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Santos F, Renuy A, Ozguler A, Ribet C, Goldberg M, Zins M, Artaud F, Elbaz A. Norms for Usual and Fast Walking Speed in Adults 45-69 Years Old From the French General Population: Constances Study. J Am Med Dir Assoc 2024; 25:266-274. [PMID: 37944906 DOI: 10.1016/j.jamda.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 09/25/2023] [Accepted: 10/01/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES Walking speed (WS) represents an objective measure of motor function and health. We aimed to develop usual (UWS) and fast WS (FWS) norms for the general population using a regression-based approach, while considering age, sex, height, and education. DESIGN Cross-sectional analysis of a population-based study. SETTING AND PARTICIPANTS French Constances study (45-69 years). METHODS UWS/FWS were measured over 3 m (dynamic start) using photoelectric cells. We addressed selection effects (related to survey sampling and nonresponse) and missing data using a combination of inverse probability weighting (IPW) and multiple imputation (MI). Norms by sex, age, height, and education ( RESULTS Analyses are based on 44,772 participants (51.2% women) with a mean age of 56.8 years (SE = 0.2) for women and 57.3 years (SE = 0.2) for men, and a mean height of 161.4 cm (SE = 0.1) for women and 174.2 cm (SE = 0.1) for men after IPW/MI. WS estimates decreased after IPW/MI. The mean UWS was 116.9 cm/s (SE = 0.8) in women and 120.7 cm/s (SE = 0.8) in men, and the mean FWS was 168.7 cm/s (SE = 1.0) in women and 182.8 cm/s (SE = 1.2) in men. In the multiadjusted model, UWS/FWS decreased with age and increased with height and education. Men had faster FWS than women; they had slightly slower UWS than women in the low-education group, but there were no sex differences in the high-education group. CONCLUSIONS AND IMPLICATIONS We developed UWS/FWS norms by age, sex, height, and education for the French general population (45-69 years) that are available through a web app (https://cesp-proxy2.vjf.inserm.fr/NORMES-VM-EN/). These norms can be used to identify in midlife persons with lower motor performances than the general population, given their age, sex, height, and education, who are at higher risk of adverse outcomes.
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Affiliation(s)
- Félicia Santos
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 94805, Villejuif, France
| | - Adeline Renuy
- Inserm, Université Paris Cité, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), UMS 011 « Population-based cohorts unit », Villejuif, France
| | - Anna Ozguler
- Inserm, Université Paris Cité, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), UMS 011 « Population-based cohorts unit », Villejuif, France
| | - Céline Ribet
- Inserm, Université Paris Cité, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), UMS 011 « Population-based cohorts unit », Villejuif, France
| | - Marcel Goldberg
- Inserm, Université Paris Cité, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), UMS 011 « Population-based cohorts unit », Villejuif, France
| | - Marie Zins
- Inserm, Université Paris Cité, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), UMS 011 « Population-based cohorts unit », Villejuif, France
| | - Fanny Artaud
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 94805, Villejuif, France
| | - Alexis Elbaz
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 94805, Villejuif, France.
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Segaux L, Oubaya N, Leissing-Desprez C, Cleret De Langavant L, Broussier A, Naga H, Fromentin I, David JP, Bastuji-Garin S. More than a third of middle-aged adults (50-65) have understated executive dysfunction. Aging Ment Health 2022; 27:708-713. [PMID: 35243938 DOI: 10.1080/13607863.2022.2046696] [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] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Understated executive dysfunction (UED) is predictive of cognitive decline and death. We aimed to assess the prevalence of UED, assessed with the clock-drawing test (CDT) and the Frontal Assessment Battery (FAB) in middle-aged adults and to investigate associated characteristics. METHODS Cross-sectional analysis of data on 516 community-dwellers aged 50-65, lacking cognitive complaints, who were included prospectively (2010-2017) after a multidimensional geriatric assessment at a "healthy ageing" outpatient clinic. Age- and educational-level-adjusted logistic models were used to assess factors associated with UED. RESULTS The CDT and FAB were impaired in 27.7% and 14.7% of the participants (median age: 59.7 years). The prevalence [95% confidence interval (CI)] of UED was 36.2% [32.2-40.5%]. After adjustment for age and education, participants with UED were more likely to be obese (odds ratio [95%CI] = 1.89 [1.12-3.19], P = 0.02), and to have a metabolic syndrome (1.98 [1.06-3.72], P = 0.03). CONCLUSION More than one third of middle-aged adults without cognitive complaints have UED, which was linked to obesity and metabolic syndrome. Cognitive screening tests targeting executive functions might be useful for early detection of UED and the initiation of multidomain interventions improving cognitive performance.
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Affiliation(s)
- Lauriane Segaux
- Univ Paris Est Creteil, INSERM, IMRB, Creteil, France.,AP-HP, Hôpital Henri-Mondor, Clinical Research Unit (URC Mondor), Creteil, France
| | - Nadia Oubaya
- Univ Paris Est Creteil, INSERM, IMRB, Creteil, France.,Department of Public Health, AP-HP, Hôpital Henri-Mondor, Creteil, France
| | - Claire Leissing-Desprez
- Univ Paris Est Creteil, INSERM, IMRB, Creteil, France.,Department of Geriatric Medicine, AP-HP, Hôpital Emile Roux, Limeil-Brevannes, France
| | - Laurent Cleret De Langavant
- Département d'Etudes Cognitives, École normale supérieure, PSL Research University, Paris, France.,Univ Paris Est Creteil, INSERM, IMRB, Equipe NeuroPsychologie Interventionnelle, Creteil, France.,AP-HP, Hôpital Henri Mondor, Centre de référence Maladie de Huntington, Department of Neurology, Creteil, France
| | - Amaury Broussier
- Univ Paris Est Creteil, INSERM, IMRB, Creteil, France.,Department of Geriatric Medicine, AP-HP, Hôpital Emile Roux, Limeil-Brevannes, France
| | - Henri Naga
- Department of Geriatric Medicine, AP-HP, Hôpital Emile Roux, Limeil-Brevannes, France
| | - Isabelle Fromentin
- Department of Geriatric Medicine, AP-HP, Hôpital Emile Roux, Limeil-Brevannes, France
| | - Jean-Philippe David
- Univ Paris Est Creteil, INSERM, IMRB, Creteil, France.,Department of Geriatric Medicine, AP-HP, Hôpital Henri-Mondor, Creteil, France
| | - Sylvie Bastuji-Garin
- Univ Paris Est Creteil, INSERM, IMRB, Creteil, France.,Department of Public Health, AP-HP, Hôpital Henri-Mondor, Creteil, France
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3
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Bishnoi A, Hernandez ME. Dual task walking costs in older adults with mild cognitive impairment: a systematic review and meta-analysis. Aging Ment Health 2021; 25:1618-1629. [PMID: 32757759 DOI: 10.1080/13607863.2020.1802576] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective of this systematic review and meta-analysis (PROSPERO registration No CRD42020192121) is to review existing literature focusing on effects of different dual task paradigms on walking speed in older adults with and without Mild Cognitive Impairment. METHODS (1) Data Sources: PubMEd, Cumulative Index of Nursing and Allied Health, Cochrane library, and Web of Science. (2) Study Selection: The key terms searched included those associated with dual task, walking speed, executive function, older adults, and MCI. (3) Data Extraction: The search yielded 140 results with 20 studies meeting the inclusion criteria, which were rated by two independent reviewers using the Quality Assessment Tool. Descriptions of each study including the single and dual task protocol, outcome measure, and final outcomes were extracted. Meta-analysis was performed to evaluate the dual task effects on walking costs in older adults with and without MCI. RESULTS Meta-analysis revealed that there were significant differences in the dual task walking costs among older adults with or without MCI (p < .05). Pooled effect sizes of the serial subtraction (9.54; 95%CI, 3.93-15.15) and verbal fluency tasks (10.06; 95%CI, 6.26-15.65) showed that there are higher motor dual-task costs in older adults with MCI than age-matched controls. For quality assessment, all studies ranged from 12 to 16 in score, out of 18 (high quality). CONCLUSIONS In the studies included in this review, mental tracking tasks, consisting of serial subtraction and verbal fluency, were found to be the most sensitive in detecting MCI-related changes in older adults, and could serve an important role as a target measure for evaluating the efficacy of interventions aimed at improving cognitive and motor function in older adults.
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Affiliation(s)
- Alka Bishnoi
- Mobility and Fall Prevention Research Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Manuel E Hernandez
- Mobility and Fall Prevention Research Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Nilsson MH, Tangen GG, Palmqvist S, van Westen D, Mattsson-Carlgren N, Stomrud E, Hansson O. The Effects of Tau, Amyloid, and White Matter Lesions on Mobility, Dual Tasking, and Balance in Older People. J Gerontol A Biol Sci Med Sci 2021; 76:683-691. [PMID: 32506119 PMCID: PMC8011701 DOI: 10.1093/gerona/glaa143] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Indexed: 11/12/2022] Open
Abstract
Background This study aimed to investigate whether white matter lesions (WML), β-amyloid-, and tau pathologies are independently associated with mobility, dual tasking, and dynamic balance performance in older nondemented individuals. Methods We included 299 older people (mean, SD, age: 71.8, 5.6 years) from the Swedish BioFINDER study, whereof 175 were cognitively unimpaired and 124 had mild cognitive impairment (MCI). In multivariable regression analyses, dependent variables included mobility (Timed Up & Go [TUG]), dual tasking (TUG with a simultaneous subtraction task, that is, TUG-Cog, as well as dual task cost), and balance (Figure-of-eight). The analyses were controlled for age, sex, education, diagnosis (ie, MCI), and comorbidity (stroke, diabetes, and ischemic heart disease). Independent variables included WML volume, and measures of β-amyloid (abnormal cerebrospinal fluid [CSF] Aβ42/40 ratio) and tau pathology (CSF phosphorylated tau [p-tau]). Results Multivariable regression analyses showed that an increased WML volume was independently associated with decreased mobility, that is, TUG (standardized β = 0.247; p < .001). Tau pathology was independently associated with dual tasking both when using the raw data of TUG-Cog (β = 0.224; p = .003) and the dual-task cost (β= −0.246; p = .001). Amyloid pathology was associated with decreased balance, that is, Figure-of-eight (β = 0.172; p = .028). The independent effects of WML and tau pathology were mainly observed in those with MCI, which was not the case for the effects of amyloid pathology on balance. Conclusions Common brain pathologies have different effects where WML are independently associated with mobility, tau pathology has the strongest effect on dual tasking, and amyloid pathology seems to be independently associated with balance. Although these novel findings need to be confirmed in longitudinal studies, they suggest that different brain pathologies have different effects on mobility, balance, and dual-tasking in older nondemented individuals.
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Affiliation(s)
- Maria H Nilsson
- Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.,Clinical Memory Research Unit, Faculty of Medicine, Lund University, Sweden
| | - Gro Gujord Tangen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tonsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Norway
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Danielle van Westen
- Diagnostic Radiology, Department of Clinical Sciences, Lund University, Sweden.,Image and Function, Skane University Hospital, Lund, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Sweden.,Wallenberg Center for Molecular Medicine, Lund University, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
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Segaux L, Broussier A, Oubaya N, Leissing-Desprez C, Laurent M, Naga H, Fromentin I, David JP, Bastuji-Garin S. Several frailty parameters highly prevalent in middle age (50-65) are independent predictors of adverse events. Sci Rep 2021; 11:8774. [PMID: 33888851 PMCID: PMC8062562 DOI: 10.1038/s41598-021-88410-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 04/09/2021] [Indexed: 12/26/2022] Open
Abstract
Although frailty can arise in middle age, very few studies have investigated frailty before 65 years. Our objectives were to assess the prevalence of frailty parameters in middle-aged individuals and probe the association with future adverse events. We performed cross-sectional and longitudinal analyses of community-dwelling individuals aged 50 to 65 (n = 411, median age: 59.0) having undergone a multidomain geriatric assessment (2010–2015) in an outpatient clinic in the greater Paris area of France (SUCCEED cohort). The primary outcome was a composite measure of adverse events (non-accidental falls, fractures, unplanned hospitalizations, death), recorded in 2016/2017. Multivariable logistic regression models were built to identify independent predictors. Six frailty parameters were highly prevalent (> 20%): low activity (40.1%), exhaustion (31.3%), living alone (28.5%), balance impairment (26.8%), weakness (26.7%), and executive dysfunction (23.2%). Female sex (odds ratio: 2.67 [95% confidence interval: 1.17–6.11]), living alone (2.39 [1.32–4.33]), balance impairment (2.09 [1.16–3.78]), executive dysfunction (2.61, [1.18–5.77]), and exhaustion (2.98 [1.65–5.39]) were independent predictors of adverse events. Many frailty parameters are already altered in middle-aged individuals and are predictive of adverse health events. Our findings highlight a possible need for frailty screening and preventive programs targeting middle-aged individuals.
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Affiliation(s)
- Lauriane Segaux
- Univ Paris Est Creteil, INSERM, IMRB, 94010, Creteil, France. .,Clinical Research Unit (URC Mondor), AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil Cedex, France.
| | - Amaury Broussier
- Univ Paris Est Creteil, INSERM, IMRB, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94450, Limeil-Brévannes, France
| | - Nadia Oubaya
- Univ Paris Est Creteil, INSERM, IMRB, 94010, Creteil, France.,Department of Public Health, AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil, France
| | - Claire Leissing-Desprez
- Univ Paris Est Creteil, INSERM, IMRB, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94450, Limeil-Brévannes, France
| | - Marie Laurent
- Univ Paris Est Creteil, INSERM, IMRB, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94450, Limeil-Brévannes, France
| | - Henri Naga
- Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94450, Limeil-Brévannes, France
| | - Isabelle Fromentin
- Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94450, Limeil-Brévannes, France
| | - Jean-Philippe David
- Univ Paris Est Creteil, INSERM, IMRB, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil, France.,Departments of Geriatric Medicine, AP-HP, Hôpitaux Henri-Mondor, 94450, Limeil-Brévannes, France
| | - Sylvie Bastuji-Garin
- Univ Paris Est Creteil, INSERM, IMRB, 94010, Creteil, France.,Clinical Research Unit (URC Mondor), AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil Cedex, France.,Department of Public Health, AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil, France
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6
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Leissing-Desprez C, Thomas E, Segaux L, Broussier A, Oubaya N, Marie-Nelly N, Laurent M, Cleret de Langavant L, Fromentin I, David JP, Bastuji-Garin S. Understated Cognitive Impairment Assessed with the Clock-Drawing Test in Community-Dwelling Individuals Aged ≥50 Years. J Am Med Dir Assoc 2020; 21:1658-1664. [PMID: 32387111 DOI: 10.1016/j.jamda.2020.03.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To estimate the prevalence of understated cognitive impairment by administering the Clock-Drawing Test (CDT) to community-dwelling individuals aged ≥50 years and to investigate the associated clinical phenotype. DESIGN A cross-sectional analysis of baseline data on community-dwelling individuals assessed at an outpatient clinic in the Paris region of France. SETTING AND PARTICIPANTS Participants aged ≥50 years (n = 488, median age: 62.1 years) prospectively included in the SUCCessful agEing outpatiEnt's Department survey between 2010 and 2014. METHODS A multidimensional geriatric assessment, including cognition [7-point CDT, Mini-Mental State Examination (MMSE), the 5-word screening test (5-WT), and the Frontal Assessment Battery (FAB)], gait speed in dual tasks, mood [the Geriatric Depression Scale (GDS)], balance, physical functions (gait speed and handgrip strength), nutrition, bone density, and comorbidities; major cardiovascular risk factors, and Scheltens and Fazekas scores on brain magnetic resonance imaging. Baseline characteristics were analyzed as a function of the CDT score (<7 vs 7), using age-adjusted logistic models. RESULTS The prevalence of impairment in the CDT was 23.6%; higher than the values for the MMSE (12.7%), 5-WT (2.3%), and FAB (16.6%). In age-adjusted analyses, a lower educational level (odds ratio [95% confidence interval] = 0.72 [0.58‒0.89]), diabetes (2.57 [1.14‒5.79]), metabolic syndrome (1.93 [1.05‒3.56]), lower gait speed in the cognitive dual task (1.27 [1.05‒1.53]), a poorer Geriatric Depression Scale score (1.86 [1.04‒3.32]), a poorer MMSE score (2.56 [1.35‒4.88]), a poorer FAB score (1.79 [1.01‒3.16]), impaired episodic memory in the 5-WT (4.11 [1.12‒15.02]), and a higher Scheltens score (P = .001) were significantly associated with CDT impairment. CONCLUSIONS AND IMPLICATIONS Understated cognitive impairment is common among young seniors and is associated with factors known to be linked to a higher risk of cognitive decline and dementia. These findings suggest that the CDT may be of value for identifying high-risk individuals who may then benefit from targeted multidomain prevention actions (diet, exercise, cognitive training, and vascular risk factor management).
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Affiliation(s)
- Claire Leissing-Desprez
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, Creteil, France; AP-HP, Hôpitaux Henri-Mondor, Department of Geriatric Medecine, Creteil, France.
| | - Emilie Thomas
- AP-HP, Hôpitaux Henri-Mondor, Department of Geriatric Medecine, Creteil, France
| | - Lauriane Segaux
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, Creteil, France; AP-HP, Hôpitaux Henri-Mondor, Clinical Research Unit (URC Mondor), Creteil, France
| | - Amaury Broussier
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, Creteil, France; AP-HP, Hôpitaux Henri-Mondor, Department of Geriatric Medecine, Creteil, France
| | - Nadia Oubaya
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, Creteil, France; AP-HP, Hôpitaux Henri-Mondor, Department of Public Health, Creteil, France
| | | | - Marie Laurent
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, Creteil, France; AP-HP, Hôpitaux Henri-Mondor, Department of Geriatric Medecine, Creteil, France
| | - Laurent Cleret de Langavant
- AP-HP, Hôpitaux Henri-Mondor, Department of Neurology, Creteil, France; INSERM U955 E01, IMRB and ENS-DEC, PSL Research University (NeuroPsychologie Interventionnelle), Creteil and Paris, France
| | - Isabelle Fromentin
- AP-HP, Hôpitaux Henri-Mondor, Department of Geriatric Medecine, Creteil, France
| | - Jean-Philippe David
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, Creteil, France; AP-HP, Hôpitaux Henri-Mondor, Department of Geriatric Medecine, Creteil, France
| | - Sylvie Bastuji-Garin
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, Creteil, France; AP-HP, Hôpitaux Henri-Mondor, Clinical Research Unit (URC Mondor), Creteil, France; AP-HP, Hôpitaux Henri-Mondor, Department of Public Health, Creteil, France
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7
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Hada M, Azuma T, Irie K, Yonenaga T, Watanabe K, Deguchi F, Obora A, Kojima T, Tomofuji T. Periodontal Condition Is Correlated with Deep and Subcortical White Matter Hyperintensity Lesions in Japanese Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051694. [PMID: 32150917 PMCID: PMC7084602 DOI: 10.3390/ijerph17051694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 11/16/2022]
Abstract
Deep and subcortical white matter hyperintensity (DSWMH) lesions are a small-vessel disease of the brain. The aim of this cross-sectional study was to investigate the relationship between DSWMH lesions and periodontal status in Japanese adults who participated in a health check. We enrolled 444 consecutive participants (mean age, 54.5 years) who received both brain and oral health evaluation services at the Asahi University Hospital. Magnetic resonance imaging was used to detect DSWMH lesions. Periodontal status was assessed using the community periodontal index. Of the study participants, 215 (48.4%) had DSWMH lesions. Multivariate logistic regression showed that the presence of DSWMH lesions was significantly related to age ≥ 65 years (vs. < 65 years, odds ratio [OR] = 2.984, 95% confidence interval [CI] = 1.696-5.232), systolic blood pressure ≥ 140 mmHg (vs. < 140 mmHg, OR = 2.579, 95% CI = 1.252-5.314), the presence of ≥ 28 teeth (vs. < 28 teeth, OR = 0.635, 95% CI = 0.420-0.961), and probing pocket depth (PPD) ≥ 6 mm (vs. PPD < 6 mm, OR = 1.948, 95% CI = 1.132-3.354) after adjustment for confounding factors. Having PPD ≥ 6 mm may be a risk factor for DSWMH lesions in Japanese adults.
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Affiliation(s)
- Minako Hada
- Department of Community Oral Health, School of Dentistry, Asahi University, Mizuho, Gifu 501-0296, Japan; (M.H.); (T.A.); (T.Y.)
| | - Tetsuji Azuma
- Department of Community Oral Health, School of Dentistry, Asahi University, Mizuho, Gifu 501-0296, Japan; (M.H.); (T.A.); (T.Y.)
| | - Koichiro Irie
- Department of Oral Health and Preventive Dentistry, Meikai University School of Dentistry, Sakado, Saitama 350-0283, Japan;
| | - Takatoshi Yonenaga
- Department of Community Oral Health, School of Dentistry, Asahi University, Mizuho, Gifu 501-0296, Japan; (M.H.); (T.A.); (T.Y.)
| | - Kazutoshi Watanabe
- Asahi University Hospital, 3- 23 Hashimoto-cho, Gifu, Gifu 500-8523, Japan; (K.W.); (F.D.); (A.O.); (T.K.)
| | - Fumiko Deguchi
- Asahi University Hospital, 3- 23 Hashimoto-cho, Gifu, Gifu 500-8523, Japan; (K.W.); (F.D.); (A.O.); (T.K.)
| | - Akihiro Obora
- Asahi University Hospital, 3- 23 Hashimoto-cho, Gifu, Gifu 500-8523, Japan; (K.W.); (F.D.); (A.O.); (T.K.)
| | - Takao Kojima
- Asahi University Hospital, 3- 23 Hashimoto-cho, Gifu, Gifu 500-8523, Japan; (K.W.); (F.D.); (A.O.); (T.K.)
| | - Takaaki Tomofuji
- Department of Community Oral Health, School of Dentistry, Asahi University, Mizuho, Gifu 501-0296, Japan; (M.H.); (T.A.); (T.Y.)
- Correspondence: ; Tel.: +81-58-329-1496
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8
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Ersoy A, Yasar H, Mertoglu C, Koc U, Akturan S, Gok G, Erel O. Is ischemia associated with the formation of White matter lesions in migraine? Clin Neurol Neurosurg 2020; 193:105770. [PMID: 32197144 DOI: 10.1016/j.clineuro.2020.105770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/12/2020] [Accepted: 03/01/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVE White matter lesions (WMLs) are more common in migraine patients than in the normal population. Ischemia/hypoxia and oxidative stress are considered to play a role in WMLs formation. This study aimed to investigate ischemia-modified albumin (IMA), ferroxidase and thiol/disulfide homeostasis in migraineurs with and without WMLs. PATIENTS AND METHODS Sixty-two migraineurs with WML, 59 migraineurs without WML and 61 controls were included in the study. All participants underwent brain MRI. WMLs was evaluated according to the Fazekas scale. IMA, ferroxidase, total thiol, native thiol and disulfide measurements were carried out in all participants. RESULTS The IMA levels were higher in the migraine groups compared to the control group (p < 0.001) and in the WML group compared to non-WML (p < 0.001). The total and native thiol levels were higher in the non-WML group compared to the control and WML groups (p < 0.001 for both). The disulfide levels were similar between the control and non-WML groups, but they were significantly lower in the WML group compared to the control and non-WML groups. There was no significant difference between the groups in terms of the ferroxidase levels (p = 0.092). The thiol/disulfide, IMA and ferroxidase levels were not significantly correlated with the frequency and duration of attacks, severity of pain and disability due to migraine. CONCLUSION Increased serum IMA levels in migraineurs point to the role of ischemia/hypoxia, and increased total thiol and decreased disulfide levels indicate an oxidant/antioxidant imbalance in migraine. Ischemia/hypoxia may play a role in WMLs formation in migraine.
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Affiliation(s)
- Alevtina Ersoy
- Neurology, Erzincan Binali Yildirim University, Faculty of Medcine, Erzincan, Turkey.
| | - Hasan Yasar
- Neurology, Erzincan Binali Yildirim University, Faculty of Medcine, Erzincan, Turkey
| | - Cuma Mertoglu
- Clinical Biochemistry, Erzincan Binali Yildirim University, Faculty of Medicine, Erzincan, Turkey
| | - Ural Koc
- Radiology, Golbasi Sehit Ahmet Ozsoy State Hospital, Ankara, Turkey
| | - Selcuk Akturan
- Medicine Education, Karadeniz Tecnical University, Faculty of Medicine, Trabzon, Turkey
| | - Gamze Gok
- Clinical Biochemistry, Yildirim Beyazit University, Faculty of Medicine, Ankara, Turkey
| | - Ozcan Erel
- Clinical Biochemistry, Yildirim Beyazit University, Faculty of Medicine, Ankara, Turkey
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9
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Segaux L, Oubaya N, Broussier A, Baude M, Canouï-Poitrine F, Naga H, Laurent M, Leissing-Desprez C, Audureau E, Ferrat E, Chailloleau C, Fromentin I, David JP, Bastuji-Garin S. Identification of five frailty profiles in community-dwelling individuals aged 50-75: A latent class analysis of the SUCCEED survey data. Maturitas 2019; 127:1-11. [PMID: 31351514 DOI: 10.1016/j.maturitas.2019.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 04/24/2019] [Accepted: 05/13/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVES We sought to identify frailty profiles in individuals aged 50-75 by considering frailty as an unobservable latent variable in a latent class analysis (LCA). STUDY DESIGN 589 prospectively enrolled community-dwelling individuals aged 50-75 (median: 61.7 years) had undergone a standardized, multidomain assessment in 2010-2015. Adverse health outcomes (non-accidental falls, fractures, unplanned hospitalizations, and death) that had occurred since the assessment were recorded in 2016-2017. MAIN OUTCOME MEASURES The LCA used nine indicators (unintentional weight loss, relative slowness, weakness, impaired balance, osteoporosis, impaired cognitive functions, executive dysfunction, depression, and hearing impairment) and three covariates (age, gender, and consultation for health complaints). The resulting profiles were characterized by the Fried phenotype and adverse health outcomes. RESULTS We identified five profiles: "fit" (LC1, 29.7% of the participants; median age: 59 years); "weight loss, relative slowness, and osteoporosis" (LC2, 33.2%; 63 years); "weakness and osteopenia" (LC3, 21.9%; 60 years); "impaired physical and executive functions" (LC4, 11%; 67 years); and "impaired balance, cognitive functions, and depression" (LC5, 4.3%; 70 years). Almost all members of LC3 and LC4 were female, and were more likely than members of other profiles to have a frail or pre-frail Fried phenotype. Non-accidental falls were significantly more frequent in LC4. LC5 (almost all males) had the highest number of comorbidities and cardiovascular risk factors but none was frail. CONCLUSIONS Our data-driven approach covered most geriatric assessment domains and identified five frailty profiles. With a view to tailoring interventions and prevention, frailty needs to be detected among young seniors.
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Affiliation(s)
- Lauriane Segaux
- Université Paris Est (UPEC), IMRB, A-TVB DHU, CEpiA EA 7376 (Clinical Epidemiology and Ageing Unit), Créteil, France; Assistance Publique Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Clinical Research Unit (URC Mondor), Créteil, France.
| | - Nadia Oubaya
- Université Paris Est (UPEC), IMRB, A-TVB DHU, CEpiA EA 7376 (Clinical Epidemiology and Ageing Unit), Créteil, France; AP-HP, Hôpital Henri-Mondor, Department of Public Health, Créteil, France
| | - Amaury Broussier
- Université Paris Est (UPEC), IMRB, A-TVB DHU, CEpiA EA 7376 (Clinical Epidemiology and Ageing Unit), Créteil, France; AP-HP, Hôpital Henri-Mondor/Emile Roux, Department of Geriatrics, Créteil, France
| | - Marjolaine Baude
- AP-HP, Hôpital Henri-Mondor, Department of Public Health, Créteil, France
| | - Florence Canouï-Poitrine
- Université Paris Est (UPEC), IMRB, A-TVB DHU, CEpiA EA 7376 (Clinical Epidemiology and Ageing Unit), Créteil, France; AP-HP, Hôpital Henri-Mondor, Department of Public Health, Créteil, France
| | - Henri Naga
- AP-HP, Hôpital Henri-Mondor/Emile Roux, Department of Geriatrics, Créteil, France
| | - Marie Laurent
- Université Paris Est (UPEC), IMRB, A-TVB DHU, CEpiA EA 7376 (Clinical Epidemiology and Ageing Unit), Créteil, France; AP-HP, Hôpital Henri-Mondor/Albert Chenevier, Department of Geriatrics, Créteil, France
| | - Claire Leissing-Desprez
- Université Paris Est (UPEC), IMRB, A-TVB DHU, CEpiA EA 7376 (Clinical Epidemiology and Ageing Unit), Créteil, France; AP-HP, Hôpital Henri-Mondor/Emile Roux, Department of Geriatrics, Créteil, France
| | - Etienne Audureau
- Université Paris Est (UPEC), IMRB, A-TVB DHU, CEpiA EA 7376 (Clinical Epidemiology and Ageing Unit), Créteil, France; AP-HP, Hôpital Henri-Mondor, Department of Public Health, Créteil, France
| | - Emilie Ferrat
- Université Paris Est (UPEC), IMRB, A-TVB DHU, CEpiA EA 7376 (Clinical Epidemiology and Ageing Unit), Créteil, France; UPEC, Faculté de médecine de Créteil, Primary Care Department, Créteil, France
| | | | - Isabelle Fromentin
- AP-HP, Hôpital Henri-Mondor/Emile Roux, Department of Geriatrics, Créteil, France
| | - Jean-Philippe David
- Université Paris Est (UPEC), IMRB, A-TVB DHU, CEpiA EA 7376 (Clinical Epidemiology and Ageing Unit), Créteil, France; AP-HP, Hôpital Henri-Mondor/Emile Roux, Department of Geriatrics, Créteil, France
| | - Sylvie Bastuji-Garin
- Université Paris Est (UPEC), IMRB, A-TVB DHU, CEpiA EA 7376 (Clinical Epidemiology and Ageing Unit), Créteil, France; Assistance Publique Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Clinical Research Unit (URC Mondor), Créteil, France; AP-HP, Hôpital Henri-Mondor, Department of Public Health, Créteil, France
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10
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Mol A, Reijnierse EM, Bui Hoang PTS, van Wezel RJ, Meskers CG, Maier AB. Orthostatic hypotension and physical functioning in older adults: A systematic review and meta-analysis. Ageing Res Rev 2018; 48:122-144. [PMID: 30394339 DOI: 10.1016/j.arr.2018.10.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 09/17/2018] [Accepted: 10/17/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Orthostatic hypotension (OH) may negatively affect physical functioning and aggravate morbidities, but existing evidence is contradictory. METHODS MEDLINE (from 1946), PubMed (from 1966) and EMBASE databases (from 1947) were systematically searched for studies on the association of OH and physical functioning in older adults, categorized as: balance, gait characteristics, walking speed, Timed Up and Go time, handgrip strength (HGS), physical frailty, exercise tolerance, physical activity, activities of daily living (ADL), and performance on the Hoehn and Yahr scale (HY) and Unified Parkinson's Disease Rating Scale (UPDRS). Study quality was assessed using the Newcastle Ottawa Scale. RESULTS Forty-two studies were included in the systematic review (29,421 individuals) and 29 studies in the meta-analyses (23,879 individuals). Sixteen out of 42 studies reported a significant association of OH with worse physical functioning. Meta-analysis showed a significant association of OH with impaired balance, ADL performance and HY/UPDRS III performance, but not with gait characteristics, mobility, walking speed, TUG, HGS, physical frailty, exercise tolerance, physical activity and UPDRS II performance. CONCLUSIONS OH was associated with impaired balance, ADL performance and HY/UPDRS III performance, but not with other physical functioning categories. The results suggest that OH interventions could potentially improve some aspects of physical functioning.
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11
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White matter lesions in magnetic resonance imaging of the brain in 56 patients with visual vertigo. The Journal of Laryngology & Otology 2018; 132:550-553. [PMID: 30019667 DOI: 10.1017/s0022215118000701] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Visual vertigo is defined as a condition in which there is worsening or triggering of vestibular symptoms in certain visual environments. Previous studies have associated visual vertigo with an increased prevalence of underlying white matter lesions on brain imaging. METHOD This study evaluated the magnetic resonance imaging scans of the brain from a cohort of patients with visual vertigo, and compared the outcomes to an age- and gender-matched group of healthy volunteers.Results and conclusionWhite matter lesions were observed in 17.9 per cent of the patient group and in 16.3 per cent of the control group. The prevalence of white matter lesions in the patient group was not too different to that expected based on age.
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12
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Kuriyama N, Ozaki E, Mizuno T, Ihara M, Mizuno S, Koyama T, Matsui D, Watanabe I, Akazawa K, Takeda K, Takada A, Inaba M, Yamada S, Motoyama K, Takeshita W, Iwai K, Hashiguchi K, Kobayashi D, Kondo M, Tamura A, Yamada K, Nakagawa M, Watanabe Y. Association between α-Klotho and Deep White Matter Lesions in the Brain: A Pilot Case Control Study Using Brain MRI. J Alzheimers Dis 2018; 61:145-155. [PMID: 29154273 DOI: 10.3233/jad-170466] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The anti-aging protein, α-Klotho, may be involved in cognitive decline and has potential as a surrogate marker that reflects dementia. However, the role of α-Klotho in the brain has not been sufficiently investigated. OBJECTIVE Here, we investigated the association between α-Klotho and cognitive decline that is associated with cerebral deep white matter lesions (DWMLs). METHODS Two hundred-eighty participants (187 males and 93 females, mean age: 70.8 years old) were evaluated for DWMLs, and the Fazekas scale (Grade) was assessed following brain magnetic resonance imaging. A questionnaire concerning lifestyle and neuropsychological tests was administered, and their associations with the blood α-Klotho level were retrospectively investigated. RESULTS The α-Klotho level was 685.1 pg/mL in Grade 0 (68 subjects), 634.1 in G1 (134), 596.0 in G2 (62), and 571.6 in G3 (16), showing that the level significantly decreased with advanced grades. Significant correlations were noted between the α-Klotho level and higher brain function tests including the Mini-Mental State Examination and word fluency tests (p < 0.05). When a 90th percentile value of the level in the G0 group (400 pg/mL) or lower was defined as a low α-Klotho level, the odds ratio of the high-grade G3 group was 2.9 (95% confidence interval: 1.4-7.8) (after correction for age, sex, hypertension, and chronic kidney disease), which was significant. CONCLUSION A reduced blood α-Klotho level was correlated with grading of cerebral DWMLs and was accompanied by cognitive decline as an independent risk factor. The α-Klotho level may serve as a useful clinical index of vascular cognitive impairment.
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Affiliation(s)
- Nagato Kuriyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Department of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Etsuko Ozaki
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Toshiki Mizuno
- Department of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masafumi Ihara
- Division of Neurology, Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Shigeto Mizuno
- Department of Endoscopy, Kindai University Nara Hospital, Japan
| | - Teruhide Koyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Daisuke Matsui
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Isao Watanabe
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kentaro Akazawa
- Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kazuo Takeda
- Kyoto Industrial Health Association, Kyoto, Japan
| | | | - Masaaki Inaba
- Department of Metabolism, Endocrinology, and Molecular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Shinsuke Yamada
- Department of Metabolism, Endocrinology, and Molecular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Koka Motoyama
- Department of Metabolism, Endocrinology, and Molecular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Wakiko Takeshita
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Komei Iwai
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kanae Hashiguchi
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Daiki Kobayashi
- Department of Medicine, Division of General Internal Medicine, St. Luke's International Hospital, Tokyo, Japan
| | - Masaki Kondo
- Department of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Aiko Tamura
- Department of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kei Yamada
- Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masanori Nakagawa
- North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshiyuki Watanabe
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
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