1
|
He L, de Souto Barreto P, Sánchez Sánchez JL, Rolland Y, Guyonnet S, Parini A, Lucas A, Vellas B. Prospective Associations of Plasma Growth Differentiation Factor 15 With Physical Performance and Cognitive Functions in Older Adults. J Gerontol A Biol Sci Med Sci 2022; 77:2420-2428. [PMID: 35037034 DOI: 10.1093/gerona/glac020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Growth differentiation factor 15 (GDF15) has been associated with several age-related disorders, but its associations with functional abilities in community-dwelling older adults are not well studied. METHODS The study was a secondary analysis of 1 096 community-dwelling older adults (aged 69-94 years) recruited from the Multidomain Alzheimer's Preventive Trial. Plasma GDF15 was measured 1 year after participants' enrollment. Annual data of physical performance (grip strength and Short Physical Performance Battery [SPPB]) and global cognitive functions (Mini-Mental State Examination [MMSE] and a composite cognitive score) were measured for 4 years. Adjusted mixed-effects linear models were performed for cross-sectional and longitudinal association analyses. RESULTS A higher GDF15 was cross-sectionally associated with a weaker grip strength (β = -1.1E-03, 95% CI [-2.0E-03, -1.5E-04]), a lower SPPB score (β = -3.1E-04, 95% CI [-5.4E-04, -9.0E-05]), and worse cognitive functions (β = -2.4E-04, 95% CI [-3.3E-04, -1.6E-04] for composite cognitive score; β = -4.0E-04, 95% CI [-6.4E-04, -1.6E-04] for MMSE). Participants with higher GDF15 demonstrated greater longitudinal declines in SPPB (β = -1.0E-04, 95% CI [-1.7E-04, -2.0E-05]) and composite cognitive score (β = -2.0E-05, 95% CI [-4.0E-05, -3.6E-06]). The optimal initial GDF15 cutoff values for identifying participants with minimal clinically significant decline after 1 year were 2 189 pg/mL for SPPB (AUC: 0.580) and 2 330 pg/mL for composite cognitive score (AUC: 0.587). CONCLUSIONS Plasma GDF15 is cross-sectionally and longitudinally associated with lower-limb physical performance and global cognitive function in older adults. Circulating GDF15 alone has a limited capacity of discriminating older adults who will develop clinically significant functional declines. CLINICAL TRIAL REGISTRATION NCT00672685.
Collapse
Affiliation(s)
- Lingxiao He
- School of Public Health, Xiamen University, Xiamen, China.,Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalier-Universitaire de Toulouse, Toulouse, France
| | - Philipe de Souto Barreto
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalier-Universitaire de Toulouse, Toulouse, France.,CERPOP, INSERM 1295, Université de Toulouse, UPS, Toulouse, France
| | - Juan Luis Sánchez Sánchez
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalier-Universitaire de Toulouse, Toulouse, France.,Faculty of Sport Science, Universidad Europea de Madrid, Madrid, Spain
| | - Yves Rolland
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalier-Universitaire de Toulouse, Toulouse, France.,CERPOP, INSERM 1295, Université de Toulouse, UPS, Toulouse, France
| | - Sophie Guyonnet
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalier-Universitaire de Toulouse, Toulouse, France.,CERPOP, INSERM 1295, Université de Toulouse, UPS, Toulouse, France
| | - Angelo Parini
- Institute of Metabolic and Cardiovascular Diseases, UMR1297, Toulouse, France.,Paul Sabatier University, Toulouse, France
| | - Alexandre Lucas
- Institute of Metabolic and Cardiovascular Diseases, UMR1297, Toulouse, France.,Paul Sabatier University, Toulouse, France
| | - Bruno Vellas
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalier-Universitaire de Toulouse, Toulouse, France.,CERPOP, INSERM 1295, Université de Toulouse, UPS, Toulouse, France
| | | |
Collapse
|
2
|
Lu WH, Giudici KV, Morley JE, Guyonnet S, Parini A, Aggarwal G, Nguyen AD, Li Y, Bateman RJ, Vellas B, de Souto Barreto P. Investigating the combination of plasma amyloid-beta and geroscience biomarkers on the incidence of clinically meaningful cognitive decline in older adults. GeroScience 2022; 44:1489-1503. [PMID: 35445358 PMCID: PMC9213609 DOI: 10.1007/s11357-022-00554-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/22/2022] [Indexed: 11/04/2022] Open
Abstract
We investigated combining a core AD neuropathology measure (plasma amyloid-beta [Aβ] 42/40) with five plasma markers of inflammation, cellular stress, and neurodegeneration to predict cognitive decline. Among 401 participants free of dementia (median [IQR] age, 76 [73-80] years) from the Multidomain Alzheimer Preventive Trial (MAPT), 28 (7.0%) participants developed dementia, and 137 (34.2%) had worsening of clinical dementia rating (CDR) scale over 4 years. In the models utilizing plasma Aβ alone, a tenfold increased risk of incident dementia (nonsignificant) and a fivefold increased risk of worsening CDR were observed as each nature log unit increased in plasma Aβ levels. Models incorporating Aβ plus multiple plasma biomarkers performed similarly to models included Aβ alone in predicting dementia and CDR progression. However, improving Aβ model performance for composite cognitive score (CCS) decline, a proxy of dementia, was observed after including plasma monocyte chemoattractant protein 1 (MCP1) and growth differentiation factor 15 (GDF15) as covariates. Participants with abnormal Aβ, GDF15, and MCP1 presented higher CCS decline (worsening cognitive function) compared to their normal-biomarker counterparts (adjusted β [95% CI], - 0.21 [- 0.35 to - 0.06], p = 0.005). In conclusion, our study found limited added values of multi-biomarkers beyond the basic Aβ models for predicting clinically meaningful cognitive decline among non-demented older adults. However, a combined assessment of inflammatory and cellular stress status with Aβ pathology through measuring plasma biomarkers may improve the evaluation of cognitive performance.
Collapse
Affiliation(s)
- Wan-Hsuan Lu
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), 31000, Toulouse, France
- Inserm CERPOP - UMR1295, University of Toulouse III, 31000, Toulouse, France
| | - Kelly Virecoulon Giudici
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), 31000, Toulouse, France
| | - John E Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Sophie Guyonnet
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), 31000, Toulouse, France
- Inserm CERPOP - UMR1295, University of Toulouse III, 31000, Toulouse, France
| | - Angelo Parini
- Institute of Metabolic and Cardiovascular Diseases (I2MC), Inserm UMR 1048, University of Toulouse, 31400, Toulouse, France
| | - Geetika Aggarwal
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO, USA
- Henry and Amelia Nasrallah Center for Neuroscience, Saint Louis University, St. Louis, MO, USA
| | - Andrew D Nguyen
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO, USA
- Henry and Amelia Nasrallah Center for Neuroscience, Saint Louis University, St. Louis, MO, USA
| | - Yan Li
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Randall J Bateman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Bruno Vellas
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), 31000, Toulouse, France
- Inserm CERPOP - UMR1295, University of Toulouse III, 31000, Toulouse, France
| | - Philipe de Souto Barreto
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), 31000, Toulouse, France
- Inserm CERPOP - UMR1295, University of Toulouse III, 31000, Toulouse, France
| |
Collapse
|
3
|
Teipel SJ, Amaefule CO, Lüdtke S, Görß D, Faraza S, Bruhn S, Kirste T. Prediction of Disorientation by Accelerometric and Gait Features in Young and Older Adults Navigating in a Virtually Enriched Environment. Front Psychol 2022; 13:882446. [PMID: 35548510 PMCID: PMC9083357 DOI: 10.3389/fpsyg.2022.882446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 03/22/2022] [Indexed: 11/23/2022] Open
Abstract
Objective To determine whether gait and accelerometric features can predict disorientation events in young and older adults. Methods Cognitively healthy younger (18–40 years, n = 25) and older (60–85 years, n = 28) participants navigated on a treadmill through a virtual representation of the city of Rostock featured within the Gait Real-Time Analysis Interactive Lab (GRAIL) system. We conducted Bayesian Poisson regression to determine the association of navigation performance with domain-specific cognitive functions. We determined associations of gait and accelerometric features with disorientation events in real-time data using Bayesian generalized mixed effect models. The accuracy of gait and accelerometric features to predict disorientation events was determined using cross-validated support vector machines (SVM) and Hidden Markov models (HMM). Results Bayesian analysis revealed strong evidence for the effect of gait and accelerometric features on disorientation. The evidence supported a relationship between executive functions but not visuospatial abilities and perspective taking with navigation performance. Despite these effects, the cross-validated percentage of correctly assigned instances of disorientation was only 72% in the SVM and 63% in the HMM analysis using gait and accelerometric features as predictors. Conclusion Disorientation is reflected in spatiotemporal gait features and the accelerometric signal as a potentially more easily accessible surrogate for gait features. At the same time, such measurements probably need to be enriched with other parameters to be sufficiently accurate for individual prediction of disorientation events.
Collapse
Affiliation(s)
- Stefan J Teipel
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) Rostock/Greifswald, Rostock, Germany.,Department of Psychosomatic Medicine, University Medicine Rostock, Rostock, Germany
| | - Chimezie O Amaefule
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) Rostock/Greifswald, Rostock, Germany
| | - Stefan Lüdtke
- Mobile Multimedia Information Systems, Institute for Visual and Analytic Computing, University of Rostock, Rostock, Germany.,Institute for Enterprise Systems, University of Mannheim, Mannheim, Germany
| | - Doreen Görß
- Department of Psychosomatic Medicine, University Medicine Rostock, Rostock, Germany
| | - Sofia Faraza
- Department of Psychosomatic Medicine, University Medicine Rostock, Rostock, Germany
| | - Sven Bruhn
- Institute for Sports Science, University of Rostock, Rostock, Germany
| | - Thomas Kirste
- Mobile Multimedia Information Systems, Institute for Visual and Analytic Computing, University of Rostock, Rostock, Germany
| |
Collapse
|
4
|
Mortamais M, Laure-Anne G, Balem M, Bars EL, de Champfleur NM, Bouyahia A, Chupin M, Perus L, Fisher C, Vellas B, Andrieu S, Mangin JF, Berr C, Gabelle A. Sulcal morphology as cognitive decline predictor in older adults with memory complaints. Neurobiol Aging 2022; 113:84-94. [DOI: 10.1016/j.neurobiolaging.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/08/2021] [Accepted: 02/08/2022] [Indexed: 11/16/2022]
|
5
|
Mura T, Coley N, Amieva H, Berr C, Gabelle A, Ousset PJ, Vellas B, Andrieu S. Cognitive decline as an outcome and marker of progression toward dementia, in early preventive trials. Alzheimers Dement 2021; 18:676-687. [PMID: 34482607 DOI: 10.1002/alz.12431] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 05/05/2021] [Accepted: 06/24/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Recent Food and Drug Administration guidance endorses cognitive assessment as a possible primary endpoint for early trials for Alzheimer's disease but emphasizes the need for certainty regarding the relationship with progression to dementia. METHODS We compared the validity of the 2-year change (Y0-Y2) of 11 markers of neuropsychological and functional abilities for the prediction of incident dementia over the following 3 years (Y2-Y5), in 860 subjects aged 70 years or older, who consulted for memory loss and were included in the "GuidAge" prevention trial. RESULTS The Free and Cued Selective Reminding Test-Free Recall (FCSRT-FR) score showed the most predictive 2-year change (area under the curve = 0.72 95% confidence interval = 0.64;0.81). Changes in other subscores of the FCSRT, verbal fluencies tasks, and composite cognitive score were also significantly predictive. Conversely, 2-year change of Mini-Mental State Examination, Trail Making test (TMT)-A, TMT-B, Clinical Dementia Rating Sum of Boxes, and Instrumental Activities of Daily Living scores did not significantly predict occurrence of dementia. CONCLUSION The FCSRT, the Fluency Task, and the composite cognitive score appear to be good cognitive markers of progression toward dementia in early prevention trials.
Collapse
Affiliation(s)
- Thibault Mura
- INSERM-University of Toulouse, UMR1027, Toulouse, France.,Department of Epidemiology and Public Health, CHU Toulouse, Toulouse, France.,Department of Biostatistics, Clinical Epidemiology, Public Health and Innovation in Methodology (BESPIM), CHU Nîmes, University of Montpellier, Nimes, France
| | - Nicola Coley
- INSERM-University of Toulouse, UMR1027, Toulouse, France.,Department of Epidemiology and Public Health, CHU Toulouse, Toulouse, France
| | - Hélène Amieva
- Inserm U1219 Bordeaux Population Health Center, Université de Bordeaux, Bordeaux, France
| | - Claudine Berr
- INSERM-University of Montpellier, U1061, Montpellier, France.,Memory Resources and Research Center, Department of Neurology, Gui de Chauliac University Hospital, Montpellier, France
| | - Audrey Gabelle
- INSERM-University of Montpellier, U1061, Montpellier, France.,Memory Resources and Research Center, Department of Neurology, Gui de Chauliac University Hospital, Montpellier, France
| | - Pierre-Jean Ousset
- INSERM-University of Toulouse, UMR1027, Toulouse, France.,Department of Geriatric Medicine, CHU Toulouse, Gerontopole, Toulouse, France
| | - Bruno Vellas
- INSERM-University of Toulouse, UMR1027, Toulouse, France.,Department of Geriatric Medicine, CHU Toulouse, Gerontopole, Toulouse, France
| | - Sandrine Andrieu
- INSERM-University of Toulouse, UMR1027, Toulouse, France.,Department of Epidemiology and Public Health, CHU Toulouse, Toulouse, France
| | | |
Collapse
|
6
|
Schneider LS, Goldberg TE. Composite cognitive and functional measures for early stage Alzheimer's disease trials. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12017. [PMID: 32432155 PMCID: PMC7233425 DOI: 10.1002/dad2.12017] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/18/2019] [Accepted: 02/03/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Composite scales have been advanced as primary outcomes in early stage Alzheimer's disease trials, and endorsed by the U.S. Food and Drug Administration (FDA) for pivotal trials. They are generally composed of several neurocognitive subscales and may include clinical and functional activity scales. METHODS We summarized the development of 12 composite scales intended as outcomes for clinical trials and assessed their characteristics. RESULTS Composite scales have been constructed from past observational and clinical trial databases by selecting components of individual neuropsychological tests previously used in clinical trials. The atheoretical approaches to combining scales into a composite scale that have often been used risk omitting clinically important measures and so may include redundant, irrelevant, or noncontributory tests. The deliberate combining of neurocognitive scales with functional activity scales provides arbitrary weightings that also may be clinically irrelevant or obscure change in a particular domain. Basic psychometric information is lacking for most of the composites. DISCUSSION Although composite scales are desirable for pivotal clinical trials because they, in principle, provide for a single, primary outcome combining neurocognitive and/or functional domains, they have substantial limitations, including their common derivations, inattention to basic psychometric principles, redundancy, absence of alternate forms, and, arguably, the inclusion of functional measures in some. In effect, any currently used composite is undergoing validation through its use in a trial. The assumption that a composite, by its construction alone, is more likely than an individual measure to detect an effect from any particular drug and that the effect is more clinically relevant or valid has not been demonstrated.
Collapse
Affiliation(s)
| | - Terry E. Goldberg
- Department of PsychiatryColumbia University Medical CenterNew YorkNew York
| |
Collapse
|
7
|
Malek-Ahmadi M, Chen K, Perez SE, Mufson EJ. Cerebral Amyloid Angiopathy and Neuritic Plaque Pathology Correlate with Cognitive Decline in Elderly Non-Demented Individuals. J Alzheimers Dis 2020; 67:411-422. [PMID: 30594928 DOI: 10.3233/jad-180765] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Cerebral amyloid angiopathy (CAA) is a vascular neuropathology commonly reported in non-cognitively impaired (NCI), mild cognitive impairment, and Alzheimer's disease (AD) brains. However, it is unknown whether similar findings are present in non-demented elderly subjects. OBJECTIVE This study determined the association between CAA and cognition among elderly NCI subjects with varying levels of AD pathology. METHODS Data from 182 cases that received a diagnosis of NCI at their first clinical assessment were obtained from the Rush Religious Orders study (RROS). A cognitive composite score was used to measure cognitive decline. CAA was dichotomized as present or absent. Cases were also dichotomized according to CERAD neuropathological diagnosis and Braak staging. A mixed model-repeated measures analysis assessed decline on the cognitive composite score. RESULTS CAA, alone, was not associated with cognitive decline [-0.87 (95% CI: -3.33, 1.58), p = 0.49]. However, among those with CAA, the High CERAD group had significantly greater decline relative to the Low CERAD group [-4.08 (95% CI: -7.10, -1.06), p = 0.008]. The High and Low CERAD groups were not significantly different [-1.77 (95% CI: -6.14, 2.60), p = 0.43] in those without CAA. Composite score decline in the High and Low Braak groups with [-1.32 (95% CI: -4.40, 1.75), p = 0.40] or without [0.27 (95% CI: -4.01, 4.56), p = 0.90] CAA was not significantly different. CONCLUSION The current data shows that an interaction between CAA and plaque load is associated with greater decline on a cognitive composite score used to test non-cognitively impaired elderly participants in AD prevention trials.
Collapse
Affiliation(s)
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - Sylvia E Perez
- Department of Neurobiology, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Elliott J Mufson
- Department of Neurobiology, Barrow Neurological Institute, Phoenix, AZ, USA
| |
Collapse
|
8
|
Marizzoni M, Ferrari C, Macis A, Jovicich J, Albani D, Babiloni C, Cavaliere L, Didic M, Forloni G, Galluzzi S, Hoffmann KT, Molinuevo JL, Nobili F, Parnetti L, Payoux P, Pizzini F, Rossini PM, Salvatore M, Schönknecht P, Soricelli A, Del Percio C, Hensch T, Hegerl U, Tsolaki M, Visser PJ, Wiltfang J, Richardson JC, Bordet R, Blin O, Frisoni GB. Biomarker Matrix to Track Short Term Disease Progression in Amnestic Mild Cognitive Impairment Patients with Prodromal Alzheimer’s Disease. J Alzheimers Dis 2019; 69:49-58. [DOI: 10.3233/jad-181016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Moira Marizzoni
- Laboratory of Neuroimaging and Alzheimer’s Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Clarissa Ferrari
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Ambra Macis
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Jorge Jovicich
- Center for Mind/Brain Sciences, University of Trento, Italy
| | - Diego Albani
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Claudio Babiloni
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Rome, Italy
- Hospital San Raffaele Cassino, Cassino (FR), Italy
| | - Libera Cavaliere
- Laboratory of Neuroimaging and Alzheimer’s Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Mira Didic
- Aix-Marseille Université, Inserm, INS UMR_S 1106, Marseille, France
- APHM, Timone, Service de Neurologie et Neuropsychologie, APHM Hôpital Timone Adultes, Marseille, France
| | - Gianluigi Forloni
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Samantha Galluzzi
- Laboratory of Neuroimaging and Alzheimer’s Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - José Luis Molinuevo
- Alzheimer’s Disease Unit and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, and Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalunya, Spain
| | - Flavio Nobili
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lucilla Parnetti
- Clinica Neurologica, Università di Perugia, Ospedale Santa Maria della Misericordia, Perugia, Italy
| | - Pierre Payoux
- INSERM; Imagerie cérébrale et handicaps neurologiques UMR 825, Toulouse, France
| | - Francesca Pizzini
- Department of Diagnostics and Pathology, Neuroradiology, Verona University Hospital, Italy
| | - Paolo Maria Rossini
- Department of Gerontology, Area of Neuroscience, Neurosciences & Orthopedics, Catholic University, Policlinic A. Gemelli Foundation Rome, Italy
| | | | - Peter Schönknecht
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | | | | | - Tilman Hensch
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Ulrich Hegerl
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Magda Tsolaki
- 3rd Neurologic Clinic, Medical School, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Pieter Jelle Visser
- Department of Neurology, Alzheimer Centre, VU Medical Centre, Amsterdam, The Netherlands
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, LVR-Hospital Essen, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August-University, Goettingen, Germany
- iBiMED, Medical Sciences Department, University of Aveiro, Aveiro, Portugal
| | - Jill C. Richardson
- Neurosciences Therapeutic Area, GlaxoSmithKline R&D, Gunnels Wood Road, Stevenage, UK
| | - Régis Bordet
- University of Lille, Inserm, CHU Lille, U1171-Degenerative and vascular cognitive disorders, Lille, France
| | - Olivier Blin
- Aix Marseille University, UMR-CNRS 7289, Service de Pharmacologie Clinique, AP-HM, Marseille, France
| | - Giovanni B. Frisoni
- Laboratory of Neuroimaging and Alzheimer’s Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | | |
Collapse
|
9
|
Langhammer B, Sagbakken M, Kvaal K, Ulstein I, Nåden D, Rognstad MK. Music Therapy and Physical Activity to Ease Anxiety, Restlessness, Irritability, and Aggression in Individuals With Dementia With Signs of Frontotemporal Lobe Degeneration. J Psychosoc Nurs Ment Health Serv 2019; 57:29-37. [PMID: 30753735 DOI: 10.3928/02793695-20190124-02] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 09/14/2018] [Indexed: 11/20/2022]
Abstract
The purpose of the current study was to evaluate whether a combined intervention of physical activity and music therapy could reduce anxiety, restlessness, irritability, and aggression among individuals with severe dementia. An exploratory design was used to evaluate a combined intervention of physical activity, music therapy, and daily walking. Interventions were systematically implemented for 8 weeks. Target groups were individuals with dementia with frontal lobe symptoms in institutional care. Primary outcome measure was the Brøset Violence Checklist (BVC). Four men and two women (mean age = 84.3 years) and their primary caretakers (n = 6) participated. The most prominent symptoms among participants at baseline were confusion, irritability, and verbal threats. The individual BVC total scores indicated significant improvements (p = 0.03). Implementation of individualized music therapy combined with increased physical activity for 8 weeks was a feasible intervention that reduced anxiety, restlessness, irritability, and aggression in the current study. [Journal of Psychosocial Nursing and Mental Health Services, 57(5), 29-37.].
Collapse
|
10
|
Andre L, Gallini A, Montastruc F, Coley N, Montastruc JL, Vellas B, Andrieu S, Gardette V. Anticholinergic exposure and cognitive decline in older adults: effect of anticholinergic exposure definitions in a 3-year analysis of the multidomain Alzheimer preventive trial (MAPT) study. Br J Clin Pharmacol 2018; 85:71-99. [PMID: 30098049 DOI: 10.1111/bcp.13734] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 06/19/2018] [Accepted: 07/27/2018] [Indexed: 01/02/2023] Open
Abstract
AIM The aim of the present study was to assess the association between anticholinergic (atropinic) burden and cognitive decline in older adults over the course of 3 years. METHODS We used data from Multidomain Alzheimer Preventive Trial (MAPT) study participants aged ≥70 years and at risk of cognitive decline. Cognitive function was assessed with a composite score [Mini-Mental State Examination (MMSE) orientation, Free and Cued Selective Reminding Test, Category Naming Test, Digit Symbol Substitution Test] at 12, 24 and 36 months. Participants declining by more than 0.236 points on the composite score (representing the lowest quintile of 1-year cognitive change) during any 1-year period were considered to have undergone cognitive decline. Anticholinergic exposure was defined by four methods for each of four anticholinergic scales (Anticholinergic Drug Scale, Anticholinergic Cognitive Burden, Anticholinergic Risk Scale, the Durán list). The association between cognitive decline and time-varying anticholinergic exposure [primary analysis using the Durán list and maximal anticholinergic score (0, 1 or 3)] was assessed using Cox proportional hazards models. Other cognitive decline definitions were used in sensitivity analyses. RESULTS At baseline, among 1396 patients included, 7.4-23.5% were exposed to anticholinergic agents, depending on the anticholinergic scale used. Sixty-four per cent of participants experienced cognitive decline during follow-up. Regardless of the anticholinergic scale/exposure measurement used, no significant association was observed with cognitive decline {primary analysis: compared with non-anticholinergic agent users, hazard ratio [HR] = 1.14 [95% confidence interval (CI) = 0.95, 1.38] for anticholinergic score = 1; HR = 0.92 [95% CI = 0.65, 1.30] for score = 3}. Results were stable in sensitivity analyses. CONCLUSION We found no significant association between anticholinergic exposure and cognitive decline in older adults using anticholinergic scales and definitions of exposure.
Collapse
Affiliation(s)
- Laurine Andre
- UMR INSERM 1027, Université de Toulouse, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), France.,Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France.,Service d'Epidémiologie, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France
| | - Adeline Gallini
- UMR INSERM 1027, Université de Toulouse, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), France.,Service d'Epidémiologie, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France
| | - François Montastruc
- UMR INSERM 1027, Université de Toulouse, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), France.,Service de Pharmacologie Médicale et Clinique, Centre Midi-Pyrénées de PharmacoVigilance, Pharmacoépidémiologie et d'Informations sur le Médicament, Centre Hospitalier Universitaire, Faculté de Médecine, Toulouse, France
| | - Nicola Coley
- UMR INSERM 1027, Université de Toulouse, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), France.,Service d'Epidémiologie, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France
| | - Jean-Louis Montastruc
- UMR INSERM 1027, Université de Toulouse, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), France.,Service de Pharmacologie Médicale et Clinique, Centre Midi-Pyrénées de PharmacoVigilance, Pharmacoépidémiologie et d'Informations sur le Médicament, Centre Hospitalier Universitaire, Faculté de Médecine, Toulouse, France
| | - Bruno Vellas
- UMR INSERM 1027, Université de Toulouse, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), France.,Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France
| | - Sandrine Andrieu
- UMR INSERM 1027, Université de Toulouse, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), France.,Service d'Epidémiologie, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France
| | - Virginie Gardette
- UMR INSERM 1027, Université de Toulouse, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), France.,Service d'Epidémiologie, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France
| | | |
Collapse
|
11
|
Malek-Ahmadi M, Chen K, Perez SE, He A, Mufson EJ. Cognitive composite score association with Alzheimer's disease plaque and tangle pathology. ALZHEIMERS RESEARCH & THERAPY 2018; 10:90. [PMID: 30205840 PMCID: PMC6134796 DOI: 10.1186/s13195-018-0401-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 07/02/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Cognitive composite scores are used as the primary outcome measures for Alzheimer's disease (AD) prevention trials; however, the extent to which these composite measures correlate with AD pathology has not been fully investigated. Since many on-going AD prevention studies are testing therapies that target either amyloid or tau, we sought to establish an association between a cognitive composite score and the underlying pathology of AD. METHODS Data from 192 older deceased and autopsied persons from the Rush Religious Order Study were used in this study. All participants were classified at their initial evaluations with a clinical diagnosis of no cognitive impairment (NCI). Of these individuals, 105 remained NCI at the time of their death while the remaining 87 progressed to mild cognitive impairment (MCI) or AD. A cognitive composite score composed of eight cognitive tests was used as the outcome measure. Individuals were classified into groups based on Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropathological diagnosis and Braak stage. RESULTS The rate of annualized composite score decline was significantly greater for the high CERAD (p < 0.001, d = 0.56) and Braak (p < 0.001, d = 0.55) groups compared with the low CERAD and Braak groups, respectively. Mixed-model repeated measure (MMRM) analyses revealed a significantly greater difference in composite score change from baseline for the high CERAD group relative to the low CERAD group after 5 years (Δ = -2.74, 95% confidence interval (CI) -5.01 to -0.47; p = 0.02). A similar analysis between low and high Braak stage groups found no significant difference in change from baseline (Δ = -0.69, 95% CI -3.03 to 1.66; p = 0.56). CONCLUSIONS These data provide evidence that decreased cognitive composite scores were significantly associated with increased AD pathology and provide support for the use of cognitive composite scores in AD prevention trials.
Collapse
Affiliation(s)
| | - Kewei Chen
- Banner Alzheimer's Institute, 901 E. Willetta St, Phoenix, AZ, USA
| | - Sylvia E Perez
- Department of Neurobiology and Neurology, Barrow Neurological Institute, 350 W. Thomas Rd, Phoenix, AZ, 85013, USA
| | - Anna He
- Banner Alzheimer's Institute, 901 E. Willetta St, Phoenix, AZ, USA
| | - Elliott J Mufson
- Department of Neurobiology and Neurology, Barrow Neurological Institute, 350 W. Thomas Rd, Phoenix, AZ, 85013, USA.
| |
Collapse
|
12
|
Grande G, Vanacore N, Vetrano DL, Cova I, Rizzuto D, Mayer F, Maggiore L, Ghiretti R, Cucumo V, Mariani C, Cappa SF, Pomati S. Free and cued selective reminding test predicts progression to Alzheimer’s disease in people with mild cognitive impairment. Neurol Sci 2018; 39:1867-1875. [DOI: 10.1007/s10072-018-3507-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 07/18/2018] [Indexed: 10/28/2022]
|
13
|
Tan J, Tsakok FHM, Ow EK, Lanskey B, Lim KSD, Goh LG, Tan CH, Cheah IKM, Larbi A, Foo R, Loh M, Wong CKY, Suckling J, Li J, Mahendran R, Kua EH, Feng L. Study Protocol for a Randomized Controlled Trial of Choral Singing Intervention to Prevent Cognitive Decline in At-Risk Older Adults Living in the Community. Front Aging Neurosci 2018; 10:195. [PMID: 30042673 PMCID: PMC6048740 DOI: 10.3389/fnagi.2018.00195] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 06/11/2018] [Indexed: 12/18/2022] Open
Abstract
Introduction: This study is a parallel-arm randomized controlled trial evaluating choral singing’s efficacy and underlying mechanisms in preventing cognitive decline in at-risk older participants. Methods: Three-hundred and sixty community-dwelling, non-demented older participants are recruited for a 2-year intervention. Inclusion criteria are self-reported cognitive complaints, early cognitive impairment based on neuropsychological test scores or multiple risk factors of dementia. Participants are randomized to either weekly choral singing sessions or general health education. The primary outcome is cognitive performance, measured by a composite cognitive test score (CCTS). Secondary outcomes include depression, anxiety and neuropsychiatric symptoms; perceived stress; sleep quality and severity of dementia symptoms. Underlying mechanisms are examined using blood- and urine-based biomarkers and neuroimaging. Results: Screening began in July 2016. The first group of participants (n = 93) have been recruited. Intervention and control treatments are ongoing and will end in December 2019. Discussion: An evidence-based singing intervention for dementia prevention holds potential for healthcare savings and societal welfare. Trial Registration: NCT02919748, IRB Approval Number: NUS 2508.
Collapse
Affiliation(s)
- Jasmine Tan
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom
| | | | - Elisabeth K Ow
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Bernard Lanskey
- Yong Siew Toh Conservatory of Music, National University of Singapore, Singapore, Singapore
| | | | - Lee Gan Goh
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Chay-Hoon Tan
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Irwin Kee-Mun Cheah
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Anis Larbi
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Roger Foo
- Genome Institue of Singapore (GIS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Marie Loh
- Translational Laboratory in Genetic Medicine, Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | | | - John Suckling
- Department of Psychiatry, University of Cambridge and Cambridge and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Jialiang Li
- Department of Statistics & Applied Probability, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ee-Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| |
Collapse
|
14
|
Grober E, Veroff AE, Lipton RB. Temporal unfolding of declining episodic memory on the Free and Cued Selective Reminding Test in the predementia phase of Alzheimer's disease: Implications for clinical trials. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2018; 10:161-171. [PMID: 29552631 PMCID: PMC5852329 DOI: 10.1016/j.dadm.2017.12.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction Free and Cued Selective Reminding Test (FCSRT) performance identifies patients with preclinical disease at elevated risk for developing Alzheimer's dementia, predicting diagnosis better than other memory tests. Methods Based on literature mapping FCSRT performance to clinical outcomes and biological markers, and on longitudinal preclinical data from the Baltimore Longitudinal Study of Aging, we developed the Stages of Objective Memory Impairment (SOMI) model. Five sequential stages of episodic memory decline are defined by Free Recall (FR) and Total Recall (TR) score ranges and years prior to dementia diagnosis. We sought to replicate the SOMI model using longitudinal assessments of 142 Einstein Aging Study participants who developed AD over 10 years. Results Time to diagnosis was at least seven years if FR was intact, at least four years if TR was intact, and two years if TR was impaired, consistent with SOMI model predictions. The SOMI identified incipient dementia with excellent sensitivity and specificity. Discussion The SOMI model provides an efficient approach for clinical trial cognitive screening in advance of more costly biomarker studies and ultimately in clinical practice, and provides a vocabulary for understanding AD biomarker patterns and for re-analysis of existing clinical trial data.
Collapse
Affiliation(s)
- Ellen Grober
- Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | | | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| |
Collapse
|
15
|
Coley N, Raman R, Donohue MC, Aisen PS, Vellas B, Andrieu S. Defining the Optimal Target Population for Trials of Polyunsaturated Fatty Acid Supplementation Using the Erythrocyte Omega-3 Index: A Step Towards Personalized Prevention of Cognitive Decline? J Nutr Health Aging 2018; 22:982-998. [PMID: 30272103 DOI: 10.1007/s12603-018-1052-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES to identify the optimal erythrocyte omega-3 index cut-off for predicting cognitive decline and/or polyunsaturated fatty acid (PUFA) treatment response, in order to better define the target population for future dementia prevention trials. DESIGN AND SETTING Secondary exploratory analysis of the randomized controlled MAPT prevention trial. PARTICIPANTS 724 dementia-free subjects aged 70 or older with subjective memory complaints, limitations in one instrumental activity of daily living, and/or slow gait speed. INTERVENTION 800mg docosahexaenoic acid (DHA) and 225mg eicosapentaenoic acid (EPA) daily versus placebo. MEASUREMENTS Erythrocyte omega-3 index was measured at baseline. Cognition was measured over 3 years with a composite cognitive score (mean of 4 z-scores). RESULTS Placebo group subjects in the lowest quartile of baseline erythrocyte omega-3 index (i.e. ≤4.83%) underwent significantly more 3-year cognitive decline than the other quartiles (mean composite score difference 0.14, 95%CI [0.00, 0.28], p=0.048). In a ROC curve analysis, the optimal omega-3 index cut-off for predicting notable cognitive decline was 5.3%. There was a consistent but non-significant difference in 3-year cognitive decline of approximately 0.12 points between PUFA-treated and placebo subjects with "low" baseline omega-3 index when the cut-off was set at ≤5.27%. CONCLUSIONS Dementia-free older adults with an omega-3 index below approximately 5% are at increased risk of cognitive decline, and could be a good target population for testing the cognitive effects of PUFA supplementation.
Collapse
Affiliation(s)
- N Coley
- Nicola Coley, Faculté de Médecine, 37 allées Jules Guesde, 31000 Toulouse, France, Tel: +33 (0)5 61 14 56 80,
| | | | | | | | | | | |
Collapse
|
16
|
Andrieu S, Guyonnet S, Coley N, Cantet C, Bonnefoy M, Bordes S, Bories L, Cufi MN, Dantoine T, Dartigues JF, Desclaux F, Gabelle A, Gasnier Y, Pesce A, Sudres K, Touchon J, Robert P, Rouaud O, Legrand P, Payoux P, Caubere JP, Weiner M, Carrié I, Ousset PJ, Vellas B. Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): a randomised, placebo-controlled trial. Lancet Neurol 2017; 16:377-389. [PMID: 28359749 DOI: 10.1016/s1474-4422(17)30040-6] [Citation(s) in RCA: 508] [Impact Index Per Article: 72.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 01/25/2017] [Accepted: 01/29/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND No large trials have been done to investigate the efficacy of an intervention combining a specific compound and several lifestyle interventions compared with placebo for the prevention of cognitive decline. We tested the effect of omega 3 polyunsaturated fatty acid supplementation and a multidomain intervention (physical activity, cognitive training, and nutritional advice), alone or in combination, compared with placebo, on cognitive decline. METHODS The Multidomain Alzheimer Preventive Trial was a 3-year, multicentre, randomised, placebo-controlled superiority trial with four parallel groups at 13 memory centres in France and Monaco. Participants were non-demented, aged 70 years or older, and community-dwelling, and had either relayed a spontaneous memory complaint to their physician, limitations in one instrumental activity of daily living, or slow gait speed. They were randomly assigned (1:1:1:1) to either the multidomain intervention (43 group sessions integrating cognitive training, physical activity, and nutrition, and three preventive consultations) plus omega 3 polyunsaturated fatty acids (ie, two capsules a day providing a total daily dose of 800 mg docosahexaenoic acid and 225 mg eicosapentaenoic acid), the multidomain intervention plus placebo, omega 3 polyunsaturated fatty acids alone, or placebo alone. A computer-generated randomisation procedure was used to stratify patients by centre. All participants and study staff were blinded to polyunsaturated fatty acid or placebo assignment, but were unblinded to the multidomain intervention component. Assessment of cognitive outcomes was done by independent neuropsychologists blinded to group assignment. The primary outcome was change from baseline to 36 months on a composite Z score combining four cognitive tests (free and total recall of the Free and Cued Selective Reminding test, ten Mini-Mental State Examination orientation items, Digit Symbol Substitution Test, and Category Naming Test) in the modified intention-to-treat population. The trial was registered with ClinicalTrials.gov (NCT00672685). FINDINGS 1680 participants were enrolled and randomly allocated between May 30, 2008, and Feb 24, 2011. In the modified intention-to-treat population (n=1525), there were no significant differences in 3-year cognitive decline between any of the three intervention groups and the placebo group. Between-group differences compared with placebo were 0·093 (95% CI 0·001 to 0·184; adjusted p=0·142) for the combined intervention group, 0·079 (-0·012 to 0·170; 0·179) for the multidomain intervention plus placebo group, and 0·011 (-0·081 to 0·103; 0·812) for the omega 3 polyunsaturated fatty acids group. 146 (36%) participants in the multidomain plus polyunsaturated fatty acids group, 142 (34%) in the multidomain plus placebo group, 134 (33%) in the polyunsaturated fatty acids group, and 133 (32%) in the placebo group had at least one serious emerging adverse event. Four treatment-related deaths were recorded (two in the multidomain plus placebo group and two in the placebo group). The interventions did not raise any safety concerns and there were no differences between groups in serious or other adverse events. INTERPRETATION The multidomain intervention and polyunsaturated fatty acids, either alone or in combination, had no significant effects on cognitive decline over 3 years in elderly people with memory complaints. An effective multidomain intervention strategy to prevent or delay cognitive impairment and the target population remain to be determined, particularly in real-world settings. FUNDING French Ministry of Health, Pierre Fabre Research Institute, Gerontopole, Exhonit Therapeutics, Avid Radiopharmaceuticals.
Collapse
Affiliation(s)
- Sandrine Andrieu
- INSERM UMR 1027, Toulouse, France; University of Toulouse III, Toulouse, France; Department of Epidemiology and Public Health, CHU Toulouse, Toulouse, France.
| | - Sophie Guyonnet
- INSERM UMR 1027, Toulouse, France; University of Toulouse III, Toulouse, France; Gérontopôle, Department of Geriatrics, CHU Toulouse, Purpan University Hospital, Toulouse, France
| | - Nicola Coley
- INSERM UMR 1027, Toulouse, France; University of Toulouse III, Toulouse, France; Department of Epidemiology and Public Health, CHU Toulouse, Toulouse, France
| | - Christelle Cantet
- INSERM UMR 1027, Toulouse, France; University of Toulouse III, Toulouse, France; Gérontopôle, Department of Geriatrics, CHU Toulouse, Purpan University Hospital, Toulouse, France
| | - Marc Bonnefoy
- Geriatrics Department, Centre Hospitalier Lyon-Sud, Lyon, France
| | - Serge Bordes
- Geriatrics Department, Hospital of Tarbes, Tarbes, France
| | | | | | - Thierry Dantoine
- Geriatrics Department, Memory Research Resource Center, University Hospital of Limoges, Limoges, France
| | - Jean-François Dartigues
- INSERM U897, Memory Research Resource Center for Alzheimer's Disease, University Hospital of Bordeaux, Bordeaux, France
| | | | - Audrey Gabelle
- Memory Research Resource Center for Alzheimer's Disease, Department of Neurology, University Hospital of Montpellier, Montpellier, France; INSERM U1183, Montpellier, France
| | | | - Alain Pesce
- Geriatrics Department, Hospital of Princess Grace, Monaco
| | - Kristel Sudres
- Geriatrics Department, Hospital of Montauban, Montauban, France
| | - Jacques Touchon
- Memory Research Resource Center for Alzheimer's Disease, Department of Neurology, University Hospital of Montpellier, Montpellier, France; INSERM U1061, Montpellier, France
| | - Philippe Robert
- Memory Center CHU, CoBTeK 7276, University Côte d'Azur, Nice, France
| | - Olivier Rouaud
- Memory Research Resource Center, Neurology Department, University Hospital of Dijon, Dijon, France
| | | | - Pierre Payoux
- Department of Nuclear Medicine, CHU Toulouse, Purpan University Hospital, Toulouse, France; Toulouse NeuroImaging Centre, University of Toulouse, INSERM, UPS, France
| | | | - Michael Weiner
- University of California, San Francisco, San Francisco, CA, USA
| | - Isabelle Carrié
- Gérontopôle, Department of Geriatrics, CHU Toulouse, Purpan University Hospital, Toulouse, France
| | - Pierre-Jean Ousset
- INSERM UMR 1027, Toulouse, France; University of Toulouse III, Toulouse, France; Gérontopôle, Department of Geriatrics, CHU Toulouse, Purpan University Hospital, Toulouse, France
| | - Bruno Vellas
- INSERM UMR 1027, Toulouse, France; University of Toulouse III, Toulouse, France; Gérontopôle, Department of Geriatrics, CHU Toulouse, Purpan University Hospital, Toulouse, France
| | | |
Collapse
|
17
|
Loewenstein DA, Curiel RE, Duara R, Buschke H. Novel Cognitive Paradigms for the Detection of Memory Impairment in Preclinical Alzheimer's Disease. Assessment 2017; 25:348-359. [PMID: 29214859 DOI: 10.1177/1073191117691608] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
In spite of advances in neuroimaging and other brain biomarkers to assess preclinical Alzheimer's disease (AD), cognitive assessment has relied on traditional memory paradigms developed well over six decades ago. This has led to a growing concern about their effectiveness in the early diagnosis of AD which is essential to develop preventive and early targeted interventions before the occurrence of multisystem brain degeneration. We describe the development of novel tests that are more cognitively challenging, minimize variability in learning strategies, enhance initial acquisition and retrieval using cues, and exploit vulnerabilities in persons with incipient AD such as the susceptibility to proactive semantic interference, and failure to recover from proactive semantic interference. The advantages of various novel memory assessment paradigms are examined as well as how they compare with traditional neuropsychological assessments of memory. Finally, future directions for the development of more effective assessment paradigms are suggested.
Collapse
Affiliation(s)
| | | | - Ranjan Duara
- 2 Florida International University, Miami, FL, USA.,3 University of Florida, Gainesville, FL, USA.,4 Mount Sinai Medical Center, Miami Beach, FL, USA
| | | |
Collapse
|
18
|
Jutten RJ, Harrison J, de Jong FJ, Aleman A, Ritchie CW, Scheltens P, Sikkes SAM. A composite measure of cognitive and functional progression in Alzheimer's disease: Design of the Capturing Changes in Cognition study. ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2017; 3:130-138. [PMID: 29067324 PMCID: PMC5651369 DOI: 10.1016/j.trci.2017.01.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Cognitive testing in Alzheimer's disease (AD) is essential for establishing diagnosis, monitoring progression, and evaluating treatments. Assessments should ideally be brief, reliable, valid, and reflect clinically meaningful changes. There is a lack of instruments that meet all these criteria. In the Capturing Changes in Cognition (Catch-Cog) study, we seek to correct these deficiencies through the development and validation of a composite measure combining cognition and function: the cognitive-functional composite (CFC). We expect that the CFC is able to detect clinically relevant changes over time in early dementia stages of AD. METHODS/DESIGN We will include patients (n = 350) with mild cognitive impairment or mild dementia due to AD from memory clinics in the Netherlands and the United Kingdom. We will include cognitively healthy volunteers (n = 30) as a control group. The CFC is based on the "cognitive composite" and the Amsterdam instrumental activities of daily living questionnaire. We will investigate test-retest reliability with baseline and 2- to 3-week follow-up assessments (n = 50 patients and n = 30 healthy controls). We will involve experts and participants to evaluate the initial feasibility and refine the CFC if needed. Subsequently, we will perform a longitudinal construct validation study in a prospective cohort (n = 300) with baseline, 3-, 6-, and 12-month follow-up assessments. The main outcome is cognitive and functional progression measured by the CFC. Reference measures for progression include traditional cognitive and functional tests, disease burden measures, and brain imaging methods. Using linear mixed modeling, we will investigate longitudinal changes on the CFC and relate these to the reference measures. Using linear regression analyses, we will evaluate the influence of possible confounders such as age, gender, and education on the CFC. DISCUSSION By performing an independent longitudinal construct validation, the Catch-Cog study of the novel CFC will contribute to the improvement of disease monitoring and treatment evaluation in early dementia stages of AD.
Collapse
Affiliation(s)
- Roos J Jutten
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - John Harrison
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Metis Cognition Ltd, Kilmington Common, Warminster, United Kingdom
| | - Frank Jan de Jong
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - André Aleman
- Department of Neurosciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Craig W Ritchie
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, United Kingdom
| | - Philip Scheltens
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Sietske A M Sikkes
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| |
Collapse
|