Background
People with dementia and their care partners can face a challenging post-diagnostic journey to navigate the health and aged care systems, and adapt their lifestyle. The Sustainable Personalised Interventions for Cognition, Care, and Engagement (SPICE) Program is delivered over twelve-weeks by allied health practitioners in groups of up to seven people with dementia and their care partners, who both live in the community. This study aimed to provide an in-depth analysis of the experiences and perspectives of participants who completed SPICE during 2022-2024.

Methods
Semi-structured interviews were audio recorded and transcribed with people with dementia (n=49) and care partners (n=46). Transcripts were grouped together by participant type and underwent content analysis. The line of enquiry prompted self-reported changes from engagement in the program's various components and perspectives about its structure and style.

Results
People with dementia shared themes of ‘enjoyment’, ‘meeting people’ and that SPICE was ‘useful’, particularly the exercise sessions. Care partners observed positive changes in their loved one with themes of ‘connection’, ‘enjoyment’, ‘being understood’, as well as enhancements in physical and social capacity. Care partner self-reflections involved themes of ‘belonging’, ‘social connection', and increased understanding about dementia itself, and feeling equipped with strategies and support. A majority of participants would recommend SPICE and found value in the program components. Some participants recommended scheduling changes due to the intensity of sessions.

Conclusions
Findings support growing evidence for wider availability of early post-diagnostic care that can improve quality of life for people with dementia and their care partners.

The introduction of human-centred design in aged care facility projects highlights the need to balance nursing practice and the built environment. Yet, project management, which is essential for delivering successful projects, is often overlooked in this field. Given the condition of many aged care facilities in Australia, renovation is often a more cost-effective way to update the built environment. However, there is limited understanding of the potential gap between the intended therapeutic design in aged care facility renovations and the actual results that have been delivered.

To determine whether such a gap exists, it is crucial to have a comprehensive understanding of the interrelationships between the therapeutic design in residential aged care facilities, renovation project management and the decision-making process. Questionnaires with 327 respondents and 14 semi-structured interviews were conducted with project managers, aged care providers and designers from November 2023 to March 2024. It is expected that large organisations tend to have more experience with their own departments in dealing with designers and project managers, while smaller organisations with less or no experience in projects heavily rely on external consultants. Additionally, the level of informativeness before engaging with any experts aligns with these results. From the perspective of aged care providers, a shared understanding of certain terms affects decision-making efficiency. In addition to agreeing with this opinion, project managers and designers also mention that the level of information available could also be a key factor driving final decisions.

Background: Advance care planning (ACP) is underutilised. This cross-sectional study explores associations among health literacy, depression, anxiety, decisional conflict, and ACP engagement and the mediating role of the decisional conflict in these associations.
Methods: The study included 262 -dwelling older adults in Australia. Data were collected using the Health Literacy Screening Questions (Chew et al., 2004), Hospital Anxiety and Depression Scale (Zigmond & Snaith, 1983), Decisional Conflict Scale (O'Connor, 1995), and ACP Engagement Survey (Sudore, Heyland, et al., 2017). General linear modelling was used for data analysis.
Results: Anxiety and decisional conflict were directly associated with ACP engagement even after controlling for potential confounders. Decisional conflict partially mediated the association between anxiety and ACP engagement.
Conclusion: Increased anxiety and decisional conflict could reduce ACP engagement, even among community-dwelling older adults with higher levels of education and health literacy.
References
Chew, L. D., Bradley, K. A., & Boyko, E. J. (2004). Brief questions to identify patients with inadequate health literacy. Family Medicine, 36(8), 588–594.
O’Connor, A. M. (1995). Validation of a Decisional Conflict Scale. Medical Decision Making, 15(1), 25–30.
Sudore, R. L., Heyland, D. K., Barnes, D. E., Howard, M., Fassbender, K., Robinson, C. A., Boscardin, J., & You, J. J. (2017). Measuring advance care planning: Optimizing the advance care planning engagement survey. Journal of Pain and Symptom Management, 53(4), 669-681.e8
Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.

Background & Aims
Pain prevalence increases with increasing age, with significant impacts on older adult’s well-being and quality of life. Given the global population ageing, a better understanding of the prevalence and incidence of pain is crucial if we are to promote healthy ageing and reduce pain burden. This highlights the importance of data collection on pain across various resources, particularly from longitudinal cohort studies. To provide an overview of pain data availability and gaps, we identified and systematised ageing cohorts across the globe.

Methods
We searched for ageing cohorts across the globe that included participants aged 60+ at baseline. We extracted data availability on pain in each cohort study, as one of the intrinsic capacity domains that shape older adult’s healthy ageing.

Results
We found 287 ageing cohort studies globally, spanning Europe (n=82), Oceania (n=25), Asia (n=68), North America (n=90), South America (n=8), the Middle East (n=8), and Africa (n=7). Over 80% of cohort studies from Oceania collected at least one pain-related data, followed by 75% in South America, 71% in Africa, 67% in Europe, about 60% in the Middle East and Asia, and <50% in North America.

Conclusions
These results underscore current wealth of data, which can be used to provide evidence-based information with the goal of reducing the prevalence of pain and its consequences. However, overall data availability remains limited in South America, the Middle East, and Africa, which needs to be addressed. This project represents a novel/comprehensive synthesis of ageing cohort studies to inform better research.

Background:
Communication is a vital but neglected element of ageing: underlying individual decisions about health and aged care; the delivery of personalised aged care funding, supports and services; the (complaints-based) regulation of the aged care sector; and safeguarding of older people from neglect and abuse.

Aim:
This paper is an exploratory study of lived experiences of communication support needs in community and residential aged care.

Method:
60 in-depth interviews, 2 focus groups, and 4 participant observations were conducted with people using community and residential aged care services; their significant others; and front-line aged care staff about communication and aged care. Thematic analysis identified core issues.

Findings:
Communication support was identified as a significant unmet need within aged care. At the individual level, occasions of in-home support, personal care, or other direct support may not allow for the time, space, and skills needed for effective communication. At the service level, the need for better communication supports when interacting with service organisations was identified, as well as during transition into and out of services at different stages of a person’s aged care journey. At the system level, participants felt communication was not prioritised in aged care funding, complaints and regulation processes, or between aged care and other systems such as healthcare and income support.

Implications:
Recognition of the impact of communication support needs in individual interactions, inside services and residences, and in the aged care system itself is essential to providing effective interactions, quality aged care services, person-centred care, and support.

Aims
This review aimed to identify the type, direction, and association between psychological and psychosocial factors and important health outcomes in older adults with low back pain (LBP).

Methods
This scoping review followed Arksey and O’Malley’s five stage framework. Databases searched included Medline, CINAHL, Embase, and PsycINFO. The included studies involved participants ≥ 65 years old with LBP, reported psychological or psychosocial factors, health outcomes (falls, polypharmacy, pain, activities of daily living (ADLs), frailty or time in hospital) and used quantitative, qualitative, or mixed methods study designs.

Results
The search yielded 5,027 citations, with 776 progressing to full text review. The included studies encompassed various designs, including cross-sectional, qualitative, and prospective cohort studies. Psychological factors were evaluated using the Geriatric Depression Scale, and Pain Catastrophizing Scale. Additionally, fear avoidance beliefs, kinesiophobia, anxiety and fear of falling were assessed, along with some psychosocial factors, including marital and living status, loneliness, social support and stigma. Health outcomes predominantly focused on ADLs, such as mobility or gait speed, while there was limited reporting on falls, polypharmacy, pain concurrent with LBP, or frailty. No included studies reported the health outcome related to time spent in hospitals.

Conclusion
This scoping review identified research highlighting the association between psychological factors (such as depression, anxiety and catastrophizing) and the performance of ADLs (such as mobility) in older adults with LBP. It is critically important to understand these associations in the context of LBP in older age to better manage this underserved population.

Introduction: There are growing expectations from the public, policy makers, and the research community for improvements in the quality of care for aged care residents. Six percent of aged care residents have an indwelling urinary catheter. Little is known about their experiences and the nature of the care they receive. The aim of this project was to consult with residential aged care stakeholders to obtain insights into the experience of having a catheter and caring for residents with catheters.

Method: A mixed-methods approach was used. This included qualitative interviews with residential aged care staff in clinical roles and residents with catheters, a survey of residential aged care managers, and focus groups with Residential In-Reach (RIR) staff.

Results: We identified different stakeholder perspectives about the quality of catheter care. Whilst managers reported being equipped at an organisational level to respond to the care needs and complications of residents with catheters, aged care and RIR staff identified a lack of internal expertise to change catheters and respond to complications. They attributed this to a deskilled residential aged care workforce and gaps in education.

Conclusion: The findings suggest there is a need to strengthen education programs for residential aged care staff about best practice urinary catheter care. This project provides evidence about a complex range of issues associated with these catheters in residential aged care, pointing to the need for a multi-faceted and targeted intervention.

OBJECTIVES: This study aims to explore fall-related gait characteristics in older adults with higher-level gait disorders using Inertial Measurement Units (IMUs) and their association with cognitive impairment. METHODS: A descriptive cross-sectional study with two groups: older adults with higher-level gait disorders and an age and gender matched non-gait disorder group. Both groups received gait assessments using IMUs under different walking conditions and cognitive assessments. RESULTS: In comparison to the non-gait disorder group, those with gait disorders showed worse cognitive performance assessed by MoCA, Stroop, SDMT and TMT B-A; worse gait performance with reduced speed (gait speed, stride length, foot strike angle and toe off angle), increased postural instability (double support %GCT), and increased gait variability (CoV% of stride length). Medium strength of the association was shown in between all the gait variables and cognitive variables except large effect size between SDMT and gait speed, stride length and double support, and small effect size between CoV% of stride length and LEMOCOT and TMT B-A. All these associations were statistically significant at .05 level. CONCLUSION: It is feasible to conduct gait assessment using instrumented wearable systems (IMUs) in the natural home environment as well as cognitive assessment in older adults with higher-level gait disorders. Individuals with higher-level gait disorders exhibit diminished gait performance, characterised by decreased gait speed, increased postural instability and gait variability; decreased cognitive performance in attention, processing speed, motor planning and cognitive flexibility. There is association between gait performance and cognitive performance.