse and has produced contradictory results. This study aims to investigate the effects of short and intensive foreign language learning on executive functions in healthy older adults. METHODS: In a randomised controlled trial, we will assign 60 native German-speaking monolingual healthy older adults, aged 65-80 years, to either a foreign language learning or a waiting list control group. Language learners will attend a face-to-face, group-based Spanish course for beginners for 1.5 h a day, 5 days a week, for a total of 3 weeks. Cognitive performance in executive functions will be assessed before and after the intervention or after a waiting period of 3 weeks (waiting list control group). Participants will be tested again after 3 months to evaluate longitudinal effects of foreign language learning. The waiting list control group will receive Spanish lessons only after the final assessment and will be invited to an additional voluntary evaluation after completion of the course. DISCUSSION: To the best of our knowledge, we are conducting the first randomised controlled trial on the effects of short and intensive foreign language learning in older adulthood on executive functions. Enhanced cognitive performance after foreign language learning would indicate that learning a foreign language could enlarge cognitive reserve and thus promote healthy cognitive ageing in older adults. TRIAL REGISTRATION: German Clinical Trials Register DRKS00016552 . Registered on 11 February 2019.

Views of nursing staff on computerized dementia screening : A validation and pilot study in a general hospital.

BACKGROUND: Cognitive disorders such as dementia are common among older adults admitted to general hospitals. They can complicate treatment leading to longer hospitalization and worse outcomes. They often remain underdiagnosed as the busy routine of the hospital does not enable efficient screening and available screening instruments are not suitable for the hospital environment. Computerized cognitive testing (CCT) has been proposed as an efficient screening method as it can be employed by nonspecialists, such as nurses while featuring automatic scoring and interpretation of results. OBJECTIVE: This study validated a newly developed questionnaire for measuring the attitudes of Greek nurses towards computerized dementia screening. MATERIAL AND METHODS: The questionnaire was validated in a sample of 212 undergraduate psychology students and subsequently administered to a sample of 19 nurses working in a general hospital. Reliability of the questionnaire was calculated using Cronbach's alpha (= 0.762). Factor analysis revealed the existence of a single factor (acceptability-feasibility) that accounted for 33.73% of variance with an eigenvalue of 3.036. RESULTS: The total score of all the items loading on the single factor (acceptability-feasibility) was calculated. Scores ranged between 10 and 40 with the average score for the validation group being 29.33 (SD = 4.89) and the average score for the nurses' group being 29.50 (SD = 3.20). DISCUSSION: The questionnaire has acceptable reliability. Results indicate that acceptability-feasibility is high in both groups and there were no statistically significant differences between the two groups.

Expectations of nursing personnel and physicians on dementia training : A descriptive survey in general hospitals in Germany and Greece.

BACKGROUND: The number of dementia training programs in hospital settings is steadily increasing. The way training sessions are designed influences the way the learning content is implemented in practice. To develop a successful training it is important to meet the needs of the target group; however, not much is known about staff preferences and expectations relevant to future dementia training programs in hospitals in Germany and Greece. OBJECTIVE: The aim of this survey was to explore staff training needs relevant to the topic of dementia, in general hospitals in Germany and Greece. This study analyzed the interests of staff members, preferences and expectations with respect to dementia training. MATERIAL AND METHODS: This was a descriptive survey based on a 54-item questionnaire conducted with 61 nursing staff, head nurses and physicians (Germany: n = 25, Greece: n = 36) recruited from 5 hospitals (Germany: n = 3, Greece: n = 2). Parts of the questionnaire explored participants' previous education regarding dementia and their expectations towards future dementia programs. RESULTS: Although staff attendance in educative programs was high in the last 5 years for both countries, participation in dementia training programs was low (Germany 24%, Greece 5.5%). Additionally, the great majority of participants were willing to be trained in future dementia training programs (Germany 96%, Greece 100%). Employees from both countries expect increased clinical skills as a result of participation in such training programs. In Greece, staff members hope for better handling of people with dementia, while in Germany, concrete practical advice is preferred. CONCLUSION: There seems to be a strong willingness to participate in further dementia training programs where not only theoretical knowledge is provided but also practical advice.

Influence of combined physical and cognitive training on cognition: a systematic review.

BACKGROUND: Numerous daily activities require simultaneous application of motor and cognitive skills (dual-tasking). The execution of such tasks is especially difficult for the elderly and for people with (neuro-) degenerative disorders. Training of physical and cognitive abilities helps prevent or slow down the age-related decline of cognition. The aim of this review is to summarise and assess the role of combined physical-and-cognitive-training characteristics in improving cognitive performance and to propose an effective training scheme within the frame of a suitable experimental design. METHODS: A systematic electronic literature search was conducted in selected databases. The following criteria were compulsory for inclusion in the study: 1. A (Randomized) Controlled Trial (RCT or CT) design; 2. Implementation of combined physical and cognitive training, either simultaneously (dual task) or subsequently - at least one hour per weekly over four weeks or more; 3. Cognitive outcomes as a study's endpoint. RESULTS: Twenty articles met the inclusion criteria. It appears that either simultaneous or subsequently combined physical and cognitive training is more successful compared to single physical or single cognitive exercise. Training characteristics like length, frequency, duration, intensity and level of task difficulty seem to determine cognitive performance. However, the articles show that cognitive improvement seems to remain somewhat confined to trained cognitive functions rather than generalising to other cognitive or daily-living skills. CONCLUSION: Due to methodological heterogeneity among studies, results need to be treated with caution. We critically discuss the role of training characteristics and propose a potentially effective training intervention within an appropriate experimental design.

Dementia Knowledge, Attitude toward Dementia, and Confidence in Dementia Care: Impact of a Dementia Training on German Nursing Students.

Background: The number of people with dementia (PwD) in acute care hospitals is steadily increasing, posing a challenge for those who work closely with patients. To date, no German study has addressed the extent to which prospective nurses benefit from dementia training in terms of their knowledge, attitudes, and confidence in caring for PwD. Objective: The aim of this study is to investigate whether a validated dementia training for registered nurses can positively change nursing students' knowledge about dementia, their attitude toward PwD, and their confidence in caring for them, as well as the stability over time. Methods: In the one-group pre-test, post-test design, a sample of 81 nursing students was recruited from two nursing schools in Germany between May and June 2023. They completed a questionnaire consisting of the Dementia Knowledge Assessment Scale, the Dementia Attitude Scale, and the Confidence in Dementia Scale, as well as sociodemographic questions and experiences with PwD at three measurement points. The data were analyzed using the Wilcoxon test and repeated measures ANOVA. Results: The training has a significant effect on knowledge in dementia (z = -5.07, p < 0.001), attitude toward PwD (z = -4.42, p < 0.001), and confidence in caring for them at the post-test (z = -3. 21, p < 0.001, r = 0.36). The repeated measures ANOVA shows stability over time only for dementia knowledge. Conclusions: The results indicate the need for further research in this field as well as the validation of the dementia training specifically addressing nursing students.

Translation, validation, and comparison of genetic knowledge scales in Greek and German.

Introduction : Advances in biosciences have significantly expanded our knowledge and capabilities in medicine and technology. Genetic tests can now predict hereditary predisposition or susceptibility to diseases, while gene-editing tools like CRISPR/Cas enable easy repair of disease genes in both somatic and germline cells, ensuring permanent genome correction. Despite these advancements, there is a shortage of valid instruments for studying the knowledge about these technologies. To fill this gap, our study aims to translate and validate various scales to effectively measure the public's knowledge of genetics. Methods: A convenience sample of N = 567 (Germany n = 317, Greece n = 250) participants completed a Google Forms questionnaire between December 2022 and June 2023, which included the General Knowledge of Genes and Heredity (GKGH), Knowledge about Gene-Environment Interaction (KGEI), and Knowledge of Modern Genetics and Genomics (KMGG) questionnaires. Analyses included internal consistency, structural validity, construct validity, and retest reliability with a subset of n = 72 (DE) and n = 50 (GR). Correlation analyses and group differences were evaluated for gender, education, religiosity, age, prior experience with genetic testing, and preferences toward potential providers of genetic testing. This study used the STROBE checklist for reporting. Results: The GKGH exhibited low values in internal consistency and item analysis, along with a ceiling effect within the German group. However, it demonstrated good values in retest and construct validity. In the Greek group, all properties were highly satisfactory. The KMGG consistently displayed excellent properties across all analyses, whereas the KGEI only showed convincing results in construct validity and item analysis. Discussion: The GKGH and KMGG demonstrated strong psychometric properties with varying difficulty levels dependent on the sample, with the German sample demonstrating a notably higher understanding of genetic technologies. Despite displaying acceptable properties, the KGEI fell short of measuring what its title suggests. Participants' level of education showed a significant correlation with knowledge of genetic technologies, and only in the Greek sample did experiences with genetic tests influence knowledge. Preferences regarding availability of genetic testing are comparable between the two countries, with variations influenced by factors such as age, gender and religiosity.

Validation of the "Perceptions Regarding pRE-Symptomatic Alzheimer's Disease Screening" (PRE-ADS) Questionnaire in the German Population: Attitudes, Motivations, and Barriers to Pre-Symptomatic Dementia Screening.

BACKGROUND: Attitudes, motivations, and barriers to pre-symptomatic screening for Alzheimer's disease (AD) in the general population are unclear, and validated measurement tools are lacking. OBJECTIVE: Translation and validation of the German version of the "Perceptions regarding pRE-symptomatic Alzheimer's Disease Screening" (PRE-ADS) questionnaire. METHODS: A convenience sample (N = 256) was recruited via an online platform. Validation of the PRE-ADS-D consisted of assessments of reliability, structural validity using Principal Component Analysis (PCA) and Exploratory Factor Analysis (EFA) and construct validity using known-group tests. A subscale "Acceptability of Screening", with 5 PRE-ADS-D items, was extracted to measure acceptance of screening in clinical practice. The STROBE checklist was used for reporting. RESULTS: EFA revealed a three-factor model for the PRE-ADS-D. Acceptable to good internal consistency was found for the 25-item scale (α= 0.78), as well as for the three factors "Concerns about Screening" (α= 0.85), "Intention to be Screened" (α= 0.87), and "Preventive Health Behaviors" (α= 0.81). Construct validity was confirmed for both the 25-item PRE-ADS-D and the "Acceptability of Screening" scale (α= 0.91). Overall, 51.2% of the participants showed a preference for screening. Non-parametric tests were conducted to further explore group differences of the sample. CONCLUSIONS: The PRE-ADS-D is a reliable and valid tool to measure attitudes, motives, and barriers regarding pre-symptomatic dementia screening in the German-speaking general population. Additionally, the subscale "Acceptability of Screening" demonstrated good construct validity and reliability, suggesting its promising potential as a practical tool in clinical practice.

Attitudes of Family Members and Caregivers Regarding Alzheimer's Disease Pre-Symptomatic Screening.

Background: In recent years, studies have examined the acceptability and attitudes that influence the intention to early screen for Alzheimer's disease (AD) in the general population, older people, carers, and asymptomatic individuals who report a family history of AD. However, it remains unclear what specific factors promote or reduce the acceptability of pre-symptomatic screening. Objective: The aim of this study is to explore the attitudes of family and non-family members as well as caregivers and non-caregivers toward the pre-symptomatic screening of AD. Methods: A total of 213 participants completed the Perceptions regarding pRE-symptomatic Alzheimer's Disease Screening (PRE-ADS) Questionnaire. Group comparisons using t-test and one-way ANOVA were used to examine differences in attitudes toward pre-symptomatic screening regarding age, family history, knowing someone with AD, influence of depression, and feelings of anxiety. The subscale "Acceptability of Screening" was developed to investigate the willingness to undergo pre-symptomatic screening. Results: Participants with a family history showed greater acceptance of pre-symptomatic screening while both caregivers and non-caregivers had similar attitudes. People with a family history as well as those with personal connections to dementia indicate a greater need for knowledge. The findings suggest that younger adults appear to perceive less harm from testing, whereas those who experience higher levels of anxiety and depression seem to perceive more testing harms. Conclusions: Comparing the attitudes of people with and without a family history as well as caregivers and non-caregivers toward pre-symptomatic screening of AD is critical to understand the differences between these groups and develop comprehensive screening programs.

Measuring Dementia Knowledge in German: Validation and Comparison of the Dementia Knowledge Assessment Scale, the Knowledge in Dementia Scale, and the Dementia Knowledge Assessment Tool 2.

BACKGROUND: Assessing dementia knowledge is critical for developing and improving effective interventions. There are many different tools to assess dementia knowledge, but only one has been validated in German so far. OBJECTIVE: To validate two tools for assessing dementia knowledge - the Dementia Knowledge Assessment Scale (DKAS-D) and the Knowledge in Dementia Scale (KIDE-D) for the German general population - and compare their psychometric properties with the Dementia Knowledge Assessment Tool 2 (DKAT2-D). METHODS: A convenience sample of 272 participants completed online surveys. Analyses included internal consistency, structural validity, construct validity through the known-groups method, retest-reliability with a subgroup of n = 88, and floor and ceiling effects. This study used the STROBE checklist. RESULTS: Internal consistency was acceptable for DKAT2-D (α= 0.780), very good for DKAS-D (α= 0.873), and poor for KIDE-D (α= 0.506). Construct validity was confirmed for all questionnaires. Retest-reliability was good for DKAT2-D (0.886; 0.825-0.926) and KIDE-D (0.813; 0.714-0.878), while it was great for DKAS-D (0.928; 0.891-0.953). Trends toward ceiling effects were observed for DKAT2-D and KIDE-D but not for DKAS-D. The principal component analysis did not reveal a coherent structure for DKAT2-D or KIDE-D, while the confirmatory factor analysis proposed the removal of 5 items for DKAS-D, resulting in the shortened DKAS20-D, which had nearly identical properties. CONCLUSION: Both DKAS-D and its shortened version, DKAS20-D, are reliable instruments for evaluating programs intended for the general population, as they were found to be convincing in all aspects.

Foreign language learning can improve response inhibition in individuals with lower baseline cognition: Results from a randomized controlled superiority trial.

Introduction: The world's population is aging, increasing the prevalence of dementia. Recently, foreign language learning in later life has been suggested to improve cognition and thus support healthy cognitive aging. To date, however, there are only a few studies with conflicting findings. Therefore, the purpose of this study was to examine whether learning a foreign language can improve executive attention and executive functions in healthy older adults. Additionally, we sought to identify factors affecting cognitive change in foreign language learners, such as cognitive reserve, previous foreign knowledge and usage, and global cognition at baseline. Methods: In a randomized-controlled trial, we assigned 34 monolinguals between the ages of 65 and 80 to a language learning or a waiting list control group. The participants enrolled in a Spanish course for beginners that met five days a week for 1.5 h for a total of 3 weeks. The waiting list control group received no intervention but had the opportunity to join the language training at the end of the study. All participants underwent an assessment of executive attention (primary outcome), executive functions, verbal fluency, and attention (secondary outcomes) before, immediately after the course, or after a waiting period of 3 weeks for the control group and 3 months after the course or the waiting period. Results: Foreign language learning did not significantly improve primary or secondary outcomes, neither immediately nor 3 months after the course. However, moderation analyses revealed that participants with lower global baseline cognition tended to improve more on response inhibition than individuals with higher baseline cognition. This relationship was not evident in the waiting list control group. Discussion: Our results suggest that studying a foreign language does not generally improve executive attention or executive functioning. Nevertheless, individuals with poorer baseline cognition may benefit cognitively from foreign language learning in response inhibition, a domain particularly affected by cognitive aging. Our findings highlight the need of focusing dementia prevention efforts on groups that are more vulnerable to cognitive decline. Additionally, more individualized approaches, including utilizing technology-assisted learning, might enable participants to practice at their performance level, increasing the likelihood of discernible cognitive gains. Clinical trial registration: https://drks.de/search/en, identifier DRKS00016552.

The Dementia Knowledge Assessment Scale, the Knowledge in Dementia Scale, and the Dementia Knowledge Assessment Tool 2: Which Is the Best Tool to Measure Dementia Knowledge in Greece?

Background: Measuring dementia knowledge can be a valuable tool for assessing the effectiveness of dementia awareness activities, identifying the potential benefits of dementia training programs, and breaking down common myths and stereotypes about dementia. Objective: To compare the psychometric properties of three widely used dementia knowledge tools, the Dementia Knowledge Assessment Tool 2 (DKAT2-G), the Dementia Knowledge Assessment Scale (DKAS-G), and the Knowledge in Dementia Scale (KIDE-G) in the Greek adult population. Methods: A convenience sample of 252 participants from the general population completed the survey online. Statistical analyses included Cronbach's internal reliability, retest reliability, factor analysis, concurrent and construct validity, and floor and ceiling effects. Results: The DKAS-G had the most appropriate reliability levels (Cronbach's alpha  =  0.845; retest reliability  =  0.921), whereas the DKAT2-G had satisfactory indexes (Cronbach's α= 0.760; retest reliability  =  0.630). The KIDE-G showed unsatisfactory reliability (Cronbach's α= 0.419; retest reliability  =  0.619). Construct validity was confirmed for all questionnaires, showing that all of them detected participants with pre-existing knowledge of dementia. Confirmatory factor analysis revealed a four-factor model for the DKAS-G and proposed the removal of 5 items. Floor and ceiling effects were found for the DKAT2-G and the KIDE-G, mainly among those who had previously participated in dementia training. Conclusions: The DKAS-G was found to have the highest levels of reliability and validity. The results prove that the DKAS-G meets the requirements for measuring dementia knowledge and evaluating dementia training programs in health professionals, caregivers, and the general population.

Attitudes toward pre-symptomatic screening for Alzheimer's dementia in five European countries: a comparison of family members of people with Alzheimer's dementia versus non-family members.

Introduction: Pre-symptomatic screening is getting more attention in healthcare as it detects the risk for developing neurodegenerative diseases like Alzheimer's disease (AD), which is very useful for treatment or prevention. AD screening could play an important role in individuals with at least one affected first-degree relative, but also without family history. As the demand for screening is rising worldwide, it is important to consider possible cross-cultural differences in attitudes toward pre-symptomatic screening in order to tailor healthcare services to the needs of each country. Objective: This study aims to investigate the attitudes of family members and non-family members of people with dementia toward pre-symptomatic screening and explore possible differences in attitudes across five European countries (Belgium, Germany, Greece, Spain, Turkey) using translated versions of the "Perceptions regarding pRE-symptomatic Alzheimer's Disease Screening" questionnaire (PRE-ADS). Methods: The multicultural sample (N = 650) was recruited from samples that were previously used in validation studies of the translated PRE-ADS versions. The subscale "Acceptability of Screening", consisting of five PRE-ADS items to specifically explore willingness to undergo screening, was created. Ιnternal consistency was measured, and structural validity was determined using Confirmatory Factor Analysis (CFA). Group comparisons were performed to investigate differences in attitudes toward pre-symptomatic AD screening regarding family history and country of origin using the PRE-ADS and the "Acceptability of Screening" mean scores. Results: Construct validity was acceptable for the PRE-ADS. Both the PRE-ADS (α = 0.76) and its subscale "Acceptability of Screening" (α = 0.90) had good internal consistency. Overall, 56.9% of the total sample expressed a positive intention toward pre-symptomatic AD screening. T-tests showed significantly higher mean scores of participants with an affected family member. An international comparison revealed differences in the "Acceptability of Screening" mean score across the five European countries. No cross-cultural differences were found for the PRE-ADS mean score after adjusting for confounding variables. Conclusion: The PRE-ADS and its subscale are reliable tools for assessing pre-symptomatic AD screening attitudes. Variations in the acceptability of screening seem to be linked to family history and cultural influences. Further research with larger samples is needed to explore underlying relationships.

Validation of the Adapted German Versions of the Dementia Knowledge Assessment Tool 2, the Dementia Attitude Scale, and the Confidence in Dementia Scale for the General Population.

BACKGROUND: There are almost no validated tools in German that assess dementia knowledge, attitude toward dementia, and confidence in the general population. OBJECTIVE: Translation and validation of the German version of the Dementia Knowledge Assessment Tool 2 (DKAT2), the Dementia Attitude Scale (DAS), and the Confidence in Dementia Scale (CODE). METHODS: Instruments were translated into German and adapted for the general public. A convenience sample of 263 persons was recruited via an online platform. Validation of the tools' psychometric properties consisted of an assessment of its reliability (internal consistency and 4-week test-retest reliability of a subgroup with n = 110), an analysis of its construct validity through principal component analysis and known-group analysis, convergent validity, and an item analysis for DKAT2-D. This study used the STROBE checklist for reporting. RESULTS: Acceptable to excellent internal reliability was found for DAS-D (α= 0.90), DKAT2-D (α= 0.78), and CODE-D (α= 0.93). The principal component analysis confirmed the two-factor model for the DAS-D as well as the one-factor solution for CODE-D. The intra-class correlation coefficient between the first and the 4-week retest was good (CODE-D: 0.897; 0.849-0.929) to excellent (DKAT2-D: 0.918; 0.879-0.945 and DAS-D: 0.940; 0.910-0.960). Known-group analysis revealed that DAS-D, DKAT-D, and CODE-D could distinguish between individuals with or without experience with people with dementia and with or without participation in a dementia course. CONCLUSION: The German versions DAS-D, DKAT2-D, and CODE-D are reliable and valid tools to measure knowledge, attitude, and confidence in dementia in the German-speaking general population.

Informal Caregivers' Attitude Toward Dementia: The Impact of Dementia Knowledge, Confidence in Dementia Care, and the Behavioral and Psychological Symptoms of the Person with Dementia. A Cross-Sectional Study.

BACKGROUND: Dementia is rapidly increasing worldwide due to demographic aging. More than two-thirds of patients are cared by family members. The quality of care depends on the caregivers' attitude toward dementia influencing patient care decisions. OBJECTIVE: The aim of this study is to examine the factors that influence the caregivers' attitude and whether there is an association between participation in a psycho-educational program and attitude. METHODS: We performed a cross-sectional study using a structured closed-ended questionnaire to retrieve socio-demographic information from caregivers and the persons with dementia (N = 86). The study included validated scales such as the Dementia Attitude Scale, the Dementia Knowledge Assessment Tool 2, the Positive Aspects of Caregiving, the Zarit Burden Interview, the Confidence in Dementia Scale, and Spielberger's State-Trait Anxiety Inventory, as well as a neuropsychological battery to assess the condition of people with dementia. RESULTS: Our final model explains 55.6% of the total variance and shows a significant correlation of five factors with attitude toward dementia: confidence, behavioral and psychological symptoms of dementia, anxiety as a trait, positive aspects of caregiving, and dementia knowledge. The caregivers who participated in a psycho-educational program showed a significantly more positive attitude toward dementia, better dementia knowledge, higher confidence in dementia care, and lower anxiety as a state. CONCLUSION: The strong correlation of attitude and knowledge, as well as confidence in dementia care, supports the tripartite model of attitude, which hypothesizes the interrelation of affect, cognition, and behavior.

Does bilingualism influence neuropsychological test performance in older adults? A systematic review.

OBJECTIVE: Using standardized tests which have been normed on monolinguals for the assessment of bilinguals presents challenges to the accurate characterization of cognitive profile as the literature provides compelling evidence for the influence of bilingualism on cognitive abilities. However, little is known about the generalizability of these findings to clinical neuropsychology. The aim of this review was to address this gap by summarizing current evidence on the performance of bilingual older adults on standardized tests routinely used in clinical practice. METHOD: A systematic search of Web of Science, PsycINFO and PubMed was conducted. 27 cross-sectional and longitudinal studies which use at least one standardized neuropsychological test for cognitive impairment were included in the review. Potential demographic (cultural/linguistic background of the participants, immigrant status), clinical (diagnostic status), and methodological confounders (language of test administration, components of bilingualism) were also examined. The review protocol was registered at the PROSPERO International Prospective Register of Systematic Review with registration number CRD42018114658. RESULTS: The results of this review revealed some bilingual advantage on measures of inhibitory control and bilingual disadvantage on measures of verbal fluency in cross-sectional studies. Bilingualism status was not associated with test performance in longitudinal studies. However, findings lack consistency due to demographic variables and methodological differences across studies. CONCLUSION: Neuropsychological tests assessing language domains and, to some extent executive function act as clinically relevant features of bilingualism for neuropsychological evaluation. However, immigration status, acculturation level and language of test administration needs to be taken into account when assessing bilingual older adults.

Cross-cultural comparison of MMSE and RUDAS in German and Turkish patients with Alzheimer's disease.

OBJECTIVE: Given the increasing cultural, linguistic diversity in Europe, there is a growing need for cognitive screening tools that minimize the influence of linguistic, cultural, and demographic differences as they are the first means to determine the need for further clinical evaluation of individuals with suspected cognitive impairment. This cross-sectional study compared performance on the Mini-Mental State Examination (MMSE) and the Rowland Universal Dementia Assessment Scale (RUDAS) in Alzheimer's Disease (AD) patients in relation to cultural, demographic, and immigration-related factors (acculturation, bilingualism). METHOD: The study comprised Turkish immigrant (n = 21) and monolingual, nonimmigrant German (n = 20) and Turkish (n = 24) patients with AD. All participants were administered cognitive screening tools, measures of depression, and dementia severity. RESULTS: The mean MMSE total score was significantly higher in German patients with AD compared to both patient groups, but did not differ between native-born Turkish and Turkish immigrant groups. After adjustment for years of education, differences in MMSE performance were no longer significant between groups. Furthermore, bilingualism was associated with better performance on the MMSE in Turkish-immigrant patients. The mean RUDAS total scores were similar between groups with and without adjustment for educational level. Performance on the RUDAS was not associated with demographic and immigration-related variables. CONCLUSIONS: The findings highlight the need to consider the educational background, linguistic integration of older non-Western immigrants for the objective characterization of cognitive profiles. The results provide support for the use of the RUDAS, particularly, among older Turkish immigrants with lower educational levels and varying degrees of acculturation, bilingualism. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Evaluation and Effectiveness of a Two-Day Dementia Training Program for Hospital Staff Working in an Emergency Department.

BACKGROUND: Entering the hospital via an Emergency Department (ED) is a pivotal moment in the life of People with Dementia (PwD) and often starts an avoidable downward spiral. Therefore, it is required to further educate ED staff to raise awareness of the needs of PwD. Although there are many studies about existing dementia training programs for the hospital setting, empirical evidence for the ED setting and cross-level training evaluations are lacking. OBJECTIVE: The study aims to evaluate a two-day dementia training course for ED staff on the outcome levels of learning, individual performance, and organizational performance. Furthermore, the study examines whether the training fulfilled participants' expectations. METHODS: Mixed methods were used to assess data from head nurses, nursing, and administrative staff working in EDs. We conducted semi-structured interviews three weeks before (N = 18) and eight months after (N = 9) the training. Questionnaire data were assessed before the training, three months, and six months after the training (N = 44). A qualitative content analysis was conducted to analyze qualitative data; quantitative data was described descriptively. RESULTS: The intervention seems to be effective on both learning and individual performance levels. However, we did not observe any changes in the organizational performance. The training program met attendees' expectations only partly. The working environment of EDs needs to be taken more into account. CONCLUSION: Hospital staffs' expectations of a dementia training program depend on the work area in which they operate. Results support the implementation of intervention bundles to enable sustainable cross-level changes.

Psychometric properties of dementia attitudes scale, dementia knowledge assessment tool 2 and confidence in dementia scale in a Greek sample.

Aim: Τo validate the Greek version of the Dementia Knowledge Assessment Tool 2, the Dementia Attitudes Scale and Confidence in Dementia Scale. Design: A quantitative cross-sectional design was applied for translation and validation. The STROBE checklist for observational research has been followed to this survey. Method: Two hundred and twelve students from the School of Psychology (Aristotle University of Thessaloniki). Psychometric properties were assessed through construct validity (principal component analysis), internal consistency (Cronbach's alpha) and convergent validity. Results: High internal reliability was found for Confidence in Dementia Scale (α = 0.85), adequate reliability for Dementia Attitudes Scale (α = 0.74) and acceptable reliability for Dementia Knowledge Assessment Tool 2 (α = 0.68). Construct validity was satisfactory for Dementia Attitudes Scale (two factors: social comfort and knowledge). The convergent validity was supported to this survey. All three tools are reliable and valid to measure knowledge, confidence and attitudes towards dementia in Greek research context.