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Bacigalupo I, Giaquinto F, Salvi E, Carnevale G, Vaccaro R, Matascioli F, Remoli G, Vanacore N, Lorenzini P. A new national survey of centers for cognitive disorders and dementias in Italy. Neurol Sci 2024; 45:525-538. [PMID: 37592124 PMCID: PMC10791890 DOI: 10.1007/s10072-023-06958-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/08/2023] [Indexed: 08/19/2023]
Abstract
INTRODUCTION A new national survey has been carried out by the Italian Centers for Cognitive Disorders and Dementias (CCDDs). The aim of this new national survey is to provide a comprehensive description of the characteristics, organizational aspects of the CCDDs, and experiences during the COVID-19 pandemic. METHODS A list of all national CCDDs was requested from the delegates of each Italian region. The online questionnaire is divided in two main sections: a profile section, containing information on location and accessibility, and a data collection form covering organization, services, treatments, activities, and any service interruptions caused by the COVID-19 outbreak. RESULTS In total, 511 out of 534 (96%) facilities completed the profile section, while 450 out of 534 (84%) CCDDs also completed the data collection form. Almost half of the CCDDs (55.1%) operated for 3 or fewer days a week. About one-third of the facilities had at least two professional figures among neurologists, geriatricians and psychiatrists. In 2020, only a third of facilities were open all the time, but in 2021, two-thirds of the facilities were open. CONCLUSION This paper provides an update on the current status of CCDDs in Italy, which still shows considerable heterogeneity. The survey revealed a modest improvement in the functioning of CCDDs, although substantial efforts are still required to ensure the diagnosis and care of patients with dementia.
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Affiliation(s)
- Ilaria Bacigalupo
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Via Giano Della Bella 34, 00161, Rome, Italy.
| | - Francesco Giaquinto
- Department of Human and Social Sciences, University of Salento, Lecce, Italy
| | - Emanuela Salvi
- National Center for Drug Research and Evaluation, Italian National Institute of Health, Rome, Italy
| | - Giulia Carnevale
- Italian National Institute of Health FONDEM Study Group, Rome, Italy
| | - Roberta Vaccaro
- Italian National Institute of Health FONDEM Study Group, Rome, Italy
- GINCO, Aware Aging Group, Como, Italy
| | - Fabio Matascioli
- Italian National Institute of Health FONDEM Study Group, Rome, Italy
- TAM Onlus, Social Cooperative, Naples, Italy
| | - Giulia Remoli
- Neurology Section, University of Milano-Bicocca, Milan, Italy
| | - Nicola Vanacore
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Via Giano Della Bella 34, 00161, Rome, Italy
| | - Patrizia Lorenzini
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Via Giano Della Bella 34, 00161, Rome, Italy
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Seong SJ, Kim BN, Kim KW. Comparative Analysis on the Policy Approaches in the National Dementia Plans of G7 Countries and Korea and Their Implementation. J Korean Med Sci 2023; 38:e227. [PMID: 37527910 PMCID: PMC10396431 DOI: 10.3346/jkms.2023.38.e227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 05/03/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND The World Health Organization (WHO) proposed a global action plan for dementia and aimed to have 75% of their member states formulating National Dementia Plans (NDPs) by 2025. The Organization for Economic Cooperation and Development (OECD) proposed the ten key objectives of dementia policy in 2015. Among previous studies on NDPs, few studies have investigated measures for proper implementation of NDPs. This study aimed to compare the implementation basis and specific action plans of NDPs between the G7 countries and South Korea. METHODS We investigated the measures for proper implementation of the NDPs of G7 countries and South Korea. To compare the specific policy approaches, the seven action areas of the WHO action plan and the ten key objectives of dementia policy proposed by the OECD were integrated into 11 targets (prevention, diagnosis, awareness, caregiver support, appropriate environments, long-term care, health service, end-of-life care, care coordination, research and technology, information systems). RESULTS Although most NDPs included specific action plans of the 11 targets, caregiver support, safe environments, healthcare services, and end-of-life care were lacking in some NDPs. For implementation, some countries reinforced the policy priority of their NDPs by timely updates, evaluation, legislations, or head-of-state leadership. However, only three countries had a legislative basis, and three countries included outcome measures in their latest NDP. CONCLUSION Effective measures for feasible implementation are needed. The WHO should promote not only the establishment of NDPs, but also their proper implementation.
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Affiliation(s)
- Su Jeong Seong
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Bin Na Kim
- Department of International Development Cooperation, Graduate school of Pan-pacific International Studies, Kyung Hee University, Yongin, Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Korea
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Korea.
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Therapeutic Role of Additional Mirror Therapy on the Recovery of Upper Extremity Motor Function after Stroke: A Single-Blind, Randomized Controlled Trial. Neural Plast 2022; 2022:8966920. [PMID: 36624743 PMCID: PMC9825233 DOI: 10.1155/2022/8966920] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/09/2022] [Accepted: 12/19/2022] [Indexed: 01/02/2023] Open
Abstract
Background Rehabilitation of upper extremity hemiplegia after stroke remains a great clinical challenge, with only 20% of patients achieving a basic return to normal hand function. How to promote the recovery of motor function at an early stage is crucial to the life of the patient. Objectives To invest the effects of additional mirror therapy in improving upper limb motor function and activities of daily living in acute and subacute stroke patients, and further explore the effects of other factors on the efficacy of MT. Methods Participants who presented with unilateral upper extremity paralysis due to a first ischemic or hemorrhagic stroke were included in the study. They were randomly allocated to the experimental or control group. Patients in the control group received occupational therapy for 30 minutes each session, six times a week, for three weeks, while patients in the experimental group received 30 minutes of additional mirror therapy based on occupational therapy. The primary outcome measures were Fugl-Meyer Assessment-upper extremity (FMA-UE), Action Research Arm Test (ARAT), and Instrumental Activity of Daily Living (IADL) which were evaluated by two independent occupational therapists before treatment and after 3-week treatment. A paired t-test was used to compare the values between pretreatment and posttreatment within an individual group. Two-sample t-test was utilized to compare the changes (baseline to postintervention) between the two groups. Results A total of 52 stroke patients with unilateral upper extremity motor dysfunction who were able to actively cooperate with the training were included in this study. At baseline, no significant differences were found between groups regarding demographic and clinical characteristics (P > 0.05 for all). Upper limb motor function and ability to perform activities of daily living of the patients were statistically improved in both groups towards the third week (P < 0.05). In addition, statistical analyses showed more significant improvements in the score changes of FMA-UE and IADL in the experimental group compared to the control group after treatment (P < 0.05), but no significant difference was observed in the ARAT score changes between the two groups (P > 0.05). The subgroup analysis showed that no significant heterogeneity was observed in age, stroke type, lesion side, and clinical stage (P > 0.05). Conclusion In conclusion, some positive changes in aspects of upper limb motor function and the ability to perform instrumental activities of daily living compared with routine occupational therapy were observed in additional mirror therapy. Therefore, the application of additional mirror therapy training should be reconsidered to improve upper extremity motor in stroke patients.
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4
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Mouton A, Plonka A, Fabre R, Tran TM, Robert P, Macoir J, Manera V, Gros A. The course of primary progressive aphasia diagnosis: a cross-sectional study. Alzheimers Res Ther 2022; 14:64. [PMID: 35538502 PMCID: PMC9092839 DOI: 10.1186/s13195-022-01007-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 04/19/2022] [Indexed: 11/23/2022]
Abstract
Background The primary progressive aphasia (PPA) diagnosis trajectory is debated, as several changes in diagnosis occur during PPA course, due to phenotype evolution from isolated language alterations to global cognitive impairment. The goal of the present study, based on a French cohort, was to describe the demographics and the evolution of subjects with (PPA) in comparison with Alzheimer’s disease (AD) on a period of 7 years. Methods We conducted a repeated cross-sectional study. The study population comprised individuals with PPA and AD diagnosis (N=167,191) from 2010 to 2016 in the French National data Bank (BNA). Demographic variables, MMSE scores, diagnosis status at each visit and prescribed treatments were considered. Results From 2010 to 2016, 5186 patients were initially diagnosed with PPA, 162,005 with AD. Compared to AD subjects, significant differences were found concerning age (younger at first diagnosis for PPA), gender (more balanced in PPA), education level (higher in PPA) and MMSE score (higher of 1 point in PPA). Percentage of pending diagnosis, delay between first consultation and first diagnosis and the number of different diagnoses before the diagnosis of interest were significantly higher in PPA group compared to AD group. Pharmacological and non-pharmacological treatments were significatively more recommended following PPA than AD diagnosis. Conclusion This study improves the knowledge of PPA epidemiology and has the potential to help adopting appropriate public health service policies. It supports the hypothesis that PPA is diagnosed later than AD. The PPA diagnosis increases the prescription of non-pharmacological treatments, especially speech and language therapy (SLT) that is the main treatment available and most effective when at the initial stage. Trial registration ClinicalTrials.gov identifier NCT03687112 Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01007-6.
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Affiliation(s)
- A Mouton
- Centre Hospitalier Universitaire de Nice, Laboratoire CoBTeK, Service Clinique Gériatrique du Cerveau et du Mouvement, Université Côte d'Azur, Nice, France
| | - A Plonka
- Centre Hospitalier Universitaire de Nice, Laboratoire CoBTeK, Service Clinique Gériatrique du Cerveau et du Mouvement, Université Côte d'Azur, Nice, France.,Institut NeuroMod, Université Côte d'Azur, Sophia Antipolis, France
| | - R Fabre
- Centre Hospitalier Universitaire de Nice, Laboratoire CoBTeK, Service Clinique Gériatrique du Cerveau et du Mouvement, Université Côte d'Azur, Nice, France
| | - T M Tran
- Laboratoire STL, UMR 8163, Université de Lille, Lille, France
| | - P Robert
- Centre Hospitalier Universitaire de Nice, Laboratoire CoBTeK, Service Clinique Gériatrique du Cerveau et du Mouvement, Université Côte d'Azur, Nice, France.,Faculté de Médecine de Nice, Département d'Orthophonie, Université Côte d'Azur, Nice, France
| | - J Macoir
- Department of rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada.,CERVO Brain Research Center, Quebec, QC, Canada
| | - V Manera
- Faculté de Médecine de Nice, Département d'Orthophonie, Université Côte d'Azur, Nice, France.,Laboratoire CoBTeK, Université Côte d'Azur, Nice, France
| | - A Gros
- Centre Hospitalier Universitaire de Nice, Laboratoire CoBTeK, Service Clinique Gériatrique du Cerveau et du Mouvement, Université Côte d'Azur, Nice, France. .,Faculté de Médecine de Nice, Département d'Orthophonie, Université Côte d'Azur, Nice, France.
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Prediction of Autonomy Loss in Alzheimer’s Disease. FORECASTING 2021. [DOI: 10.3390/forecast4010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The evolution of functional autonomy loss leads to institutionalization of people affected by Alzheimer’s disease (AD), to an alteration of their quality of life and that of their caregivers. To predict loss of functional autonomy could optimize prevention strategies, aids and cost of care. The aim of this study was to develop and to cross-validate a model to predict loss of functional autonomy as assessed by Instrumental Activities of Daily Living (IADL) score. Outpatients with probable AD and with 2 or more visits to the Clinical and Research Memory Centre of the University Hospital were included. Four Tree-Augmented Naïve bayesian networks (6, 12, 18 and 24 months of follow-up) were built. Variables included in the model were demographic data, IADL score, MMSE score, comorbidities, drug prescription (psychotropics and AD-specific drugs). A 10-fold cross-validation was conducted to evaluate robustness of models. The study initially included 485 patients in the prospective cohort. The best performance after 10-fold cross-validation was obtained with the model able to predict loss of functional autonomy at 18 months (area under the curve of the receiving operator characteristic curve = 0.741, 27% of patients misclassified, positive predictive value = 77% and negative predictive value = 73%). The 13 variables used explain 41.6% of the evolution of functional autonomy at 18 months. A high-performing predictive model of AD evolution of functional autonomy was obtained. An external validation is needed to use the model in clinical routine so as to optimize the patient care.
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Gallini A, Jegou D, Lapeyre-Mestre M, Couret A, Bourrel R, Ousset PJ, Fabre D, Andrieu S, Gardette V. Development and Validation of a Model to Identify Alzheimer's Disease and Related Syndromes in Administrative Data. Curr Alzheimer Res 2021; 18:142-156. [PMID: 33882802 DOI: 10.2174/1567205018666210416094639] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/12/2021] [Accepted: 03/30/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Administrative data are used in the field of Alzheimer's Disease and Related Syndromes (ADRS), however their performance to identify ADRS is unknown. OBJECTIVE i) To develop and validate a model to identify ADRS prevalent cases in French administrative data (SNDS), ii) to identify factors associated with false negatives. METHODS Retrospective cohort of subjects ≥ 65 years, living in South-Western France, who attended a memory clinic between April and December 2013. Gold standard for ADRS diagnosis was the memory clinic specialized diagnosis. Memory clinics' data were matched to administrative data (drug reimbursements, diagnoses during hospitalizations, registration with costly chronic conditions). Prediction models were developed for 1-year and 3-year periods of administrative data using multivariable logistic regression models. Overall model performance, discrimination, and calibration were estimated and corrected for optimism by resampling. Youden index was used to define ADRS positivity and to estimate sensitivity, specificity, positive predictive and negative probabilities. Factors associated with false negatives were identified using multivariable logistic regressions. RESULTS 3360 subjects were studied, 52% diagnosed with ADRS by memory clinics. Prediction model based on age, all-cause hospitalization, registration with ADRS as a chronic condition, number of anti-dementia drugs, mention of ADRS during hospitalizations had good discriminative performance (c-statistic: 0.814, sensitivity: 76.0%, specificity: 74.2% for 2013 data). 419 false negatives (24.0%) were younger, had more often ADRS types other than Alzheimer's disease, moderate forms of ADRS, recent diagnosis, and suffered from other comorbidities than true positives. CONCLUSION Administrative data presented acceptable performance for detecting ADRS. External validation studies should be encouraged.
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Affiliation(s)
- Adeline Gallini
- CERPOP, Universite de Toulouse, Inserm, UPS, Toulouse, France
| | - David Jegou
- CERPOP, Universite de Toulouse, Inserm, UPS, Toulouse, France
| | | | - Anaïs Couret
- CERPOP, Universite de Toulouse, Inserm, UPS, Toulouse, France
| | - Robert Bourrel
- Caisse Nationale d'Assurance Maladie des Travailleurs Salaries (CNAMTS), Echelon Regional du Service Medical Midi-Pyrenees - F31000 Toulouse, France
| | - Pierre-Jean Ousset
- CHU Toulouse, Centre Memoire de Ressources et de Recherches - F31000 Toulouse, France
| | - D Fabre
- CHU Toulouse, Departement D'information Medicale - F31000 Toulouse, France
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Ribaldi F, Chicherio C, Altomare D, Martins M, Tomczyk S, Jelescu I, Maturana E, Scheffler M, Haller S, Lövblad KO, Pievani M, Garibotto V, Kliegel M, Frisoni GB. Brain connectivity and metacognition in persons with subjective cognitive decline (COSCODE): rationale and study design. ALZHEIMERS RESEARCH & THERAPY 2021; 13:105. [PMID: 34034799 PMCID: PMC8152092 DOI: 10.1186/s13195-021-00846-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/17/2021] [Indexed: 12/28/2022]
Abstract
Background Subjective cognitive decline (SCD) is the subjective perception of a decline in memory and/or other cognitive functions in the absence of objective evidence. Some SCD individuals however may suffer from very early stages of neurodegenerative diseases (such as Alzheimer’s disease, AD), minor psychiatric conditions, neurological, and/or somatic comorbidities. Even if a theoretical framework has been established, the etiology of SCD remains far from elucidated. Clinical observations recently lead to the hypothesis that individuals with incipient AD may have overestimated metacognitive judgements of their own cognitive performance, while those with psychiatric disorders typically present underestimated metacognitive judgements. Moreover, brain connectivity changes are known correlates of AD and psychiatric conditions and might be used as biomarkers to discriminate SCD individuals of different etiologies. The aim of the COSCODE study is to identify metacognition, connectivity, behavioral, and biomarker profiles associated with different etiologies of SCD. Here we present its rationale and study design. Methods COSCODE is an observational, longitudinal (4 years), prospective clinical cohort study involving 120 SCD, and 80 control study participants (40 individuals with no cognitive impairment, and 40 living with mild cognitive impairment - MCI, or dementia due to AD), all of which will undergo diffusion magnetic resonance imaging (MRI) and functional magnetic resonance imaging (fMRI) as well as behavioral and biomarker assessments at baseline and after 1 and 2 years. Both hypothesis-driven and data-driven cluster analysis approaches will be used to identify SCD sub-types based on metacognition, connectivity, behavioral, and biomarker features. Conclusion COSCODE will allow defining and interpreting the constellation of signs and symptoms associated with different etiologies of SCD, paving the way to the development of cost-effective risk assessment and prevention protocols.
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Affiliation(s)
- Federica Ribaldi
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland. .,Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.
| | - Christian Chicherio
- Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.,Center for Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Geneva, Switzerland
| | - Daniele Altomare
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland.,Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Marta Martins
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
| | - Szymon Tomczyk
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
| | - Ileana Jelescu
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland.,Animal Imaging and Technology, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Enrique Maturana
- Department of Radiology, Geneva University Hospitals, Geneva, Switzerland
| | - Max Scheffler
- Division of Radiology, Geneva University Hospitals, Geneva, Switzerland
| | - Sven Haller
- CIMC - Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland.,Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden.,Faculty of Medicine of the University of Geneva, Geneva, Switzerland.,Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, P. R. China
| | - Karl-Olof Lövblad
- Neurodiagnostic and Neurointerventional Division, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland
| | - Michela Pievani
- Laboratory of Alzheimer's Neuroimaging and Epidemiology (LANE), IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Valentina Garibotto
- Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTlab), Geneva University Neurocenter and Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland
| | - Matthias Kliegel
- Center for Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Geneva, Switzerland.,Cognitive Aging Lab, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland.,Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
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Cations M, Lang CE, Ward SA, Crotty M, Whitehead C, Maddison J, Inacio M. Cohort profile: Dementia in the Registry of Senior Australians. BMJ Open 2021; 11:e039907. [PMID: 33526495 PMCID: PMC7852970 DOI: 10.1136/bmjopen-2020-039907] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Clinical quality registries (CQRs) are being established in many countries to monitor, benchmark, and report on the quality of dementia care over time. Case ascertainment can be challenging given that diagnosis occurs in a variety of settings. The Registry of Senior Australians (ROSA) includes a large cohort of people with dementia from all Australian states and territories identified using routinely collected aged care assessment data. In ROSA, assessment data are linked to information about aged and health service use, medicine dispensing, hospitalisations and the National Death Index. The ROSA dementia cohort was established to capture people for the Australian dementia CQR currently in development who may not be identified elsewhere. PARTICIPANTS There were 373 695 people with dementia identified in aged care assessments from 2008 to 2016. Cross-sectional analysis from the time of cohort entry (e.g. when first identified with dementia on an aged care assessment) indicates that individuals were 84.1 years old on average, and 63.1% were female. More than 44% were first identified at entry to permanent residential aged care. The cohort recorded more severe cognitive impairment at entry than other international dementia registries. FINDINGS TO DATE The cohort has so far been used to demonstrate a declining prevalence of dementia in individuals entering the aged care sector, examine trends in psychotropic medicine prescribing, and to examine the impact of dementia on aged care service use and outcomes. FUTURE PLANS The ROSA dementia cohort will be updated periodically and is a powerful resource both on its own and as a contributor to the Australian dementia CQR. Integration of the ROSA dementia cohort with the dementia CQR will ensure that people with dementia using aged care services can benefit from the ongoing monitoring and benchmarking of care that a registry can provide.
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Affiliation(s)
- Monica Cations
- Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Catherine E Lang
- Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Stephanie A Ward
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- Department of Geriatric Medicine, The Prince of Wales Hospital, Sydney, New South Wales, Australia
- School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
| | - Maria Crotty
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Southern Adelaide Local Health Network, SA Health, Adelaide, South Australia, Australia
| | - Craig Whitehead
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Southern Adelaide Local Health Network, SA Health, Adelaide, South Australia, Australia
| | - John Maddison
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Northern Adelaide Local Health Network, SA Health, Adelaide, South Australia, Australia
| | - Maria Inacio
- Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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Dufournet M, Moutet C, Achi S, Delphin-Combe F, Krolak-Salmon P, Dauphinot V. Proposition of a corrected measure of the Lawton instrumental activities of daily living score. BMC Geriatr 2021; 21:39. [PMID: 33430781 PMCID: PMC7802257 DOI: 10.1186/s12877-020-01995-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/29/2020] [Indexed: 11/18/2022] Open
Abstract
Background We aimed to propose a correction of the Lawton instrumental activity of daily living (IADL) score to take into account the possibility to have never done some activities, and measured its agreement and reliability with the usual IADL score. Methods A cross-sectional study was conducted in outpatients attending French memory clinics between 2014 and 2017. Lawton IADL, cognitive performance, diagnosis, neuropsychiatric symptoms, and sociodemographics characteristics were collected. A corrected IADL was calculated and its agreement with the usual IADL was assessed. Results The study included of 2391 patients (79.9 years old, 61.7% female). Based on the usual IADL, 36.9% of patients had never carried out at least one of the activities. This proportion reached 68.8% for men and 17.7% for women. Women had a mean IADL higher than men: 4.72 vs 3.49, this difference decreased when considering the corrected IADL: 4.82 vs 4.26 respectively. Based on Bland-Altman method, 93.5% of observations lied within the limits agreement. The ICC between the 2 scores was 0.98. The relationships between patients’ characteristics and the IADL scores were similar, regardless the usual or corrected version. Conclusions This corrected IADL score had an excellent degree of agreement with the usual version based the ICC. This simple correction could benefit both for the clinical practice by providing a more accurate description of the real clinical state of the patients allowing to manage them more precisely, and for research involving the evaluation of the functional abilities of patients.
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Affiliation(s)
- Marine Dufournet
- Clinical and Research Memory Centre of Lyon of Lyon (CMRR Lyon), Lyon Institute For Elderly (Institut du vieillissement I-Vie), Hospices civils de Lyon, Lyon, France
| | - Claire Moutet
- Clinical and Research Memory Centre of Lyon of Lyon (CMRR Lyon), Lyon Institute For Elderly (Institut du vieillissement I-Vie), Hospices civils de Lyon, Lyon, France
| | - Sarah Achi
- Clinical and Research Memory Centre of Lyon of Lyon (CMRR Lyon), Lyon Institute For Elderly (Institut du vieillissement I-Vie), Hospices civils de Lyon, Lyon, France
| | - Floriane Delphin-Combe
- Clinical and Research Memory Centre of Lyon of Lyon (CMRR Lyon), Lyon Institute For Elderly (Institut du vieillissement I-Vie), Hospices civils de Lyon, Lyon, France
| | - Pierre Krolak-Salmon
- Clinical and Research Memory Centre of Lyon of Lyon (CMRR Lyon), Lyon Institute For Elderly (Institut du vieillissement I-Vie), Hospices civils de Lyon, Lyon, France.,Research Clinic Centre Aging Brain Frailty (CRC - VCF), Lyon Institute For Elderly (Institut du vieillissement I-Vie), Hospices civils de Lyon, Lyon, France.,University Lyon 1, INSERM, U1028, UMR CNRS 5292, Research Centre of Neurosciences of Lyon, Lyon, France
| | - Virginie Dauphinot
- Clinical and Research Memory Centre of Lyon of Lyon (CMRR Lyon), Lyon Institute For Elderly (Institut du vieillissement I-Vie), Hospices civils de Lyon, Lyon, France. .,Hôpital des Charpennes, 27 avenue Gabriel Péri, 69 100, Villeurbanne, France.
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Removal of Drugs for Alzheimer’s Disease from the List of Reimbursable Drugs in France: Analysis of Change in Drug Use, Disease Management and Cognition Using the National Alzheimer Data Bank (BNA). Drugs Aging 2021; 38:63-74. [DOI: 10.1007/s40266-020-00817-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2020] [Indexed: 01/06/2023]
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Canevelli M, Di Pucchio A, Marzolini F, Mayer F, Massari M, Salvi E, Palazzesi I, Lacorte E, Bacigalupo I, Di Fiandra T, Vanacore N. A National Survey of Centers for Cognitive Disorders and Dementias in Italy. J Alzheimers Dis 2021; 83:1849-1857. [PMID: 34459403 PMCID: PMC8609685 DOI: 10.3233/jad-210634] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Italy has one of the oldest populations in the World and more than one million dementia cases can be estimated at the national level. OBJECTIVE The objectives of this national survey include: 1) to report the administrative features and the professional competencies of Centers for Cognitive Disorders and Dementias (CCDDs); 2) to document possible discrepancies by geographic macro-area; and 3) to identify the features of CCDDs that are associated with a better quality in the provision of care. METHODS A survey of Italian CCDDs was conducted between February 2014 and December 2015. A list of CCDDs was obtained through direct interactions with designed delegates from each Italian region. A questionnaire was defined on five sections concerning: 1) location of the CCDD; 2) access to the CCDD; 3) organization of the CCDD; 4) services and treatments provided; and 5) quantitative data on the activities of the CCDD. RESULTS Overall, 577 out of the 597 eligible CCDDs returned the completed survey questionnaire (response rate: 96.6%): 260 (45.1%) from Northern Italy, 103 (17.8%) from Central Italy, and 214 (37.1%) from Southern-Islands Italy. More than a third of CCDDs were open only once or twice weekly. A median of 450 (IQR: 200-800) patients regularly attended these services. Most patients (70%) were affected by dementia or mild cognitive impairment (19%). CONCLUSION We have provided a snapshot of the organization and activities of CCDDs in Italy and documented existing inequalities in the provision of care.
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Affiliation(s)
- Marco Canevelli
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Alessandra Di Pucchio
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
| | - Fabrizio Marzolini
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
| | - Flavia Mayer
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
| | - Marco Massari
- National Center for Drug Research and Evaluation, Italian National Institute of Health, Rome, Italy
| | - Emanuela Salvi
- National Center for Drug Research and Evaluation, Italian National Institute of Health, Rome, Italy
| | - Ilaria Palazzesi
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
| | - Eleonora Lacorte
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
| | - Ilaria Bacigalupo
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
| | | | - Nicola Vanacore
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
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12
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Malattia a corpi di Lewy. Neurologia 2020. [DOI: 10.1016/s1634-7072(20)44006-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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13
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Dauphinot V, Boublay N, Moutet C, Achi S, Bathsavanis A, Krolak-Salmon P. Comparison of Instrumental Activities of Daily Living assessment by face-to-face or telephone interviews: a randomized, crossover study. ALZHEIMERS RESEARCH & THERAPY 2020; 12:24. [PMID: 32169093 PMCID: PMC7068883 DOI: 10.1186/s13195-020-00590-w] [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: 11/20/2019] [Accepted: 02/26/2020] [Indexed: 11/29/2022]
Abstract
Background The functional autonomy assessment is essential to manage patients with a neurodegenerative disease, but its evaluation is not always possible during a consultation. To optimize ambulatory autonomy assessment, we compared the Lawton Instrumental Activities of Daily Living (IADL) questionnaire collected by telephone and face-to-face interviews. Methods A randomized, crossover study was carried out among patients attending a memory clinic (MC). The IADL questionnaire was collected for patients during telephone and face-to-face interviews between nurses and patients’ caregivers. The agreement between the two methods was measured using the proportion of participants giving the same response, Cohen’s kappa, intraclass correlation (ICC) coefficient, and Bland and Altman method. The associations between patients’ characteristics, events occurring between the two assessments, and agreement were assessed. Results Among the 292 patients (means ± SD age 81.5 ± 7, MMSE 19.6 ± 6, 39.7% with major neurocognitive disorders) analyzed, the proportion of agreement between the two modes was 89.4% for the total IADL score. Weighted kappa coefficient was 0.66 and ICC score was 0.91 for total IADL score. The mean difference between the IADL score by telephone or face-to-face was 0.32. Overall, 96.9% of measures lay within the 95% limits of agreement. The occurrence of fall was less likely associated with the probability to lie within the 95% limits of agreement (OR = 0.07 [0.02–0.27]). Conclusion The administration of IADL by telephone with the caregiver appears to be an acceptable method of assessment for MC patients compared to face-to-face interview. The events such as falls which could occur in a time close to the evaluation should be reported. Study registration ClinicalTrials.gov, NCT02654574. Retrospectively registered: 13 January 2016
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Affiliation(s)
- Virginie Dauphinot
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute For Elderly, Hospices Civils de Lyon, Lyon, France. .,Hôpital des Charpennes, 27 rue Gabriel Péri, 69100, Villeurbanne, France.
| | - Nawèle Boublay
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute For Elderly, Hospices Civils de Lyon, Lyon, France.,Université Lyon 1, Lyon, France
| | - Claire Moutet
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute For Elderly, Hospices Civils de Lyon, Lyon, France
| | - Sarah Achi
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute For Elderly, Hospices Civils de Lyon, Lyon, France
| | - Anthony Bathsavanis
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute For Elderly, Hospices Civils de Lyon, Lyon, France
| | - Pierre Krolak-Salmon
- Memory Clinical and Research Center of Lyon (CMRR), Lyon Institute For Elderly, Hospices Civils de Lyon, Lyon, France.,Université Lyon 1, Lyon, France.,INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Brain Dynamics and Cognition Team, F-69000, Lyon, France
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14
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Dufournet M, Dauphinot V, Moutet C, Verdurand M, Delphin-Combe F, Krolak-Salmon P, Krolak-Salmon P, Dauphinot V, Delphin-Combe F, Makaroff Z, Federico D, Coste MH, Rouch I, Dorey JM, Lepetit A, Danaila K, Vernaudon J, Bathsavanis A, Sarciron A, Guilhermet Y, Gaujard S, Grosmaître P, Moutet C, Verdurand M. Impact of Cognitive, Functional, Behavioral Disorders, and Caregiver Burden on the Risk of Nursing Home Placement. J Am Med Dir Assoc 2019; 20:1254-1262. [DOI: 10.1016/j.jamda.2019.03.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 03/21/2019] [Accepted: 03/22/2019] [Indexed: 01/10/2023]
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15
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Epelbaum S, Paquet C, Hugon J, Dumurgier J, Wallon D, Hannequin D, Jonveaux T, Besozzi A, Pouponneau S, Hommet C, Blanc F, Berly L, Julian A, Paccalin M, Pasquier F, Bellet J, Boutoleau-Bretonniere C, Charriau T, Rouaud O, Madec O, Mouton A, David R, Bekadar S, Fabre R, Liegey E, Deberdt W, Robert P, Dubois B. How many patients are eligible for disease-modifying treatment in Alzheimer's disease? A French national observational study over 5 years. BMJ Open 2019; 9:e029663. [PMID: 31239309 PMCID: PMC6597622 DOI: 10.1136/bmjopen-2019-029663] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE We aimed to study the epidemiology of the prodromal and mild stages of Alzheimer's disease (AD) patients who are eligible for clinical trials with disease-modifying therapies. SETTINGS We analysed two large complementary databases to study the incidence and characteristics of this population on a nationwide scope in France from 2014 to 2018. The National Alzheimer Database contains data from 357 memory centres and 90 private neurologists. Data from 2014 to 2018 have been analysed. PARTICIPANTS Patients, 50-85 years old, diagnosed with AD who had an Mini-Mental State Exam (MMSE) score of ≥20 were included. We excluded patients with mixed and non-AD neurocognitive disorders. PRIMARY OUTCOME MEASURE Descriptive statistics of the population of interest was the primary measure. RESULTS In the National Alzheimer Database, 550 198 patients were assessed. Among them, 72 174 (13.1%) were diagnosed with AD and had an MMSE ≥20. Using corrections for specificity of clinical diagnosis of AD, we estimated that about 50 000 (9.1%) had a prodromal or mild AD. In the combined electronic clinical records database of 11 French expert memory centres, a diagnosis of prodromal or mild AD, certified by the use of cerebrospinal fluid AD biomarkers, could be established in 195 (1.3%) out of 14 596 patients. CONCLUSIONS AD was not frequently diagnosed at a prodromal or mild dementia stage in France in 2014 to 2018. Diagnosis rarely relied on a pathophysiological marker even in expert memory centres. National databases will be valuable to monitor early stage AD diagnosis efficacy in memory centres when a disease-modifying treatment becomes available.
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Affiliation(s)
- Stéphane Epelbaum
- Institute of Memoryand Alzheimer’s Disease (IM2A) and Brain and Spine Institute(ICM) UMR S 1127, Inria, Aramis-Project Team, Department of Neurology, AP-HP, Pitié-Salpêtrière University Hospital, Sorbonne Universities, Pierre et Marie Curie University, Paris 06 and National Reference Center for Rare or Early Dementias and Center of Excellence of Neurodegenerative Disease (CoEN), Paris, France
| | - Claire Paquet
- Neurology Memory Center, Lariboisière FW Saint Louis University Hospital, Paris, France
| | - Jacques Hugon
- Center of Cognitive Neurology, Groupe hospitalier Lariboisiere Fernand-Widal, Paris, France
- Cognitive Neurology Center, CMRR Paris-Nord Ile-de-France, Groupe hospitalier Lariboisiere Fernand-Widal, Paris, France
| | - Julien Dumurgier
- Cognitive Neurology Center, CMRR Paris-Nord Ile-de-France, Groupe hospitalier Lariboisiere Fernand-Widal, Paris, France
- U942 Team Biomarkers and Neurocognition, INSERM/Université Paris Diderot, Paris, France
| | - David Wallon
- Department of Neurology, Rouen University Hospital, Rouen, France
| | | | | | | | | | | | - Frederic Blanc
- Department of Neurology, University Hospital of Strasbourg, Strasbourg, France
| | | | | | - Marc Paccalin
- Geriatrics Department University Hospital La Milétrie, Poitiers, France
| | - Florence Pasquier
- Neurology, Centre Hospitalier Regional et Universitaire de Lille (CHRU- LILLE), Lille, France
| | - Julie Bellet
- Neurology, Centre Hospitalier Regional Universitaire de Lille Pole Neurosciences et Appareil Locomoteur, Lille, France
| | | | | | | | | | - Aurélie Mouton
- Department of Neuropsychiatry, CHU de nice, Nice, France
| | - Renaud David
- Centre Mémoire de Ressources et de Recherche, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Samir Bekadar
- Department of Clinical Research, Institut du cerveau et de la moelle epiniere, Paris, France
| | - Roxane Fabre
- Department of Neuropsychiatry, CHU de nice, Nice, France
| | - Emmanuelle Liegey
- Délégation à la Recherche Clinique et à l’Innovation, Assistance publique–Hôpitaux de Paris, Paris, France
| | - Walter Deberdt
- Medical Department, Eli Lilly and Co, Indianapolis, Indiana, USA
| | | | - Bruno Dubois
- Neurology, CHU de la Pitiè Salpêtrière-AP-HP, Paris, France
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16
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Alzheimer's disease: Estimating its prevalence rate in a French geographical unit using the National Alzheimer Data Bank and national health insurance information systems. PLoS One 2019; 14:e0216221. [PMID: 31059547 PMCID: PMC6502320 DOI: 10.1371/journal.pone.0216221] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 04/16/2019] [Indexed: 12/14/2022] Open
Abstract
Background Reliable epidemiological data on Alzheimer's disease are scarce. However, these are necessary to adapt healthcare policy in terms of prevention, care and social needs related to this condition. To estimate the prevalence rate in the Alpes-Maritimes on the French Riviera, with a population of one million, we present a capture-recapture procedure applied to cases of Alzheimer’s disease, based on two epidemiological surveillance systems. Methods To estimate the total number of patients affected by Alzheimer's disease, a capture-recapture study included a cohort of patients with Alzheimer's disease or receiving medications only eligible for use for this condition, recorded by a specific health insurance information system (Health Insurance Cohort, HIC), and those registered in the French National Alzheimer’s Data Bank (“Banque Nationale Alzheimer”, BNA) in 2010 and 2011. We applied Bayesian estimation of the Mt ecological model, taking into account age and gender as covariates, i.e. factors of inhomogeneous catchability. Results Overall, 5,562 patients with Alzheimer's disease were recorded, of whom only 856 were common to both information systems. Mean age and F/M sex ratio differed between BNA and HIC surveillance systems, 81 vs 84 years and 2.7 vs 3.2, respectively. A Bayesian estimation, with age and gender as covariates, yields an estimate of 15,060 cases of Alzheimer's disease [95%HPDI: 14,490–15,630] in the Alpes-Maritimes. The completeness of the HIC and BNA databases were respectively of 25.4% and 17.2%. The estimated prevalence rate among the population over 65 years old was 6.3% in 2010–2011. Conclusions This study demonstrates that it is possible to determine the number of subjects affected by Alzheimer's disease in a geographical unit, using available data from two existing surveillance systems in France, i.e. 15,060 cases in the Alpes-Maritimes. This is the first stage of a population-based approach in view of adapting available resources to the population’s needs.
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17
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Mouton A, Blanc F, Gros A, Manera V, Fabre R, Sauleau E, Gomez-Luporsi I, Tifratene K, Friedman L, Thümmler S, Pradier C, Robert PH, David R. Sex ratio in dementia with Lewy bodies balanced between Alzheimer's disease and Parkinson's disease dementia: a cross-sectional study. ALZHEIMERS RESEARCH & THERAPY 2018; 10:92. [PMID: 30208961 PMCID: PMC6136211 DOI: 10.1186/s13195-018-0417-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 07/31/2018] [Indexed: 01/09/2023]
Abstract
Background Gender distribution varies across neurodegenerative disorders, with, traditionally, a higher female frequency reported in Alzheimer’s disease (AD) and a higher male frequency in Parkinson’s disease (PD). Conflicting results on gender distribution are reported concerning dementia with Lewy bodies (DLB), usually considered as an intermediate disease between AD and PD. The aim of the present study was to investigate gender differences in DLB in French specialized memory settings using data from the French national database spanning from 2010 to 2015 and to compare sex ratio in DLB with that in AD, Parkinson’s disease dementia (PDD), and PD. Our hypothesis was that there is a balanced sex ratio in DLB, different from that found in AD and PD. Methods We conducted a repeated cross-sectional study. The study population comprised individuals with a DLB, AD, PDD, or PD diagnosis according to the International Classification of Diseases, Tenth Revision, in the French National Alzheimer Database between 2010 and 2015. Sex ratio and demographic data were compared using multinomial logistic regression and a Bayesian statistical model. Results From 2010 to 2015 in French specialized memory settings, sex ratios (female percent/male percent) were found as follows: 1.21 (54.7%/45.3%) for DLB (n = 10,309), 2.34 (70.1%/29.9%) for AD (n = 135,664), 0.76 (43.1%/56.9%) for PD (n = 8744), and 0.83 (45.4%/54.6%) for PDD (n = 3198). Significant differences were found between each group, but not between PDD and PD, which had a similar sex ratio. Conclusions This large-sample prevalence study confirms the balanced gender distribution in the DLB population compared with AD and PD-PDD. Gender distribution and general demographic characteristics differed between DLB and PDD. This is consistent with the hypothesis that DLB is a distinct disease with characteristics intermediate between AD and PD, as well as with the hypothesis that DLB could have at least partially distinct neuropathological correlates.
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Affiliation(s)
- A Mouton
- Université Côte d'Azur, CobTeK lab, Nice, France. .,Centre Mémoire de Ressources et de Recherche, Institut Claude Pompidou, 10 rue Molière, 06100, Nice, France.
| | - F Blanc
- Geriatrics Department, University Hospitals of Strasbourg, CMRR (Research and Resources Memory Centre), Geriatric Day Hospital, Strasbourg, France.,University of Strasbourg and CNRS, ICube Laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), Team IMIS/Neurocrypto, Strasbourg, France
| | - A Gros
- Université Côte d'Azur, CobTeK lab, Nice, France
| | - V Manera
- Université Côte d'Azur, CobTeK lab, Nice, France
| | - R Fabre
- Université Côte d'Azur, CobTeK lab, Nice, France.,Centre Hospitalier Universitaire de Nice, Department of Public Health, L'Archet Hospital, Nice University Hospital, EA 6312, Nice, France
| | - E Sauleau
- University of Strasbourg and CNRS, ICube Laboratory UMR 7357, Strasbourg, France
| | | | - K Tifratene
- Université Côte d'Azur, CobTeK lab, Nice, France.,Antibes Hospital, Memory Center, Antibes, France
| | - L Friedman
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford University, Stanford, CA, USA
| | - S Thümmler
- Université Côte d'Azur, CobTeK lab, Nice, France.,Centre Hospitalier Universitaire de Nice, University Department of Child and Adolescent Psychiatry, Children's Hospitals CHU-Lenval, Nice, France
| | - C Pradier
- Centre Hospitalier Universitaire de Nice, Department of Public Health, L'Archet Hospital, Nice University Hospital, EA 6312, Nice, France
| | - P H Robert
- Université Côte d'Azur, CobTeK lab, Nice, France
| | - R David
- Université Côte d'Azur, CobTeK lab, Nice, France
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Damian D, Rouaud O, Draganski B, Brioschi-Guevara A, Bortolotti M, Laouadi MH, Demonet JF. Memory center. CLINICAL AND TRANSLATIONAL NEUROSCIENCE 2018. [DOI: 10.1177/2514183x18773482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Daniel Damian
- Centre Leenaards de la Mémoire, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Olivier Rouaud
- Centre Leenaards de la Mémoire, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Bogdan Draganski
- Laboratoire de Recherche en Neuroimagerie (LREN), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
- Max-Planck-Institut fur Kognitions- und Neurowissenschaften, Leipzig, Germany
| | - Andrea Brioschi-Guevara
- Centre Leenaards de la Mémoire, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Murielle Bortolotti
- Centre Leenaards de la Mémoire, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Marie-Helene Laouadi
- Centre Leenaards de la Mémoire, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Jean-François Demonet
- Centre Leenaards de la Mémoire, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Serrano-Pozo A, Aldridge GM, Zhang Q. Four Decades of Research in Alzheimer's Disease (1975-2014): A Bibliometric and Scientometric Analysis. J Alzheimers Dis 2018; 59:763-783. [PMID: 28671119 DOI: 10.3233/jad-170184] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Bibliometric and scientometric methods can be applied to the study of a research field. OBJECTIVE We hypothesized that a bibliometric and scientometric analysis of the Alzheimer's disease (AD) research field could render trends that provide researchers and funding agencies valuable insight into the history of the field, current tendencies, and potential future directions. METHODS We performed searches in publicly available databases including PubMed, Scopus, Web of Science, and Alzheimer's Funding Analyzer for the period 1975-2014, and conducted a curve fitting analysis with non-linear regression. RESULTS While the rate and impact of publications continue to increase, the number of patents per year is currently declining after peaking in the late 2000s, and the funding budget has plateaued in the last 5-10 years analyzed. Genetics is the area growing at a fastest pace, whereas pathophysiology and therapy have not grown further in the last decade. Among the targets of pathophysiology research, amyloid-β continues to be the focus of greatest interest, with tau and apolipoprotein E stagnant after a surge in the 1990s. The role of inflammation, microglia, and the synapse are other research topics with growing interest. Regarding preventative strategies, education attainment, diet, and exercise are recently gaining some momentum, whereas NSAIDs and statins have lost the spotlight they once had. CONCLUSION Our bibliometric and scientometric analysis provides distinct trends in AD research in the last four decades, including publication and patent output, funding, impact, and topics. Our findings could inform the decision-making of research funding agencies in the near future.
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Affiliation(s)
- Alberto Serrano-Pozo
- Department of Neurology, University of IowaHospitals and Clinics, Iowa City, IA, USA
| | - Georgina M Aldridge
- Department of Neurology, University of IowaHospitals and Clinics, Iowa City, IA, USA
| | - Qiang Zhang
- Department of Neurology, University of IowaHospitals and Clinics, Iowa City, IA, USA
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David R, Manera V, Fabre R, Pradier C, Robert P, Tifratene K. Evolution of the Antidepressant Prescribing in Alzheimer's Disease and Related Disorders Between 2010 and 2014: Results from the French National Database on Alzheimer's Disease (BNA). J Alzheimers Dis 2018; 53:1365-73. [PMID: 27392860 DOI: 10.3233/jad-160238] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Safety warnings from health authorities are currently intended to limit the use of psychotropic agents in dementia-related conditions. Evidence concerning the use of antidepressants in dementia is, however, scarce and contradictory. OBJECTIVE To evaluate antidepressant use among individuals with Alzheimer's disease (AD) and related disorders in the French population between 2010 and 2014. METHOD Antidepressant prescriptions in individuals with AD, mixed dementia (MD), and vascular dementia (VaD) in the French National Alzheimer Database between 2010 and 2014 were analyzed (N = 199,544). RESULTS Multivariate analysis showed an annual significant increase (p < 0.001) in the prescription rate of antidepressants from 26% (2010) to 31% (2014), and identified female gender, younger age, higher education, living in long-term facilities, more severe cognitive decline, and presence of vascular signs (VaD and MD) as associated factors for antidepressant prescribing. CONCLUSION The annual increase of antidepressant prescribing among individuals with AD, MD, and VaD in French specialized settings may be partially related to the lack of current valuable medications for dementia-related behavioral symptoms.
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Affiliation(s)
- Renaud David
- EA Cobtek, University of Nice Sophia-Antipolis, Nice, France.,Research Memory Centre, Nice University Hospital, Nice, France
| | - Valeria Manera
- EA Cobtek, University of Nice Sophia-Antipolis, Nice, France
| | - Roxane Fabre
- EA Cobtek, University of Nice Sophia-Antipolis, Nice, France.,Department of Public Health, L'Archet Hospital, Nice University Hospital, Nice, France
| | - Christian Pradier
- Department of Public Health, L'Archet Hospital, Nice University Hospital, Nice, France
| | - Philippe Robert
- EA Cobtek, University of Nice Sophia-Antipolis, Nice, France.,Research Memory Centre, Nice University Hospital, Nice, France
| | - Karim Tifratene
- EA Cobtek, University of Nice Sophia-Antipolis, Nice, France.,Department of Public Health, L'Archet Hospital, Nice University Hospital, Nice, France
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Dauphinot V, Mouchoux C, Veillard S, Delphin-Combe F, Krolak-Salmon P. Anticholinergic drugs and functional, cognitive impairment and behavioral disturbances in patients from a memory clinic with subjective cognitive decline or neurocognitive disorders. ALZHEIMERS RESEARCH & THERAPY 2017; 9:58. [PMID: 28764796 PMCID: PMC5540419 DOI: 10.1186/s13195-017-0284-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 07/04/2017] [Indexed: 12/14/2022]
Abstract
Background Drugs with anticholinergic properties may be associated with various adverse clinical effects. The relationship between the anticholinergic (AC) burden and functional, global cognitive performance and behavior disturbances was assessed among elderly patients. Methods A cross-sectional study was conducted between January 2012 and June 2014 in a memory clinic among outpatients living at home and with subjective cognitive decline (SCD) or neurocognitive disorders (NCD). The AC burden was measured using the Anticholinergic Drug Scale (ADS), the Anticholinergic Risk Scale (ARS), the Anticholinergic Cognitive Burden (ACB), Chew’s score, Han’s score, and the number of drugs with AC activity. Functional, cognitive performance and behavior disturbances were assessed using the Instrumental Activities of Daily Living (IADL) scale (IADL), the Mini Mental State Examination (MMSE), and the Neuropsychiatric Inventory (NPI). Results Among 473 included patients, 46.3% were at major NCD. Patients took on average 5.3 ± 2.6 drugs. MMSE was lower when Han’s score (p = 0.04) and number of AC drugs were higher (p < 0.001). IADL was lower when AC burden was higher, whatever the AC measurement. NPI was higher when ACB, Han’s score, and number of AC drugs were higher. After adjustment, all AC scores remained associated with IADL, while Han’s score and number of drugs with AC remained associated with the MMSE. Conclusions In patients with SCD or NCD, AC burden is associated with lower functional score, whereas the cross-sectional association between AC burden and cognitive performance or behavioral disturbance varies according to AC scores. Particular attention should be paid when prescribing drugs with AC properties, especially among patients with memory complaints.
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Affiliation(s)
- Virginie Dauphinot
- Centre Mémoire de Ressources et de Recherche (CMRR) de Lyon, Hôpital des Charpennes, Hospices Civils de Lyon, 27 rue Gabriel Péri, 69100, Villeurbanne, France. .,Centre de Recherche Clinique (CRC) - VCF (Vieillissement-Cerveau-Fragilité), Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne, France.
| | - Christelle Mouchoux
- Centre de Recherche Clinique (CRC) - VCF (Vieillissement-Cerveau-Fragilité), Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne, France.,Hospices Civils de Lyon, Groupement Hospitalier, Service pharmaceutique, Lyon, France.,Université Lyon 1, INSERM, U1028; UMR CNRS 5292, Centre de Recherche en Neurosciences de Lyon, Lyon, France
| | - Sébastien Veillard
- Centre Mémoire de Ressources et de Recherche (CMRR) de Lyon, Hôpital des Charpennes, Hospices Civils de Lyon, 27 rue Gabriel Péri, 69100, Villeurbanne, France
| | - Floriane Delphin-Combe
- Centre Mémoire de Ressources et de Recherche (CMRR) de Lyon, Hôpital des Charpennes, Hospices Civils de Lyon, 27 rue Gabriel Péri, 69100, Villeurbanne, France
| | - Pierre Krolak-Salmon
- Centre Mémoire de Ressources et de Recherche (CMRR) de Lyon, Hôpital des Charpennes, Hospices Civils de Lyon, 27 rue Gabriel Péri, 69100, Villeurbanne, France.,Centre de Recherche Clinique (CRC) - VCF (Vieillissement-Cerveau-Fragilité), Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne, France.,Université Lyon 1, INSERM, U1028; UMR CNRS 5292, Centre de Recherche en Neurosciences de Lyon, Lyon, France
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Barbay M, Taillia H, Nedelec-Ciceri C, Arnoux A, Puy L, Wiener E, Canaple S, Lamy C, Godefroy O, Roussel M. Vascular cognitive impairment: Advances and trends. Rev Neurol (Paris) 2017; 173:473-480. [DOI: 10.1016/j.neurol.2017.06.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 06/15/2017] [Indexed: 10/18/2022]
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Factors influencing time between onset of signs/symptoms and referral for dementia in elderly outpatients. Rev Neurol (Paris) 2017; 174:36-43. [PMID: 28595977 DOI: 10.1016/j.neurol.2017.05.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 03/09/2017] [Accepted: 04/27/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND The few studies that have focused on Time between Onset of Signs and Symptoms and Referral (TOSR) for dementia to a memory center suggest a substantial delay of 1-3 years. This delay has a negative impact on both patients' and their caregivers' quality of life. OBJECTIVE This study aimed to evaluate this delay and the factors associated with it in a cohort of community-dwelling elderly people attending a memory clinic, as well as assess the impact of the Third French National Alzheimer Plan (2008-2012). METHODS All patients referred to the Bretonneau Memory Clinic for the first time between January 2006 (the clinic has maintained a specific database since then) and March 2016 were included in the study. RESULTS Of the 8543 patients attending our Memory Clinic during the study period, 3353 attending for the first time and with complete data were included. Briefly, their ages were 82±7 years, and 67.2% were female; MMSE score was 21.2±6.6, IADL was 4.06±0.78 and the social-needs category of the Groupes Iso Ressources (GIR); Iso-Resource Group (IRG) scale was 4.04±0.37. The TOSR was, on average, 35.4±30.24 months, and increased after implementation of the Third French National Alzheimer Plan, from 26.68±26.28 months before 2009 to 40.08±31.2 months after 2009. Age and MMSE were associated with TOSR, but not the type of dementia, household composition and social characteristics. Also, there was a shorter TOSR for mild cognitive impairment than for dementia patients. CONCLUSION Our results emphasize the need for more education and information among the general public about the early signs of cognitive impairment, especially in elderly people.
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Tifratene K, Manera V, Fabre R, Gros A, Thummler S, Pradier C, Robert P, David R. Antipsychotic prescribing for Alzheimer's disease and related disorders in specialized settings from 2010 to 2014 in France: a repeated cross-sectional study. ALZHEIMERS RESEARCH & THERAPY 2017; 9:34. [PMID: 28446209 PMCID: PMC5405526 DOI: 10.1186/s13195-017-0256-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 03/24/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Safety warnings from health authorities are currently intended to limit the use of antipsychotics (APs) in dementia-related conditions to treat neuropsychiatric symptoms, such as disturbing and/or delusional behaviors. The aim of this study is to investigate prevalence, correlates and trends of AP prescribing among people with dementia between 2010 and 2014 in the French population. METHODS AP prescribing and associated factors among individuals with AD, mixed dementia and vascular dementia in the French National Alzheimer Database between 2010 and 2014 were analyzed using multivariate generalized estimating equations models (n = 199,549). RESULTS In 2014, 7.7% of people with dementia were prescribed an AP. Compared with 2010 there was a 16% increase in AP use. Multivariate analysis showed a linear increase risk of prescription with an adjusted odds ratio (95% confidence interval) of 1.23 (1.17-1.30) in 2014 compared with 2010. Factors associated with AP prescribing were male gender, more severe cognitive decline and living in long-term care facilities. Older age and higher education were protective toward AP prescribing. The type of dementia did not have any influence on AP prescribing. CONCLUSION An increase in AP prescribing among individuals with dementia in French specialized settings over the last 5 years occurred despite safety warnings. This phenomenon suggests that alternative solutions for the management of behavioral and psychiatric symptoms in these populations are still urgently needed.
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Affiliation(s)
- Karim Tifratene
- EA Cobtek, University of Nice Sophia-Antipolis, Nice, France.,Department of Public Health, L'Archet Hospital, Nice University Hospital, Nice, France
| | - Valeria Manera
- EA Cobtek, University of Nice Sophia-Antipolis, Nice, France
| | - Roxane Fabre
- EA Cobtek, University of Nice Sophia-Antipolis, Nice, France.,Department of Public Health, L'Archet Hospital, Nice University Hospital, Nice, France
| | - Auriane Gros
- EA Cobtek, University of Nice Sophia-Antipolis, Nice, France.,Research and Resources Memory Centre, Nice University Hospital, Nice, France
| | | | - Christian Pradier
- Department of Public Health, L'Archet Hospital, Nice University Hospital, Nice, France
| | - Philippe Robert
- EA Cobtek, University of Nice Sophia-Antipolis, Nice, France.,Research and Resources Memory Centre, Nice University Hospital, Nice, France
| | - Renaud David
- EA Cobtek, University of Nice Sophia-Antipolis, Nice, France. .,Research and Resources Memory Centre, Nice University Hospital, Nice, France. .,Present address: Centre Mémoire de Ressources et de Recherche, Institut Claude Pompidou, 10 rue Molière, 06100, Nice, France.
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GREFON recommendations for assessment of instrumental activities of daily living in memory clinics. Rev Neurol (Paris) 2017; 173:194-200. [DOI: 10.1016/j.neurol.2017.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 11/21/2016] [Accepted: 03/08/2017] [Indexed: 10/19/2022]
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Asghar I, Cang S, Yu H. Assistive technology for people with dementia: an overview and bibliometric study. Health Info Libr J 2017; 34:5-19. [DOI: 10.1111/hir.12173] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 01/08/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Ikram Asghar
- Faculty of Science and Technology; Bournemouth University (BU); Poole Dorset UK
| | - Shuang Cang
- Faculty of Management; Bournemouth University (BU); Poole Dorset UK
| | - Hongnian Yu
- Faculty of Science and Technology; Bournemouth University (BU); Poole Dorset UK
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Évolution de la prise en charge médicamenteuse de la maladie d’Alzheimer en EHPAD : impact de la campagne médiatique contre les médicaments spécifiques de la maladie d’Alzheimer. Encephale 2017; 43:21-26. [DOI: 10.1016/j.encep.2015.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 03/23/2015] [Indexed: 01/09/2023]
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Risk Factors of Caregiver Burden Evolution, for Patients With Subjective Cognitive Decline or Neurocognitive Disorders: A Longitudinal Analysis. J Am Med Dir Assoc 2016; 17:1037-1043. [PMID: 27575984 DOI: 10.1016/j.jamda.2016.07.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/29/2016] [Accepted: 07/06/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND/OBJECTIVES The identification of factors used to predict caregiver burden may help preventive care. This study aimed to assess the relationship between evolution of patients with subjective cognitive decline (SCD) or progressive neurocognitive disorder (NCD) and evolution of caregiver burden. DESIGN Observational, longitudinal study. SETTING The study was conducted in the Clinical and Research Memory Center of the University Hospital of Lyon (France), between the November 1, 2011 and the June 30, 2014, with a maximum follow-up of 30 months. PARTICIPANTS The study population included outpatients with SCD or NCD at all stages, and their informal caregiver. MEASUREMENTS The caregiver burden was assessed during 2 visits of the patients and their caregiver, with the short version of the Zarit Burden Inventory (ZBI). Functional, cognitive performance, and behavioral and psychological symptoms were measured twice, concomitantly with the ZBI, using the Instrumental Activities of Daily Living (IADL) scale, the Mini-Mental State Examination (MMSE), and the Neuropsychiatric Inventory (NPI), respectively. Etiology and stage of the cognitive impairment were collected. RESULTS The population study included 222 patients (mean age at inclusion: 80 years old, 62.9% females), with an average follow-up 12.6 ± 6 months. Proportion of patients with major NCD at the second visit (62.2%) increased compared with inclusion (50.0%). MMSE and IADL decreased between the 2 visits (P < .001), whereas ZBI increased (mean ZBI: 3.2 ± 2 at baseline, mean ZBI: 3.8 ± 2 at follow-up, P < .001). In unadjusted analyses, ZBI tended to be higher for patients whose MMSE decreased of at least 3 points between the visits. ZBI increased over time when IADL decreased (P value for within-patient effect <.001), while it remained stable when the IADL increased. ZBI increased when NPI increased. After mutual adjustment for change of MMSE, IADL, NPI, and etiologies, increase of ZBI over time remained significant when MMSE decreased at least 3 points between baseline and follow-up, when IADL decreased, and when NPI increased of at least 4 points. CONCLUSIONS In a study population of patients with SCD or NCD at all stages, concomitant decrease of cognitive performance, increase of functional impairment, and increase neuropsychiatric symptoms over time were independently associated with increased caregiver burden. The identification of risk factors associated with an increased caregiver burden over time may allow a better evaluation of the impact of specific interventions on cognitive, behavioral, and functional dimensions of NCD on caregivers. TRIAL REGISTRATION ClinicalTrials.govNCT02825732.
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Paquet C, Magnin E, Wallon D, Troussière AC, Dumurgier J, Jager A, Bellivier F, Bouaziz-Amar E, Blanc F, Beaufils E, Miguet-Alfonsi C, Quillard M, Schraen S, Pasquier F, Hannequin D, Robert P, Hugon J, Mouton-Liger F. Utility of CSF biomarkers in psychiatric disorders: a national multicentre prospective study. ALZHEIMERS RESEARCH & THERAPY 2016; 8:27. [PMID: 27357952 PMCID: PMC4928321 DOI: 10.1186/s13195-016-0192-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 05/16/2016] [Indexed: 12/27/2022]
Abstract
Background Affective and psychotic disorders are mental or behavioural patterns resulting in an inability to cope with life’s ordinary demands and routines. These conditions can be a prodromal event of Alzheimer’s disease (AD). The prevalence of underlying AD lesions in psychiatric diseases is unknown, and it would be helpful to determine them in patients. AD cerebrospinal fluid (CSF) biomarkers (amyloid β, tau and phosphorylated tau) have high diagnostic accuracy, both for AD with dementia and to predict incipient AD (mild cognitive impairment due to AD), and they are sometimes used to discriminate psychiatric diseases from AD. Our objective in the present study was to evaluate the clinical utility of CSF biomarkers in a group of patients with psychiatric disease as the main diagnosis. Methods In a multicentre prospective study, clinicians filled out an anonymous questionnaire about all of their patients who had undergone CSF biomarker evaluation. Before and after CSF biomarker results were obtained, clinicians provided a diagnosis with their level of confidence and information about the treatment. We included patients with a psychiatric disorder as the initial diagnosis. In a second part of the study conducted retrospectively in a followed subgroup, clinicians detailed the psychiatric history and we classified patients into three categories: (1) psychiatric symptoms associated with AD, (2) dual diagnosis and (3) cognitive decline not linked to a neurodegenerative disorder. Results Of 957 patients, 69 had an initial diagnosis of a psychiatric disorder. Among these 69 patients, 14 (20.2 %) had a CSF AD profile, 5 (7.2 %) presented with an intermediate CSF profile and 50 (72.4 %) had a non-AD CSF profile. Ultimately, 13 (18.8 %) patients were diagnosed with AD. We show that in the AD group psychiatric symptoms occurred later and the delay between the first psychiatric symptoms and the cognitive decline was shorter. Conclusions This study revealed that about 20 % of patients with a primary psychiatric disorder diagnosis before undergoing a CSF exploration for cognitive disorder displayed a CSF biomarker AD profile. In memory clinics, it seems important to consider AD as a possible diagnosis before finalizing a diagnosis of a psychiatric disorder.
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Affiliation(s)
- Claire Paquet
- INSERM UMR-S942 Université Paris Diderot, 75010, Paris, France. .,Centre Mémoire (CMRR) Paris Nord Ile de France, Groupe Hospitalier Lariboisiere FW Saint-Louis, APHP, Université Paris Diderot, 200, rue du Faubourg Saint Denis, 75010, Paris, France. .,Unité d'Histologie et de Biologie du Vieillissement, Groupe Hospitalier Lariboisiere FW Saint Louis APHP, Université Paris Diderot, 75010, Paris, France.
| | - Eloi Magnin
- Centre Mémoire (CMRR) de Besançon, Hôpital Universitaire de Besançon, 25000, Besançon, France
| | - David Wallon
- Centre Mémoire (CMRR) and INSERM UMR1079, Hôpital Universitaire de Rouen, 76000, Rouen, France
| | - Anne-Cécile Troussière
- Centre Mémoire (CMRR) de Lille, Université Lille Nord de France, UDSL, 59000, Lille, France
| | - Julien Dumurgier
- INSERM UMR-S942 Université Paris Diderot, 75010, Paris, France.,Centre Mémoire (CMRR) Paris Nord Ile de France, Groupe Hospitalier Lariboisiere FW Saint-Louis, APHP, Université Paris Diderot, 200, rue du Faubourg Saint Denis, 75010, Paris, France.,Unité d'Histologie et de Biologie du Vieillissement, Groupe Hospitalier Lariboisiere FW Saint Louis APHP, Université Paris Diderot, 75010, Paris, France
| | - Alain Jager
- Centre de Neurologie, 6 place Luxembourg, 57100, Thionville, France
| | - Frank Bellivier
- INSERM UMR-S1144 and Service de Psychiatrie, Groupe Hospitalier Lariboisiere FW Saint-Louis, APHP, Université Paris Diderot, 75010, Paris, France
| | - Elodie Bouaziz-Amar
- Service de Biochimie, Groupe Hospitalier Lariboisiere FW Saint-Louis, APHP, Université Paris Diderot, 75010, Paris, France
| | - Frédéric Blanc
- Université de Strasbourg, CNRS, Laboratoire ICube UMR 7357 and Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000, Strasbourg, France.,Centre Mémoire (CMRR), Hôpital Universitaire de Strasbourg, Département de Gériatrie, Hôpital de Jour Gériatrique, 67000, Strasbourg, France
| | - Emilie Beaufils
- Centre Mémoire (CMRR) de Tours, Hôpital Universitaire Tours, 37000, Tours, France
| | | | - Muriel Quillard
- Service de Biochimie, Hôpital Universitaire de Rouen, 76000, Rouen, France
| | - Susanna Schraen
- Université Lille, CHU-Lille, Inserm, UF de Neurobiologie, CBPG, Lille, France
| | - Florence Pasquier
- Centre Mémoire (CMRR) de Lille, Université Lille Nord de France, UDSL, 59000, Lille, France
| | - Didier Hannequin
- Centre Mémoire (CMRR) and INSERM UMR1079, Hôpital Universitaire de Rouen, 76000, Rouen, France
| | - Philippe Robert
- CMRR COBTEK research unit, Université de Nice Sophia Antipolis, 06100, Nice, France
| | - Jacques Hugon
- INSERM UMR-S942 Université Paris Diderot, 75010, Paris, France.,Centre Mémoire (CMRR) Paris Nord Ile de France, Groupe Hospitalier Lariboisiere FW Saint-Louis, APHP, Université Paris Diderot, 200, rue du Faubourg Saint Denis, 75010, Paris, France.,Unité d'Histologie et de Biologie du Vieillissement, Groupe Hospitalier Lariboisiere FW Saint Louis APHP, Université Paris Diderot, 75010, Paris, France
| | - François Mouton-Liger
- INSERM UMR-S942 Université Paris Diderot, 75010, Paris, France.,Centre Mémoire (CMRR) Paris Nord Ile de France, Groupe Hospitalier Lariboisiere FW Saint-Louis, APHP, Université Paris Diderot, 200, rue du Faubourg Saint Denis, 75010, Paris, France
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Dauphinot V, Ravier A, Novais T, Delphin-Combe F, Moutet C, Xie J, Mouchoux C, Krolak-Salmon P. Relationship Between Comorbidities in Patients With Cognitive Complaint and Caregiver Burden: A Cross-Sectional Study. J Am Med Dir Assoc 2016; 17:232-7. [DOI: 10.1016/j.jamda.2015.10.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 10/13/2015] [Accepted: 10/14/2015] [Indexed: 11/28/2022]
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Anthony S, Pradier C, Chevrier R, Festraëts J, Tifratene K, Robert P. The French National Alzheimer database: a fast growing database for researchers and clinicians. Dement Geriatr Cogn Disord 2015; 38:271-80. [PMID: 24994018 DOI: 10.1159/000360281] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/03/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is a major public health issue. The French National Alzheimer database (BNA) registers all medical acts performed by memory units and independent specialists throughout France. This article describes the national coverage, the registered patient characteristics and illustrates research possibilities. METHODS All data transmitted up to December 2012 were analyzed. The following patient characteristics were studied: age, sex, educational level, place of living, diagnosis, Mini-Mental State Examination score and existence of pharmacological or psychosocial interventions. RESULTS At the end of 2012, the BNA included 84% (n = 357) of all French memory units, contained 341,498 patients and more than 800,000 medical acts. AD accounted for 26.4% of all registered diagnoses, related disorders for 21.7% and mild cognitive impairment for 8.7%. CONCLUSION The BNA offers a multitude of research possibilities. In the coming years, the BNA will play a major role in monitoring trends and related risk factors in AD.
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Affiliation(s)
- Sabine Anthony
- Department of Public Health, Nice University Hospital, Nice, France
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Jacquin-Piques A, Sacco G, Tavassoli N, Rouaud O, Bejot Y, Giroud M, Robert P, Vellas B, Bonin-Guillaume S. Psychotropic Drug Prescription in Patients with Dementia: Nursing Home Residents Versus Patients Living at Home. J Alzheimers Dis 2015; 49:671-80. [DOI: 10.3233/jad-150280] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Agnès Jacquin-Piques
- University Hospital of Dijon, Centre Mémoire de Ressources et de Recherches, Department of Neurology, Dijon, France
| | - Guillaume Sacco
- Centre Mémoire de Ressource et de Recherche, EA CoBTeK, Université de Nice Sophia-Antipolis, Nice, France
| | - Neda Tavassoli
- Gérontopôle de Toulouse, Département de Médecine Interne et Gérontologie Clinique, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Olivier Rouaud
- University Hospital of Dijon, Centre Mémoire de Ressources et de Recherches, Department of Neurology, Dijon, France
| | - Yannick Bejot
- University Hospital of Dijon, Centre Mémoire de Ressources et de Recherches, Department of Neurology, Dijon, France
| | - Maurice Giroud
- University Hospital of Dijon, Centre Mémoire de Ressources et de Recherches, Department of Neurology, Dijon, France
| | - Philippe Robert
- Centre Mémoire de Ressource et de Recherche, EA CoBTeK, Université de Nice Sophia-Antipolis, Nice, France
| | - Bruno Vellas
- Gérontopôle de Toulouse, Département de Médecine Interne et Gérontologie Clinique, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Sylvie Bonin-Guillaume
- University Hospital AP-HM, Department of Internal Medicine and Geriatrics, Aix Marseille University, Marseille, France
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Bereau M, Sylvestre G, Mauny F, Puyraveau M, Baudier F, Magnin E, Berger E, Vandel P, Galmiche J, Chopard G. [Assessment of 10 years of memory consultations in the Franche-Comté: Description and analysis of the RAPID regional database]. Rev Neurol (Paris) 2015. [PMID: 26212200 DOI: 10.1016/j.neurol.2015.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aim of this study was to evaluate the impact, on a regional scale (Franche-Comté), of 3 National Alzheimer care plans, particularly concerning the development of the offer of care management by clinicians as well as the panel of diagnoses concerned. Data on sociodemographic, neuropsychological and diagnostic characteristics were retrieved from the RAPID regional database between 1st January 2003 and 31st December 2012. These analyses focused exclusively on patients who had an initial consultation (n=12,017) during the same period. The existence of a previously established health network capable of carrying out governmental health plans has produced an effective interface between regional administrative structures responsible for the implementation of these plans and health professionals responsible for carrying out them out. This network study, the use of a battery of tests and a common software database have enabled the development of patient care management throughout the Franche-Comté region. It also showed the diversification of diagnoses mentioned over the past years as well as changes in clinical practices on how to address the issue of cognitive impairment.
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Affiliation(s)
- M Bereau
- Service de neurologie générale, CHRU de Besançon, boulevard Fleming, 25000 Besançon, France; Service de neurologie, centre mémoire de ressources et de recherche (CMRR) de Franche-Comté, CHRU de Besançon, boulevard Fleming, 25000 Besançon, France; Réseau d'aide au diagnostic et à la prise en charge des détériorations cognitives et de maladies neurologiques chroniques en Franche-Comté et niveau national (RAPID-fr-nat), 3 et 5, place des lumières, 100, rue de Chalezeule, 25000 Besançon, France
| | - G Sylvestre
- Service de neurologie générale, CHRU de Besançon, boulevard Fleming, 25000 Besançon, France; Service de neurologie, centre mémoire de ressources et de recherche (CMRR) de Franche-Comté, CHRU de Besançon, boulevard Fleming, 25000 Besançon, France; Réseau d'aide au diagnostic et à la prise en charge des détériorations cognitives et de maladies neurologiques chroniques en Franche-Comté et niveau national (RAPID-fr-nat), 3 et 5, place des lumières, 100, rue de Chalezeule, 25000 Besançon, France
| | - F Mauny
- Service de psychiatrie de l'adulte, CHRU de Besançon, boulevard Fleming, 25000 Besançon, France; UMR 6249, laboratoire chrono-environnement, CNRS, université de Franche-Comté, université Bourgogne Franche-Comté, 16, route de Gray, 25000 Besançon, France
| | - M Puyraveau
- Centre de méthodologie clinique, CHRU de Besançon, place St.-Jacques, 25000 Besançon, France
| | - F Baudier
- Agence régionale de santé région Franche-Comté, 3, avenue Louise-Michel, 25000 Besançon, France
| | - E Magnin
- Service de neurologie générale, CHRU de Besançon, boulevard Fleming, 25000 Besançon, France; Service de neurologie, centre mémoire de ressources et de recherche (CMRR) de Franche-Comté, CHRU de Besançon, boulevard Fleming, 25000 Besançon, France; Réseau d'aide au diagnostic et à la prise en charge des détériorations cognitives et de maladies neurologiques chroniques en Franche-Comté et niveau national (RAPID-fr-nat), 3 et 5, place des lumières, 100, rue de Chalezeule, 25000 Besançon, France; EA 481, laboratoire neurosciences intégratives et cliniques, université de Franche-Comté, université Bourgogne Franche-Comté, 2, place Leclerc, 25000 Besançon, France
| | - E Berger
- Service de neurologie générale, CHRU de Besançon, boulevard Fleming, 25000 Besançon, France; Service de neurologie, centre mémoire de ressources et de recherche (CMRR) de Franche-Comté, CHRU de Besançon, boulevard Fleming, 25000 Besançon, France; Réseau d'aide au diagnostic et à la prise en charge des détériorations cognitives et de maladies neurologiques chroniques en Franche-Comté et niveau national (RAPID-fr-nat), 3 et 5, place des lumières, 100, rue de Chalezeule, 25000 Besançon, France
| | - P Vandel
- Service de neurologie, centre mémoire de ressources et de recherche (CMRR) de Franche-Comté, CHRU de Besançon, boulevard Fleming, 25000 Besançon, France; Service de psychiatrie de l'adulte, CHRU de Besançon, boulevard Fleming, 25000 Besançon, France; Réseau d'aide au diagnostic et à la prise en charge des détériorations cognitives et de maladies neurologiques chroniques en Franche-Comté et niveau national (RAPID-fr-nat), 3 et 5, place des lumières, 100, rue de Chalezeule, 25000 Besançon, France; EA 481, laboratoire neurosciences intégratives et cliniques, université de Franche-Comté, université Bourgogne Franche-Comté, 2, place Leclerc, 25000 Besançon, France
| | - J Galmiche
- Service de neurologie générale, CHRU de Besançon, boulevard Fleming, 25000 Besançon, France; Service de neurologie, centre mémoire de ressources et de recherche (CMRR) de Franche-Comté, CHRU de Besançon, boulevard Fleming, 25000 Besançon, France; Réseau d'aide au diagnostic et à la prise en charge des détériorations cognitives et de maladies neurologiques chroniques en Franche-Comté et niveau national (RAPID-fr-nat), 3 et 5, place des lumières, 100, rue de Chalezeule, 25000 Besançon, France
| | - G Chopard
- Service de neurologie, centre mémoire de ressources et de recherche (CMRR) de Franche-Comté, CHRU de Besançon, boulevard Fleming, 25000 Besançon, France; Service de psychiatrie de l'adulte, CHRU de Besançon, boulevard Fleming, 25000 Besançon, France; Réseau d'aide au diagnostic et à la prise en charge des détériorations cognitives et de maladies neurologiques chroniques en Franche-Comté et niveau national (RAPID-fr-nat), 3 et 5, place des lumières, 100, rue de Chalezeule, 25000 Besançon, France; EA 481, laboratoire neurosciences intégratives et cliniques, université de Franche-Comté, université Bourgogne Franche-Comté, 2, place Leclerc, 25000 Besançon, France.
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Tifratene K, Robert P, Metelkina A, Pradier C, Dartigues JF. Progression of mild cognitive impairment to dementia due to AD in clinical settings. Neurology 2015; 85:331-8. [PMID: 26136516 DOI: 10.1212/wnl.0000000000001788] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 03/26/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To describe the positive predictive value of mild cognitive impairment (MCI) and the factors associated with progression in routine practice. METHODS A retrospective cohort study was conducted from the French National Alzheimer Database. Among 446,439 patients cared for in the participating centers between January 2009 and January 2014, 45,386 (10.2%) were classified as having MCI and 23,676 had at least one follow-up visit. Annual progression rate was used to describe the progression of patients with MCI to dementia due to Alzheimer disease. Hazard ratios of dementia due to Alzheimer disease were estimated using Cox regression model. RESULTS Annual progression rate (95% confidence interval) was 13.7% person-years (py) (13.5%-13.9%) with higher rate for amnestic MCI (aMCI) (18.2% py [17.9%-18.5%]) than for nonamnestic MCI (naMCI) (9.5% py [9.3%-9.6%]). Separate regression models were performed for each MCI subtype. Higher education, older age, female sex, and lower Mini-Mental State Examination score were associated with an increased risk of progression for both subtypes. Use of anxiolytics (adjusted hazard ratio [95% confidence interval]: 0.77 [0.66-0.91]) was a protective factor for aMCI whereas antidepressant drugs (1.16 [1.04-1.29]) were associated with an increased risk. For naMCI, prescriptions of antidepressants (0.85 [0.74-0.98]) and antipsychotics (0.55 [0.32-0.93]) were protective for progression. CONCLUSIONS Under circumstances emulating routine clinical practice, the positive predictive value of an MCI diagnosis is in line with previous clinical studies and the external validity of the concept is strengthened. Distinguishing between aMCI and naMCI is particularly relevant.
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Affiliation(s)
- Karim Tifratene
- From the Department of Public Health (K.T.) and CMRR de Nice (P.R.), CHU de Nice and EA Cobtek, Université de Nice Sophia Antipolis, Nice; Laboratoire d'Informatique (A.M.), Signaux et Systèmes de Sophia-Antipolis (I3S), UMR 7271, UNS CNRS; Department of Public Health (C.P.), CHU de Nice; and ISPED (J.F.D.), Université de Bordeaux, INSERM U897, France.
| | - Philippe Robert
- From the Department of Public Health (K.T.) and CMRR de Nice (P.R.), CHU de Nice and EA Cobtek, Université de Nice Sophia Antipolis, Nice; Laboratoire d'Informatique (A.M.), Signaux et Systèmes de Sophia-Antipolis (I3S), UMR 7271, UNS CNRS; Department of Public Health (C.P.), CHU de Nice; and ISPED (J.F.D.), Université de Bordeaux, INSERM U897, France
| | - Asya Metelkina
- From the Department of Public Health (K.T.) and CMRR de Nice (P.R.), CHU de Nice and EA Cobtek, Université de Nice Sophia Antipolis, Nice; Laboratoire d'Informatique (A.M.), Signaux et Systèmes de Sophia-Antipolis (I3S), UMR 7271, UNS CNRS; Department of Public Health (C.P.), CHU de Nice; and ISPED (J.F.D.), Université de Bordeaux, INSERM U897, France
| | - Christian Pradier
- From the Department of Public Health (K.T.) and CMRR de Nice (P.R.), CHU de Nice and EA Cobtek, Université de Nice Sophia Antipolis, Nice; Laboratoire d'Informatique (A.M.), Signaux et Systèmes de Sophia-Antipolis (I3S), UMR 7271, UNS CNRS; Department of Public Health (C.P.), CHU de Nice; and ISPED (J.F.D.), Université de Bordeaux, INSERM U897, France
| | - Jean François Dartigues
- From the Department of Public Health (K.T.) and CMRR de Nice (P.R.), CHU de Nice and EA Cobtek, Université de Nice Sophia Antipolis, Nice; Laboratoire d'Informatique (A.M.), Signaux et Systèmes de Sophia-Antipolis (I3S), UMR 7271, UNS CNRS; Department of Public Health (C.P.), CHU de Nice; and ISPED (J.F.D.), Université de Bordeaux, INSERM U897, France
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Krolak-Salmon P, Xie J. Malattia a corpi di Lewy. Neurologia 2014. [DOI: 10.1016/s1634-7072(14)68870-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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The mini mental state examination at the time of Alzheimer's disease and related disorders diagnosis, according to age, education, gender and place of residence: a cross-sectional study among the French National Alzheimer database. PLoS One 2014; 9:e103630. [PMID: 25093735 PMCID: PMC4122367 DOI: 10.1371/journal.pone.0103630] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 07/03/2014] [Indexed: 01/29/2023] Open
Abstract
The aim of this study was firstly to describe the MMSE (Mini-Mental State Examination) score upon initial diagnosis of Alzheimer's disease and related disorders among the French population, according to age. Secondly, education, gender and place of residence were studied as factors potentially associated with delayed Alzheimer's disease diagnosis. Design we conducted a cross sectional analysis of the French National Alzheimer database (BNA). Data from 2008 to 2012 were extracted. Patients were selected at the moment of their first diagnosis of AD (n = 39,451). Results The MMSE score at initial diagnosis dropped significantly with increasing age. The test score increased with the degree of educational background regardless of age. Gender and place of residence were significantly related to the MMSE score, women and persons living in medical institutions having lower MMSE scores under the age of 90 years and at all educational levels. Conclusions Health care professionals should be aware of these risk factors in order to maximize chances of earliest possible diagnosis of Alzheimer's disease and related disorders.
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Affiliation(s)
- Patrick Devos
- Department of Research, Lille University Hospital, Lille, France
| | | | | | | | - Joël Ménard
- Fondation Plan Alzheimer, 75013 Paris, France.
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Gervès C, Chauvin P, Bellanger MM. Evaluation of full costs of care for patients with Alzheimer's disease in France: The predominant role of informal care. Health Policy 2014; 116:114-22. [PMID: 24461717 DOI: 10.1016/j.healthpol.2014.01.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 11/30/2013] [Accepted: 01/01/2014] [Indexed: 11/26/2022]
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Impact of cerebro-spinal fluid biomarkers of Alzheimer’s disease in clinical practice: a multicentric study. J Neurol 2013; 261:144-51. [PMID: 24162039 DOI: 10.1007/s00415-013-7160-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 10/12/2013] [Indexed: 10/26/2022]
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Vannier-Nitenberg C, Dauphinot V, Bongue B, Sass C, Rouch I, Beauchet O, Krolak-Salmon P, Fantino B. Early detection of memory impairment in people over 65 years old consulting at Health Examination Centers for the French health insurance: the EVATEM protocol. BMC Geriatr 2013; 13:55. [PMID: 23742705 PMCID: PMC3681660 DOI: 10.1186/1471-2318-13-55] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Accepted: 04/20/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Only half of those living with Alzheimer's disease in France are currently diagnosed, and only one patient in three is supported during the early stages of dementia. This study aims to evaluate three cognitive tests for their predictive ability to diagnose mild cognitive impairments and Alzheimer's disease and related disorders. For people aged 65 years or over, presenting with a memory complaint, these tests can be performed easily during a preventative consultation. METHOD/DESIGN The EVATEM (évaluation des troubles de l'équilibre et de la mémoire (evaluation of balance and memory problems)) cohort study was designed to prospectively assess the predictive value of tests for the diagnosis of mild cognitive impairments and Alzheimer's disease in elderly subjects aged 65 years or over. Subjects were recruited from three health examination centers that are part of the French health insurance system. If a memory complaint was identified (using a dedicated questionnaire), the five-word test, the cognitive disorders examination test and the verbal fluency test were administered during a preventative consultation. A memory consultation was performed at a University Hospital to diagnosis any potential cognitive disorder and a one-year follow-up consultation was also scheduled. We recorded 2041 cases of memory complaint at our Health Examination Centers. Cognitive tests were refused by 33.6% of people who had a memory complaint. The number of subjects sent to a University Hospital memory consultation was 832 and 74.5% of them completed this consultation. The study population therefore includes 620 subjects. DISCUSSION Tests for the early diagnosis of a mild cognitive impairment or Alzheimer's disease and related disorders should be used in centers dedicated to disease prevention. These should guide subjects with memory impairment to full memory consultations at hospitals and improve the access to early medical and behavioral support. TRIAL REGISTRATION ClinicalTrials.gov:NCT01316562.
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Affiliation(s)
| | - Virginie Dauphinot
- Centre Mémoire de Ressources et de Recherche (CMRR) Lyon, Hôpital des Charpennes, Hospices civils de Lyon, Lyon, France
| | - Bienvenu Bongue
- Centre Technique d’Appui et de Formation des Centres d’Examens de Santé (CETAF), Saint-Étienne, France
- Laboratory EA4607 SNA-EPIS, Jean Monnet University of Saint-Etienne, PRES Lyon, Saint-Etienne, France
| | - Catherine Sass
- Centre Technique d’Appui et de Formation des Centres d’Examens de Santé (CETAF), Saint-Étienne, France
| | - Isabelle Rouch
- Centre Mémoire de Ressources et de Recherche (CMRR) Lyon, Hôpital des Charpennes, Hospices civils de Lyon, Lyon, France
| | - Olivier Beauchet
- Centre Technique d’Appui et de Formation des Centres d’Examens de Santé (CETAF), Saint-Étienne, France
- Département de Médecine Interne et Gérontologie clinique, CHU D’Angers, Angers, France
| | - Pierre Krolak-Salmon
- Centre Mémoire de Ressources et de Recherche (CMRR) Lyon, Hôpital des Charpennes, Hospices civils de Lyon, Lyon, France
- Inserm U1028; CNRS UMR5292; Lyon Neuroscience Research Center, Brain Dynamics and Cognition Team, Lyon, France
- University Lyon 1, Lyon, France
| | - Bruno Fantino
- Département de Médecine Interne et Gérontologie clinique, CHU D’Angers, Angers, France
- Direction de la Performance et de la Gestion des Risques- Agence Régionale de santé de Lorraine, Nancy, France
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Tifratene K, Duff FL, Pradier C, Quetel J, Lafay P, Schück S, Benzenine E, Quantin C, Robert P. Use of drug treatments for Alzheimer's disease in France: a study on a national level based on the National Alzheimer's Data Bank (Banque Nationale Alzheimer). Pharmacoepidemiol Drug Saf 2012; 21:1005-12. [PMID: 22718684 DOI: 10.1002/pds.3303] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Revised: 03/30/2012] [Accepted: 05/08/2012] [Indexed: 11/07/2022]
Abstract
PURPOSE To examine the way in which specific drug treatments for Alzheimer's disease are used and whether their use complies with clinical practice guidelines issued by the French National Authority for Health in patients with Alzheimer's disease. METHODS We analysed a cross-section of the French National Alzheimer's databank (BNA). Participants were individuals who consulted centres contributing to the BNA in 2010 and diagnosed with Alzheimer's disease and with at least one Mini Mental State Examination (MMSE) score recorded during the course of the year. RESULTS Of 191, 919 consultations recorded in the database, 29.9% involved a diagnosis of Alzheimer's disease, and 26, 809 patients had completed at least one MMSE. In 76.9% of cases, treatment was given with an anti-Alzheimer's drug. Monotherapy with an acetylcholinesterase inhibitor was prescribed for 48.3% of patients, monotherapy with memantine in 14.2% and dual therapy in 14.4% of cases. Treatment given did not comply with the guidelines in 20.7% of cases. Prescriptions not complying with the guidelines were associated with a lower mean MMSE score (13.6 vs. 18.0; p < 0.00001) and more cases of treatment with antidepressants (29.2% vs. 22.8%; p < 0.00001), anxiolytics (14.7% vs. 12.3%; p < 0.00001) and antipsychotics (8.7% vs. 4.9%; p < 0.00001). CONCLUSION Four of five prescriptions for treatment with anti-Alzheimer's drugs complied with the specific drug treatment chapter of the 2008 French clinical guidelines. Prescriptions not complying with the guidelines for acetylcholinesterase inhibitors and memantine were usually issued in situations involving advanced-stage Alzheimer's disease. The BNA can provide precise information on medical practice in Alzheimer's disease and related disorders.
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