Biomedical subjects

C Fabrigoule

Publications and source records attributed to C Fabrigoule.

24 records · Page 2Linked to original sources

PubMed1997

Disability and cognitive impairment in the elderly.

Disability and cognitive impairment show similar patterns of increasing frequency with ageing. A review of the published literature shows that there is a cross-sectional relationship between cognitive impairment and disability, independent of demographic, medical, and lifestyle factors. Some instrumental activities of daily living (IADL) items appear more specifically related to cognitive impairment, but cognition and functional impairment are distinct concepts requiring separate assessments. Subjects with low cognitive performances are at higher risk of functional impairment in the following years. Cognitive impairment as well as disability increase the risk of death and institutionalization. Preventive strategies could be directed against the risk factors of cognitive impairment and disability, and would aim to delay the onset of dementia. Prevention of disability associated with cognitive impairment needs further assessment in elderly community-dwellers. Further research is needed to better identify the specific areas cognition involved in the disablement process.

Activities of Daily Living↗

PubMed1997

[Longitudinal study of cognitive aging in non-demented elderly subjects].

BACKGROUND: The aim of this study is to describe and compare the course of the score of two psychometric tests during a five-year period in a cohort of non-demented elderly subjects. We studied a timed test of simple logical reasoning (the Digit Symbol Substitution Test of Wechsler) and a test of short-term visual memory (the Benton Visual Retention Test). Then we compared the course of these two tests with the course of the Mini-Mental State Examination (MMSE) which evaluates the general cognitive functioning and which has been studied previously. METHODS: The sample consisted of 2792 subjects aged 65 years and older living at home at the beginning of the study (the Paquid cohort in Gironde). Subjects were interviewed at home by a psychologist at the baseline visit and one year, 3 years and 5 years after the baseline visit. All subjects who were diagnosed as demented at any of the four examinations were excluded from this study (218 subjects). The statistical analysis was performed using a mixed effects linear model and an additional analysis was performed to study sensitivity of the results to hypotheses regarding missing data mechanism. RESULTS: Among the three tests studied, only the score of the Digit Symbol Substitution Test declined over the five years (by -1.15 points for subjects aged 65 years to -3.4 points for subjects aged 85 years). We observed an improvement of the score between the first two visits which is sharper for the test of Benton and the MMSE than for the Digit Symbol Substitution Test and which reflects a stress effect at the baseline visit or a learning effect at the second visit. The difference between the cross-sectional measure of age effect and the longitudinal measure of time effect suggests either a cohort effect or a practice effect which would persist during the five years. CONCLUSIONS: The cognitive change in a non-demented elderly population is different according to the psychometric test used. Among the three tests studied, only the score of the Digit Symbol Substitution Test which has a a speed component declined over the five years.

Age Factors↗

PubMed1995

Social and leisure activities and risk of dementia: a prospective longitudinal study.

OBJECTIVE: To study the relationship between social and leisure activities and risk of subsequent dementia in older community residents. SETTING: A cohort study of people aged 65 and older were followed-up 1 and 3 years after a baseline screening (the Paquid study). PARTICIPANTS: 2040 older subjects living at home in Gironde (France) were randomly selected and followed for at least 3 years. DATA COLLECTION: Information about social and leisure activities was collected during the baseline screening with an interview by a psychologist. Incident cases of dementia were detected during the first and third year follow-up screenings according to the DSM-III-R criteria. MAIN RESULTS: All but one of the social and leisure activities noted were significantly associated with a lower risk of dementia. Only golden club participation was not significantly associated with this risk. After adjustment for age and cognitive performance measured by the Mini-Mental State Exam, visual memory test, and verbal fluency test, only traveling (Relative risk (RR) = .48,95% Confidence Interval (95% CI) = .24-.94), odd jobs or knitting (RR = .46,95% CI = .26-.85), and gardening (RR = .53, 95% CI = .28-.99) remained significant. CONCLUSIONS: Regular participation in social or leisure activities such as traveling, odd jobs, knitting, or gardening were associated with a lower risk of subsequent dementia.

Aged↗

PubMedDate not supplied

Deterioration of controlled processes in the preclinical phase of dementia: a confirmatory analysis.

Preclinical deficits in dementia have recently been investigated in the PAQUID cohort by means of a principal component analysis (PCA) performed from various test scores. According to the interpretation of the first PCA factor, which was found to be an independent predictor of dementia 2 years later, the authors suggested that cognitive deficits occurring in the preclinical phase of dementia may reflect the deterioration of controlled processes. Because this hypothesis relies essentially on the interpretation of PCA factors, the present study was designed to test it within the same cohort. The analyses were focused on one of the tests administered to the subjects, the Wechsler Paired Associate Test (WPAT) divided into two subscores in order to provide a measure of controlled processes of memory functioning (i.e. retrieval of unrelated pairs) as well as of more automatic processes (i.e. retrieval of related pairs). The results showed that the future demented subjects, although significantly impaired compared to elderly controls, were able to increase their performance across trials. More importantly, a new PCA including the subscores of the WPAT showed that the unrelated pair scores were strongly correlated to factor 1, which remained the only factor associated with subsequent dementia, whereas the related pair scores were rather correlated to factor 2. Therefore, these results confirm our previous PCA interpretation, lending more weight to our hypothesis of a preclinical impairment of controlled processes in dementia.

Aged↗

PubMedDate not supplied

[Memory, aging and risk factors. Lessons from clinical trials and epidemiologic studies].

Memory troubles associated with age justify treatment and medical attention because they lead to real disabilities in daily living even without dementia, and also because they are early predictors of dementia in Alzheimer's Disease (AD). However, the treatment of these troubles remains uncertain, badly codified and extremely variable depending on the health systems concerned. Moreover, the dominant idea of many physicians, in the general population and even in health authorities, is that it is normal to have memory troubles in the elderly. This fact explains the common attitude of therapeutic nihilism. However, recent progress in the treatment of AD demonstrates that this disease should not be considered as an irremediable phenomenon. Moreover, on the basis of the follow up of an elderly cohort, it is possible to determine subjects at high risk of dementia where preventive interventions could be undertaken.

Aging↗

PubMedDate not supplied

[Epidemiology of memory disorders].

To study the predictive value of memory complaints resulting in consultation with a GP as to the risk of subsequent dementia, we analysed the data from the follow-up of the Paquid cohort study carried out around Bordeaux. A sample of 1503 elderly people over 65, living at home and non-demented at the baseline screening, was considered. The risk of dementia was measured two and four years after the baseline screening: 60.8 per cent of subjects themselves perceived a memory impairment and 15.6 per cent expressed this complaint to their GP. Forty-eight developed a subsequent dementia. Taking the group without memory complaint as the reference set, three groups of elderly people could be recognized as at high risk of dementia: subjects with self-perceived memory impairment, consulting a GP with low memory performance or with normal memory performances, and subjects with memory complaints not resorting to a GP but with low memory performance. In non-demented elderly people, memory complaints expressed to the GP may be a strong predictor of dementia and should not be neglected.

Aged↗