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Echeveste B, Tellechea P, Montoya G, Espinoza-Vinces C, Fernandez-Montero A, Riverol M. [Neuropsychological differences in Alzheimer's disease depending on the age of onset]. Rev Esp Geriatr Gerontol 2024; 59:101433. [PMID: 38039605 DOI: 10.1016/j.regg.2023.101433] [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] [Received: 04/12/2023] [Revised: 10/03/2023] [Accepted: 10/09/2023] [Indexed: 12/03/2023]
Abstract
INTRODUCTION Early-onset Alzheimer's disease (EOAD) has been defined as a dementia due to AD presenting before the arbitrarily established age of 65 (as opposed to late-onset Alzheimer's disease or LOAD). There is still little research about other age sub-groups, the use of so-called senile dementia has been banished, usually including it within the late-onset Alzheimer's dementia. To the extent of our knowledge, there are no studies comparing the neuropsychological features of very-late-onset patients with early and late-onset ones. METHODS We retrospectively selected 359 patients with a diagnosis of probable AD dementia. We subdivided patients into three groups attending to the age of onset of the disease: early-onset AD (EOAD; younger than 65 years old), late-onset AD (LOAD; between 65 and 80) and very-late-onset AD (VLOAD; defined here as onset age older than 80), and then we compared their neuropsychological results. RESULTS AD patients with a younger age at onset scored worse on attention, executive function and visuospatial skills, while older-onset patients scored worse in memory tasks and language. Patients with a very-late-onset differed from the late-onset ones in a greater impairment of semantic fluency and naming. CONCLUSION Although the point of separation between EOAD and later-onset forms of EA at the age of 65 is an arbitrary one, our study shows that there are significant differences between these groups from a neuropsychological point of view. However, these differences do seem to follow a linear trend with age, rather than representing fundamentally distinct clinical pictures.
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Affiliation(s)
- Beatriz Echeveste
- Servicio de Neurología, Clínica Universidad de Navarra, Navarra, España.
| | - Paula Tellechea
- Servicio de Neurología, Hospital Universitario de Navarra, Navarra, España
| | - Genoveva Montoya
- Servicio de Neurología, Clínica Universidad de Navarra, Navarra, España
| | | | | | - Mario Riverol
- Servicio de Neurología, Clínica Universidad de Navarra, Navarra, España
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Pirani A, Nasreddine Z, Neviani F, Fabbo A, Rocchi MB, Bertolotti M, Tulipani C, Galassi M, Belvedere Murri M, Neri M. MoCA 7.1: Multicenter Validation of the First Italian Version of Montreal Cognitive Assessment. J Alzheimers Dis Rep 2022; 6:509-520. [PMID: 36186724 PMCID: PMC9484132 DOI: 10.3233/adr-210053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 07/13/2022] [Indexed: 12/04/2022] Open
Abstract
Background: The early detection of neurocognitive disorders, especially when mild, is a key issue of health care systems including the Italian Dementia National Plan. The Mini-Mental State Examination (MMSE), i.e., the reference screening tool for dementia in Italian Memory Clinics, has low sensitivity in detecting mild cognitive impairment (MCI) or mild dementia. Objective: Availability of a 10-minute screening test sensitive to MCI and mild dementia, such as the Montreal Cognitive Assessment (MoCA), is relevant in the field. This study presents initial validity and reliability data for the Italian version of MoCA 7.1 that is being collected as part of a large ongoing longitudinal study to evaluate the rate of incident MCI and dementia in older adults. Methods: MoCA 7.1 and MMSE were administered to cognitive impaired patients (n = 469; 214 with MCI, 255 with dementia; mean age: 75.5; 52% females,) and healthy older adults (n = 123, mean age: 69.7, 64 % females). Results: Test-retest (0.945, p < 0.001) and inter-rater (0.999, p < 0.001) reliability of MoCA 7.1, assessed on randomly selected participants with normal cognition, MCI, dementia, were significant. MoCA 7.1 showed adequate sensitivity (95.3%) and specificity (84.5%) in detecting MCI compared to MMSE (sensitivity: 53.8%; specificity: 87.5%). The Area Under the Curve of MoCA 7.1 was significantly greater than that of MMSE (0.963 versus 0.742). MoCA 7.1 showed similar results in detecting both MCI and dementia. Conclusion: MoCA 7.1 is a reliable and useful tool that can aid in the diagnosis of MCI and dementia in the Italian population.
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Affiliation(s)
- Alessandro Pirani
- Center for Cognitive Disorders and Dementia, Health County of Ferrara, Cento, Italy
- Alzheimer’s Association “Francesco Mazzuca”, Cento, (Fe), Italy
| | | | - Francesca Neviani
- Center for Cognitive Disorders and Dementia. Chair of Geriatrics, University of Modenaand Reggio Emilia, Italy
| | - Andrea Fabbo
- Dementia Program, HealthTrust, Health County of Modena, Italy
| | | | - Marco Bertolotti
- Division of Geriatric Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia and University Hospital of Modena, Modena, Italy
- Center for Gerontological Evaluation and Research, University of Modena and Reggio Emilia, Modena, Italy
| | - Cristina Tulipani
- Center for Cognitive Disorders and Dementia, Health County of Ferrara, Cento, Italy
- Alzheimer’s Association “Francesco Mazzuca”, Cento, (Fe), Italy
| | - Matteo Galassi
- Center for Cognitive Disorders and Dementia. Chair of Geriatrics, University of Modenaand Reggio Emilia, Italy
| | - Martino Belvedere Murri
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Italy
| | - Mirco Neri
- Center for Cognitive Disorders and Dementia. Chair of Geriatrics, University of Modenaand Reggio Emilia, Italy
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Galbussera AA, Mandelli S, Rosso S, Zanetti R, Rossi M, Giacomin A, Detoma P, Riva E, Tettamanti M, Porta MGD, Lucca U. Mild anemia and 11- to 15-year mortality risk in young-old and old-old: Results from two population-based cohort studies. PLoS One 2022; 16:e0261899. [PMID: 34972180 PMCID: PMC8719676 DOI: 10.1371/journal.pone.0261899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 12/13/2021] [Indexed: 12/21/2022] Open
Abstract
Background Mild anemia is a frequent although often overlooked finding in old age. Nevertheless, in recent years anemia has been linked to several adverse outcomes in the elderly population. Objective of the study was to investigate the association of mild anemia (hemoglobin concentrations: 10.0–11.9/12.9 g/dL in women/men) with all-cause mortality over 11–15 years and the effect of change in anemia status on mortality in young-old (65–84 years) and old-old (80+ years). Methods The Health and Anemia and Monzino 80-plus are two door-to-door, prospective population-based studies that included residents aged 65-plus years in Biella municipality and 80-plus years in Varese province, Italy. No exclusion criteria were used. Results Among 4,494 young-old and 1,842 old-old, mortality risk over 15/11 years was significantly higher in individuals with mild anemia compared with those without (young-old: fully-adjusted HR: 1.35, 95%CI, 1.15–1.58; old-old: fully-adjusted HR: 1.28, 95%CI, 1.14–1.44). Results were similar in the disease-free subpopulation (age, sex, education, smoking history, and alcohol consumption adjusted HR: 1.54, 95%CI, 1.02–2.34). Both age groups showed a dose-response relationship between anemia severity and mortality (P for trend <0.0001). Mortality risk was significantly associated with chronic disease and chronic kidney disease mild anemia in both age groups, and with vitamin B12/folate deficiency and unexplained mild anemia in young-old. In participants with two hemoglobin determinations, seven-year mortality risk was significantly higher in incident and persistent anemic cases compared to constant non-anemic individuals in both age groups. In participants without anemia at baseline also hemoglobin decline was significantly associated with an increased mortality risk over seven years in both young-old and old-old. Limited to the Monzino 80-plus study, the association remained significant also when the risk was further adjusted also for time-varying covariates and time-varying anemia status over time. Conclusions Findings from these two large prospective population-based studies consistently suggest an independent, long-term impact of mild anemia on survival at older ages.
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Affiliation(s)
- Alessia A. Galbussera
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Sara Mandelli
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Stefano Rosso
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Roberto Zanetti
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Marianna Rossi
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | - Paolo Detoma
- Laboratory of Analysis, Ospedale degli Infermi, Biella, Italy
| | - Emma Riva
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Mauro Tettamanti
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Matteo G. Della Porta
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Ugo Lucca
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
- * E-mail:
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Zeng Y, Que S, Lin C, Fang Y. The Expected Demand for Elderly Care Services and Anticipated Living Arrangements Among the Oldest Old in China Based on the Andersen Model. Front Public Health 2021; 9:715586. [PMID: 34676193 PMCID: PMC8523921 DOI: 10.3389/fpubh.2021.715586] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/20/2021] [Indexed: 11/17/2022] Open
Abstract
Objective: The first aim of this study was to explore expected demands of the oldest old and their determinants for different types of elderly care services. The second aim was to investigate preferred choices of living arrangements among the oldest old and the influencing factors. Methods: Data of 4,738 participants aged ≥80 years were extracted from the Chinese Longitudinal Health Longevity Survey carried out in 2014. Using the Andersen model as the analysis framework, a multiple logistic regression analysis was performed to analyze the relationship between the expected elderly care services and living arrangements and other influencing factors. The odds ratios were calculated to indicate the relationship between the influencing factors and the dependent variables. Results: From the descriptive analysis results, we found that the oldest old showed high anticipated needs for home visits (83.5%) and health education (76.4%). Further, there existed a huge imbalance between the supply and demand of care services for the aged. Living with children is still the most important way of providing for the oldest old. The regression results showed that the expected demands for elderly care services and anticipated living arrangements among the oldest old in China are influenced by age, residence, housing property rights, economic status, loneliness, and activities of daily living (ADLs). The oldest old who are older without housing property rights, childless, and have restricted ADLs were more frequently observed to live in long-term care institutions. Conclusions: There is an inequality of the supply and expected demand for elderly care services, and living with children is still a preferred choice of the Chinese oldest old. Our findings indicate that when planning how to promote elderly care services among the oldest old, it is important to consider their expectations, especially for the subgroup that is relatively disadvantaged. Related policies should be developed to offer incentives to family caregivers when they live with the oldest old.
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Affiliation(s)
- Yanbing Zeng
- School of Public Health, Capital Medical University, Beijing, China.,Key Laboratory of Health Technology Assessment, School of Public Health, Xiamen University, Xiamen, China
| | - Shuang Que
- Key Laboratory of Health Technology Assessment, School of Public Health, Xiamen University, Xiamen, China
| | - Chenxi Lin
- Key Laboratory of Health Technology Assessment, School of Public Health, Xiamen University, Xiamen, China
| | - Ya Fang
- Key Laboratory of Health Technology Assessment, School of Public Health, Xiamen University, Xiamen, China.,State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
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Nicoli C, Galbussera AA, Bosetti C, Franchi C, Gallus S, Mandelli S, Marcon G, Quadri P, Riso P, Riva E, Lucca U, Tettamanti M. The role of diet on the risk of dementia in the oldest old: The Monzino 80-plus population-based study. Clin Nutr 2021; 40:4783-4791. [PMID: 34242918 DOI: 10.1016/j.clnu.2021.06.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 06/08/2021] [Accepted: 06/10/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND & AIMS Longevity also carries its dark side of age-related chronic diseases, dementia being one of the worst and the most prevalent. Since dementia lacks effective treatments, preventing or delaying it is highly desirable. Dietary habits and nutrition have been found to be important modifiable risk factors for many chronic diseases, but evidence on the role of diet on the risk of dementia is still limited, particularly among the very old. Aim of the present work is to study the association of the Mediterranean diet and its components with prevalent and incident dementia in the oldest-old. METHODS We analyzed data from the Monzino 80-plus study, a population-based study in subjects 80 years or older in the Varese province, Italy. A validated food frequency questionnaire was used to collect information on 23 different foods consumed in the previous year. A Mediterranean diet score was calculated and its components were classified into tertiles. Multivariable models for dementia prevalence and incidence were adjusted for demographic and clinical characteristics. RESULTS Information on nutrition was available for 1390 subjects in the cross-sectional study and 512 subjects in the longitudinal study, mean respective ages 93 and 92. Greater adherence to Mediterranean diet, greater consumption of eggs, fruits and vegetables, carbohydrates, and greater food intake were associated with a lower prevalence of dementia. Increasing number of portions per week and consumption of legumes significantly decreased the incidence of dementia during the 3.6 year mean follow-up: corresponding hazard ratios of highest vs. lowest tertiles (95% confidence intervals) were 0.66 (0.46-0.95) and 0.68 (0.47-0.97), respectively. CONCLUSION Oldest-old eating less and having diets with less variety and nutrient density were more frequent among subjects with dementia. The longitudinal analysis confirmed oldest-old subjects who eat more portions, as well as those who have a higher intake of legumes, are at decreased risk of developing dementia even though reverse causality cannot be completely ruled out.
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Affiliation(s)
- Cristina Nicoli
- Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, Università degli Studi di Milano, Via Celoria 2, 20133, Milano, (MI), Italy.
| | - Alessia Antonella Galbussera
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milano, (MI), Italy.
| | - Cristina Bosetti
- Laboratory of Methodology for Clinical Research, Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milano, (MI), Italy.
| | - Carlotta Franchi
- Laboratory of Quality Assessment of Geriatric Therapies and Services, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milano, (MI), Italy; Italian Institute for Planetary Health, Via Mario Negri 2, 20156, Milano, (MI), Italy.
| | - Silvano Gallus
- Laboratory of Lifestyle Epidemiology, Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milano, (MI), Italy.
| | - Sara Mandelli
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milano, (MI), Italy.
| | - Gabriella Marcon
- Department of Medical Science, University of Trieste, Piazzale Europa 1, 34127, Trieste, (TS), Italy; Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Via Costantino Costantinides 2, 34128, Trieste, (TS), Italy; DAME, University of Udine, Via Palladio 8, 33100, Udine, (UD), Italy.
| | - Pierluigi Quadri
- Ospedale Della Beata Vergine, Ente Ospedaliero Cantonale, Ospedale Regionale di Mendrisio, Via Turconi 23, 6850, Mendrisio, Switzerland.
| | - Patrizia Riso
- Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, Università degli Studi di Milano, Via Celoria 2, 20133, Milano, (MI), Italy.
| | - Emma Riva
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milano, (MI), Italy.
| | - Ugo Lucca
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milano, (MI), Italy.
| | - Mauro Tettamanti
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milano, (MI), Italy.
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Fabio RA, Gallo R, Colombo B. Physical and mental health in the oldest-old: a mixed-methods study on a southern Italy sample. Aging Clin Exp Res 2021; 33:1549-1556. [PMID: 32705588 DOI: 10.1007/s40520-020-01659-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 07/13/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND The world's aging population has been constantly increasing in the last decades, causing the number oldest-old individuals to increase. AIMS The present study aims to explore the different variables that contribute to the oldest-old wellbeing using a mixed-methods approach, including self-reports, standardized measures, and semi-structured interviews. METHODS Thirty-nine oldest-old (90-103) from southern Italy were involved in the study, together with a control sample of younger individuals (51-71) from the same families. RESULTS Data suggest that the oldest-old have better mental health, higher resilience, and more optimism than younger individuals. High resilience seems to be the key variable that promotes the overall wellbeing. DISCUSSION The oldest-old tend to have better mental health, higher resilience and more optimism than younger individuals. CONCLUSIONS Wellbeing in the oldest-old appeared to be promoted by the sense of belonging and life purpose.
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Affiliation(s)
- Rosa Angela Fabio
- Department of Clinical and Experimental Medicine, University of Messina, Messina, ME, Italy
| | - Roberta Gallo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, ME, Italy
| | - Barbara Colombo
- Neuroscience Lab, Champlain College, Burlington, VT, 05402, USA.
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Treyer V, Meyer RS, Buchmann A, Crameri GAG, Studer S, Saake A, Gruber E, Unschuld PG, Nitsch RM, Hock C, Gietl AF. Physical activity is associated with lower cerebral beta-amyloid and cognitive function benefits from lifetime experience-a study in exceptional aging. PLoS One 2021; 16:e0247225. [PMID: 33606797 PMCID: PMC7895362 DOI: 10.1371/journal.pone.0247225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 02/03/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Exceptional agers (85+ years) are characterized by preserved cognition presumably due to high cognitive reserve. In the current study, we examined whether personality, risk and protective factors for dementia as well as quality of life are associated with core features of Alzheimer's disease (amyloid-deposition and hippocampal volume) as well as cognition in exceptional aging. METHODS We studied 49 exceptional agers (average 87.8 years, range 84-94 years), with preserved activities of daily living and absence of dementia. All participants received a detailed clinical and neuropsychological examination. We used established questionnaires to measure lifetime experience, personality, recent physical and cognitive activity as well as quality of life. Cerebral amyloid-deposition was estimated by 18-[F]-Flutemetamol-PET and manual hippocampal volumetry was performed on 3D T1 MRI images. RESULTS In this sample of exceptional agers with preserved activities of daily living, we found intact cognitive performance in the subjects with the highest amyloid-load in the brain, but a lower quality of life with respect to autonomy as well as higher neuroticism. Higher self-reported physical activity in the last twelve months went with a lower amyloid load. Higher self-reported leisure-time/ not work-related activity went with better executive functioning at older age. CONCLUSION Even in exceptional aging, high amyloid load may subtly influence personality and quality of life. Our findings support a close relationship between high physical activity and low amyloid-deposition and underscore the importance of extracurricular activities for executive functions. As executive functions are known to be a central resource for everyday functioning in fostering extracurricular activities may be effective in delaying the onset of dementia.
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Affiliation(s)
- Valerie Treyer
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
- Department of Nuclear Medicine, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Rafael S. Meyer
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Andreas Buchmann
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | | | - Sandro Studer
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Antje Saake
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Esmeralda Gruber
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Paul G. Unschuld
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
- Hospital for Psychogeriatric Medicine, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Roger M. Nitsch
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
- Neurimmune, Schlieren-Zurich, Switzerland
| | - Christoph Hock
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
- Neurimmune, Schlieren-Zurich, Switzerland
| | - Anton F. Gietl
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
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Escourrou E, Durrieu F, Chicoulaa B, Dupouy J, Oustric S, Andrieu S, Gardette V. Cognitive, functional, physical, and nutritional status of the oldest old encountered in primary care: a systematic review. BMC FAMILY PRACTICE 2020; 21:58. [PMID: 32220228 PMCID: PMC7099824 DOI: 10.1186/s12875-020-01128-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 03/18/2020] [Indexed: 11/23/2022]
Abstract
Background The oldest old (individuals over 90 years) are a fast-growing population. Characterizing their specificity would be helpful to adapt health care. This study aimed to characterize the cognitive, functional, nutritional, and physical status of individuals over 90. Methods We conducted a systematic review of cross-sectional or cohort studies of individuals aged 90 years old or more, living at home or in a nursing home, in April 2018. Two reviewers selected eligible articles, extracted data, and evaluated the risk of bias (assessed by the Newcastle-Ottawa Scale). Results The search strategy identified 3086 references; 35 articles were included referring to 8 cross-sectional and 27 longitudinal studies. Dementia was diagnosed in 30–42.9% of study participants, cognitive impairment in 12–50%, and 31–65% had no cognitive impairment. In terms of activities of daily living, 14–72.6% of individuals had no difficulty, 35.6–38% had difficulty, and 14.4–55.5% were dependent. For instrumental activities of daily living, 20–67.9% needed help. Regarding nutritional status, the Mini Nutritional Assessment Short Form mean score ranged from 10.3 (SD: 1.8) to 11.1 (SD: 2.4). Eight to 32% of individuals could not stand up from a chair, 19–47% could stand without the use of their arms; and 12.9–15% were not able to walk 4 m. Conclusions These results suggest a heterogeneous population with a certain proportion of oldest old with a low level of disability. These findings suggest that a specific approach in the care of the oldest old could help prevent disability.
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Affiliation(s)
- Emile Escourrou
- Département Universitaire de Médecine Générale, Faculté de Médecine Rangueil, Université Paul Sabatier Toulouse III, Toulouse, France. .,UMR 1027 INSERM, Université Paul Sabatier Toulouse III, Toulouse, France. .,Maison de Santé Pluri Professionnelle Universitaire La Providence, 1 avenue Louis Blériot, 31500, Toulouse, France.
| | - Florence Durrieu
- Département Universitaire de Médecine Générale, Faculté de Médecine Rangueil, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Bruno Chicoulaa
- Département Universitaire de Médecine Générale, Faculté de Médecine Rangueil, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Julie Dupouy
- Département Universitaire de Médecine Générale, Faculté de Médecine Rangueil, Université Paul Sabatier Toulouse III, Toulouse, France.,UMR 1027 INSERM, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Stéphane Oustric
- Département Universitaire de Médecine Générale, Faculté de Médecine Rangueil, Université Paul Sabatier Toulouse III, Toulouse, France.,UMR 1027 INSERM, Université Paul Sabatier Toulouse III, Toulouse, France.,Maison de Santé Pluri Professionnelle Universitaire La Providence, 1 avenue Louis Blériot, 31500, Toulouse, France
| | - Sandrine Andrieu
- UMR 1027 INSERM, Université Paul Sabatier Toulouse III, Toulouse, France.,Service d'épidémiologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Virginie Gardette
- UMR 1027 INSERM, Université Paul Sabatier Toulouse III, Toulouse, France.,Service d'épidémiologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
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9
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Lucca U, Tettamanti M, Tiraboschi P, Logroscino G, Landi C, Sacco L, Garrì M, Ammesso S, Biotti A, Gargantini E, Piedicorcia A, Mandelli S, Riva E, Galbussera AA, Recchia A. Incidence of dementia in the oldest-old and its relationship with age: The Monzino 80-plus population-based study. Alzheimers Dement 2020; 16:472-481. [PMID: 31786127 DOI: 10.1016/j.jalz.2019.09.083] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Relationship between age and dementia at extreme old ages is still an open question, yet population-based studies in this high-risk age segment are rare. METHODS The Monzino 80-plus is a population-based study among residents 80 years and older in the Varese province, Italy. Of 1371 eligible individuals, 1294 (94.4%), of whom 64 are centenarians, were included in the incidence study. RESULTS Since 2002, 584 new cases of all-cause dementia were identified over 15 years. The overall incidence rate was 7.9 per 100 person-years. Dementia risk rose with age (IRR: 1.06), with the cubic model providing the best fit (R2 = 0.91-0.96). Cumulative incidences of dementia unadjusted and adjusted for competing mortality risk progressively diverged with age. CONCLUSION Dementia incidence also keeps rising in nonagenarians and centenarians. Slowing down in growing risk of developing dementia with age is mainly attributable to increasing competing risk of death and resulting selective survival of individuals at lower risk of dementia.
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Affiliation(s)
- Ugo Lucca
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Mauro Tettamanti
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Pietro Tiraboschi
- Division of Neurology V and Neuropathology, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy
| | | | - Cristina Landi
- European Foundation of Biomedical Research (FERB), Division of Neurological Rehabilitation, Cernusco s/N (Milano), Italy
| | - Leonardo Sacco
- Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland
| | - Mariateresa Garrì
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Sonia Ammesso
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Anna Biotti
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Elena Gargantini
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Alessandro Piedicorcia
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Sara Mandelli
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Emma Riva
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Alessia A Galbussera
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Angela Recchia
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
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10
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Tettamanti M, Marcon G. Cohort profile: 'Centenari a Trieste' (CaT), a study of the health status of centenarians in a small defined area of Italy. BMJ Open 2018; 8:e019250. [PMID: 29439076 PMCID: PMC5829861 DOI: 10.1136/bmjopen-2017-019250] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
PURPOSE Centenarians, a segment of the population which some 50 years ago comprised only a few individuals, now count thousands in many countries, and demographic projections forecast that this growth will continue. The study of this new population will give us new information on extreme longevity and help prepare for their health and social needs. The aim of the Centenari a Trieste study is to describe the health and health service use by centenarians, with specific focus on cognitive status. PARTICIPANTS This is a population-based study of centenarians living in the province of Trieste (Italy), a small area with a high prevalence of centenarians and a close network of health and social services, which makes it possible to conduct a study. Consenting individuals were visited by a clinician, tested by neuropsychologists and also gave a sample of their blood. Administrative data were retrieved as well. FINDINGS TO DATE Of the 163 centenarians, 70 could be contacted and participated in the study. The main reasons for non-participation were impossibility to contact the subject (70) and death (20). Centenarians were mostly women (90%), tended to live in a nursing home (60%) and were generally severely functionally impaired (Barthel Index <50: 61%). Data from the administrative database showed that about one out of five needed hospitalisation in the preceding year and more than three out of four had at least one drug prescription. FUTURE PLANS In 2017, we started a new wave of the study enrolling people who had just become centenarian and reassessing subjects already seen; we hope to extend this recruitment in the next years. Subjects are now examined also by cardiologists and dental specialists. We are collecting further different biological specimens to investigate new hypotheses on the cognitive function of the centenarians.
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Affiliation(s)
- Mauro Tettamanti
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Gabriella Marcon
- ASUITS - Dipartimento di Scienze Mediche Chirurgiche e della Salute (DSMCS), University of Trieste, Trieste, Italy
- Dipartimento di Area Medica (DAME), University of Udine, Udine, Italy
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11
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Bacigalupo I, Mayer F, Lacorte E, Di Pucchio A, Marzolini F, Canevelli M, Di Fiandra T, Vanacore N. A Systematic Review and Meta-Analysis on the Prevalence of Dementia in Europe: Estimates from the Highest-Quality Studies Adopting the DSM IV Diagnostic Criteria. J Alzheimers Dis 2018; 66:1471-1481. [PMID: 30412486 PMCID: PMC6294583 DOI: 10.3233/jad-180416] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Dementia, including Alzheimer's disease (AD), is one of the most burdensome medical conditions. Usually, the reviews that aim at calculating the prevalence of dementia include estimates from studies without assessing their methodological quality. Alzheimer's Disease International (ADI) proposed a score to assess the methodological quality of population-based studies aimed at estimating the prevalence of dementia. During the last three years, the European Commission has funded three projects (Eurodem, EuroCoDe, and ALCOVE) in order to estimate the prevalence of dementia in Europe. OBJECTIVE The aim of this study was to perform a systematic review and meta-analysis of data on the prevalence of dementia in Europe derived from studies that included only subjects with a diagnosis of dementia according to the DSM IV criteria, and that had a high quality score according to ADI criteria. METHODS We considered the studies selected by the two projects EuroCoDe (1993-2007) and Alcove (2008-2011), and we performed a new bibliographic search. For the systematic review, we only selected the subset of articles that included subjects with a diagnosis of dementia according to the DSM IV criteria. The studies were qualitatively assessed using the ADI tool. RESULTS The meta-analysis considered 9 studies that were carried out in Europe between 1993 and 2018 including a total of 18,263 participants, of which 2,137 were diagnosed with dementia. The prevalence rate standardized for age and sex resulted 7.1%. DISCUSSION This is the first systematic review on the prevalence of dementia in Europe considering only high-quality studies adopting the same diagnostic criteria (i.e., DSM IV).
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Affiliation(s)
- Ilaria Bacigalupo
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Flavia Mayer
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Eleonora Lacorte
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Alessandra Di Pucchio
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Fabrizio Marzolini
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Marco Canevelli
- Department of Human Neuroscience “Sapienza” University of Rome, Rome, Italy
| | - Teresa Di Fiandra
- General Directorate for Health Prevention, Ministry of Health, Rome, Italy
| | - Nicola Vanacore
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
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12
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Tan JP, Li N, Lan XY, Zhang SM, Cui B, Liu LX, He X, Zeng L, Tau LY, Zhang H, Wang XX, Wang LN, Zhao YM. The impact of methods to handle missing data on the estimated prevalence of dementia and mild cognitive impairment in a cross-sectional study including non-responders. Arch Gerontol Geriatr 2017; 73:43-49. [PMID: 28755569 DOI: 10.1016/j.archger.2017.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 07/15/2017] [Accepted: 07/17/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Although several statistical methods for adjusting for missing data have been developed and are widely applied in research, few studies have investigated these methods in adjusting for missingness in datasets that aim to estimate the prevalence of dementia. We attempted to develop a more feasible approach for handling missingness in a cross-sectional study among elderly. METHODS Five methods of estimating prevalence, including stratified weighting (SW), inverse-probability weighting (IPW), hot deck imputation (HDI), ordinal logistic regression (OLR) and multiple imputation (MI), were applied to handle the missing data yielded by a dataset that include 2231 non-responders. RESULTS Compared with the results of the complete case analysis, the differences in the prevalence rates of dementia and mild cognitive impairment (MCI) calculated by the prevalence-estimating methods after adjusting for non-responders were less than 7% and 6%, respectively. In contrast to the results of other methods, the estimated prevalence of dementia and MCI calculated by MI increased when more predictive factors were included, and the lowest rate of missing data was achieved using MI. Using the participants' ages, the cognitive screening sores and activity of daily life sores as predictive variables when correcting for missingness induced relatively larger effects on the estimated dementia prevalence. CONCLUSIONS When adjusting for missingness while estimating the prevalence of dementia in cross-sectional studies, a simple method, such as SW, is recommended when limited information is available, whereas MI is the preferred method when additional information is available. Further simulation studies are needed to determine the optimal approach.
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Affiliation(s)
- Ji-Ping Tan
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, PR China
| | - Nan Li
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, PR China
| | - Xiao-Yang Lan
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, PR China
| | - Shi-Ming Zhang
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, PR China
| | - Bo Cui
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, PR China
| | - Li-Xin Liu
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, PR China
| | - Xin He
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, PR China
| | - Lin Zeng
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, PR China
| | - Li-Yuan Tau
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, PR China
| | - Hua Zhang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, PR China
| | - Xiao-Xiao Wang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, PR China
| | - Lu-Ning Wang
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, PR China.
| | - Yi-Ming Zhao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, PR China.
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13
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Bruti G, Cavallucci E, Mancini M, Bitossi A, Baldereschi M, Sorbi S. A systematic review of the quality of studies on dementia prevalence in Italy. BMC Health Serv Res 2016; 16:615. [PMID: 27784338 PMCID: PMC5081842 DOI: 10.1186/s12913-016-1871-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 08/11/2016] [Indexed: 11/23/2022] Open
Abstract
Background Dementia, including Alzheimer’s disease (AD), is one of the most burdensome medical conditions. In order to better understand the epidemiology of dementia in Italy, we conducted a systematic search of studies published between 1980 and April 2014 investigating the prevalence of dementia and AD in Italy and then evaluated the quality of the selected studies. Methods A systematic search was performed using PubMed/Medline and Embase to identify Italian population-based studies on the prevalence of dementia among people aged ≥60 years. The quality of the studies was scored according to Alzheimer’s Disease International (ADI) criteria. Results Sixteen articles on the prevalence of dementia and AD in Italy were eligible and 75 % of them were published before the year 2000. Only one study was a national survey, whereas most of the studies were locally based (Northern Italy and Tuscany). Overall, the 16 studies were attributed a mean ADI quality score of 7.6 (median 7.75). Conclusions Available studies on the prevalence of dementia and AD in Italy are generally old, of weak quality, and do not include all regions of Italy. The important limitations of the few eligible studies included in our analysis, mostly related to their heterogeneous design, make our systematic review difficult to interpret from an epidemiologic point of view. Full implementation of a Dementia National Plan is highly needed to better understand the epidemiology of the disease and monitor dementia patients.
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Affiliation(s)
- Gianluca Bruti
- Eli Lilly Italia S.p.A, Via A. Gramsci 731/733, 5019, Sesto Fiorentino, FI, Italy
| | | | - Michele Mancini
- Eli Lilly Italia S.p.A, Via A. Gramsci 731/733, 5019, Sesto Fiorentino, FI, Italy.
| | - Alessandro Bitossi
- Eli Lilly Italia S.p.A, Via A. Gramsci 731/733, 5019, Sesto Fiorentino, FI, Italy
| | - Marzia Baldereschi
- Institute of Neurosciences, Italian National Research Council, Via Madonna del Piano 10, 50019, Sesto Fiorentino, FI, Italy
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Viale Pieraccini 6 Firenze and Centro IRCCS "Don Carlo Gnocchi", Via di Scandicci 269, Firenze, Italy
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14
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Bruti G, Cavallucci E, Mancini M, Bitossi A, Baldereschi M, Sorbi S. A systematic review of the quality of studies on dementia prevalence in Italy. BMC Health Serv Res 2016; 16:507. [PMID: 27659233 PMCID: PMC5034570 DOI: 10.1186/s12913-016-1741-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 08/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dementia, including Alzheimer's disease (AD), is one of the most burdensome medical conditions. In order to better understand the epidemiology of dementia in Italy, we conducted a systematic search of studies published between 1980 and April 2014 investigating the prevalence of dementia and AD in Italy and then evaluated the quality of the selected studies. METHODS A systematic search was performed using PubMed/Medline and Embase to identify Italian population-based studies on the prevalence of dementia among people aged ≥60 years. The quality of the studies was scored according to Alzheimer's Disease International (ADI) criteria. RESULTS Sixteen articles on the prevalence of dementia and AD in Italy were eligible and 75 % of them were published before the year 2000. Only one study was a national survey, whereas most of the studies were locally based (Northern Italy and Tuscany). Overall, the 16 studies were attributed a mean ADI quality score of 7.6 (median 7.75). CONCLUSIONS Available studies on the prevalence of dementia and AD in Italy are generally old, of weak quality, and do not include all regions of Italy. The important limitations of the few eligible studies included in our analysis, mostly related to their heterogeneous design, make our systematic review difficult to interpret from an epidemiologic point of view. Full implementation of a Dementia National Plan is highly needed to better understand the epidemiology of the disease and monitor dementia patients.
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Affiliation(s)
- Gianluca Bruti
- Eli Lilly Italia S.p.A., Via A Gramsci 731/733, 50019 Sesto Fiorentino, FI Italy
| | | | - Michele Mancini
- Eli Lilly Italia S.p.A., Via A Gramsci 731/733, 50019 Sesto Fiorentino, FI Italy
| | - Alessandro Bitossi
- Eli Lilly Italia S.p.A., Via A Gramsci 731/733, 50019 Sesto Fiorentino, FI Italy
| | - Marzia Baldereschi
- Institute of Neurosciences, Italian National Research Council, Via Madonna del Piano 10, 50019 Sesto Fiorentino, FI Italy
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Viale Pieraccini 6 Firenze and Centro IRCCS “Don Carlo Gnocchi”, Via di Scandicci 269, Florence, Italy
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15
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Miller IN, Himali JJ, Beiser AS, Murabito JM, Seshadri S, Wolf PA, Au R. Normative Data for the Cognitively Intact Oldest-Old: The Framingham Heart Study. Exp Aging Res 2016. [PMID: 26214098 DOI: 10.1080/0361073x.2015.1053755] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
UNLABELLED BACKGROUND/STUDY CONTEXT: The number of individuals who reach extreme age is quickly increasing. Much of the current literature focuses on impaired cognition in extreme age, and debate continues regarding what constitutes "normal" cognition in extreme age. This study aimed to provide oldest-old normative data and to compare cognitive performances of cognitively intact elderly individuals from the Framingham Heart Study. METHODS A total of 1302 individuals aged 65+ years from the Framingham Heart Study were separated into 5-year age bands and compared on cognitive tests. Multivariate linear regression analyses were conducted, adjusting for gender, the Wide Range Achievement Test-Third Edition (WRAT-III) Reading score, and cohort. Analyses also included comparisons between 418 individuals aged 80+ and 884 individuals aged 65-79, and comparisons within oldest-old age bands. RESULTS Normative data for all participants are presented. Significant differences were found on most tests between age groups in the overall analysis between young-old and oldest-old, and analysis of oldest-old age bands also revealed select significant differences (all ps <.05). CONCLUSION As aging increases, significant cognitive differences and increased variability in performances are evident. These results support the use of age-appropriate normative data for oldest-old individuals.
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Affiliation(s)
- Ivy N Miller
- a Department of Psychology , Minneapolis VA Healthcare System , Minneapolis , Minnesota , USA
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16
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Tan JP, Li N, Cui B, Wang LN, Zhao YM, Zhang BH, Liu ZY, Zhang SG, Sun LY, Liu N, Deng RX, Ma LH, Chen WJ, Zhang YQ. Characteristics of participants' and caregivers' influence on non-response in a cross-sectional study of dementia in an older population. Arch Gerontol Geriatr 2015; 62:143-51. [PMID: 26466781 DOI: 10.1016/j.archger.2015.08.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Revised: 08/18/2015] [Accepted: 08/20/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The issue of non-response in dementia epidemiological studies, which may result in the underestimation of the prevalence of dementia, has attracted little attention. We aimed to explore the causes and related factors of non-response in a dementia survey among Chinese veterans. METHODS A two-phase, cross-sectional study investigated the prevalence of dementia and mild cognitive impairment in Chinese veterans aged ≥ 60 years. We collected the socio-demographic data and prior medical history, evaluated the health status of veterans and their caregivers, assessed the cognitive status of veterans, and evaluated the care burden of caregivers by Caregiver Burden Inventory (CBI). RESULTS Of 9676 eligible participants, 525 (5.4%) veterans in phase 1 and 1706 (35.0%) veterans among 4875 veterans in phase 2 did not respond. Illness, hospitalization and death accounted for 63.0% and 75.5% non-response in phases 1 and 2, respectively. Non-participation in social activities, self-perceived poor health status, worsened health changes, self-reported need for life care, and history of hearing loss or glaucoma independently predicted non-response in phase 1 or 2. The heavy care burden, suggested by the higher CBI scores and self-reported health deterioration of the primary caregivers, predicted non-response in phase 1 or 2. CONCLUSIONS The negative factors from both the participants and their caregivers independently predicted the non-response in the dementia study in an older population. Preventative strategies from the perspectives of the participants and caregivers should be developed to improve the response rates in both phases in a cross-sectional study.
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Affiliation(s)
- Ji-ping Tan
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, PR China
| | - Nan Li
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, PR China
| | - Bo Cui
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, PR China
| | - Lu-ning Wang
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, PR China.
| | - Yi-ming Zhao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, PR China.
| | - Bao-he Zhang
- Cadre Department, Navy General Hospital, Beijing, PR China
| | - Zhi-ying Liu
- Department of Neurology, Chinese PLA 264 Hospital, Taiyuan, PR China
| | - Shao-gang Zhang
- Third Cadre Department, Chinese PLA 254 Hospital, Tianjin, PR China
| | - Lan-ying Sun
- Third Internal Medicine Department, Chinese PLA 44 Hospital, Guiyang, PR China
| | - Nan Liu
- Department of Neurology, Chinese PLA 451 Hospital, Xi'an, PR China
| | - Rui-xiang Deng
- Cadre Department, Chinese PLA 252Hospital, Baoding, PR China
| | - Li-hua Ma
- Cadre Department, Chinese PLA 253 Hospital, Huhhot, PR China
| | - Wen-jun Chen
- Department of Neurology, Wuhan General Hospital of Guangzhou Military Command, Wuhan, PR China
| | - Yong-qing Zhang
- Cadre Department, General Hospital of Armed Police Forces, Beijing, PR China
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Abstract
Einleitung
Menschen, die derzeit in Pflegeheimen betreut werden, sind in der Regel hochbetagt und fortgeschritten multimorbid. Die Mehrzahl von ihnen ist an Demenz erkrankt. Daher haben sich die Hauptaufgaben der Pflegeheime in den vergangenen 25 Jahren grundlegend verändert. Gute Lebensqualität für die Betroffenen kann nur durch fachgerechte Pflegeleistungen, professionelle geriatrische und palliativmedizinische Behandlung, sowie Kompetenz aller Mitarbeiter in Kommunikation mit Menschen mit Demenz gewährleistet werden.
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Affiliation(s)
- Marina Kojer
- ⁎ Honorarprof. Dr. Dr. Marina KojerAlpen-Adria-Universität KlagenfurtFakultät für Interdisziplinäre Forschung und Fortbildung (IFF)Institut für Palliative Care und OrganisationsethikSchottenfeldgasse 29/4/1
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18
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Nishtala A, Himali JJ, Beiser A, Murabito JM, Seshadri S, Wolf PA, Au R. Midlife Hypertension Risk and Cognition in the Non-Demented Oldest Old: Framingham Heart Study. J Alzheimers Dis 2015; 47:197-204. [PMID: 26402768 PMCID: PMC4827717 DOI: 10.3233/jad-141881] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Midlife cardiovascular risk, hypertension (HTN) in particular, has been related cross-sectionally to poorer neuropsychological (NP) performance in middle age and older adults. This study investigated whether a similar relationship persists between midlife HTN or systolic blood pressure (SBP) and NP performance approximately 30 years later. 378 Framingham stroke and dementia-free Original cohort participants, with HTN and SBP ascertained between 50-60 years of age (mean age 55 ± 1, 65% women), were administered a NP assessment at age ≥80 years. Tests included Logical Memory, Visual Reproduction, Paired Associate, Hooper Visual Organization Test, Trail Making A & B, Digit Span Forward and Backward, Controlled Word Association Test (COWAT), and Similarities. Multivariable linear regression, adjusted for age, time interval between risk factor and NP testing, gender, and premorbid intelligence, assessed association between midlife HTN/SBP and NP outcomes. Midlife HTN was not significantly associated with NP outcome measures. Midlife SBP was associated with poorer Digit Span Forward and COWAT performance (p < 0.05). No significant interaction of age on HTN/SBP to NP associations was found. There was a significant interaction between ApoE4 status and SBP in their effects on COWAT (pinteraction = 0.074); SBP was negatively associated with COWAT only in those with the ApoE4 allele (p = 0.025). While midlife HTN is not associated with late life cognitive impairment, midlife SBP is related to late life attention and verbal fluency impairments, particularly among ApoE4+ individuals. These results offer insight into processes that are operative in the absence of overt cognitive impairment and dementia.
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Affiliation(s)
- Arvind Nishtala
- Framingham Heart Study, Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Jayandra J. Himali
- Framingham Heart Study, Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Alexa Beiser
- Framingham Heart Study, Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Joanne M. Murabito
- Framingham Heart Study, Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Sudha Seshadri
- Framingham Heart Study, Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Philip A. Wolf
- Framingham Heart Study, Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Rhoda Au
- Framingham Heart Study, Department of Neurology, Boston University School of Medicine, Boston, MA, USA
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Lucca U, Tettamanti M, Logroscino G, Tiraboschi P, Landi C, Sacco L, Garrì M, Ammesso S, Bertinotti C, Biotti A, Gargantini E, Piedicorcia A, Nobili A, Pasina L, Franchi C, Djade CD, Riva E, Recchia A. Prevalence of dementia in the oldest old: The Monzino 80‐plus population based study. Alzheimers Dement 2014; 11:258-70.e3. [DOI: 10.1016/j.jalz.2014.05.1750] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 04/15/2014] [Accepted: 05/15/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Ugo Lucca
- Department of Neuroscience Laboratory of Geriatric Neuropsychiatry, IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri” Milan Italy
| | - Mauro Tettamanti
- Department of Neuroscience Laboratory of Geriatric Neuropsychiatry, IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri” Milan Italy
| | | | - Pietro Tiraboschi
- Division of Neuropathology Fondazione IRCCS Istituto Neurologico “Carlo Besta” Milan Italy
| | - Cristina Landi
- Division of Neurological Rehabilitation European Foundation of Biomedical Research (FERB) Milan Italy
| | - Leonardo Sacco
- Division of Neurology Neurocentre of Southern Switzerland Lugano Switzerland
| | - Mariateresa Garrì
- Department of Neuroscience Laboratory of Geriatric Neuropsychiatry, IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri” Milan Italy
| | - Sonia Ammesso
- Department of Neuroscience Laboratory of Geriatric Neuropsychiatry, IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri” Milan Italy
| | - Chiara Bertinotti
- Department of Neuroscience Laboratory of Geriatric Neuropsychiatry, IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri” Milan Italy
| | - Anna Biotti
- Department of Neuroscience Laboratory of Geriatric Neuropsychiatry, IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri” Milan Italy
| | - Elena Gargantini
- Department of Neuroscience Laboratory of Geriatric Neuropsychiatry, IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri” Milan Italy
| | - Alessandro Piedicorcia
- Department of Neuroscience Laboratory of Geriatric Neuropsychiatry, IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri” Milan Italy
| | - Alessandro Nobili
- Department of Neuroscience, Laboratory of Quality Assessment of Geriatric Therapies and Services IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri” Milan Italy
| | - Luca Pasina
- Department of Neuroscience, Laboratory of Quality Assessment of Geriatric Therapies and Services IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri” Milan Italy
| | - Carlotta Franchi
- Department of Neuroscience, Laboratory of Quality Assessment of Geriatric Therapies and Services IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri” Milan Italy
| | - Codjo Djignefa Djade
- Department of Neuroscience, Laboratory of Quality Assessment of Geriatric Therapies and Services IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri” Milan Italy
| | - Emma Riva
- Department of Neuroscience Laboratory of Geriatric Neuropsychiatry, IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri” Milan Italy
| | - Angela Recchia
- Department of Neuroscience Laboratory of Geriatric Neuropsychiatry, IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri” Milan Italy
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Misiak B, Cialkowska-Kuzminska M, Frydecka D, Chladzinska-Kiejna S, Kiejna A. European studies on the prevalence of dementia in the elderly: time for a step towards a methodological consensus. Int J Geriatr Psychiatry 2013; 28:1211-21. [PMID: 23450739 DOI: 10.1002/gps.3948] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2012] [Accepted: 01/25/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The aim of this study was to discuss methodological limitations in studies on the prevalence of dementia across European countries with particular attention to post-EURODEM studies. METHODS Two people independently focused on an iterative literature search for studies published in the years 2000-2012 using the following keywords: 'dementia', 'Alzheimer', 'incidence', 'prevalence' that were cross-linked with names of European countries. After that, the results obtained were compared and publications in English were included in a subsequent analysis. RESULTS We included 26 studies published in the years 2000-2012. The majority of epidemiological studies come from Spain and Italy. The past decade has not provided prevalence rates from a considerable number of countries. There is also a lack of nationwide surveys on the prevalence of dementia. Predominantly, epidemiological studies on the prevalence of dementia follow a two-stage approach that consists of a screening phase and a subsequent confirmation of dementia. However, several differences, particularly with regard to the neuropsychological instruments used, still exist and contribute to inconsistent prevalence rates. CONCLUSIONS Although the EURODEM study was a milestone in the epidemiology of dementia in Europe and provided several future directions for research, methodological limitations are apparent in a number of European studies on the prevalence of dementia and require particular attention. In particular, a variety of diagnostic instruments requires unification for future studies. On the other hand, given the lack of epidemiological studies from a number of countries and the increasing prevalence of dementia, the need for population-based surveys should be emphasized.
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Affiliation(s)
- Blazej Misiak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
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