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Biomedical subjects

C Helmer

Publications and source records attributed to C Helmer.

25 records · Page 2Linked to original sources
PubMed1999

Psychological disorder and mortality in French older adults: do social relations modify the association?

The possible modifying effect of social relations on the association between depression and mortality was examined in a community-based cohort study. A total of 3,777 randomly selected persons 65 years of age and older in southwest France were followed over a 5-year period from 1988 in the Personnes Agees Quid (PAQUID). At study entry, the prevalence of elevated depressive symptomatology was 12.9% for men and 14.7% for women, and the reported relative isolation was 14.1% for men and 26.0% for women. During a total of 16,984 person-years of follow-up, 849 deaths occurred. Among participants with high levels of depressive symptomatology, the age-adjusted mortality rate ratio was 2.10 (95% confidence interval 1.7-2.7) in men and 1.76 (95% confidence interval 1.4-2.3) in women. When compared with individuals with the most connections, men and women with few social network connections were also at increased risk of mortality: age-adjusted rate ratio = 2.69 (95% confidence interval 1.9-3.8) for men and 1.56 (95% confidence interval 1.0-2.4) for women. Satisfaction with social support had a small but nonsignificant effect on mortality risk. For women, the excess risks due to depressive symptoms and few network connections are observed only in the 65- to 74-year age group, after adjusting for health and health behaviors. Social relations did not significantly modify the depression-mortality associations for either men or women, although the depression-mortality effect was reduced by 12.8% in men. The latter findings do not appear to be compatible with the buffering hypothesis, whereby we would expect social relations to decrease the depression-mortality association. Nonetheless, there are independent effects from these two factors, and older men who are depressed and not socially connected are at increased risk of dying earlier.

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PubMed1999

Agrobacterium radiobacter as a cause of pseudobacteremia.

Agrobacterium radiobacter was isolated from 15 blood cultures collected from 15 newborns. Contamination of blood cultures was suspected because, in most cases, the babies' illnesses seemed incompatible with infection. A radiobacter was isolated from citrated tubes used for clotting-factor studies. Review of venipuncture technique revealed that occasionally the coagulation study tubes were being inoculated before the blood-culture bottles. This investigation demonstrated how an environmental source coupled with faulty technique caused a cluster of false-positive blood cultures.

Bacteremia↗
PubMed1999

Subjective health and mortality in French elderly women and men.

OBJECTIVES: To examine the predictive value of subjective health on mortality separately in women and men, independently of other health measures, and to explain the differences between sexes by way of cognition, depression, and disability. METHODS: The PAQUID (Personnes Agées QUID) cohort is a representative sample of 3,660 nondemented elderly community residents, aged 65 and older. The relationship between subjective health and 5-year mortality was studied using the Cox model with delayed entry. RESULTS: In men, subjective health was a predictor of mortality, independent of sociodemographic characteristics, physical health status, depressive symptomatology, cognitive function, and disability, particularly in the middle-range categories of subjective health. In women, the relationship between subjective health and mortality was explained by physical health status and disability. DISCUSSION: Self-rated health seems to be a better predictor of mortality in men than in women. In men, the way in which self-ratings of health are produced remains unknown. In order to better understand sex differences, the pathways from healthy life to dependency and death, and their related changes in subjective health, should be explored further.

Activities of Daily Living↗
PubMed1999

Functional impairment in instrumental activities of daily living: an early clinical sign of dementia?

OBJECTIVE: To estimate the predictive value of four IADLs on 3- and 5-year incident dementia. DESIGN: Prospective cohort study. SETTING: A community survey in 37 randomly selected parishes. SUBJECTS: A random sample of French community dwellers aged 65 and older included in the PAQUID study followed-up at 3 (1582 subjects) and 5 years (1283 subjects). MAIN OUTCOME MEASURES: Incidence of dementia at 3 and 5 years, diagnosed by two-step screening: (1) MMS and DSM-III-R; (2) diagnosis of dementia confirmed by a neurologist. RESULTS: A score summing up the number of dependencies at baseline on four IADLs is a predictor of 3-year but not of 5-year incident dementia. Increase in the level of dependence between baseline and 3-year follow-up is associated with an increased risk of incident dementia at 5-year follow-up. CONCLUSION: These four IADLs can help to identify older subjects at high risk of dementia who should then undergo neuropsychological testing.

Activities of Daily Living↗
PubMed1999

Are sex and educational level independent predictors of dementia and Alzheimer's disease? Incidence data from the PAQUID project.

OBJECTIVES: To examine the age specific risk of Alzheimer's disease according to sex, and to explore the role of education in a cohort of elderly community residents aged 65 years and older. METHODS: A community based cohort of elderly people was studied longitudinally for 5 years for the development of dementia. Dementia diagnoses were made according to the DSM III R criteria and Alzheimer's disease was assessed using the NINCDS-ADRDA criteria. Among the 3675 non-demented subjects initially included in the cohort, 2881 participated in the follow up. Hazard ratios of dementia were estimated using a Cox model with delayed entry in which the time scale is the age of the subjects. RESULTS: During the 5 year follow up, 190 incident cases of dementia, including 140 cases of Alzheimer's disease were identified. The incidence rates of Alzheimer's disease were 0.8/100 person-years in men and 1.4/100 person-years in women. However, the incidence was higher in men than in women before the age of 80 and higher in women than in men after this age. A significant interaction between sex and age was found. The hazard ratio of Alzheimer's disease in women compared with men was estimated to be 0.8 at 75 years and 1.7 at 85 years. The risks of dementia and Alzheimer's disease were associated with a lower educational attainment (hazard ratio=1.8, p<0.001). The increased risk of Alzheimer's disease in women was not changed after adjustment for education. CONCLUSION: Women have a higher risk of developing dementia after the age of 80 than men. Low educational attainment is associated with a higher risk of Alzheimer's disease. However, the increased risk in women is not explained by a lower educational level.

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