Poster Presentations P2 S337

to foster omnidirectional flow of information and resources between scien-

tists, caregivers, and clinicians.

P2-082 DISCOURSE ANALYSIS OF ALZHEIMER’S

DISEASE PATIENTS: FROM THE LEXICON TO

DISCOURSE

Renne P. Alegria, Ricardo B. Ferreira, Rita C. G. Marques,

Cassio M. C. Bottino, Maria I. Nogueira, University of Sao Paulo, Sao

Paulo, Brazil. Contact e-mail: realegrias@yahoo.com.br

Background: Little attention has been given to the population with Alz-

heimer’s disease concerning the sociolinguistic underpinnings of their dis-

courses. Language performance research has been the focus recently,

especially for advancing our understanding of the multiple cognitive and so-

ciolinguistic influences on the patients with dementia. Objective: to demon-

strate the sociolinguistic underpinnings of Alzheimer’s disease patients

Methods: The participants for this study were eight Alzheimer’s disease pa-

tients and six controls. The patients were four men and four women aged 80

and older, and the controls were three male and three female, aged 75 and

older.All the patients were from PROTER- Old Age Program - ambulatory

care of the Institute of Psychiatry of the School of Medicine of the University

of Sao Paulo. The controls were their caregivers and/or relatives. The patients

and controls had 4 to 11 years of education, their Mini Mental State Exam

(MMSE) scores 13 to 30. The controls were also evaluated by other scales

such as SRQ-20.Their discursive performances were recorded and analyzed

by the computational tool Stablex, based on mathematical-statistical-com-

puter assisted program which mainly distinguish the results of preferential,

basic and differential vocabulary. Results: The sociolinguistic influences

of the discourses of the patients are not necessarily destroyed compared to

the discourse of the control subjects. The program Stablex shows that pref-

erential vocabulary is constituted of the thematic vocabulary and the lexical

components of more sociolinguistic frequency in the discourses. The patients

produced more preferential words than the controls and they were shown to

be statistically significant. The patients preserve more words with ideologi-

cal, historical and cultural meanings Conclusions: Assessing the discourse

performance of patients with Alzheimer’s disease provides opportunities to

unravel the connections and changes among language, communication and

behavior. For patients with dementia, analysis of sociolinguistic discourse

is an access for a better communication with their caregivers.

P2-083 HOSPICE CARE IN U.S. NURSING HOMES FOR

PERSONS WITH END-STAGE DEMENTIA: HOW

U.S. MEDICARE PAYMENT POLICY INFLUENCES

HOSPICE ELECTION AND END-OF-LIFE

HOSPITALIZATIONS

Susan C. Miller1, Julie C. Lima1, Susan L. Mitchell2, 1Brown University,Providence, RI, USA; 2Hebrew SeniorLife Institute for Aging Research,

Boston, MA, USA. Contact e-mail: Susan_Miller@brown.edu

Background: Over 60 percent of older Americans who die with dementia

each year die in nursing homes (NHs). While studies show benefits associ-

ated with NH Medicare hospice enrollment, U.S. government regulations

prohibit NH residents from simultaneously accessing Medicare hospice

care and Medicare financed NH care (i.e., skilled nursing facility [SNF]

care), and it is financially disadvantageous for residents/families and for

NHs to switch from Medicare NH care to hospice care. Methods: For years

1999 through 2006 in the 50 U.S. states and the District of Columbia we

merged resident assessment data (MDS) with Medicare data to identify

NH decedents with end-stage dementia (i.e., an MDS dementia diagnosis

and severe to very severe dementia per the cognitive performance scale).

We identified for years 1999-2006 the proportion of decedents who received

Medicare hospice and their hospice lengths of stay. In 2006, we identified

residents receiving Medicare-reimbursed SNF care in the last 90 days of

life, and for these, we determined the proportion electing hospice, hospice

lengths of stay, and the prevalence of end-of-life hospitalizations (by hospice

enrollment). Results: A significantly higher proportion of NH decedents

with end-stage dementia enrolled in NH hospice in 2006 compared to

1999 (40% versus 13% respectively). Also, mean hospice stays were longer

in 2006 versus in 1999 (149 versus 49 days respectively), as were median

stays (39 days versus 16 respectively). In 2006, hospice enrollment differed

for residents who did and did not receive Medicare SNF care in the last 90

days of life; 32% with versus 43% without SNF care enrolled in hospice.

Those SNF residents who did enroll in hospice, compared to SNF residents

who did not enroll in hospice, had significantly fewer hospitalizations in the

last 90 days of life and were significantly less likely to die in a hospital (1%

versus 17% respectively; p < .001). Conclusions: There has been much

growth in the use and earlier use of Medicare hospice by NH residents

with end-stage dementia. However, government policy appears to be associ-

ated with lower hospice enrollment by SNF residents and in resulting greater

hospital use.

P2-084 BEIDEYES IN KURIGRAM DISTRICT OF

BANGLADESH: THEIR KNOWLEDGE OF

COMMON MENTAL HEALTH PROBLEMS AND

POSSIBLE ROLE IN PRIMARY HEALTH CARE

Ariful Haque MollikPeoples Integrated Alliance, Dhaka, Bangladesh.

Contact e-mail: mollik_bge@live.com

Background: Traditional medicine is the wisdom crystallization of human

civilization, which has made an indelible contribution to human surviving

and multiplying. Even-today, with highly developed modern science and

technology, we still need to face the complexity of life and disease. Countries

around the world are re-examining the status and the role of traditional med-

icine to raise the level and reduce the costs of health care. In order to achieve

the goal of ‘‘Health for All’’, World Health Organization has clearly advo-

cated to vigorously promoting the use of traditional medicine. Traditional

medicines are used to treat common mental health problems, which have of-

ten been viewed as culturally specific problems, and so these treatments have

been seen as effective only in this specific context. However, empirical med-

ical experience appears to demonstrate the opposite, indicating instead that

the therapeutic techniques of indigenous or native people have a transcul-

tural dimension, responding to human constants that are invariable or ar-

chetypal. An ethnomedicinal survey was carried out amongst Beideyes

[traditional medicinal practitioners] of several villages in Kurigram district

of Bangladesh. It was ascertained in a preliminary survey that the popula-

tion of these villages relies primarily on these Beideyes for treatment of

common mental health problems. Methods: Extensive interviews were

conducted of the Beideyes and plant samples as pointed out by the Bei-

deyes were photographed, collected, deposited and identified at the Bangla-

desh National Herbarium. Results: Some of the plant names obtained in

this survey included Oroxylum indicum [stem], Desmodium motorium

[leaf], Crataeva religiosa [bark, leaf], Santalum album [stem], Nicotiana

tobacum [leaf], Mimosa diplotricha [seed, root], Piper cubeba [fruit], Ca-mellia sinensis [leaf], Costus speciosus [tuber root], Brassica napus [seed],

Coffea arabica [seed], Bacopa monnieri [all parts], Asparagus racemosus

[root], Cocos nucifera [fruit juice], Ocimum gratissimum [all parts], Law-

sonia inermis [leaf], Cinnamomum camphora [all parts], Hemidesmus indi-cus [root], Datura metel [fruit, root], Piper betle [all parts], and Withania

somnifera [all parts]. Conclusions: Since the rural population in Kurigram

district of Bangladesh mostly do not have access to primary medical facil-

ities, the above plants can form the basis of treatment for common mental

health problems without resorting to costly urban visits and/or allopathic

practitioners.

P2-085 WEB TECHNOLOGY FOR DELIVERING

COGNITIVE INTERVENTIONS TO THE HOME

Holly B. Jimison, Misha Pavel, Oregon Health & Science University,

Portland, OR, USA. Contact e-mail: jimisonh@ohsu.edu

Background: Recent research has shown evidence of neural plasticity at

older ages and that cognitive exercise or training may help performance