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Norton J, Gutierrez LA, Gourdeau C, Amieva H, Bernier P, Berr C. Mapping Cognitive Trajectories and Detecting Early Dementia Using the Mini-Mental State Examination Cognitive Charts: Application to the French Three-City Cohort. J Alzheimers Dis 2024; 98:403-409. [PMID: 38393910 DOI: 10.3233/jad-231176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
The Cognitive Quotient (QuoCo) classification algorithm monitoring decline on age- and education-adjusted Mini-Mental State Examination (MMSE)-derived cognitive charts has proved superior to the conventionally-used cut-off for identifying incident dementia; however, it remains to be tested in different settings. Data were drawn from the Three-City Cohort to 1) assess the screening accuracy of the QuoCo, and 2) compare its performance to that of serial MMSE tests applying different cut-offs. For the QuoCo, sensitivity was 74.2 (95% CI: 71.4-76.8) and specificity 84.1 (83.6-84.7) and for the MMSE < 24, 64.1 (61.1-67.0) and 94.8 (94.4-95.1), respectively; whereas overall accuracy and sensitivity was highest for MMSE cut-offs <25 and <26. User-friendly charts for mapping cognitive trajectories over visits with an alert for potentially 'abnormal' decline can be of practical use and encourage regular monitoring in primary care where the <24 cut-off is still widely used despite its poor sensitivity.
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Affiliation(s)
- Joanna Norton
- Institute for Neurosciences of Montpellier (INM), Inserm, University of Montpellier, Montpellier, France
| | - Laure-Anne Gutierrez
- Institute for Neurosciences of Montpellier (INM), Inserm, University of Montpellier, Montpellier, France
| | | | - Hélène Amieva
- INSERM, Bordeaux Population Health Research Center, UMR U1219, University of Bordeaux, Bordeaux, France
| | - Patrick Bernier
- Specialised Geriatric Services, CIUSSS Capitale-Nationale, Québec City, Canada
| | - Claudine Berr
- Institute for Neurosciences of Montpellier (INM), Inserm, University of Montpellier, Montpellier, France
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Rapin A, Calmus A, Pradeau C, Taiar R, Belassian G, Godefroy O, Carazo-Mendez S, Boyer FC. Effect of oxygen therapy duration on cognitive impairment 12 months after hospitalization for SARS-COV-2 infection. J Rehabil Med 2023; 55:jrm12609. [PMID: 37974332 DOI: 10.2340/jrm.v55.12609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/08/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE To identify predictors of persistent cognitive impairment at 12 months after hospitalization due to COVID-19 (SARS-CoV-2) infection. DESIGN Retrospective, single-centre study. SUBJECTS All consecutive patients assessed in physical and rehabilitation medicine consultations at 3 months with a neuropsychiatric testing (NPT) at 6 months. METHODS A Mini Mental State Examination (MMSE) was performed at 3 months and NPT at 6 and 12 months, exploring global cognitive efficiency, attention and processing speed, short-term memory and executive function. Logistic regression and receiver operating characteristic curves were used to identify predictors of persistent cognitive impairment. RESULTS Among 56 patients, 64.3% and 53.6% had 1 or more impaired cognitive functions at 6 and 12 months, respectively, attention and processing speed being the most represented (41.1% at 12 month). Duration of oxygen therapy (odds ratio 0.926 [0.871-0.985], p = 0.015) and MMSE score at 3 months (odds ratio 0.464 [0.276-0.783], p = 0.004) were associated with cognitive impairment at 12 months by multivariable analysis (R² 0.372-0.497). CONCLUSIONS Half of patients have cognitive impairment 12 months after acute SARS-CoV-2 infection requiring hospitalization. The duration of oxygen therapy in acute care could be a protective parameter. Systematic evaluation with the MMSE at 3 months after infection might be an effective tool to detect risk.
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Affiliation(s)
- Amandine Rapin
- Department of Physical and Rehabilitation Medicine, hôpital Sebastopol, Reims, France; Faculty of Medicine, Reims Champagne-Ardenne University, MATIM, Reims, France VieFra, EA3797, Reims, France.
| | - Arnaud Calmus
- Department of Physical and Rehabilitation Medicine, hôpital Sebastopol, Reims, France; Reims Champagne-Ardenne University, C2S, EA6291, Reims, France
| | - Charles Pradeau
- Physical and Rehabilitation Medicine department, Strasbourg University Hospital, Strasbourg, France
| | - Redha Taiar
- Reims Champagne-Ardenne University, MATIM, Reims, France
| | - Gaël Belassian
- Department of Physical and Rehabilitation Medicine, hôpital Sebastopol, Reims, France
| | - Olivier Godefroy
- Functional neuroscience and pathologies laboratory (UR UPJV 4559), Amiens University Hospital , Amiens, France
| | - Sandy Carazo-Mendez
- Department of Physical and Rehabilitation Medicine, hôpital Sebastopol, Reims, France
| | - Francois C Boyer
- Department of Physical and Rehabilitation Medicine, hôpital Sebastopol, Reims, France; Faculty of Medicine, Reims Champagne-Ardenne University, MATIM, Reims, France VieFra, EA3797, Reims, France
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Weng X, Liang H, Liu K, Chen J, Fei Q, Liu S, Guo X, Wen L, Wu Y, Nie Z, Jing C. Relationship between urinary dichlorophenols and cognitive function among people over 60 years old from NHANES. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:73341-73352. [PMID: 35624369 DOI: 10.1007/s11356-022-20840-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
Studies have shown that exposure to dichlorophenols (DCPs) and their precursors might have potential neurotoxicity, which may be related to low cognitive function, but there are few large-scale, representative population data to explore the association between DCP exposure and cognitive function. We aimed to examine the relationship between urinary DCPs and cognitive function in the US older people. A total of 952 participants ≥ 60 years old from the National Health and Nutrition Examination Survey (NHANES) in two cycles (2011-2014) were enrolled. The Consortium to Establish a Registry for Alzheimer's disease Word Learning subtest (CERAD W-L), the Animal Fluency test (AFT), and the Digit Symbol Substitution test (DSST) were used to assess cognition. Multivariate logistic regression and restricted cubic spline (RCS) were used to evaluate the relationship between DCP exposure and cognitive function. A positive association between 2,5-DCP and the risk of bad performance of DSST was observed (P for trend = 0.024) after adjusting for the covariates. Compared to the lowest quartile, OR of DSST for the highest quartile of 2,5-DCP was 1.72 (95%CI:1.03-2.87, P = 0.039). There were no significant associations between DCPs and the other tests. The RCS plot showed an inverted J-shaped relationship between 2,5-DCP, 2,4-DCP, and the DSST score. The inflection points for the curves were found at 1.531 μg/L and 0.230 μg/L, respectively. On the right side of the inflection points, the DSST score dropped sharply. In subgroup analysis, those under 70 years old, smokers, and alcohol drinkers had a higher risk of bad performance in DSST when exposed to 2,5-DCP. The higher concentration of urinary DCPs is associated with a lower score of DSST in the US older people.
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Affiliation(s)
- Xueqiong Weng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Huanzhu Liang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Kun Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Jingmin Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Qiaoyuan Fei
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Shan Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Xinrong Guo
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Lin Wen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Yingying Wu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Zhiqiang Nie
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Chunxia Jing
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China.
- Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou, 510632, Guangdong, China.
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Zare Sakhvidi MJ, Yang J, Lequy E, Chen J, de Hoogh K, Letellier N, Mortamais M, Ozguler A, Vienneau D, Zins M, Goldberg M, Berr C, Jacquemin B. Outdoor air pollution exposure and cognitive performance: findings from the enrolment phase of the CONSTANCES cohort. Lancet Planet Health 2022; 6:e219-e229. [PMID: 35278388 DOI: 10.1016/s2542-5196(22)00001-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 10/27/2021] [Accepted: 01/04/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Air pollution exposure is one of the modifiable risk factors of cognitive decline. We aimed to test the association between exposure to several outdoor air pollutants and domain-specific cognitive performance. METHODS In this cross-sectional study, we used data from the enrolment phase of the French CONSTANCES cohort. From the 220 000 people (aged 18-69 years) randomly recruited in the French CONSTANCES cohort, participants aged 45 years old or older (104 733 people) underwent a comprehensive cognitive assessment (verbal episodic memory, language skills, and executive functions). After exclusion of those who were not suitable for our analysis, 61 462 participants with available data were included in the analyses. We used annual mean concentrations at residential addresses, derived from land-use regression models, to assign exposure to particulate matter with aerodynamic diameters less than 2·5 μm (PM2·5), nitrogen dioxide (NO2), and black carbon. We used multiple linear regression models with different covariate adjustments to test the associations between each pollutant and cognitive outcomes. We did several sensitivity analyses, including multilevel modelling, meta-analysis by centre of recruitment, and exclusion of specific population groups. FINDINGS We found significantly poorer cognitive function, especially on semantic fluency and domains of executive functions, with an increase in exposure to black carbon and NO2. Exposure to PM2·5 was mainly significant for the semantic fluency test. We found that decrease in cognitive performance with an increase of one interquartile range of exposure ranged from 1% to nearly 5%. The largest effect size (percentage decrease) for both PM2.5 and NO2 was found for the semantic fluency test (PM2.5 4·6%, 95% CI 2·1-6·9 and NO2 3·8%, 1·9-5·7), whereas for black carbon, the largest effect size was found for the digit symbol substitution test of the domains of executive functions (4·5%, 2·7-6·3). Monotonic and linear exposure-response associations were found between air pollution exposure and cognitive performance, starting from a low level of exposures. INTERPRETATION Significantly poorer cognitive performance was associated with exposure to outdoor air pollution even at low levels of exposure. This highlights the importance of further efforts to reduce exposure to air pollution. FUNDING The Caisse Nationale d'Assurance Maladie, and partly funded by Merck Sharp & Dohme and L'Oréal, the French National Research Agency, and Fondation de France. TRANSLATION For the French translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Mohammad Javad Zare Sakhvidi
- Université de Rennes, Inserm, EHESP, Institut de Recherche en Santé, Environnement, et Travail, UMR_S 1085, Rennes, France
| | - Jun Yang
- Université de Rennes, Inserm, EHESP, Institut de Recherche en Santé, Environnement, et Travail, UMR_S 1085, Rennes, France
| | - Emeline Lequy
- Centre de Recherche du CHUM, Montreal, QC, Canada; Unité Cohortes en Population, Université de Paris, Inserm, Université Paris Saclay, UVSQ, UMS 011, Paris, France
| | - Jie Chen
- Utrecht University, Utrecht, Netherlands
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Noémie Letellier
- University of Montpellier, Inserm, Institute of Neurosciences of Montpellier, U1298, F34091, Montpellier, France
| | - Marion Mortamais
- University of Montpellier, Inserm, Institute of Neurosciences of Montpellier, U1298, F34091, Montpellier, France
| | - Anna Ozguler
- Unité Cohortes en Population, Université de Paris, Inserm, Université Paris Saclay, UVSQ, UMS 011, Paris, France
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Marie Zins
- Unité Cohortes en Population, Université de Paris, Inserm, Université Paris Saclay, UVSQ, UMS 011, Paris, France
| | - Marcel Goldberg
- Unité Cohortes en Population, Université de Paris, Inserm, Université Paris Saclay, UVSQ, UMS 011, Paris, France
| | - Claudine Berr
- University of Montpellier, Inserm, Institute of Neurosciences of Montpellier, U1298, F34091, Montpellier, France; Memory Research and Resources Centre, Department of Neurology, Montpellier University Hospital Gui de Chauliac, Montpellier, France
| | - Bénédicte Jacquemin
- Université de Rennes, Inserm, EHESP, Institut de Recherche en Santé, Environnement, et Travail, UMR_S 1085, Rennes, France.
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Letellier N, Gutierrez LA, Pilorget C, Artaud F, Descatha A, Ozguler A, Goldberg M, Zins M, Elbaz A, Berr C. Association Between Occupational Exposure to Formaldehyde and Cognitive Impairment. Neurology 2021; 98:e633-e640. [PMID: 34937783 DOI: 10.1212/wnl.0000000000013146] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/16/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To our knowledge, no study has investigated the effect of exposure to formaldehyde on cognition in the general population. Our objective was to examine the association between occupational exposure to formaldehyde and cognitive impairment in middle-aged and young- old adults (≥45 years). METHODS In the French CONSTANCES cohort, cognitive function was assessed with a standardized battery of seven cognitive tests to evaluate global cognitive function, episodic verbal memory, language abilities and executive functions (e.g., Digit Symbol Substitution Test, DSST). A global cognitive score was created using principal component analysis. Cognitive impairment was assessed in reference to norms of neuropsychological battery according to age, sex and education. Lifetime exposure to formaldehyde was assessed using a French job-exposure matrix created in the framework of the Matgéné project. After performing multiple imputation, separate modified Poisson regression models were used to evaluate the association between cognitive impairment (<25th percentile) and formaldehyde exposure (exposed/never exposed), exposure duration, cumulative exposure index (CEI), and combination of CEI and time of last exposure. RESULTS Among 75 322 participants (median age: 57.5 years, women: 53%), 8% were exposed to formaldehyde during their professional life. These participants were at higher risk of global cognitive impairment (for global cognitive score: adjusted relative risk, aRR, 1.17, 95% confidence interval, CI: 1.11-1.23), after adjusting for confounders (age, sex, education, income, solvent exposure, Effort-Reward Imbalance, night-shift, repetitive, and noisy work). They were at higher risk of cognitive impairment for all cognitive domains explored. Longer exposure duration and high CEI were associated with cognitive impairment, with a dose-effect relationship for exposure duration. Recent exposure was associated with impairment in all cognitive domains. Time did not fully attenuate formaldehyde-associated cognitive deficits especially in highly exposed individuals (for DSST: high past exposure aRR 1.23, 95%CI: 1.11-1.36; high recent exposure: aRR 1.24, 95%CI: 1.13-1.35). CONCLUSION Our findings highlight the long-term detrimental effect of formaldehyde exposure on cognitive health in a relatively young population.
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Affiliation(s)
- Noemie Letellier
- Univ Montpellier, INSERM, INM (Institute for Neurosciences of Montpellier) Montpellier, France
| | - Laure-Anne Gutierrez
- Univ Montpellier, INSERM, INM (Institute for Neurosciences of Montpellier) Montpellier, France
| | | | - Fanny Artaud
- Paris-Saclay University, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" team, CESP, 94807, Villejuif, France
| | - Alexis Descatha
- INSERM, Population-Based Epidemiological Cohorts Research Unit, UMS 011, Villejuif, France.,UVSQ, INSERM, VIMA; Aging and chronic diseases, U1168, Villejuif, France.,UNIV Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S1085 ; CHU Angers, Poisoning Control Center- Clinical Data Center ; Angers, France
| | - Anna Ozguler
- INSERM, Population-Based Epidemiological Cohorts Research Unit, UMS 011, Villejuif, France
| | - Marcel Goldberg
- INSERM, Population-Based Epidemiological Cohorts Research Unit, UMS 011, Villejuif, France.,Université de Paris, Paris, France
| | - Marie Zins
- INSERM, Population-Based Epidemiological Cohorts Research Unit, UMS 011, Villejuif, France.,UVSQ, INSERM, VIMA; Aging and chronic diseases, U1168, Villejuif, France.,Université de Paris, Paris, France
| | - Alexis Elbaz
- Paris-Saclay University, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" team, CESP, 94807, Villejuif, France
| | - Claudine Berr
- Univ Montpellier, INSERM, INM (Institute for Neurosciences of Montpellier) Montpellier, France.,Memory Research and Resources Center, Department of Neurology, Montpellier University Hospital Gui de Chauliac, Montpellier, France
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Calderón-Rubio E, Oltra-Cucarella J, Bonete-López B, Iñesta C, Sitges-Maciá E. Regression-Based Normative Data for Independent and Cognitively Active Spanish Older Adults: Free and Cued Selective Reminding Test, Rey-Osterrieth Complex Figure Test and Judgement of Line Orientation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12977. [PMID: 34948588 PMCID: PMC8701853 DOI: 10.3390/ijerph182412977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/02/2021] [Accepted: 12/07/2021] [Indexed: 11/21/2022]
Abstract
The aim of this work was to develop normative data for neuropsychological tests for the assessment of independent and cognitively active Spanish older adults over 55 years of age. METHODS regression-based normative data were calculated from a sample of 103 nondepressed independent community-dwelling adults aged 55 or older (66% women). The raw data for the Free and Cued Selective Reminding Test (FCSRT), the Rey-Osterrieth Complex Figure Test (ROCF) and the Judgement of Line Orientation Test (JLO) were regressed on age, sex and education. The model predicting the FCSRT delayed-recall (FCSRT-Del) scores also included the FCSRT immediate-recall (FCSRT-Imm) scores. The model predicting the ROCF immediate-recall (ROCF-Imm) scores included the ROCF copy-trial (ROCF-C) scores, and the model predicting the ROCF delayed-recall (ROCF-Del) scores included both the ROCF-C and the ROCF-Imm scores. In order to identify low scores, z-scores were used to determine the discrepancy between the observed and the predicted scores. The base rates of the low scores for both the SABIEX normative data and the published normative data obtained from the general population were compared. RESULTS the effects of the different sociodemographic variables (age, sex and education) varied throughout the neuropsychological measures. Despite finding similar proportions of low scores between the normative data sets, the agreement was irrelevant or only fair-to-good. CONCLUSIONS the normative data obtained from the general population might not be sensitive enough to identify low scores in cognitively active older adults, incorrectly classifying them as cognitively normal compared to the less active population.
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Affiliation(s)
- Eva Calderón-Rubio
- SABIEX, Universidad Miguel Hernández de Elche, Avda. de la Universidad, 03207 Elche, Spain; (E.C.-R.); (B.B.-L.); (C.I.); (E.S.-M.)
| | - Javier Oltra-Cucarella
- SABIEX, Universidad Miguel Hernández de Elche, Avda. de la Universidad, 03207 Elche, Spain; (E.C.-R.); (B.B.-L.); (C.I.); (E.S.-M.)
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Elche, Spain
| | - Beatriz Bonete-López
- SABIEX, Universidad Miguel Hernández de Elche, Avda. de la Universidad, 03207 Elche, Spain; (E.C.-R.); (B.B.-L.); (C.I.); (E.S.-M.)
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Elche, Spain
| | - Clara Iñesta
- SABIEX, Universidad Miguel Hernández de Elche, Avda. de la Universidad, 03207 Elche, Spain; (E.C.-R.); (B.B.-L.); (C.I.); (E.S.-M.)
| | - Esther Sitges-Maciá
- SABIEX, Universidad Miguel Hernández de Elche, Avda. de la Universidad, 03207 Elche, Spain; (E.C.-R.); (B.B.-L.); (C.I.); (E.S.-M.)
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Elche, Spain
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Dos Santos M, Licaj I, Bellera C, Cany L, Binarelli G, Soubeyran P, Joly F. Cognitive Impairment in Older Cancer Patients Treated with First-Line Chemotherapy. Cancers (Basel) 2021; 13:cancers13246171. [PMID: 34944791 PMCID: PMC8699230 DOI: 10.3390/cancers13246171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/23/2021] [Accepted: 12/02/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Chemotherapy-related cognitive impairment is frequently reported by patients and can have a negative impact on their quality of life. Elderly patients appear to be particularly at risk for cognitive decline but they are rarely included in studies. Our study investigated cognitive impairment during chemotherapy and its predictive factors among a large elderly population (≥70 years) treated with first-line chemotherapy. The aim was to identify risk factors before starting chemotherapy in order to manage and help elderly patients with decision making. Abstract Older cancer patients are vulnerable to chemotherapy-related cognitive impairment. We prospectively evaluated cognitive impairment and its predictive factors during first-line chemotherapy in elderly cancer patients (≥70 years). Cognitive function was evaluated by the Mini-Mental State Examination (MMSE) with adjusted scores for age and sociocultural level. Multidimensional geriatric assessment was performed at baseline and during chemotherapy including the MMSE, Instrumental Activities in Daily Living (IADL), Mini-Nutritional Assessment (MNA), and the Geriatric Depression Scale (GDS15). Quality of life (QoL) was evaluated using the European Organization for Research and Treatment of Cancer (EORTC) QoL Questionnaire (QLQ-C30). Of 364 patients included, 310 had two MMSE evaluations including one at baseline and were assessed. Among these patients, 86 (27.7%) had abnormal MMSE, 195 (62.9%) abnormal MNA, 223 (71.9%) abnormal IADL, and 137 (43.1%) had depressive symptoms at baseline. MMSE impairment during chemotherapy was observed in 58 (18.7%) patients. Abnormal baseline MNA (odds ratio (OR) = 1.87, p = 0.021) and MMSE (OR = 2.58, p = 0.022) were independent predictive factors of MMSE impairment. These results suggest that pre-existing cognitive impairment and malnutrition are predictive factors for cognitive decline during chemotherapy in elderly cancer patients. Detection and management of these risk factors should be systematically considered in this population before starting chemotherapy.
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Affiliation(s)
- Mélanie Dos Santos
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (I.L.); (G.B.); (F.J.)
- Department of Medical Oncology, Centre François Baclesse, 14000 Caen, France
- Interdisciplinary Research Unit for the Prevention and Treatment of Cancers (ANTICIPE), National Institute of Health and Medical Research (INSERM), 14000 Caen, France
- Correspondence: ; Tel.: +33-2-3145-5002; Fax: +33-2-3145-5158
| | - Idlir Licaj
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (I.L.); (G.B.); (F.J.)
- Interdisciplinary Research Unit for the Prevention and Treatment of Cancers (ANTICIPE), National Institute of Health and Medical Research (INSERM), 14000 Caen, France
- Department of Community Medicine, Faculty of Health Sciences, The UiT Arctic University of Norway, 9010 Tromsø, Norway
| | - Carine Bellera
- Clinical and Epidemiological Research Unit, Institut Bergonié, 33076 Bordeaux, France;
| | - Laurent Cany
- Department of Medical Oncology, Clinique Francheville, 24000 Périgueux, France;
| | - Giulia Binarelli
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (I.L.); (G.B.); (F.J.)
- Interdisciplinary Research Unit for the Prevention and Treatment of Cancers (ANTICIPE), National Institute of Health and Medical Research (INSERM), 14000 Caen, France
| | - Pierre Soubeyran
- Department of Medical Oncology, Institut Bergonie, 33076 Bordeaux, France;
| | - Florence Joly
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (I.L.); (G.B.); (F.J.)
- Department of Medical Oncology, Centre François Baclesse, 14000 Caen, France
- Interdisciplinary Research Unit for the Prevention and Treatment of Cancers (ANTICIPE), National Institute of Health and Medical Research (INSERM), 14000 Caen, France
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
- University of Caen Normandie (UNICAEN), Normandie University, 14000 Caen, France
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Dassanayake TL, Hewawasam C, Baminiwatta A, Ariyasinghe DI. Regression-based, demographically adjusted norms for Victoria Stroop Test, Digit Span, and Verbal Fluency for Sri Lankan adults. Clin Neuropsychol 2021; 35:S32-S49. [PMID: 34499569 DOI: 10.1080/13854046.2021.1973109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Lack of test norms is a major limitation in neuropsychological assessment in many non-English-speaking countries. Our objective was to generate sex-, age-, and education-adjusted, regression-based norms for three pen-and-paper-based executive function/working memory tests, viz. Victoria Stroop Test (VST), Digit Span, and Verbal Fluency, for Sinhala-Speaking Sri Lankan adults. METHOD Six-hundred and six healthy, community-living, Sinhala-speaking adults (273 men) aged 19-83 years completed VST, Digit Span (forward and backward), and Phonemic (Sinhala phonemes "N," "P," and "S") and Category (animals and vegetables) Fluency tests. We conducted multiple linear regression analyses with sex, age, and years of education fitted as predictors to model the test outcome variables. RESULTS Younger age was associated with better performance in all tests except in Phonemic Fluency. Longer education was associated with better performance in all outcomes except VST errors and interference. Women had a significant but small advantage over men in VST Neutral and Color Word tests, and Phonemic Fluency. We report regression equations to predict norms for the test performance measures based on sex, age, and years of education; and the test variances accounted by these factors. CONCLUSIONS We propose demographically adjusted norms for VST, Digit Span, and Verbal Fluency for Sinhala-speaking Sri Lankans aged 19-83 years, and supplement the regression formulae with a calculator that produces predicted and standard scores. These norms would help in interpreting the results of clinical samples in the future, taking into account the variability introduced by sex, age, and education.
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Affiliation(s)
| | - Chandana Hewawasam
- Department of Physiology, Faculty of Medicine and Allied Health Sciences, Rajarata University of Sri Lanka, Saliyapura 50008, Sri Lanka
| | - Anuradha Baminiwatta
- Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya 20400, Sri Lanka
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Letellier N, Carrière I, Cadot E, Berkman L, Goldberg M, Zins M, Berr C. Individual and neighbourhood socioeconomic inequalities in cognitive impairment: cross-sectional findings from the French CONSTANCES cohort. BMJ Open 2020; 10:e033751. [PMID: 32193263 PMCID: PMC7150592 DOI: 10.1136/bmjopen-2019-033751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES Despite the recent awareness of the environment impact on brain ageing, the influence of the neighbourhood socioeconomic status on cognitive impairment remains unclear. Here, we investigated the effects of individual and neighbourhood deprivation on cognitive impairment in middle-aged and young-old people. DESIGN Cross-sectional study. SETTINGS 21 Health Screening Centres in the entire French metropolitan territory. PARTICIPANTS A total of 44 648 participants (age range: 45 to 69 years) from the French CONSTANCES cohort were included in the analyses. MAIN OUTCOMES Associations between the overall cognitive score (based on a standardised battery of cognitive tests administered by neuropsychologists) and individual deprivation (Evaluation of Deprivation and Inequalities in Health Screening Centres; EPICES score) and geographical deprivation (French Deprivation Index; FDep index). RESULTS Based on the EPICES score (validated cut-off ≥30.17), 12% of participants were considered to be deprived. After mutual adjustment, individual and geographical deprivation were associated with higher cognitive impairment in a multilevel logistic regression analysis that was also adjusted for sociodemographic, lifestyle and health factors. Specifically, individual deprivation was associated with an odds increase of 55% (OR=1.55, 95% CI: 1.45 to 1.66). The risk of global cognitive impairment progressively increased with the neighbourhood deprivation level, evaluated by the FDep index (reference Q1; Q2: OR=1.09, 95% CI: 0.98 to 1.20; Q3: OR=1.15, 95% CI: 1.04 to 1.27; Q4: OR=1.15, 95% CI: 1.04 to 1.28; Q5: OR=1.25, 95% CI: 1.13 to 1.39). CONCLUSION Our results suggest that the neighbourhood socioeconomic deprivation level is associated with cognitive impairment, independently of the individual deprivation level. A better understanding of this association could help to define new prevention strategies to target high-risk residents and high-risk geographical areas in order to reduce social health inequalities.
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Affiliation(s)
- Noémie Letellier
- Neuropsychiat Epidemiol & Clin Res, Univ Montpellier, INSERM, Montpellier, France
| | - Isabelle Carrière
- Neuropsychiat Epidemiol & Clin Res, Univ Montpellier, INSERM, Montpellier, France
| | - Emmanuelle Cadot
- IRD - Hydrosciences UMR 5569, Montpellier University, Montpellier, France
| | - Lisa Berkman
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts, USA
| | - Marcel Goldberg
- Paris Descartes University, Paris, France
- INSERM, Population-Based Epidemiological Cohorts Research Unit, UMS 011, Villejuif, France
| | - Marie Zins
- Paris Descartes University, Paris, France
- INSERM, Population-Based Epidemiological Cohorts Research Unit, UMS 011, Villejuif, France
- UVSQ, INSERM, VIMA; Aging and chronic diseases, U1168, Villejuif, France
| | - Claudine Berr
- Neuropsychiat Epidemiol & Clin Res, Univ Montpellier, INSERM, Montpellier, France
- Memory Research and Resources Center, Department of Neurology, Montpellier University Hospital Gui de Chauliac, Montpellier, France
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Letellier N, Choron G, Artaud F, Descatha A, Goldberg M, Zins M, Elbaz A, Berr C. Association between occupational solvent exposure and cognitive performance in the French CONSTANCES study. Occup Environ Med 2020; 77:223-230. [PMID: 32075885 PMCID: PMC7079188 DOI: 10.1136/oemed-2019-106132] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 01/22/2020] [Accepted: 01/27/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the association between occupational exposure to solvents and cognitive performance in middle-aged and early-ageing participants, taking into account the working environment. METHODS In the French Cohorte des consultants des Centres d'examens de santé (CONSTANCES) cohort, 41 854 participants aged 45-69 years completed a self-reported, lifetime occupational exposure questionnaire. Exposure to solvents (gasoline for hand washing, trichloroethylene, white spirit, cellulosic thinner) was first considered as a binary variable (exposed/not exposed). We computed number of solvent types to which participants were exposed, solvent exposure time and delay since last exposure. Cognitive performance was assessed and analysed in reference to norms of neuropsychological battery previously established in CONSTANCES according to age, sex and education. Multiple linear and modified Poisson regression were used to estimate the associations between solvent exposure and cognitive performance adjusting for individual and environmental characteristics, and working conditions (night shift, repetitive and noisy work). RESULTS Men had a greater risk of global cognitive impairment when they were exposed to gasoline (relative risk (RR)=1.12, 95% CI 1.03 to 1.22), white spirit (RR=1.14, 95% CI 1.05 to 1.25) or cellulosic thinner (RR=1.17, 95% CI 1.06 to 1.31) at the workplace, even after adjusting for confounders. Women exposed to white spirit or exposed for more than 20 years had poorer global cognitive performance. CONCLUSION These findings strengthen our understanding of the detrimental effect of solvent exposure on cognitive health not only in men but also in women for the first time, in a large general population middle-aged and early-ageing sample from France, taking into account working conditions.
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Affiliation(s)
- Noémie Letellier
- Neuropsychiat Epidemiol & Clin Res, Univ Montpellier, INSERM, Montpellier, France
| | - Guillaume Choron
- Neuropsychiat Epidemiol & Clin Res, Univ Montpellier, INSERM, Montpellier, France.,Univ Montpellier, CHU, Montpellier, France, Montpellier, France
| | - Fanny Artaud
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - Alexis Descatha
- INSERM, IRSET, ESTER Team, University of Angers, U1085, Angers, France.,INSERM, Population-Based Epidemiological Cohorts Research Unit, UMS 011, Villejuif, France.,UVSQ, INSERM, VIMA; Aging and Chronic Diseases, U1168, Villejuif, France
| | - Marcel Goldberg
- INSERM, Population-Based Epidemiological Cohorts Research Unit, UMS 011, Villejuif, France.,Faculty of Medicine, Paris Descartes University, Paris, France
| | - Marie Zins
- INSERM, Population-Based Epidemiological Cohorts Research Unit, UMS 011, Villejuif, France.,UVSQ, INSERM, VIMA; Aging and Chronic Diseases, U1168, Villejuif, France.,Faculty of Medicine, Paris Descartes University, Paris, France
| | - Alexis Elbaz
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - C Berr
- Neuropsychiat Epidemiol & Clin Res, Univ Montpellier, INSERM, Montpellier, France.,Memory Research and Resources Center, Department of Neurology, Montpellier University Hospital Gui de Chauliac, Montpellier, France
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11
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Magnusdottir BB, Haraldsson HM, Sigurdsson E. Trail Making Test, Stroop, and Verbal Fluency: Regression-Based Norms for the Icelandic Population. Arch Clin Neuropsychol 2019; 36:253-266. [DOI: 10.1093/arclin/acz049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/12/2019] [Accepted: 08/22/2019] [Indexed: 12/13/2022] Open
Abstract
Abstract
Objective
The aim of this study was to construct regression-based norms for 3 executive-function tests: the Trail Making Test, Stroop, and Verbal Fluency.
Method
A sample of 1,034 healthy Icelandic adults (18–64 years) was used to calculate predicted scores for test measures from all 3 tests, controlled for the effects of age, gender, and education, as well as the interaction between these variables.
Results
The 3 demographic variables showed significant effects on most test measures and were included in the final equation for estimating predicted scores. An older age and less education predicted worse cognitive performances in most cases, and women tended to outperform men.
Conclusion
These results highlight the importance of adjusting for age, gender, and educational level when constructing normative data. Controlling for age alone may be insufficient or misleading in clinical-practice settings. A simple, user-friendly program for predicting executive-function test scores is provided.
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Affiliation(s)
- B B Magnusdottir
- Department of Psychiatry, Landspitali University Hospital, 101 Reykjavik, Iceland
- Department of Psychology, Reykjavik University, 101 Reykjavik, Iceland
| | - H M Haraldsson
- Department of Psychiatry, Landspitali University Hospital, 101 Reykjavik, Iceland
- School of Health Sciences, University of Iceland, 101 Reykjavik, Iceland
| | - E Sigurdsson
- School of Health Sciences, University of Iceland, 101 Reykjavik, Iceland
- Department of Psychiatry, Landspitali University Hospital, 101 Reykjavik, Iceland
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Norms for standard neuropsychological tests from the French
CONSTANCES
cohort. Eur J Neurol 2019; 26:1345. [DOI: 10.1111/ene.14078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Makinson A, Dubois J, Eymard-Duvernay S, Leclercq P, Zaegel-Faucher O, Bernard L, Vassallo M, Barbuat C, Gény C, Thouvenot E, Costagliola D, Ozguler A, Zins M, Simony M, Reynes J, Berr C. Increased Prevalence of Neurocognitive Impairment in Aging People Living With Human Immunodeficiency Virus: The ANRS EP58 HAND 55–70 Study. Clin Infect Dis 2019; 70:2641-2648. [DOI: 10.1093/cid/ciz670] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 07/16/2019] [Indexed: 12/21/2022] Open
Abstract
Abstract
Background
There are limited data on the comparative prevalence of neurocognitive impairment (NCI) in aging people living with human immunodeficiency virus (PLHIV) and people not living with HIV.
Methods
This was a cross-sectional study of PLHIV randomly matched by age (±4 years), gender, and education with 5 HIV-uninfected individuals from the CONSTANCES cohort. PLHIV were fluent in French and sequentially included during routine outpatient visits if aged 55–70 years, with HIV viral load <50 copies/mL, and lymphocyte T-CD4 level ≥200 cells/µL in the past 24 and 12 months, respectively. The primary outcome was NCI as defined by the Frascati criteria. Multivariate normative comparison (MNC) and −1.5 standard deviations in ≥2 neurocognitive domains were secondary outcomes of NCI.
Results
Two hundred PLHIV were matched with 1000 controls. Median age was 62 years, and 85% were men. In PLHIV, the median T-CD4 lymphocyte level was 650 cells/µL, and median nadir T-CD4 lymphocyte level was 176 cells/µL. NCI was found in 71 (35.5%) PLHIV and in 242 (24.2%) controls (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.25, 2.41). After adjusting for confounders, HIV remained significantly associated with NCI (OR, 1.50; 95% CI, 1.04, 2.16). Adjusted results were similar with NCI defined by MNC (ORMNC, 2.95; 95% CI, 1.13, 3.50) or −1.5 SD (OR−1.5, 2.24; 95% CI, 1.39, 3.62).
Conclusions
In this matched study of aging individuals, HIV was significantly associated with an increased risk of NCI after adjusting for major confounders. Results were confirmed with more stringent NCI classifications.
Clinical Trials Registration
NCT02592174.
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Affiliation(s)
- Alain Makinson
- Infectious and Tropical Diseases Department, University Hospital Montpellier, and Fédération d’Infectiologie Multidisciplinaire de l’Arc Alpin, Université Grenoble Alpes, Marseille
- Institut de Recherche et Développement, and Fédération d’Infectiologie Multidisciplinaire de l’Arc Alpin, Université Grenoble Alpes;, Institut National de la Santé et de la Recherche Médicale (French Institute of Health and Medical Research) (INSERM), University of Montpellier TransVIHMI Unit, Marseille
| | - Jonathan Dubois
- INSERM, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, and Fédération d’Infectiologie Multidisciplinaire de l’Arc Alpin, Université Grenoble Alpes, Marseille
| | - Sabrina Eymard-Duvernay
- Institut de Recherche et Développement, and Fédération d’Infectiologie Multidisciplinaire de l’Arc Alpin, Université Grenoble Alpes;, Institut National de la Santé et de la Recherche Médicale (French Institute of Health and Medical Research) (INSERM), University of Montpellier TransVIHMI Unit, Marseille
| | - Pascale Leclercq
- Infectious Disease Unit, University Hospital of Grenobles Alpes, and Fédération d’Infectiologie Multidisciplinaire de l’Arc Alpin, Université Grenoble Alpes, Marseille
| | - Olivia Zaegel-Faucher
- Clinical Immuno-Hematology Department, Aix-Marseille University, Sainte-Marguerite University Hospital, Marseille
| | - Louis Bernard
- Infectious Diseases Unit, University Hospital Tours, Nîmes
| | - Matteo Vassallo
- Department of Internal Medicine, Cannes General Hospital, Nîmes
| | | | - Christian Gény
- Neurology Department, Montpellier University Hospital Center, Gui de Chauliac Hospital, Nîmes
| | | | - Dominique Costagliola
- Sorbonne University, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Anna Ozguler
- INSERM, Paris Descartes University Population-based Epidemiological Cohorts Unit, Villejuif, France
| | - Marie Zins
- INSERM, Paris Descartes University Population-based Epidemiological Cohorts Unit, Villejuif, France
| | - Mélanie Simony
- ANRS (France Recherche Nord & Sud Sida-HIV Hépatites), Unit for Basic and Clinical Research on Viral Hepatitis and HIV, Paris, France
| | - Jacques Reynes
- Infectious and Tropical Diseases Department, University Hospital Montpellier, and Fédération d’Infectiologie Multidisciplinaire de l’Arc Alpin, Université Grenoble Alpes, Marseille
- Institut de Recherche et Développement, and Fédération d’Infectiologie Multidisciplinaire de l’Arc Alpin, Université Grenoble Alpes;, Institut National de la Santé et de la Recherche Médicale (French Institute of Health and Medical Research) (INSERM), University of Montpellier TransVIHMI Unit, Marseille
| | - Claudine Berr
- INSERM, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, and Fédération d’Infectiologie Multidisciplinaire de l’Arc Alpin, Université Grenoble Alpes, Marseille
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Goulabchand R, Castille E, Navucet S, Etchecopar-Etchart D, Maria A, Partouche L, Le Quellec A, Maréchal B, Le Bars E, Gabelle A, Menjot De Champfleur N, Guilpain P. IRM cérébrales au cours du syndrome de Gougerot–Sjögren : résultats préliminaires et aspects anatomo-cliniques. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Castille E, Goulabchand R, Navucet S, Matos A, Etchecopar-Etchart D, Maria A, Gutierez L, Berr C, Le Quellec A, Menjot De Champfleur N, Gabelle A, Guilpain P. Atteintes neurocognitives du syndrome de Gougerot–Sjögren : évaluations standardisées des fonctions cognitives et de la qualité de vie. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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