Dementia-Related Anxiety and General Illness Anxiety Differ Based on Familial Exposure to Persons With Dementia

Abstract Dementia-related anxiety is a specific form of illness anxiety that has been associated with familial exposure to persons with dementia (FMwDs). However, it is unknown whether FMwDs is specifically associated with dementia-related anxiety or whether it is also related to general illness anxiety, which has broader health implications. Furthermore, the level of exposure to family members with dementia may matter. Thus, we examined whether level of familial exposure to dementia was related to general illness anxiety and dementia-related anxiety. Participants (N = 401) aged 18-76 years (M = 39) recruited through Amazon’s Mechanical Turk completed an online survey. Dementia exposure was split into three levels: (1) not knowing a friend/family member with dementia (55.2%); (2) knowing a family member with dementia (33.9%); and (3) providing care for a family member with dementia (10.9%). Familial exposure to dementia was related to both general illness anxiety and dementia-related anxiety. Participants who provided care for FMwDs had significantly higher levels of illness anxiety than both people who had a FMwD and people who did not (ps < .001). Similarly, participants who provided care for FMwDs had significantly higher levels of dementia-related anxiety than participants who did not have a FMwD (p < .01). Caregivers play a critical role in the quality of life of those with dementia, however it is clear that the potential psychological impact of such work is pervasive. This study provides a foundation to explore differences between illness anxiety and dementia worry, and examine interventions to reduce anxiety among caregivers.

information about their illness experience, including how they cope and manage with their illness and how illnessrelated strains are related to psychosocial outcomes. Researchers also have starting using self-report data collection protocols instead of proxy-report measures to assess the impact of non-pharmacological interventions developed for individuals with dementia on well-being outcomes such as depressive symptoms, unmet needs, and relationship strain. To date, however, there are no clear guidelines or 'best practices' to assist researchers in developing study protocols that facilitate the inclusion and participation of individuals with dementia. This poster will present findings from a systematic literature review of studies that have successfully included individuals with dementia as research participants. Key areas examined include: 1) the focus and type of research question studied; 2) the use and type of cognitive screening tools for determining study eligibility; 3) implementation of qualitative versus quantitative research designs; 4) objective versus subjective measures; 5) data collection tools; 6) psychometric evidence of data obtained; and 7) how data have been analyzed. Findings highlight the importance of collecting data directly from individuals with dementia to further understand the illness experience and assess the impact of nonpharmacological interventions. Dementia-related anxiety is a specific form of illness anxiety that has been associated with familial exposure to persons with dementia (FMwDs). However, it is unknown whether FMwDs is specifically associated with dementiarelated anxiety or whether it is also related to general illness anxiety, which has broader health implications. Furthermore, the level of exposure to family members with dementia may matter. Thus, we examined whether level of familial exposure to dementia was related to general illness anxiety and dementia-related anxiety. Participants (N = 401) aged 18-76 years (M = 39) recruited through Amazon's Mechanical Turk completed an online survey. Dementia exposure was split into three levels: (1) not knowing a friend/ family member with dementia (55.2%); (2) knowing a family member with dementia (33.9%); and (3) providing care for a family member with dementia (10.9%). Familial exposure to dementia was related to both general illness anxiety and dementia-related anxiety. Participants who provided care for FMwDs had significantly higher levels of illness anxiety than both people who had a FMwD and people who did not (ps < .001). Similarly, participants who provided care for FMwDs had significantly higher levels of dementia-related anxiety than participants who did not have a FMwD (p < .01). Caregivers play a critical role in the quality of life of those with dementia, however it is clear that the potential psychological impact of such work is pervasive. This study provides a foundation to explore differences between illness GSA 2020 Annual Scientific Meeting Innovation in Aging, 2020, Vol. 4, No. S1 anxiety and dementia worry, and examine interventions to reduce anxiety among caregivers. With the increase in research related to people directly and indirectly affected by Alzheimer's Dementia and related disorders (ADRD), there is a need for short, psychometricallysound instruments to assess the variety of influences on the quality of life for the person with dementia (pwd) and their care partners. We sought to develop and assess a short version of the Dementia Attitudes Scale (DAS; O' Connor & McFadden, 2010) for use in such endeavors. Using a sample of 321 adults (Mage = 39.7, range 20 to 70 yrs; 47% female), we surveyed a host of individual characteristics (e.g., age, personality, experience with pwd) and several current measures of attitudes about pwd. Ten days later, 162 of these adults completed a retest of the DAS. Results of a confirmatory factor analysis supported the 2-factor solution reported by O'Connor and McFadden. Internal consistency was acceptable for the Comfort factor (Time 1alpha = .83; T2 alpha = .82) and for the Knowledge factor (Time 1 alpha = .86; Time 2 alpha = .87). These estimates are similar to those in the original report. Due to limitations of coefficient alpha we also used structural equations to examine the regression weights for each item as a function of chronological age and experience. These analyses showed that the factor structure was robust when considering these individual characteristics. Finally, we compared different scale lengths using a series of ROC curves. We discuss our results in the context of providing brief and psychometrically-sound measures for use in large survey studies.

DISCORDANCE BETWEEN PATIENT AND CAREGIVER ON RATINGS OF PURPOSE IN LIFE FOLLOWING A DEMENTIA DIAGNOSTIC APPOINTMENT
Matthew Wynn, 1 Catherine Ju, 1 and Patrick Hill, 2

Washington University in St. Louis, St. Louis, Missouri, United States, 2. Washington University in St. Louis, Saint Louis, Missouri, United States
Purpose in life has been linked with better well-being and reduced risk for major illness. As such, work has focused on understanding what leads to changes in sense of purpose during adulthood, with a focus on major life events. Receiving a dementia diagnosis is a major life event that could affect purpose in life both for older adults with dementia and their potential caregivers. To examine this issue participants answered questions at two timepoints, before their diagnostic appointment at a specialized memory clinic, and between two days and two weeks after the appointment. Participants provided self-report ratings of sense of purpose and as well as open-ended answers regarding their purpose in life. Data is available from both caregivers and patients and qualitative coding was performed on participants' open-ended responses. Our analysis revealed discordance between patients and caregivers, such that caregivers' ratings of patients were lower in terms of purpose in life (t = -5.63, p < .001) and being in worse health (t = -3.41, p < .001) than patients' ratings of themselves on the same measures. Discordance between caregiver and patient in the context of a dementia diagnostic appointment and outcomes associated with this discordance are discussed.

DOES ANXIETY AFFECT THE CLOCK-DRAWING TASK IN PATIENTS IN A MEMORY CLINIC? A CLINICAL CORRELATION STUDY
Hamed Khachan, Mahak Kanjolia, and Anil Nair, Alzheimer's Disease Center, Quincy, Massachusetts, United States Background: It is unknown if anxiety levels affect performance on clock drawing test (CDT) in memory clinic patients. Method: We performed a retrospective analysis of memory clinic patients in the south shore of Boston from 2010 to 2019. We correlated anxiety screen data (GAD7) to CDT scores, based on contour, numbers, and hands placement. Univariate analyses used Spearman correlation. A multivariate regression model analzed GAD7 to covariates of CDT, age, sex, and race. Hypothesis : We hypothesized a positive correlation between anxiety levels scored by the GAD7 and CDT. Results: 994 patients in the memory clinic between 2010-2020 had analyzable data. Patients were 58.6% female, 84.6 % White. Mean age was 70.1±14.4, CDT 1.84±1.04. CDT score correlated significantly to race (⍴=-0.16, p< 0.001), age (⍴=-0.28, p<0.001), gender (⍴=0.05, p=0.16), but not GAD7 (⍴=0.05, p=0.27). Multivariate model confirmed the lack of association of anxiety scores to CDT (□= 0.08, p=0.78). GAD7 scores correlated to female gender (□= -1.16, p=0.04). Conclusions: CDT scores were not affected by anxiety as measured on GAD7 scores. However, a positive correlation was shown on anxiety scores in females to CDT completion.

IS IMMEDIATE RECALL TEST SCORES AFFECTED BY ANXIETY IN A MEMORY CLINIC POPULATION? A CLINICAL CORRELATION STUDY.
Hamed Khachan, Anil Nair, Fioralba Andrea, and Mahak Kanjolia, Alzheimer's Disease Center, Quincy,

Massachusetts, United States
Background: It is unknown if anxiety affects performance on immediate recall testing (IR) in memory clinic patients. Method: We performed a retrospective analysis of memory clinic patients in the south shore of Boston from 2010 to 2019. We correlated anxiety screen data (GAD7) to IR scores. Univariate analyses used Spearman correlation. A multivariate regression model analyzed GAD7 to covariates of IR, age, sex, and race. Hypothesis: We hypothesized a positive correlation between anxiety levels scored by GAD7 and IR. Results: 994 patients in the memory clinic between 2010-2020 had analyzable data. Patients were 58.6% female, 84.6 % White. The mean age was 70.1±14.4, IR 6.62 ± 5.4, GAD7 5.5±5.71. On univariate analysis, IR correlated significantly to age (⍴ = 0.08, p = 0.01), gender (⍴ = 0.06, p = 0.046), and race (⍴= -0.25, p <0.001), but not to GAD7 (⍴=-0.07, p=0.14). The multivariate model confirmed the lack of association of anxiety scores to (□=-0.05, p=0.41) to GAD7 scores. IR task performance was significantly associated only