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Sanlaville C, Loiseau Médecin Généraliste A, Colin C, Salmon PK, Letrilliart L. [General practitioners' views on cognitive disorders diagnosis: a qualitative study]. SOINS. GÉRONTOLOGIE 2021; 26:35-42. [PMID: 34304810 DOI: 10.1016/j.sger.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Diagnosis of cognitive disorders is at medical and ethical stake. The aim of an qualitative study based on interviews was to explore the views of general practitioners on this diagnosis. General practitioners are ambivalent about the relevance and temporality of the diagnosis of cognitive disorders, which could be resolved by a shared decision making at each stage of the diagnostic approach.
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Affiliation(s)
- Claire Sanlaville
- Collège universitaire de médecine générale, université Claude-Bernard Lyon 1, 69008 Lyon, France
| | | | - Cyrille Colin
- Université Claude-Bernard Lyon 1, 69622 Villeurbanne, France; Laboratoire Health services and performance research EA 7425, université Claude-Bernard Lyon 1, 69008 Lyon, France; Pôle Information médicale évaluation recherche, Hospices civils de Lyon, 3 quai des Célestins, 69002 Lyon, France
| | - Pierre-Krolak Salmon
- Centre mémoire, ressources, recherche de Lyon, Institut du vieillissement, Hospices civils de Lyon, Institut national de la santé et de la recherche médicale 1048, Centre national de la recherche scientifique 5292, 69008 Lyon, France; Action conjointe européenne "Act on dementia", université Claude-Bernard Lyon 1, 69008 Lyon, France
| | - Laurent Letrilliart
- Collège universitaire de médecine générale, université Claude-Bernard Lyon 1, 69008 Lyon, France; Laboratoire Health services and performance research EA 7425, université Claude-Bernard Lyon 1, 69008 Lyon, France; Collège universitaire de médecine générale, Université Claude-Bernard Lyon 1, 8 avenue Rockefeller, 69373 Lyon cedex 08, France.
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Rochoy M, Bordet R, Gautier S, Chazard E. Factors associated with the onset of Alzheimer's disease: Data mining in the French nationwide discharge summary database between 2008 and 2014. PLoS One 2019; 14:e0220174. [PMID: 31344088 PMCID: PMC6657866 DOI: 10.1371/journal.pone.0220174] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 07/10/2019] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Identifying modifiable risk factors for Alzheimer's disease (AD) is critical for research. Data mining may be a useful tool for finding new AD associated factors. METHODS We included all patients over 49 years of age, hospitalized in France in 2008 (without dementia) and in 2014. Dependent variable was AD or AD dementia diagnosis in 2014. We recoded the diagnoses of hospital stays (in ICD-10) into 137 explanatory variables.To avoid overweighting the "age" variable, we divided the population into 7 sub-populations of 5 years. RESULTS We analyzed 1,390,307 patients in the PMSI in 2008 and 2014: 55,997 patients had coding for AD or AD dementia in 2014 (4.04%). We associated Alzheimer disease in 2014 with about 20 variables including male sex, stroke, diabetes mellitus, mental retardation, bipolar disorder, intoxication, Parkinson disease, depression, anxiety disorders, alcohol, undernutrition, fall and 3 less explored variables: intracranial hypertension (odd radio [95% confidence interval]: 1.16 [1.12-1.20] in 70-80 years group), psychotic disorder (OR: 1.09 [1.07-1.11] in 70-75 years group) and epilepsy (OR: 1.06 [1.05-1.07] after 70 years). DISCUSSION We analyzed 137 variables in the PMSI identified some well-known risk factors for AD, and highlighted a possible association with intracranial hypertension, which merits further investigation. Better knowledge of associations could lead to better targeting (identifying) at-risk patients, and better prevention of AD, in order to reduce its impact.
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Affiliation(s)
- Michaël Rochoy
- Univ. Lille, Lille, France
- INSERM, U1171-Degenerative and Vascular Cognitive Disorders, Lille, France
- EA2694, Public Health Department, Lille, France
| | - Régis Bordet
- Univ. Lille, Lille, France
- INSERM, U1171-Degenerative and Vascular Cognitive Disorders, Lille, France
| | - Sophie Gautier
- Univ. Lille, Lille, France
- INSERM, U1171-Degenerative and Vascular Cognitive Disorders, Lille, France
| | - Emmanuel Chazard
- Univ. Lille, Lille, France
- EA2694, Public Health Department, Lille, France
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Wanneveich M, Jacqmin-Gadda H, Dartigues JF, Joly P. Impact of intervention targeting risk factors on chronic disease burden. Stat Methods Med Res 2016; 27:414-427. [PMID: 26988925 DOI: 10.1177/0962280216631360] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aging of the population is accompanied by a sharp rise of chronic disease prevalences, such as dementia. These diseases generally cannot be prevented or cured and persist over time, with a progressive deterioration of health, requiring specific care. To reduce the burden of these diseases, it is appropriate to propose interventions targeting disease risk factors, but the association between most of these risk factors and mortality makes it difficult to anticipate the potential impact of such interventions. A method was previously proposed to estimate changes in disease prevalence following an intervention targeting subjects at a given age where the incidence of the disease is supposed to be null. Here, we propose a general framework to make projections for life expectancies with and without the disease, the age at onset, and the lifelong probability of the disease, and to evaluate the consequences of preventive interventions targeting risk factors on these various measures of disease burden. The methodology takes into account the mortality trend over calendar time and age in both healthy and diseased subjects, and the change in mortality due to the intervention. The method is applied to make projections for dementia in 2030 according to several scenarios of public health interventions.
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Affiliation(s)
- Mathilde Wanneveich
- 1 University of Bordeaux, ISPED, Bordeaux, France.,2 Inserm, ISPED, Bordeaux, France
| | - Hélène Jacqmin-Gadda
- 1 University of Bordeaux, ISPED, Bordeaux, France.,2 Inserm, ISPED, Bordeaux, France
| | | | - Pierre Joly
- 1 University of Bordeaux, ISPED, Bordeaux, France.,2 Inserm, ISPED, Bordeaux, France
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Kanagaratnam L, Dramé M, Trenque T, Novella JL, Joachim C, Nazeyrollas P, Lang PO, Jolly D, Mahmoudi R. Effets indésirables médicamenteux chez des sujets âgés hospitalisés dans une unité spécialisée dans la prise en charge des patients atteints de syndrome démentiel. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.npg.2014.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Education and WHO recommendations for fruit and vegetable intake are associated with better cognitive function in a disadvantaged Brazilian elderly population: a population-based cross-sectional study. PLoS One 2014; 9:e94042. [PMID: 24736378 PMCID: PMC3988063 DOI: 10.1371/journal.pone.0094042] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 03/10/2014] [Indexed: 11/19/2022] Open
Abstract
Brazil has one of the fastest aging populations in the world and the incidence of cognitive impairment in the elderly is expected to increase exponentially. We examined the association between cognitive impairment and fruit and vegetable intake and associated factors in a low-income elderly population. A cross-sectional population-based study was carried out with 1849 individuals aged 65 or over living in São Paulo, Brazil. Cognitive function was assessed using the Community Screening Instrument for Dementia (CSI-D). Fruit and vegetable intake was assessed with a Food Frequency Questionnaire (FFQ) and categorized into quartiles of intake and into total daily fruit and vegetable intake using the cut-off points for the WHO recommendations (<400grams/day or ≥400 grams/day). The association between cognitive impairment and each quartile of intake, and WHO recommendation levels, was evaluated in two separate multivariate logistic models. The WHO recommendations for daily intakes ≥400 grams/day were significantly associated with 47% decreased prevalence of cognitive impairment. An effect modification was found in both models between cognitive impairment and “years of education and physical activity” and “years of education and blood levels of HDL” So that, having 1 or more years of education and being physically active or having 1 or more years of education and levels higher than 50 mg/dl of HDL-cholesterol strongly decreased the prevalence of cognitive impairment. In this socially deprived population with very low levels of education and physical activity and fruit and vegetable intake, those who attained WHO recommendations, had 1 year or more of education and were physically active had a significantly lower prevalence of cognitive impairment. A more comprehensive understanding of the social determinants of mental health is needed to develop effective public policies in developing countries.
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L’éducation thérapeutique en gériatrie : quelles spécificités ? Presse Med 2013; 42:217-23. [DOI: 10.1016/j.lpm.2012.12.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Accepted: 12/05/2012] [Indexed: 11/24/2022] Open
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Qiao-feng W, Ling-ling G, Shu-guang Y, Qi Z, Sheng-feng L, Fang Z, Hai-yan Y, Yong T, Xian-zhong Y. A(1)H NMR-based metabonomic study on the SAMP8 and SAMR1 mice and the effect of electro-acupuncture. Exp Gerontol 2011; 46:787-93. [PMID: 21741463 DOI: 10.1016/j.exger.2011.06.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Revised: 05/31/2011] [Accepted: 06/21/2011] [Indexed: 12/21/2022]
Abstract
A (1)H NMR-based metabonomic method was used to investigate the metabolic change of plasma in senescence-prone 8 (SAMP8) mice before and after electro-acupuncture (EA). Sixteen SAMP8 male mice (aged 8 months) were randomly divided into model group and acupuncture treatment group while the later group received EA treatment for 21 days. Eight senescence-resistant 1 (SAMR1) mice were used as the control group. Morris water maze was used to evaluate the effects of EA. All mice plasma samples obtained from different groups were analyzed by using 600 MHz (1)H nuclear magnetic resonances ((1)H NMR) spectroscopy. The data sets were analyzed by Principal Components Analysis (PCA) and Partial Least Squares-Discriminant Analysis (PLS-DA) to discriminate the key plasma metabolites among different groups. Results indicated that both the escape and probe tasks of SAMP8 could be improved by EA treatment. Metabonomic study showed that SAMR1 and SAMP8 were separated clearly in both CPMG_OSC_PLS and LED _OSC_PLS score plots. Interestingly, samples obtained from EA group were distributed closely to SAMR1 group in CPMG_OSC_PLS score plot, but away from SAMP8 group in LED_OSC_PLS score plot. Corresponding loading plots showed that much less lactate was seen in SAMP8 mice plasma. Other changes including higher levels of dimethylamine (DMA) Choline and α-glucose but lower levels of leucine/isoleucine, HDL, LDL/VLDL, 3-Hydroxybutyrate (3-HB), and Trimethylamine N-oxide (TMAO) were observed in the SAMP8 mice plasma than in the SAMR1. After EA treatment, the levels of lactate, DMA, choline and TMAO were improved. Results of this work can provide valuable clues to the understanding of the metabolic changes in the senile impairment of mice. It is also hoped that the methodology can be used in evaluating the effects of EA and understanding the underlying acupuncture mechanism in treating neurodegenerative diseases.
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Affiliation(s)
- Wu Qiao-feng
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medcine, Chengdu, Sichuan, 610075, China.
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Verny M. Circonstances d’hospitalisation des patients âgés atteints de maladie d’Alzheimer. Rev Med Interne 2011; 32 Suppl 1:S14-6. [DOI: 10.1016/j.revmed.2011.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Akbaraly TN, Archana SM, Marmot MG, Brunner EJ. Education attenuates the association between dietary patterns and cognition. Dement Geriatr Cogn Disord 2009; 27:147-54. [PMID: 19182482 PMCID: PMC2793407 DOI: 10.1159/000199235] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2008] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND/AIMS Various foods have been shown to be associated with cognitive outcomes. As individual food items are not consumed in isolation, we examined the association between dietary patterns and cognitive function, with special attention to the role of education in this association. METHODS Analyses were carried out on 4,693 stroke-free white European participants of the Whitehall II study. Two dietary patterns were determined using principal component analysis: a 'whole food' and a 'processed food' pattern. Cognitive function was assessed using a battery of 5 tests. RESULTS After adjustment for demographic, behavioral and health measures, higher intake of 'whole food' diet was associated with lower and high consumption of 'processed food' with higher odds of cognitive deficit. However, adjustment for education significantly attenuated most of these associations. CONCLUSIONS Education, through its role as a powerful confounder, shapes the relationship between dietary patterns and cognitive deficit in a healthy middle-aged UK cohort.
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Affiliation(s)
- Tasnime N. Akbaraly
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Singh-Manoux Archana
- Department of Epidemiology and Public Health, University College London, London, UK
- INSERM U687-IFR69, University College London, London, UK
- Centre de Gérontologie, Hôpital Ste Périne, AP-HP, Paris, France
| | - Michael G. Marmot
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Eric J. Brunner
- Department of Epidemiology and Public Health, University College London, London, UK
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