New Horizons in Dementia and Mental Health

door Lies van Asche

The first onset of psychosis in individuals aged 65 years and older presents a great challenge for the healthcare professional who tries to understand the contributing mechanisms to develop a treatment plan. Differential diagnosis is complex as there are many psychosocial risk factors and underlying (medical) conditions that may increase the possibility of developing psychotic symptoms in late life. We will consider phenomenological characteristics and aspects of neuropsychological function that may aid the diagnosis in a non-invasive manner.

Lies Van Assche is a clinical (neuro)psychologist and family therapist at the Old Age Psychiatry department of the University Psychiatric Centre of the KU Leuven. She finished a PhD on the neurobiological and psychosocial mechanisms involved in late onset psychosis and currently continues her research on this topic. She is also a lecturer at the Faculty of Psychology and Educational Sciences of the KU Leuven.
Finally, she has written many articles, book chapters and books on aging and mental health in late life.

door Maarten Van Den Bossche

Behavioral and Psychological Symptoms of Dementia (BPSD) are nearly universal among people with dementia and significantly contribute to patient suffering, accelerated cognitive decline, caregiver burden, and institutionalization. While nonpharmacological and pharmacological treatments form the cornerstone of current BPSD management, a subset of patients remains severely symptomatic and treatment-resistant. Moreover, several treatment strategies result in very severe side-effects. In several neuropsychiatric disorders neuromodulation constitutes additional treatment options, even when symptoms are severe and/or patients are very vulnerable. Therefore, also in BPSD, neuromodulation may offer useful additional management options. We will give an overview of the current state-of-the-art and discuss two examples of our own clinical research: enhancement of slow wave sleep by acoustic stimulation in Alzheimer’s disease and electroconvulsive therapy for severe BPSD.

Maarten Van Den Bossche is a (geriatric) psychiatrist and head of the Department of Psychiatry at Maastricht University Medical Center (MUMC+) in the Netherlands. Before that he worked at the University Psychiatric Centre KU Leuven and the Leuven Brain Institute of the KU Leuven in Belgium for 8 years. He has been an assistant professor since 2019 and an associate professor since 2023.He earned a PhD in psychiatric genetics at the VIB Center for Molecular Neurology in Antwerp. He obtained an additional master’s degree in hospital management and a postgraduate degree in psychoanalytic psychotherapy. He has been a member of the Executive Committee of the Flemish Society for Psychiatry (VVP) for 10 years, and he is the current president of the Geriatric Psychiatry section of VVP. He is president of the Foundation Tijdschrift voor Psychiatrie and a member of the working groups on BPSD of the International Psychiatric Association. His research is focused on neuropsychiatric symptoms of dementia like sleep and agitation.

door Bettina S. Husebø

People with dementia or Parkinson’s Disease represent one of the most vulnerable and understudied populations. These individuals often exhibit limited ability to communicate their needs and experience behavioral and psychological symptoms such as agitation, depression, anxiety, and disturbances in sleep, alongside with pain and dyspnea. Inappropriate detection of these symptoms may lead to inadequate treatment and care, which can further exacerbate symptoms and diminish their QoL. In our work, we monitor these people with sensor technology, such as wearables and radar sensors, in addition to traditional questionnaires. Our preliminary findings indicate that e.g., sleep, agitation or pain are associated with alterations in vital parameters such as heart rate, respiratory patterns, and sleep architecture. Initial analyses provide important insights into digitally monitored symptoms and their interdependence.

Bettina S. Husebø, MD, PhD, is specialist in anesthesiology, intensive care, palliative care, and nursing home medicine, and postgraduate for the SQIL Leadership program, Harvard Medical School. She is Prof. at the University of Bergen, Norway, and head of the Centre for Elderly and Nursing Home Medicine. Dr. Husebø received an ERC-Consolidator Grant and obtained the newly established Trond Mohn Center for Complex Conditions and Ageing (CC.AGE). Her clinical research has been focused on method development and randomized controlled intervention trials, including nursing home residents and home-dwelling people with dementia. Her recent work involves a transdisciplinary approach on sensor technology, smart living, and AI also in healthy older adults and people with Parkinson’s Disease.

door Nadeeka Dissanayaka

Anxiety is a prominent neuropsychiatric complication in older persons living with Parkinson’s disease (PD). In this talk I will outline the phenomenology, diagnosis and treatment of anxiety in PD. I will introduce to the new Parkinson’s disease Specific Anxiety  Inventory (PDSAI), which is recently developed and validated to improve assessment of anxiety in PD. While discussing pharmacological and non-pharmacological approaches to reduce anxiety in PD, I will introduce our novel technology assisted interventions using virtual reality and telehealth approaches. We have recently developed a digital platform to assist remote delivery of anxiety interventions, which will also be discussed in this talk.

Professor Nadeeka Dissanayaka is a clinical research fellow at the University of Queensland, Australia. She leads a well-established clinical research program in Ageing, Mental Health, and Neurodegenerative disease. Her multifaceted research program investigates how to maximise psychiatric diagnosis in health services, and develops targeted mental health interventions (e.g. anxiety) for health and aged care. Prof Dissanayaka is a graduate of The University of Queensland, and competed her PhD in 2008. Her thesis focused on assessment methods and risk for depression in Parkinson’s disease. Since then, she has held four clinical research fellowships, where she expanded her work into mental health in older persons and dementia. In 2016, she established and continue to direct the Dementia & Neuro Mental Health Research Unit at The University of Queensland. Her work includes technology assisted diagnostic and psychotherapy approaches, clinical trials and rapid implementation into health and age care service models.