Better Understand to Better Predict Subjective Well-Being Among Older Greeks in COVID-19 Era: Depression, Anxiety, Attitudes Towards eHealth, Religiousness, Spiritual Experience, and Cognition.

Despite similarities with previous pandemics, the potential physical and psychosocial impact of COVID-19 on older adults is still little investigated in Greece. This study examines the intercorrelations between subjective well-being/life satisfaction, depression, state anxiety, global cognitive function, attitudes towards eHealth, religiousness and spiritual experience in older adults during COVID-19. Results revealed that statistically significant negative correlations exist between subjective life satisfaction and depressive symptomatology as well as with religiousness, a finding that can be explained by the COVID-19 externally imposed religious practice restrictions. Subjective life satisfaction was positively correlated with overall cognition as measured by Mini-Mental State Examination (MMSE). MMSE was also negatively correlated with state anxiety, depression, and attitudes towards eHealth use. The best predictors of subjective well-being is global cognition (as measured by MMSE) and depressive symptomatology (measured by GDS). The conclusions of this study underscore the need to examine in more detail psychological variables during COVID-19 and quality of life in older adults.

What goes wrong with the perceptions of elder financial abuse? Data from older adults, healthcare professionals and students from Greece.

This study examines what healthcare professionals, students and older adults believe about elder financial abuse in Greece. Participants responded to two vignettes by choosing which characteristics indicate elder financial abuse. Greeks are less likely to perceive financial exploitation when the perpetrator is a close family member, but are more likely to recognize it when perpetrated by paid caregivers or more distant (male) relatives. Signing over the victim's property to another is less likely to be perceived as elder abuse than is the taking of money from bank accounts, even though the property is often worth more than what is taken from the account. Although there are some differences in perception between healthcare professionals and others in Greek society, these (and other anomalies) make it difficult to accurately report and prevent elder financial abuse in Greece.

eHEALTH BEFORE AND DURING COVID-19: DOES DEPRESSIVE SYMPTOMATOLOGY INFLUENCE ATTITUDES OF CAD PATIENTS, HEALTHCARE STUDENTS AND PROFESSIONALS?

BACKGROUND: This study aims to clarify CAD patients' attitudes towards telemedicine-and-telecare before and after the pandemic and to compare views with those of healthcare students and professionals (doctors), while taking into consideration the influence of depressive symptomatology. METHODS: All participants completed a modified version of the Information Technology Attitude Scales for Health (ITASH), the Center for Epidemiologic Studies Depression Scale-CES-D and a demographics questionnaire. RESULTS: All three groups showed statistically significant more positive views towards eHealth in the retest condition on all questions. CAD patients held the least positive views compared to healthcare students and professionals in both time points. The majority of the participants from all three groups reported that since their initial examination they still lacked educational experience regarding eHealth. Depressive symptomatology was found not to have an influence on eHealth reports. CONCLUSIONS: eHealth plays an important role both in prevention, treatment and care, but attitudes may act as an obstacle in using them. Future research should further investigate in more depth the complex influence of additional sociocultural and/or psychological factors for the reported differences.

Liberating older adults from the bonds of vascular risk factors: What is their impact on financial capacity in amnestic mild cognitive impairment?

BACKGROUND: There is a pressing need to clarify whether vascular risk factors (VRFs) are related to the heterogeneous cognitive performance found in mild cognitive impairment (MCI) and whether the number of VRFs relates to financial capacity impairment in patients with amnestic MCI (aMCI). METHODS: A total of 112 participants were divided into three groups: patients with single-domain aMCI, patients with multiple-domain aMCI, and healthy controls (HCs), while taking into consideration whether participants had a diagnosis of one VRF or disease, or more than one VRF or disease. Patients with aMCI with VRFs (one and more than one VRF) and HCs did not differ significantly in age, education, and sex. Mini-Mental State Examination, 15-item Geriatric Depression Scale, and Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS) were administered to all groups. RESULTS: Diagnosis (P <0.001) and VRFs (P = 0.006) showed significant main effects on LCPLTAS but no interaction (P = 0.654). Patients with aMCI with high vascular burden were more frequently of the multiple-domain subtype, whereas patients with no vascular burden were more frequently of the single-domain subtype. A larger vascular burden is correlated with lower LCPLTAS scores. DISCUSSION: Vascular burden plays an important role in the heterogeneity of aMCI by impairing financial capacity.

Frontotemporal dementia and financial capacity: facing the Cerberus of overestimation or underestimation?

OBJECTIVE: This study investigates the performance of people with frontotemporal dementia (FTD) on objective assessment of financial capacity with comparison to the estimation of financial capacity by both people themselves and their caregivers. METHOD: FTD patients and healthy (age/gender/education-matched) controls from Greece underwent cognitive assessment (memory, attention, executive functioning, visuospatial skills, verbal functions), emotional (anxiety, depression), and financial capacity assessment (Legal Capacity for Property Law Transactions Assessment Scale-LCPLTAS). Additionally, they self-reported on their financial performance and a third-party living with the older participants for both groups reported their estimates of financial performance and their anxiety and depression levels. RESULTS: Financial capacity in FTD patients is severely impaired compared to controls, but caregivers of FTD patients tend to overestimate the patients' financial performance, a finding that is not related to the caregivers' depression and anxiety levels or other demographics. FTD patients overestimate their financial capacity. CONCLUSION: FTD may have significant impact on financial capacity, but people with FTD tend to overestimate their own financial capacity. This study also indicates that families and caregivers tend to overestimate financial capacity in people with FTD. This has implications for the assessment and care planning of people with FTD in clinical settings.

Catastrophe Theory Applied to Neuropsychological Data: Nonlinear Effects of Depression on Financial Capacity in Amnestic Mild Cognitive Impairment and Dementia.

Financial incapacity is one of the cognitive deficits observed in amnestic mild cognitive impairment and dementia, while the combined interference of depression remains unexplored. The objective of this research is to investigate and propose a nonlinear model that explains empirical data better than ordinary linear ones and elucidates the role of depression. Four hundred eighteen (418) participants with a diagnosis of amnestic MCI with varying levels of depression were examined with the Geriatric Depression Scale (GDS-15), the Functional Rating Scale for Symptoms of Dementia (FRSSD), and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). Cusp catastrophe analysis was applied to the data, which suggested that the nonlinear model was superior to the linear and logistic alternatives, demonstrating depression contributes to a bifurcation effect. Depressive symptomatology induces nonlinear effects, that is, beyond a threshold value sudden decline in financial capacity is observed. Implications for theory and practice are discussed.

Longitudinal Study of Depression on Amnestic Mild Cognitive Impairment and Financial Capacity.

OBJECTIVES: Amnestic mild cognitive impairment (aMCI) among other cognitive deficits also includes impairments in financial capacity, but so far the role of depression in time has not been examined. We aimed to examine the hypothesis that individuals with aMCI and comorbid worsening depression levels would demonstrate greater deficits in financial capacity atone year in relation to multiple-domain aMCI patients with stable levels of depression, aMCI patients without depression and healthy individuals. METHODS: Ninety-six Greek women and 24 men aged 54 and older (multiple-domain aMCI with, stable and increased levels of depression at one year, aMCI without depressive symptoms, and cognitively intact elders with and without depression) were examined with the Mini-mental State Examination (MMSE), the Geriatric Depression Scale (GDS-15), and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). RESULTS: Bootstrapped ANCOVA was implemented. Multiple-domain aMCI patients' performance regarding financial capacity is severely impaired when depression co-exists, resembling the performance of patients with mild Alzheimer's disease, and it declines further when depression deteriorates. CONCLUSIONS: Findings contribute to the limited evidence in financial capacity assessment when depression co-exists showing that higher depressive symptom scores are associated with reduced financial capacity scores and deterioration of depressive symptomatology worsens not only general cognitive outcome, but financial capacity in particular. CLINICAL IMPLICATIONS: Proactive care for individuals with depression is needed as this condition severely influences financial capacity in aMCI.

Mild Alzheimer Disease, Financial Capacity, and the Role of Depression: Eyes Wide Shut?

The aim of this study was to assess whether comorbid depression in patients with mild Alzheimer disease (AD) can influence financial capacity. The sample comprised 109 participants divided into 4 groups: mild AD with and without depressive symptoms, and cognitive normal elderly with and without depression. Participants were examined using a number of neuropsychological tests, with an emphasis on the Mini-Mental State Examination, the 15-item Geriatric Depression Scale, and the Legal Capacity for Property Law Transactions Assessment Scale. Financial capacity ascertained as performance in the Legal Capacity for Property Law Transactions Assessment Scale in the group of mild AD patients was severely impaired when depression coexisted, thus clearly differentiating the mild AD group from mild AD with comorbid depression.

Vascular Dementia, Depression, and Financial Capacity Assessment.

We still know little about financial capacity, which consists of multiple cognitive domains as well as specific skills, and the influence of depression in patients with vascular dementia (VaD). Participants were divided into 4 groups: (1) VaD with and (2) without depressive symptoms, (3) nondemented elders with and (4) without depression. The participants were examined with the Mini-Mental State Examination (MMSE), the Geriatric Depression Scale (GDS-15), and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). The findings extend earlier work in other groups of older patients and indicate that VaD patients' performance in cognitive functioning and financial capacity is severely impaired, while there is a statistically significant difference between depressed and nondepressed VaD patients. Thus, depression negatively influences financial capacity. Depression and mood disorders should be considered in future capacity research with older adults and with larger VaD populations.

Unraveling Ariadne's Thread Into the Labyrinth of aMCI: Depression and Financial Capacity.

BACKGROUND: People with amnestic mild cognitive impairment (aMCI) face many daily challenges as memory loss is their predominant cognitive impairment. OBJECTIVES: This study examined whether financial capacity can be influenced by comorbid depression in patients with multiple-domain aMCI. MATERIALS AND METHODS: The participants included 120 patients in 4 groups: multiple-domain aMCI with and without depressive symptoms, and nondemented elders with and without depression. Participants were examined with the Mini-Mental State Examination, the 15-item Geriatric Depression Scale, and the Legal Capacity for Property Law Transactions Assessment Scale. RESULTS: The findings extend earlier work in other groups of older patients and indicate that the performance of patients with multiple-domain aMCI in cognitive functioning and financial capacity is severely impaired when depression coexists, resembling the performance of patients with mild Alzheimer disease. CONCLUSIONS: The results support special care for individuals with depression as this condition severely influences financial capacity in aMCI.

Exploring Hubris in Physicians: Are There Emotional Correlates?

Are there emotional correlates of hubristic symptomatology in physicians working in state hospitals at intrapersonal and interpersonal levels? 188 physicians completed a series of questionnaires related to emotional aspects and a 5-point Likert scale examining hubris. Their patients responded to a satisfaction question. Results revealed that years of working experience and negative affect correlate negatively with hubris, while Others' Emotion Appraisal and Regulation of Emotion correlate positively. Patients seem not to report different levels of personal satisfaction from the provided healthcare services, based on the emotional characteristics and the hubris levels of their physician. Only work experience predicted hubris self-reported symptoms.

The Flight of Icarus: A Preliminary Study of the Emotional Correlates of Hubris in Gerontological Nurses during the SARS-CoV-2 Pandemic.

Persons in leadership positions are more likely to manifest hubristic symptomatology, the longer the person exercises power and the greater the power they exercise. No data exists for healthcare staff, such as nurses and more specifically for gerontological nurses who exercise power on their colleagues as well as older persons. This study aims to examine whether there are emotional correlates of gerontological nurses' experienced hubris when serving in a leadership position, and to investigate possible gender differences during SARS-CoV-2 pandemic, a little investigated period regarding its emotional aspects on healthcare professionals. Gerontological nurses in leadership positions completed Job Affect Scale, Emotional Labour Scale, Emotion Regulation Questionnaire, Generalized Immediacy Scale, General Index of Job Satisfaction, Maslach Burnout Inventory, Wong-Law Emotional Intelligence Scale, State-Anxiety-Inventory, Perceived Cohesion Scale, and a 5-point Likert scale measuring hubristic attributes. No statistically significant differences were found between male and female nurses regarding the abovementioned classic administered emotional scales and hubris. The analyses yielded only a negative correlation between negative affect and hubris. This research provides for the first time data regarding gerontological nurses in leadership positions, suggesting that various negative and positive emotional variables do no directly relate to hubristic symptoms for this group of healthcare professionals. As hubristic behaviors and their dangerous consequences are found not to be related to abovementioned emotional variables, researchers and hospital managers should consider and focus on other indices in their attempt to prevent such phenomena.

Functional, Dysfunctional Impulsivity and Sensation Seeking in Medical Staff.

BACKGROUND: It is important to study impulsivity and sensation seeking in medical staff because they might shed light into the effectiveness of decision-making processes and performed responses. The aims of this study were to specify if functional impulsivity prevailed in medical staff compared to dysfunctional impulsivity; how strong the relationships between functional, dysfunctional impulsivity and sensation seeking were; furthermore, it aimed to differentiate functional and dysfunctional impulsivity, according to the size of the place where medical care was practised. SUBJECTS AND METHODS: A sample of 323 medical workers and 99 medical students filled in Radoslavova and Velichkov's (2005) questionnaire measuring sensation seeking, functional impulsivity and dysfunctional impulsivity. RESULTS: Sensation seeking and functional impulsivity in medical staff did not differ statistically significantly (t(421)=1.171, p=0.242), but functional impulsivity was significantly more intensive than dysfunctional impulsivity among medical personnel (t(421)=8.132, p<0.001). Sensation seeking was significantly more strongly expressed than dysfunctional impulsivity among medical specialists (t(421)=7.388, p<0.001). Correlation analysis revealed that sensation seeking in medical specialists was more strongly related to functional impulsivity than to dysfunctional impulsivity (p<0.001). The studied medical staff practicing in the capital were more prone to functional impulsivity than the medical staff practicing in towns up to 50,000 inhabitants (pTukey=0.007). CONCLUSIONS: This was the first study to reveal stronger relationships between functional impulsivity and sensation seeking in medical staff than between dysfunctional impulsivity and sensation seeking which were interpreted as an influencing factor of the quality of decision-making responses. Functional impulsivity prevailed over dysfunctional impulsivity in medical occupations, so decision-making in medical care should be more effective and timelier than inappropriate, especially for medical personnel working in the capital.

Attitudes towards e-Health during the COVID-19 Pandemic: Untangling the Gordian Knot in Greece, Bulgaria and Romania in Healthcare Professionals and Students?

BACKGROUND: Until recent times, healthcare specialists lagged behind other fields in terms of computer networks and software usage, partly because they were uncomfortable with information and communication technologies. The rapid development of personal wearables, their easier connections with smartphones and other similar devices, and the possibilities of online or cloud storage of personal medical data led to improvements of eHealth services in terms of ease of access and reduced costs of delivery. SUBJECTS AND METHODS: The current research aimed to fill a research gap regarding attitudes towards e-Health during the COVID-19 pandemic in three Balkan countries: Greece, Bulgaria, and Romania. A total number of 775 adult participants (healthcare professionals and students in the field) were contacted in the winter of 2020 and asked to complete a questionnaire regarding their e-Health attitudes. RESULTS: The Greek participants had the most negative attitudes toward e-Health services. This may be due to forced use of eHealth applications during the pandemic crisis and the need for mastering the necessary technical skills to use them. CONCLUSIONS: It should be noted that in the scientific literature no research is found on this topic, therefore it is the first study aimed to assessing and comparing attitudes towards eHealth in these countries.

Subjective Quality of Life, Religiousness, and Spiritual Experience in Greek Orthodox Christians: Data from Healthy Aging and Patients with Cardiovascular Disease.

The goal of this study is to examine subjective quality of life-life satisfaction, religiousness, and spiritual experience in healthy younger and older adults, as well as in older patients suffering from severe cardiovascular disease, while examining the role of marital status, employment and socioeconomic status, existence of social network, urbanicity, education, depression, and personal opinion about the country's current socioeconomic situation. Results revealed that there are no age differences and that the role of demographic variables as predictors of religiousness, spiritual experience, and quality of life-life satisfaction don't seem to be very strong. Marital status, employment, and religiousness moderately predict quality of life-life satisfaction. Quality of life-life satisfaction, religiousness, and spirituality are not strongly interconnected in this Greek Orthodox Christian sample. Future cross-cultural research should further investigate the role of other psychological and social parameters that may have a stronger predictive role in quality of life of older adults.

Are left angular gyrus and amygdala volumes important for financial capacity in mild cognitive impairment?

OBJECTIVE: The aim of this study was to investigate the importance of specific brain areas for financial capacity in patients suffering from amnestic Mild Cognitive Impairment (aMCI) over time. PATIENTS AND METHODS: Fifteen aMCI patients underwent assessment of cognitive and mood functioning, as well as quantitative magnetic resonance imaging (for three times a 3 Tesla MRI). We used a detailed neuropsychological examination and a new instrument measuring financial capacity, the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS), during a 12-month period. RESULTS: Spearman and Kendall correlations revealed a number of statistically significant positive relationships at synchronous testing between financial capacity and brain volumes, while repetitive testing revealed that the right amygdala volume correlated with measured financial capacity (r first-third time=.908, P=.000), and the left angular gyrus volume difference showed a similarly strong correlation. In contrast to that, a number of neuropsychological tests correlated with financial capacity, but only MMSE seems to have the strongest correlation (r=.899, P=.000). CONCLUSION: Financial capacity in Greek aMCI patients strongly correlates with right amygdala and left angular gyrus volumes, a finding that supports that emotion as well arithmetic skills are involved in financial capacity, while the importance of MMSE as the only neuropsychological test with the strongest positive correlation is discussed.

When is a person with dementia in need of palliative care? Opinions of healthcare professionals and university students from three South East European countries.

BACKGROUND: Recommendations of the European Association for Palliative Care have been proposed to strengthen the provision of palliative care and it is clear that people with dementia can benefit from palliative care, but no research so far addresses the beliefs of university students and professionals in the social, medical and other science fields in South East Europe regarding the need from palliative care. The objective of this study is to explore when students and professionals consider a person with dementia in need of palliative care and to compare their opinions in three South East European countries. SUBJECTS AND METHODS: An anonymized questionnaire was used based on van Riet Paap et al. (2015) case-vignette. A sample of 1287 participants (student nurses, professional nurses, psychology students, professional psychologists, student doctors, professional doctors, and students and professionals from other non-relevant to medical and social care sciences) was examined in Greece, Bulgaria and Romania. RESULTS: The open responses to the "when" question revealed the categories: after her diagnosis/after the first symptoms; when she and her family cannot cope; at the advance of symptoms; all the time; when she behaves aggressively; I am not sure/there is no specific point. Unexpectedly, age, professional status and field of studies were not found to be significant predictors, but only the country of origin was found to contribute to the differences in the participants' answers regarding the start of palliative care. CONCLUSION: Although professional-student status and relevancy of subject did not predict opinions, the country of origin predicted controversies for the proposed time point of considering a person with dementia in need of palliative care.