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Pierre-Jean Ousset

Publications and source records attributed to Pierre-Jean Ousset.

5 recordsLinked to original sources
PubMed2006

Outcome of Alzheimer's disease: potential impact of cholinesterase inhibitors.

BACKGROUND: Alzheimer's disease is fast becoming a major public health concern with serious economic consequences. The cholinesterase inhibitors (CEIs) offer some benefit in the symptomatic treatment of the disease. This study aims to investigate the effect of CEIs on three clinically relevant domains (rapid cognitive decline, institutionalization, and weight loss) in patients with Alzheimer's disease. METHODS: A prospective observational study was performed in which a population of 455 Alzheimer's disease patients were recruited and followed up for at least 1 year between 1994 and 2002. Patients were reevaluated at 6 monthly intervals using standardized neurocognitive and geriatric evaluations in addition to complete clinical examination, standard paraclinical investigations, and recording of treatment received. RESULTS: The risk of rapid cognitive deterioration was significantly decreased in patients taking CEIs for at least 1 year compared to untreated patients (odds ratio [OR]=0.56, 95% confidence interval [CI], 0.34-0.93; p=.025). The potential benefit of CEI use was also found on institutionalization (OR=0.2, 95% CI, 0.08-0.48; p<.001) and weight loss (OR=0.56, 95% CI, 0.32-0.97; p=.039) after 1 year of follow-up. CONCLUSION: The special interest of this study is that all patients were recruited and followed in the same center with the same management care plan and the same medical team. This follow-up offers us a unique opportunity to compare the 1-year evolution of the disease in clinical practice before and after the marketing of CEIs and allows us to demonstrate a clinically significant improvement in patient outcome over time.

Age Factors↗
PubMed2005

[What is a mild cognitive impairment?].

The concept of mild cognitive impairment (MCI) has been proposed by Petersen et al. (1997, 1999) as a nosologic entity referring to elderly persons with mild cognitive deficit without dementia. MCI is being widely used in studies as an intermediate stage between cognitive normalcy and dementia. However, MCI appears to be a heterogeneous clinical entity. Multiple sources of heterogeneity have been described: heterogeneity in aetiological factors (various types of degenerative lesions, vascular risk factors, psychiatric features, association of pathological conditions), heterogeneity in clinical symptoms, and heterogeneity in clinical course with decliners and non decliners presenting stable or reversible cognitive impairment. Thus new criteria of MCI are proposed for use in research but also in clinical practice. MCI may henceforth correspond to the following: (1.) Cognitive complaint emanating from the patient and/or his/her family; (2.) the subject and/or notifying party report a decline in cognitive and/or functional performance relative to previous abilities; (3.) cognitive disorders evidenced by clinical evaluation: impairment in memory and/or another cognitive domain; (4.) cognitive impairment does not have any repercussions on daily life, the subject may report difficulties concerning complex day-to-day activities; (5.) no dementia.

Activities of Daily Living↗
PubMed2005

[Nutrition and Alzheimer's disease].

Weight loss is frequent in Alzheimer's disease. Its severity increases with the progression of the disease and may be a predictor of patients' mortality. Weight loss often precedes the diagnosis and may be considered as a feature of the disease itself. With the progression of the disease, disorders of eating behavior occur and result in weight loss and decreasing energy intake. Descriptive tools such as the Blandford Scale are helpful to assess eating disorders. Some hypotheses exist to explain the weight loss associated with Alzheimer's disease: atrophy of internal temporal cortex, increase of energy expenditure, biologic factors or modifications of body composition. Tools such as the Mini Nutritional Assessment allow assessment of nutritional status, diagnosis of malnutrition, cause identification and proposals for its correction. Patients' caregivers play a central role in prevention and management of nutritional disorders. Information programs for caregivers may reduce caregiver burden and improve patients' health status.

Aged↗
PubMed2003

[Behavioral disorders in dementia: intervention study in a long-term care unit].

UNLABELLED: Behavioral disorders are frequent in the course of dementia. They often result in inappropriate drug prescription, and an increased risk of morbidity and mortality. They also have a major negative impact on the caregiver's burden. We present an intervention study on the carers of demented patients in a long-term care unit. METHODS: We studied 26 patients with dementia (mean age -/+ 86.6 +/- 6.4 years) hospitalized in a long-term care unit at the Toulouse university hospital. Frequency and related distress of behavioral disturbances were assessed using the Neuropsychiatric Inventory (NPI). After a first patient evaluation, the staff of the unit underwent a specific program of education and training to cope with these behavioral problems. This was followed by a second comparative evaluation of the patients. RESULTS: We observed a significant decrease of frequency, severity and related distress of behavioral symptoms. Significant changes in severity were found in depression, delusions, hallucinations, apathy and irritability. Distress related to agitation, depression and irritability was significantly reduced. CONCLUSION: Our study shows a positive effect of an educative intervention on patient is behavior and caregiver distress. Similar actions reported in the literature note a variability in the response depending on the type of population and nature of the intervention. Due to the lack of a control group, we are unable to assess the specificity of the intervention programme. However, the magnitude of the observed changes support its general methodology. The use of quantitative tools such as the NPI is very helpful to improve the understanding of behavioral problems in demented people and to assess their management.

Aged↗