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Campos-Magdaleno M, Nieto-Vieites A, Frades-Payo B, Montenegro-Peña M, Facal D, Lojo-Seoane C, Delgado-Losada ML. Normative data for the Spanish versions of the CVLT, WMS-Logical Memory, and RBMT from a sample of middle-aged and old participants. Psychol Assess 2024; 36:114-123. [PMID: 38059958 DOI: 10.1037/pas0001292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
Episodic memory (EM), one of the most commonly assessed cognitive domains in aging, is useful for identifying pathological processes such as mild cognitive impairment and dementia. However, EM tests must be culturally adapted, and the influence of sociodemographic variables analyzed, to provide cut-off points that enable correct diagnosis. The aim of this article is to report updated Spanish normative data for three EM tests: the California Verbal Learning Test, the Logical Memory subtest of the Wechsler Memory Test, and the Rivermead Behavioral Memory Test. Measures include immediate, short-, and long-delay free recall, intrusions, and global scores. The entire sample is comprised of 1,193 cognitively unimpaired participants aged +50, recruited from three cohort studies within the Spanish Consortium for Ageing Normative Data. Participants who subsequently developed cognitive impairment, detected at follow-up, were removed from the total sample. Data analysis included transformation of percentile ranges into scalar scores, tests for the effects of education level, age, and sex on performance, and linear regression to calculate scalar adjustments. Tables with percentile ranges and scalar scores for each measure are provided, with adjustments for age, education level, and sex, as required. The normative scores provide robust data for assessing EM in Spanish middle-aged and old populations. Effects of sex, age, and education level in each measure are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- María Campos-Magdaleno
- Department of Developmental Psychology, Applied Cognitive Neuroscience and Psychogerontology Group, Health Research Institute of Santiago, University of Santiago de Compostela
| | - Ana Nieto-Vieites
- Department of Developmental Psychology, Applied Cognitive Neuroscience and Psychogerontology Group, Health Research Institute of Santiago, University of Santiago de Compostela
| | - Belén Frades-Payo
- Carlos III Institute of Health, Centro de Investigacion de Enfermedades Neurologicas (CIEN Foundation)
| | | | - David Facal
- Department of Developmental Psychology, Applied Cognitive Neuroscience and Psychogerontology Group, Health Research Institute of Santiago, University of Santiago de Compostela
| | - Cristina Lojo-Seoane
- Department of Developmental Psychology, Applied Cognitive Neuroscience and Psychogerontology Group, Health Research Institute of Santiago, University of Santiago de Compostela
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Delgado-Losada ML, Rubio-Valdehita S, López-Higes R, Campos-Magdaleno M, Ávila-Villanueva M, Frades-Payo B, Lojo-Seoane C. Phonological fluency norms for Spanish middle-aged and older adults provided by the SCAND initiative (P, M, & R). J Int Neuropsychol Soc 2024; 30:172-182. [PMID: 37465902 DOI: 10.1017/s1355617723000309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
OBJECTIVE Verbal fluency tests are quick and easy to administer neuropsychological measures and are regularly used in neuropsychological assessment. Additionally, phonological fluency is a widely used paradigm that is sensitive to cognitive impairment. This paper offers normative data of phonological verbal fluency (letters P, M, R) for Spanish middle- and older-aged adults, considering sociodemographic factors, and different measures such as the total number of words, errors (perseveration and intrusions), and 15 sec-segmented scores. METHOD A total of 1165 cognitively unimpaired participants aged between 50 and 89 years old, participated in the study. Data for P were obtained for all participants. Letters M and R were also administered to a subsample of participants (852) aged 60 to 89 years. In addition, errors and words produced every 15 seconds were collected in the subsample. To verify the effect of sociodemographic variables, linear regression was used. Adjustments were calculated for variables that explained at least 5% of the variance (R2 ≥ .05). RESULTS Means and standard deviations by age, scaled scores, and percentiles for all tests across different measures are shown. No determination coefficients equal to or greater than .05 were found for sex or age. The need to establish adjustments for the educational level was only found in some of the measures. CONCLUSIONS The current norms provide clinically useful data to evaluate Spanish-speaking natives from Spain aged from 50 to 89 years. Specific patterns of cognitive impairment can be analyzed using these normative data and may be important in neuropsychological assessment.
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Affiliation(s)
- M L Delgado-Losada
- Department of Experimental Psychology, Complutense University of Madrid, 28223 Madrid, Spain
| | - S Rubio-Valdehita
- Department of Social Work and Differential Psychology, Complutense University of Madrid, 28223 Madrid, Spain
| | - R López-Higes
- Department of Experimental Psychology, Complutense University of Madrid, 28223 Madrid, Spain
| | - M Campos-Magdaleno
- Department of Developmental and Educational Psychology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | | | - B Frades-Payo
- CIEN Foundation, Carlos III Institute of Health, 28029, Madrid, Spain
| | - C Lojo-Seoane
- Department of Developmental and Educational Psychology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
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Lojo-Seoane C, Facal D, Delgado-Losada ML, Rubio-Valdehita S, López-Higes R, Frades-Payo B, Pereiro AX. Normative scores for attentional tests used by the Spanish consortium for ageing normative data (SCAND) study: Trail Making Test, Digit Symbol and Letter Cancellation. Clin Neuropsychol 2023; 37:1766-1786. [PMID: 36772821 DOI: 10.1080/13854046.2023.2173304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 01/20/2023] [Indexed: 02/12/2023]
Abstract
Objective: This paper reports normative data for different attentional tests obtained from a sample of middle-aged and older native Spanish adults and considering effects of age, educational level and sex. Method: 2,597 cognitively intact participants, aged from 50 to 98 years old, participated voluntarily in the SCAND consortium studies. The statistical procedure included conversion of percentile ranges into scaled scores. The effects of age, education and sex were taken into account. Linear regressions were used to calculate adjusted scaled scores. Results: Scaled scores and percentiles corresponding to the TMT, Digit Symbol and Letter Cancellation Task are shown. Additional tables show the values to be added to or subtracted from the scaled scores, for age and education in the case of the TMT and Letter Cancellation Task measures, and for education in the case of the Digit Symbol subtest. Conclusions: The current norms provide clinically useful data for evaluating Spanish people aged 50 to 98 years old and contribute to improving detection of initial symptoms of cognitive impairment.
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Affiliation(s)
- Cristina Lojo-Seoane
- Department of Developmental and Educational Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - David Facal
- Department of Developmental and Educational Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Luisa Delgado-Losada
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Susana Rubio-Valdehita
- Department of Social, Work and Differential Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Ramón López-Higes
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | | | - Arturo X Pereiro
- Department of Developmental and Educational Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
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Jiménez-Mesa C, Arco JE, Valentí-Soler M, Frades-Payo B, Zea-Sevilla MA, Ortiz A, Ávila-Villanueva M, Castillo-Barnes D, Ramírez J, Del Ser-Quijano T, Carnero-Pardo C, Górriz JM. Using Explainable Artificial Intelligence in the Clock Drawing Test to Reveal the Cognitive Impairment Pattern. Int J Neural Syst 2023; 33:2350015. [PMID: 36799660 DOI: 10.1142/s0129065723500156] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The prevalence of dementia is currently increasing worldwide. This syndrome produces a deterioration in cognitive function that cannot be reverted. However, an early diagnosis can be crucial for slowing its progress. The Clock Drawing Test (CDT) is a widely used paper-and-pencil test for cognitive assessment in which an individual has to manually draw a clock on a paper. There are a lot of scoring systems for this test and most of them depend on the subjective assessment of the expert. This study proposes a computer-aided diagnosis (CAD) system based on artificial intelligence (AI) methods to analyze the CDT and obtain an automatic diagnosis of cognitive impairment (CI). This system employs a preprocessing pipeline in which the clock is detected, centered and binarized to decrease the computational burden. Then, the resulting image is fed into a Convolutional Neural Network (CNN) to identify the informative patterns within the CDT drawings that are relevant for the assessment of the patient's cognitive status. Performance is evaluated in a real context where patients with CI and controls have been classified by clinical experts in a balanced sample size of [Formula: see text] drawings. The proposed method provides an accuracy of [Formula: see text] in the binary case-control classification task, with an AUC of [Formula: see text]. These results are indeed relevant considering the use of the classic version of the CDT. The large size of the sample suggests that the method proposed has a high reliability to be used in clinical contexts and demonstrates the suitability of CAD systems in the CDT assessment process. Explainable artificial intelligence (XAI) methods are applied to identify the most relevant regions during classification. Finding these patterns is extremely helpful to understand the brain damage caused by CI. A validation method using resubstitution with upper bound correction in a machine learning approach is also discussed.
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Affiliation(s)
- Carmen Jiménez-Mesa
- Data Science and Computational Intelligence (DASCI) Institute, Spain.,Department of Signal Theory, Networking and Communications, University of Granada, Granada 18010, Spain
| | - Juan E Arco
- Data Science and Computational Intelligence (DASCI) Institute, Spain.,Department of Signal Theory, Networking and Communications, University of Granada, Granada 18010, Spain.,Department of Communications Engineering, University of Malaga, Malaga 29010, Spain
| | - Meritxell Valentí-Soler
- Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofía Foundation Alzheimer Center, Madrid, Spain
| | - Belén Frades-Payo
- Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofía Foundation Alzheimer Center, Madrid, Spain
| | - María A Zea-Sevilla
- Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofía Foundation Alzheimer Center, Madrid, Spain
| | - Andrés Ortiz
- Data Science and Computational Intelligence (DASCI) Institute, Spain.,Department of Communications Engineering, University of Malaga, Malaga 29010, Spain
| | - Marina Ávila-Villanueva
- Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofía Foundation Alzheimer Center, Madrid, Spain
| | - Diego Castillo-Barnes
- Data Science and Computational Intelligence (DASCI) Institute, Spain.,Department of Signal Theory, Networking and Communications, University of Granada, Granada 18010, Spain
| | - Javier Ramírez
- Data Science and Computational Intelligence (DASCI) Institute, Spain.,Department of Signal Theory, Networking and Communications, University of Granada, Granada 18010, Spain
| | - Teodoro Del Ser-Quijano
- Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofía Foundation Alzheimer Center, Madrid, Spain
| | | | - Juan M Górriz
- Data Science and Computational Intelligence (DASCI) Institute, Spain.,Department of Signal Theory, Networking and Communications, University of Granada, Granada 18010, Spain
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Fernández-Blázquez MA, del Ser T, Frades-Payo B, Ávila-Villanueva M, Valentí-Soler M, Benítez-Robredo MT, Bermejo-Aguña A, Pedrero-Pérez EJ, Quilis-Sancho J, Pastor AB, Fernández-Garrido C, Morales-Alonso S, Diaz-Olalla JM, Santos NC, Maestú F, Gómez-Ramírez J. MADRID+90 study on factors associated with longevity: Study design and preliminary data. PLoS One 2021; 16:e0251796. [PMID: 33999936 PMCID: PMC8128242 DOI: 10.1371/journal.pone.0251796] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 05/03/2021] [Indexed: 01/10/2023] Open
Abstract
The progressive aging of the population represents a challenge for society. In particular, a strong increase in the number of people over 90 is expected in the next two decades. As this phenomenon will lead to an increase in illness and age-related dependency, the study of long-lived people represents an opportunity to explore which lifestyle factors are associated with healthy aging and which with the emergence of age-related diseases, especially Alzheimer's type dementia. The project "Factors associated with healthy and pathologically aging in a sample of elderly people over 90 in the city of Madrid" (MADRID+90) brings together a multidisciplinary research team in neurodegenerative diseases that includes experts in epidemiology, neurology, neuropsychology, neuroimaging and computational neuroscience. In the first phase of the project, a stratified random sampling was carried out according to the census of the city of Madrid followed by a survey conducted on 191 people aged 90 and over. This survey gathered information on demographics, clinical data, lifestyles and cognitive status. Here, the main results of that survey are showed. The second phase of the project aims to characterize individual trajectories in the course of either healthy and pathological aging, from a group of 50 subjects over 90 who will undergo a comprehensive clinical examination comprised of neurological and cognitive testing, MRI and EEG. The ultimate goal of the project is to characterize the biophysical and clinical profiles of a population that tends to receive little attention in the literature. A better understanding of the rapidly increasing group of nonagenarians will also help to design new policies that minimize the impact and future social and economic consequences of rapidly aging societies.
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Affiliation(s)
- Miguel A. Fernández-Blázquez
- Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofía Foundation Alzheimer Center, Madrid, Spain
- Department of Experimental Psychology, Complutense University of Madrid (UCM), Pozuelo de Alarcón, Madrid, Spain
- * E-mail:
| | - Teodoro del Ser
- Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofía Foundation Alzheimer Center, Madrid, Spain
| | - Belén Frades-Payo
- Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofía Foundation Alzheimer Center, Madrid, Spain
| | - Marina Ávila-Villanueva
- Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofía Foundation Alzheimer Center, Madrid, Spain
| | - Meritxell Valentí-Soler
- Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofía Foundation Alzheimer Center, Madrid, Spain
| | | | - Antonio Bermejo-Aguña
- Municipal Statistics Service, S.D.G. for Statistics, Madrid City Council, Madrid, Spain
| | | | - Javier Quilis-Sancho
- Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofía Foundation Alzheimer Center, Madrid, Spain
| | - Ana B. Pastor
- Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofía Foundation Alzheimer Center, Madrid, Spain
| | | | - Sara Morales-Alonso
- Evaluation and Quality Department, Madrid Salud, Madrid City Council, Madrid, Spain
| | - José M. Diaz-Olalla
- Evaluation and Quality Department, Madrid Salud, Madrid City Council, Madrid, Spain
| | - Nadine Correia Santos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Fernando Maestú
- Department of Experimental Psychology, Complutense University of Madrid (UCM), Pozuelo de Alarcón, Madrid, Spain
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Center for Biomedical Technology, Pozuelo de Alarcón, Madrid, Spain
| | - Jaime Gómez-Ramírez
- Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofía Foundation Alzheimer Center, Madrid, Spain
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Fernández-Blázquez MA, Noriega-Ruiz B, Ávila-Villanueva M, Valentí-Soler M, Frades-Payo B, Del Ser T, Gómez-Ramírez J. Impact of individual and neighborhood dimensions of socioeconomic status on the prevalence of mild cognitive impairment over seven-year follow-up. Aging Ment Health 2021; 25:814-823. [PMID: 32067489 DOI: 10.1080/13607863.2020.1725803] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objectives: There is strong evidence about the association between low socioeconomic status (SES) and higher risk of dementia. However, it has not been conveniently addressed so far the role of SES on the incidence of mild cognitive impairment (MCI). This study examines the impact of individual and neighbourhood dimensions of SES, as well as their interaction, on the risk of developing MCI in a sample of older adults.Method: Data from the Vallecas Project cohort, an ongoing community-based longitudinal study for early detection of cognitive impairment and dementia, were used to build two indices of SES namely individual and neighbourhood, as well as a global SES as a combination of both, and to investigate their effects on MCI conversion by means of a multivariate-adjusted Cox proportional hazard model.Results: A total of 1180 participants aged 70 years and older were enrolled in this study. Of these, 199 cases of MCI (16.9%) were diagnosed at any point of the follow-up. The individual and neighbourhood dimensions of SES played different roles in the dynamics of the MCI occurrence through aging. Most importantly, the risk of developing MCI was almost double for lower SES quartiles when compared to the highest one.Conclusion: The incidence of MCI in older adults was related to both individual characteristics and socioeconomic context. Public health strategies should be holistic and focus not only on promoting the classical individual preventive measures, but also on reducing social inequalities to foster healthy aging and reduce dementia burden.
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Affiliation(s)
| | - Bárbara Noriega-Ruiz
- Neuropsychology Department, CIEN Foundation, Carlos III Institute of Health, Madrid, Spain
| | | | | | - Belén Frades-Payo
- Neuropsychology Department, CIEN Foundation, Carlos III Institute of Health, Madrid, Spain
| | - Teodoro Del Ser
- Neurology Department, CIEN Foundation, Carlos III Institute of Health, Madrid, Spain
| | - Jaime Gómez-Ramírez
- Neuroimaging Department, CIEN Foundation, Carlos III Institute of Health, Madrid, Spain
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7
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Delgado-Losada ML, López-Higes R, Rubio-Valdehita S, Facal D, Lojo-Seoane C, Montenegro-Peña M, Frades-Payo B, Fernández-Blázquez MA. Spanish Consortium for Ageing Normative Data (SCAND): Screening Tests (MMSE, GDS-15 and MFE). Psicothema 2021; 33:70-76. [PMID: 33453738 DOI: 10.7334/psicothema2020.304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Detecting cognitive impairment is a priority for health systems. The aim of this study is to create normative data on screening tests (MMSE, GDS and MFE) for middle-aged and older Spanish adults, considering the effects of sociodemographic factors. METHOD A total of 2,030 cognitively intact subjects who lived in the community, aged from 50 to 88 years old, participated voluntarily in SCAND consortium studies. The statistical procedure included the conversion of percentile ranges into scalar scores. Secondly, the effects of age, educational level and gender were verified. Linear regressions were used to calculate the scalar adjusted scores. Cut-off values for each test were also calculated. RESULTS Scalar scores and percentiles corresponding to MMSE, GDS-15 and MFE are shown. An additional table is provided which shows the points that must be added or subtracted from MMSE score depending on the subject's educational level. CONCLUSIONS The current norms should provide clinically useful data for evaluating Spanish people aged 50 to 88 years old and should contribute to improving the detection of initial symptoms of cognitive impairment in people living in the community, taking into account the influence of gender, age and educational level.
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Aragón F, Zea-Sevilla MA, Montero J, Sancho P, Corral R, Tejedor C, Frades-Payo B, Paredes-Gallardo V, Albaladejo A. Oral health in Alzheimer's disease: a multicenter case-control study. Clin Oral Investig 2018; 22:3061-3070. [PMID: 29476334 DOI: 10.1007/s00784-018-2396-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 02/16/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVES The aim of this case-control study was to carry out an oral health assessment on a group of Alzheimer's patients and to establish a hypothesis regarding the implication of the characteristics of the disease and the treatment of oral health. MATERIALS AND METHODS A total of 70 Alzheimer's patients, residents at the Alzheimer Center Reina Sofia Foundation (Madrid, Spain) and at the Alzheimer State Reference Center (Salamanca, Spain), and 36 controls (companions/acquaintances), were studied by oral examination and saliva sampling. The oral health indices DMFT/DMFS, CPI, the prosthetic condition, oral hygiene, saliva volume, and pH, as well as the specific microbiological parameters governing the risk of developing caries were assessed. RESULTS Alzheimer's patients exhibited, as compared to the control group, (1) fewer teeth (10.9 ± 10.5 vs 23.7 ± 6.5), (2) fewer obturations (2.2 ± 3.4 vs 6.6 ± 5.6), (3) fewer periodontally healthy sextants (0.1 ± 0.4 vs 1.4 ± 2.2), (4) worse oral hygiene (43.1 vs 72.2% brushed), (5) greater use of removable prostheses (47.8 vs 8.4%), (6) higher incidence of candida infection (11.8 vs 0.0%) and cheilitis (15.9 vs 0.0%), (7) lower salivary flow (0.6 ± 0.6 vs 1.1 ± 0.6), and (8) lower buffering capacity (46 vs 80%). CONCLUSIONS After taking into account the influence of age, Alzheimer's patients had worse oral health (caries and periodontal disease), more mucosal lesions (cheilitis and candidiasis), and worse saliva quantity and quality. CLINICAL RELEVANCE Clinicians should be aware of the implications of Alzheimer's disease in oral health, in order to stablish the effective preventive measures and the optimal treatment plan.
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Affiliation(s)
- F Aragón
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, Campus Miguel de Unamuno, Calle Alfonso X El Sabio s/n, 37007, Salamanca, Spain.
| | - M A Zea-Sevilla
- Alzheimer Disease Research Unit, CIEN Foundation, Alzheimer Center Reina Sofia Foundation, Carlos III Institute of Health, Calle de Valderrebollo, 5, PC 28031, Madrid, Spain
| | - J Montero
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, Campus Miguel de Unamuno, Calle Alfonso X El Sabio s/n, 37007, Salamanca, Spain
| | - P Sancho
- Department of Microbiology and Genetics, University of Salamanca, Campus Miguel de Unamuno, PC 37007, Salamanca, Spain
| | - R Corral
- Department of Microbiology and Genetics, University of Salamanca, Campus Miguel de Unamuno, PC 37007, Salamanca, Spain
| | - C Tejedor
- Department of Microbiology and Genetics, University of Salamanca, Campus Miguel de Unamuno, PC 37007, Salamanca, Spain
| | - B Frades-Payo
- Alzheimer Disease Research Unit, CIEN Foundation, Alzheimer Center Reina Sofia Foundation, Carlos III Institute of Health, Calle de Valderrebollo, 5, PC 28031, Madrid, Spain
| | - V Paredes-Gallardo
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Av. de Blasco Ibáñez, 15, PC 46010, Valencia, Spain
| | - A Albaladejo
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, Campus Miguel de Unamuno, Calle Alfonso X El Sabio s/n, 37007, Salamanca, Spain
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Olazarán J, Gil-de-Gómez L, Rodríguez-Martín A, Valentí-Soler M, Frades-Payo B, Marín-Muñoz J, Antúnez C, Frank-García A, Acedo-Jiménez C, Morlán-Gracia L, Petidier-Torregrossa R, Guisasola MC, Bermejo-Pareja F, Sánchez-Ferro Á, Pérez-Martínez DA, Manzano-Palomo S, Farquhar R, Rábano A, Calero M. A blood-based, 7-metabolite signature for the early diagnosis of Alzheimer's disease. J Alzheimers Dis 2016; 45:1157-73. [PMID: 25649659 DOI: 10.3233/jad-142925] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Accurate blood-based biomarkers of Alzheimer's disease (AD) could constitute simple, inexpensive, and non-invasive tools for the early diagnosis and treatment of this devastating neurodegenerative disease. We sought to develop a robust AD biomarker panel by identifying alterations in plasma metabolites that persist throughout the continuum of AD pathophysiology. Using a multicenter, cross-sectional study design, we based our analysis on metabolites whose levels were altered both in AD patients and in patients with amnestic mild cognitive impairment (aMCI), the earliest identifiable stage of AD. UPLC coupled to mass spectrometry was used to independently compare the levels of 495 plasma metabolites in aMCI (n = 58) and AD (n = 100) patients with those of normal cognition controls (NC, n = 93). Metabolite alterations common to both aMCI and AD patients were used to generate a logistic regression model that accurately distinguished AD from NC patients. The final panel consisted of seven metabolites: three amino acids (glutamic acid, alanine, and aspartic acid), one non-esterified fatty acid (22:6n-3, DHA), one bile acid (deoxycholic acid), one phosphatidylethanolamine [PE(36:4)], and one sphingomyelin [SM(39:1)]. Detailed analysis ruled out the influence of potential confounding variables, including comorbidities and treatments, on each of the seven biomarkers. The final model accurately distinguished AD from NC patients (AUC, 0.918). Importantly, the model also distinguished aMCI from NC patients (AUC, 0.826), indicating its potential diagnostic utility in early disease stages. These findings describe a sensitive biomarker panel that may facilitate the specific detection of early-stage AD through the analysis of plasma samples.
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Affiliation(s)
- Javier Olazarán
- Servicio de Neurología, HGU Gregorio Marañón, Alzheimer Center Reina Sofía Foundation-CIEN Foundation, Madrid, Spain
| | | | | | - Meritxell Valentí-Soler
- CIEN Foundation, Carlos III Institute of Health, Alzheimer Center Reina Sofia Foundation, Madrid, Spain
| | - Belén Frades-Payo
- CIEN Foundation, Carlos III Institute of Health, Alzheimer Center Reina Sofia Foundation, Madrid, Spain
| | - Juan Marín-Muñoz
- Hospital Clínico Universitario Virgen de la Arrixaca de Murcia, Unidad de Demencias, El Palmar, Murcia, Spain
| | - Carmen Antúnez
- Hospital Clínico Universitario Virgen de la Arrixaca de Murcia, Unidad de Demencias, El Palmar, Murcia, Spain
| | - Ana Frank-García
- IdiPaz Hospital Universitario La Paz. Paseo de la Castellana n° 261, Subdirección médica, Edificio Maternidad, Madrid, Spain
| | - Carmen Acedo-Jiménez
- IdiPaz Hospital Universitario La Paz. Paseo de la Castellana n° 261, Subdirección médica, Edificio Maternidad, Madrid, Spain
| | - Lorenzo Morlán-Gracia
- Servicio de Neurología; Servicio de Geriatría, Hospital Universitario de Getafe, Getafe, Madrid, Spain
| | | | - María Concepción Guisasola
- Unidad de Medicina y Cirugia Experimental, Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | - Félix Bermejo-Pareja
- Head Neurology Department U. H. "12 de Octubre", Madrid, Spain; CIBERNED, Carlos III National Research Institute, Madrid, Spain; Medicine Department, Complutense University, Madrid, Spain
| | - Álvaro Sánchez-Ferro
- Research Fellow at the Madrid-MIT M+Vision Consortium, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | | | | | | | - Alberto Rábano
- Departamento de Neuropatología y Banco de Tejidos, Fundación CIEN, Instituto de Salud Carlos III c/ Valderrebollo, Madrid, Spain
| | - Miguel Calero
- Chronic Disease Programme, CIBERNED and Alzheimer Disease Research Unit, CIEN Foundation, Alzheimer Center Reina Sofía Foundation, Carlos III Institute of Health, Madrid, Spain
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Martinez-Martín P, Rodriguez-Blazquez C, Paz S, Forjaz MJ, Frades-Payo B, Cubo E, de Pedro-Cuesta J, Lizán L. Parkinson Symptoms and Health Related Quality of Life as Predictors of Costs: A Longitudinal Observational Study with Linear Mixed Model Analysis. PLoS One 2015; 10:e0145310. [PMID: 26698860 PMCID: PMC4689528 DOI: 10.1371/journal.pone.0145310] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 12/01/2015] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To estimate the magnitude in which Parkinson's disease (PD) symptoms and health- related quality of life (HRQoL) determined PD costs over a 4-year period. MATERIALS AND METHODS Data collected during 3-month, each year, for 4 years, from the ELEP study, included sociodemographic, clinical and use of resources information. Costs were calculated yearly, as mean 3-month costs/patient and updated to Spanish €, 2012. Mixed linear models were performed to analyze total, direct and indirect costs based on symptoms and HRQoL. RESULTS One-hundred and seventy four patients were included. Mean (SD) age: 63 (11) years, mean (SD) disease duration: 8 (6) years. Ninety-three percent were HY I, II or III (mild or moderate disease). Forty-nine percent remained in the same stage during the study period. Clinical evaluation and HRQoL scales showed relatively slight changes over time, demonstrating a stable group overall. Mean (SD) PD total costs augmented 92.5%, from € 2,082.17 (€ 2,889.86) in year 1 to € 4,008.6 (€ 7,757.35) in year 4. Total, direct and indirect cost incremented 45.96%, 35.63%, and 69.69% for mild disease, respectively, whereas increased 166.52% for total, 55.68% for direct and 347.85% for indirect cost in patients with moderate PD. For severe patients, cost remained almost the same throughout the study. For each additional point in the SCOPA-Motor scale total costs increased € 75.72 (p = 0.0174); for each additional point on SCOPA-Motor and the SCOPA-COG, direct costs incremented € 49.21 (p = 0.0094) and € 44.81 (p = 0.0404), respectively; and for each extra point on the pain scale, indirect costs increased € 16.31 (p = 0.0228). CONCLUSIONS PD is an expensive disease in Spain. Disease progression and severity as well as motor and cognitive dysfunctions are major drivers of costs increments. Therapeutic measures aimed at controlling progression and symptoms could help contain disease expenses.
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Affiliation(s)
- Pablo Martinez-Martín
- National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain
| | | | - Silvia Paz
- Outcomes’ 10, Jaume I University, Castellon de la Plana, Castellon, Spain
| | - Maria João Forjaz
- National School of Public Health and REDISSEC, Carlos III Institute of Health, Madrid, Spain
| | - Belén Frades-Payo
- Research Unit, Alzheimer Center Reina Sofia Foundation, Carlos III Institute of Health, Madrid, Spain
| | - Esther Cubo
- Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | - Jesús de Pedro-Cuesta
- National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain
| | - Luis Lizán
- Outcomes’ 10, Jaume I University, Castellon de la Plana, Castellon, Spain
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Fernández-Blázquez M, Ávila-Villanueva M, López-Pina J, Zea-Sevilla M, Frades-Payo B. Psychometric properties of a new short version of the State-Trait Anxiety Inventory (STAI) for the assessment of anxiety in the elderly. Neurología (English Edition) 2015. [DOI: 10.1016/j.nrleng.2015.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Martinez-Martin P, Rodriguez-Blazquez C, Forjaz MJ, Frades-Payo B, Agüera-Ortiz L, Weintraub D, Riesco A, Kurtis MM, Chaudhuri KR. Neuropsychiatric symptoms and caregiver's burden in Parkinson's disease. Parkinsonism Relat Disord 2015; 21:629-34. [PMID: 25892660 DOI: 10.1016/j.parkreldis.2015.03.024] [Citation(s) in RCA: 142] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 03/16/2015] [Accepted: 03/24/2015] [Indexed: 12/12/2022]
Abstract
INTRODUCTION In Parkinson's disease (PD), neuropsychiatric symptoms (NPS) can be particularly burdensome for caregivers. The main goal of this study was to assess the impact of NPS, assessed by means of a new specific scale, on caregiver burden. METHODS A sample of 584 pairs of PD patients and their primary caregivers was studied. Patients' NPS were measured with the Scale for Evaluation of Neuropsychiatric Disorders in PD (SEND-PD), and the Zarit Caregiver Burden Inventory was used to quantify caregiver burden. Three linear regression models were built to check factors associated with caregiver burden, one for the total sample and two for subgroups stratified by the presence of dementia. RESULTS The most frequent NPS were depression (in 66% of the sample), anxiety (65%) and mental fatigue (57%). Patients with dementia (n = 94; 16% of sample) consistently presented more NPS than patients without dementia (p < 0.001). On linear regression models, the main determinants of caregiver burden (for the total sample and the sample of patients without dementia) were SEND-PD dimensions mood/apathy and psychosis, PD-related disability and disease duration. For patients with dementia, the only significant caregiver burden determinants were SEND-PD psychosis and mood/apathy subscale scores. CONCLUSIONS NPS in PD are highly associated with and are determinants of caregiver burden, and are more prevalent and burdensome in patients with dementia. Detailed assessment and specific interventions aimed at NPS could alleviate caregiver burden.
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Affiliation(s)
- Pablo Martinez-Martin
- National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain.
| | | | - Maria João Forjaz
- National School of Public Health and REDISSEC, Carlos III Institute of Health, Madrid, Spain
| | - Belén Frades-Payo
- Research Unit, Alzheimer Center Reina Sofia Foundation, Carlos III Institute of Health, Madrid, Spain
| | - Luis Agüera-Ortiz
- Research Unit, Alzheimer Center Reina Sofia Foundation, Carlos III Institute of Health, Madrid, Spain; CIBERSAM, Carlos III Institute of Health, Madrid, Spain
| | - Daniel Weintraub
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA; Departments of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA; Philadelphia Veterans Affairs Medical Center, Philadelphia, USA
| | - Ana Riesco
- Research Unit, Alzheimer Center Reina Sofia Foundation, Carlos III Institute of Health, Madrid, Spain
| | - Monica M Kurtis
- Department of Neurology, Hospital Ruber Internacional, Madrid, Spain
| | - Kallol Ray Chaudhuri
- National Parkinson Foundation Centre of Excellence, Department of Neurology, King's College Hospital, and Kings Health Partners, London, UK
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Rodríguez-Blázquez C, Martín-García S, Frades-Payo B, París MS, Martínez-López I, Forjaz MJ. Calidad de vida y estado de salud en personas mayores de 60 años con demencia institucionalizadas. Rev Esp Salud Publica 2015; 89:51-60. [DOI: 10.4321/s1135-57272015000100006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Fernández-Blázquez MA, Ávila-Villanueva M, López-Pina JA, Zea-Sevilla MA, Frades-Payo B. Psychometric properties of a new short version of the State-Trait Anxiety Inventory (STAI) for the assessment of anxiety in the elderly. Neurologia 2014; 30:352-8. [PMID: 24484757 DOI: 10.1016/j.nrl.2013.12.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 12/10/2013] [Accepted: 12/14/2013] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Anxiety has negative effects on the cognitive performance and psychosocial adjustment of elderly people. Given the high prevalence of anxiety symptoms in patients suffering from cognitive impairment, it has been suggested that these symptoms may be an early marker of dementia. The State-Trait Anxiety Inventory (STAI) is one of the most widely-used scales for evaluating anxiety in elderly people. However, inasmuch as the STAI may be difficult to apply to older people, having a short form of it would be desirable. METHODS The participants comprised 489 community-dwelling individuals aged 68 years and over. All of them were volunteers in a longitudinal study for early detection of Alzheimer' Disease (Proyecto Vallecas). The full sample was divided in two homogeneous subgroups: Group A, used to reduce the number of items and response options, and Group B, the group used to determine the psychometric properties of the new short form (STAIr). RESULTS A dichotomous Rasch model was used to obtain the STAIr. No statistically significant differences for STAIr scores were found with respect to sociodemographic variables. Psychometric properties and normative data were obtained for the new short version. CONCLUSIONS The STAIr is composed of 13 items and data fits the model well. Since it is short and easy to apply to elderly people, STAIr will be very useful in clinical and research settings.
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Affiliation(s)
- M A Fernández-Blázquez
- Unidad de Investigación Proyecto Alzheimer, Fundación CIEN, Instituto de Salud Carlos III, Centro Alzheimer Fundación Reina Sofía, Madrid, España; Servicio de Neurología, Hospital Sanitas La Moraleja, Madrid, España.
| | - M Ávila-Villanueva
- Unidad de Investigación Proyecto Alzheimer, Fundación CIEN, Instituto de Salud Carlos III, Centro Alzheimer Fundación Reina Sofía, Madrid, España
| | - J A López-Pina
- Departamento de Psicología Básica y Metodología, Facultad de Psicología, Universidad de Murcia, Murcia, España
| | - M A Zea-Sevilla
- Unidad de Investigación Proyecto Alzheimer, Fundación CIEN, Instituto de Salud Carlos III, Centro Alzheimer Fundación Reina Sofía, Madrid, España
| | - B Frades-Payo
- Unidad de Investigación Proyecto Alzheimer, Fundación CIEN, Instituto de Salud Carlos III, Centro Alzheimer Fundación Reina Sofía, Madrid, España
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Ayala A, Rodríguez-Blázquez C, Frades-Payo B, Forjaz MJ, Martínez-Martín P, Fernández-Mayoralas G, Rojo-Pérez F. [Psychometric properties of the Functional Social Support Questionnaire and the Loneliness Scale in non-institutionalized older adults in Spain]. Gac Sanit 2012; 26:317-24. [PMID: 22265651 DOI: 10.1016/j.gaceta.2011.08.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Revised: 08/12/2011] [Accepted: 08/30/2011] [Indexed: 10/14/2022]
Abstract
OBJECTIVES To examine the psychometric properties of the Social Support Questionnaire Duke-UNC (DUFSS) and the De Jong-Gierveld Loneliness Scale in a sample of non-institutionalized older adults. METHODS The sample consisted of 1,106 non-institutionalized older adults included in a national survey on quality of life. Both scales were analyzed according to classical test theory (acceptability, internal consistency, internal validity, convergent validity, discriminant validity and accuracy) and Rasch analysis. RESULTS The mean ± standard deviation scores were 44.95 ± 8.9 for the DUFSS and 1.92 ± 1.83 for the Loneliness Scale. Cronbach's alpha was 0.94 for the DUFSS and 0.77 for the Loneliness Scale. Factor analysis identified two factors in each scale (explained variance: 73.8% for the DUFSS and 67.7% for the Loneliness Scale). The instruments showed a correlation of -0.59 with each other. Rasch analysis of the DUFSS identified two dimensions with a good model fit, whereas the Loneliness Scale did not fit the Rasch model. CONCLUSIONS The DUFSS, with some modifications, meets the Rasch assumptions and provides linear measures. However, more Rasch analysis studies are needed for the Loneliness Scale. According to classical test theory, the DUFSS has good internal consistency for comparisons among people and the Loneliness Scale for comparisons among groups. Both scales have satisfactory construct validity.
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Affiliation(s)
- Alba Ayala
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, España.
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Forjaz MJ, Frades-Payo B, Martínez-Martín P. [The current state of the art concerning quality of life in Parkinson's disease: II. Determining and associated factors]. Rev Neurol 2009; 49:655-660. [PMID: 20013718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
INTRODUCTION Health-related quality of life (HRQL) in Parkinson's disease (PD) is an area that is receiving a growing amount of interest as the new biopsychosocial model of medicine is adopted. AIM. This paper is the second part of a review of the current state of the art concerning HRQL in PD and focuses on its main determining and associated factors. DEVELOPMENT A total of 56 studies are reviewed and the determining factors are grouped according to different variables, which may be disease-related (including motor and non-motor symptoms), sociodemographic (level of schooling, economic factors, gender and others), psychological and related to mental status (depression, anxiety, cognitive impairment, physician-patient relationship and others), and disability. The following characteristics of the studies were taken into account: the type of design (longitudinal or cross-sectional), the instrument used for measuring the HRQL (generic or specific), the statistical method employed (univariate or multivariate) and the sample size. CONCLUSIONS Most of the studies are cross-sectional and the majority use the 39-item Parkinson's Disease Questionnaire as a measure of HRQL with multivariate data analysis. The three most important factors determining HRQL in PD are depression, the stage of the disease and the time elapsed since onset of the disease. Nevertheless, the preferred methodology does not allow for causal inferences, due to the scarcity of longitudinal studies.
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Affiliation(s)
- M J Forjaz
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, E-28029 Madrid, España
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Frades-Payo B, Forjaz MJ, Martínez-Martín P. [The current state of the art concerning quality of life in Parkinson's disease: I. Instruments, comparative studies and treatments]. Rev Neurol 2009; 49:594-598. [PMID: 19921625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
INTRODUCTION Over the last decade there has been growing interest in the study of the impact of Parkinson's disease (PD) on the health-related quality of life (HRQL) of patients. Specific instruments have been developed to measure it and today these are frequently applied, together with generic measurements of HRQL, in clinical trials and other studies. This review is part of a series of two papers, the aim of which is to describe the current situation of studies on HRQL in PD and to detect areas in which knowledge is lacking, as a possible guide to researchers in future projects. AIM To review the concepts, instruments, comparative studies and the effect of treatments on the HRQL of patients with PD. DEVELOPMENT The fundamental concepts of HRQL and the instruments used to measure it are described. The main findings as regards comparative studies about the HRQL of patients with PD are also outlined. Finally, the article examines the effect of treatments on HRQL, including alternative therapies. CONCLUSIONS Despite the significant progress being made in this field, further studies with a rigorous methodology and longitudinal data are needed.
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Affiliation(s)
- B Frades-Payo
- Area de Epidemiología Aplicada y CIBERNED, Sección de Neuroepidemiología, Instituto de Salud Carlos III, 28029 Madrid, Espana
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Forjaz MJ, Ayala A, Rodriguez-Blazquez C, Frades-Payo B, Martinez-Martin P. Assessing autonomic symptoms of Parkinson’s disease with the SCOPA-AUT: a new perspective from Rasch analysis. Eur J Neurol 2009; 17:273-9. [DOI: 10.1111/j.1468-1331.2009.02835.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Martínez-Martín P, Prieto-Jurczynska C, Frades-Payo B. [Psychometric attributes of the Parkinson's Disease-Cognitive Rating Scale. An independent validation study]. Rev Neurol 2009; 49:393-398. [PMID: 19816841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM To perform an independent evaluation of the psychometric attributes of the Parkinson's Disease-Cognitive Rating Scale (PD-CRS). PATIENTS AND METHODS The study involved patients with Parkinson's disease (PD) free of any impediments preventing them from participating in the required evaluation. Sociodemographic and historical data were collected for use in this observational, cross-sectional study and the following evaluations were employed: Scales for Outcomes in Parkinson's Disease-Motor Scale (SCOPA-Motor), Hoehn and Yahr staging (HY), Clinical Impression of Severity Index for Parkinson's Disease (CISI-PD), Minimental State Examination (MMSE), SCOPA-Cognitive (SCOPA-Cog), Non-Motor Symptoms Questionnaire and PD-CRS. Acceptability, internal consistence, construct validity and precision of the PD-CRS were analysed. RESULTS The sample consisted of 50 patients, with a mean age of 63.6 +/- 9.3 years. In all, 66% were males, with a history of 9 +/- 5.7 years with PD, in HY stages 1 to 4. Twelve patients (24%) presented data suggestive of dementia. The PD-CRS score was: sub-cortical sub-scale: 60.9 +/- 16.5; cortical sub-scale: 27.9 +/- 4.4; and total PD-CRS: 88.7 +/- 19.8. The mean-median difference was < 10% of the maximum scores and the total score showed no ceiling or floor effect. Cronbach's alpha was 0.85; the item-total correlations ranged from 0.57 (naming) to 0.73 (working memory), and the homogeneity index of the items was 0.36. Correlation with the MMSE and the SCOPA-Cog was high (rS = 0.53 and 0.77). The PD-CRS score was significantly lower in patients with a low level of schooling and more severe PD according to levels on the CISI-PD and distinguished between patients with and without dementia (70.3 +/- 26.2 versus 94.5 +/- 13; p < 0.001. The standard error of the measurement was 1.98. CONCLUSIONS The levels of acceptability, internal consistence, construct validity and precision displayed by the PD-CRS were satisfactory.
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Affiliation(s)
- P Martínez-Martín
- Unidad de Investigación del Proyecto Alzheimer, Fundación Cien-Fundación Reina Sofía, Madrid, España.
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Affiliation(s)
- M J Forjaz
- National School of Public Health and CIBERNED, Carlos III Institute of Health, Madrid, Spain.
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Rodriguez-Blazquez C, Forjaz MJ, Frades-Payo B, De Pedro-Cuesta J, Martinez-Martin P. Independent validation of the scales for outcomes in Parkinson’s disease-autonomic (SCOPA-AUT). Eur J Neurol 2009; 17:194-201. [DOI: 10.1111/j.1468-1331.2009.02788.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Martínez-Martín P, Carroza-García E, Frades-Payo B, Rodríguez-Blázquez C, Forjaz MJ, de Pedro-Cuesta J. [Psychometric attributes of the Scales for Outcomes in Parkinson's Disease-Psychosocial (SCOPA-PS): validation in Spain and review]. Rev Neurol 2009; 49:1-7. [PMID: 19557692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIMS To evaluate the psychometric attributes of the Scales for Outcomes in Parkinson's Disease-Psychosocial (SCOPA-PS) in Spain and to compare them with previous studies. PATIENTS AND METHODS We performed a multi-centre, cross-sectional study of 387 patients with Parkinson's disease (PD), 70% of whom were in Hoehn and Yahr (HY) stages 2 or 3, with a mean age of 65.8 +/- 11.1 years and 8.1 +/- 6 years' progression. The following measures were applied: SCOPA-Motor, SCOPA-Cognition, modified Parkinson's Psychosis Rating Scale, Clinical Impression of Severity Index for Parkinson's Disease (CISI-PD), Cumulative Illness Rating Scale-Geriatrics, SCOPA-Autonomic, SCOPA-Sleep, Hospital Anxiety and Depression Scale (HADS), Fatigue and Pain Visual Analogue Scales, EQ-5D and SCOPA-PS. Acceptability, internal consistence, dimensionality, construct validity and precision of the SCOPA-PS were analysed. RESULTS The SCOPA-PS summary index displayed no ceiling or floor effect. Internal consistence was satisfactory (alpha = 0.85; item-total correlation => 0.39). Two factors were identified (53.5% of the variance). The SCOPA-PS was highly correlated (r(S) => 0.5) with the HADS, SCOPA-Motor, SCOPA-Automatic and EQ-5D index, and moderately so (r(S) = 0.35-0.49) with CISI-PD, fatigue and HY. The SCOPA-PS discriminated significantly between patients grouped according to HY stages, levels of severity of the CISI-PD, age groups and length of time with PD. The standard error of the measure was 7.24 +/- 18.7. As a whole, these findings are in agreement with previous studies. CONCLUSIONS The SCOPA-PS is a scale with a satisfactory degree of acceptability, and it is consistent, valid and precise for evaluating the psychosocial impact of PD.
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Affiliation(s)
- P Martínez-Martín
- Centro Nacional de Epidemiología, CIBERNED e Instituto de Salud Carlos III, Madrid, España.
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Martínez-Martín P, Fernández-Mayoralas G, Frades-Payo B, Rojo-Pérez F, Petidier R, Rodríguez-Rodríguez V, Forjaz MJ, Prieto-Flores ME, de Pedro Cuesta J. Validación de la Escala de Independencia Funcional. Gaceta Sanitaria 2009; 23:49-54. [DOI: 10.1016/j.gaceta.2008.06.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2007] [Accepted: 06/26/2008] [Indexed: 12/01/2022]
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Martínez-Martín P, Frades-Payo B, Rodríguez-Blázquez C, Forjaz MJ, de Pedro-Cuesta J. [Psychometric attributes of Scales for Outcomes in Parkinson's Disease-Cognition (SCOPA-Cog), Castilian language]. Rev Neurol 2008; 47:337-343. [PMID: 18841543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
AIM To test the psychometric attributes of the Scales for Outcomes in Parkinson's Disease-Cognition (SCOPA-Cog), in Castilian language. PATIENTS AND METHODS It is a multicenter, cross-sectional study carried out on 387 Parkinson's disease (PD) patients. They were 70% in Hoehn and Yahr stages 2 or 3; their mean age was 65,8 years and they underwent the disease for 8,1 years. Rater-based -SCOPA-Motor, modified Parkinson's Psychosis Rating Scale, Clinical Impression of Severity Index for PD (CISI-PD), Cumulative Illness Rating Scale-Geriatrics- and self-administered -SCOPA-Autonomic, SCOPA-Sleep, SCOPA-Psychosocial, Hospital Anxiety and Depression Scale, EuroQoL- assessments were applied. For SCOPA-Cog, the following psychometric attributes were analysed: acceptability, internal consistency, dimensionality, construct validity, and precision. A cut-off point for dementia and SCOPA-Cog score's predictors were explored. RESULTS SCOPA-Cog was free from floor and ceiling effect. The internal consistency was satisfactory (alpha = 0,83) and the item-total correlation resulted equal or upper than 0,45. Two factors were identified (52% of variance), one of them formed by 3 out of the 4 memory-related items. The correlation with other measures was weak (rS < 0,35), except for the CISI-PD's item 'cognitive state' (rS = 0,51). SCOPA-Cog scored significantly different for Hoehn and Yahr stages and for patients grouped by age, age at onset of PD, and education. The standard error of measurement was 3,02. A cut-off point 19/20 reached 76% sensitivity and specificity for dementia. Age and age at onset of PD resulted the strongest predictors. CONCLUSION SCOPA-Cog is a consistent, valid, and precise measure for assessment of the cognitive disorder in PD.
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Affiliation(s)
- P Martínez-Martín
- Centro Nacional de Epidemiologia. Instituto de Salud Carlos III, 28029 Madrid, España.
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Martínez-Martín P, Forjaz MJ, Frades-Payo B, Rusiñol AB, Fernández-García JM, Benito-León J, Arillo VC, Barberá MA, Sordo MP, Catalán MJ. Caregiver burden in Parkinson's disease. Mov Disord 2007; 22:924-31; quiz 1060. [PMID: 17238193 DOI: 10.1002/mds.21355] [Citation(s) in RCA: 179] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder that imposes an important burden upon the patient's caregiver. This study aims at assessing caregiver burden (CB) and analyzing its relationship with sociodemographic, emotional, and functional factors, as well as health-related quality of life (HRQoL). The following measures were applied to 80 patients with PD: the Hospital Anxiety and Depression Scale (HADS); the EuroQoL (for HRQoL); and PD-specific measures (Hoehn and Yahr staging and SCOPA-Motor ADL subscale). Patients' main caregivers completed the HADS, SF-36, EuroQoL, and Zarit CB Inventory (ZCBI). The ZCBI was found to be a valid and reliable measure in the context of PD. There was a significant association between CB and caregivers' HRQoL (r = -0.29 to -0.64). Mental aspects of caregivers' HRQoL and burden were affected by disability and disease severity. The presence of caregivers' depression had a significant negative effect on both CB and HRQoL. The main predictors of CB were caregivers' psychological well-being, patients' mood and clinical aspects of PD (disability and severity), and HRQoL of patients and caregivers. This study underscores the need to consider the impact of PD on caregivers' well-being.
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Affiliation(s)
- Pablo Martínez-Martín
- Neuroepidemiology Unit, National Center for Epidemiology, Carlos III Institute of Public Health, Madrid, Spain.
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Martínez-Martín P, Cubo-Delgado E, Aguilar-Barberà M, Bergareche A, Escalante S, Rojo A, Campdelacreu J, Frades-Payo B, Arroyo S. [A pilot study on a specific measure for sleep disorders in Parkinson's disease: SCOPA-Sleep]. Rev Neurol 2006; 43:577-83. [PMID: 17099848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
INTRODUCTION There is a high prevalence of sleep disorders in Parkinson's disease (PD). AIMS. To assess some basic metric attributes of the SCOPA-Sleep scale, a measure for PD patients; secondary objective: to check the impact caused by the sleep disorder on the health-related quality of life (HRQoL) of patients and their caregivers. SUBJECTS AND METHODS 68 PD patients and their main caregivers; measures: Hoehn and Yahr staging, SCOPA-Motor, Clinical Impression of Severity Index (CISI-PD), PDSS, Hospital Anxiety and Depression Scale, SCOPA-Psychosocial, and EuroQoL. Carers filled in a PDSS questionnaire about patient sleep and HRQoL measures (SF-36, EuroQoL). SCOPA-Sleep acceptability, scaling assumptions, internal consistency, construct validity and precision were determined. RESULTS SCOPA-Sleep acceptability and scaling assumptions resulted satisfactory, although the nocturnal sleep subescale (SC-Ns) showed a mild ceiling effect (22.1%) and a defective convergent validity was found for daytime sleepiness (SC-Ds) item 6. Internal consistency also was satisfactory for both scales (alpha = 0.84 and 0.75, respectively). The correlation between SC-Ns and PDSS was high (rs = -0.70), as it was between SC-Ns and PDSS questionnaire by caregiver (rs = -0.53). The corresponding coefficients with the SC-Ds gained lower values (rs = -0.41 y -0.50). Standard error of measurement was 1.45 for the SC-Ns and 1.76 for the SC-Ds. Both, patient and caregiver HRQoL showed a loose association with the sleep measures. CONCLUSION SCOPA-Sleep is a feasible, consistent, and useful scale for assessment of sleep disorder in PD patients. A weak association between sleep disorder and HRQoL was found.
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Affiliation(s)
- P Martínez-Martín
- Sección de Neuroepidemiología, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, 28029 Madrid, Spain.
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Martínez-Martín P, Guerrero-Díaz MT, Frades-Payo B. [Neuropsychological disorders in Parkinson's disease: evaluating them and their impact on the caregiver]. Rev Neurol 2004; 39:639-45. [PMID: 15490351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
INTRODUCTION There are no specific scales for evaluating the broad profile of potentially relevant neuropsychological disorders associated to Parkinson's disease. Moreover, the information about their impact on the quality of life of caregivers (QLC) is scarce. OBJECTIVES This study outlines a model of a practical questionnaire developed to evaluate the neuropsychological disorders in Parkinson's disease and how to apply it to determine the effect they have on the QLC. PATIENTS AND METHODS A study was performed in two phases: 1. The application of a list of items from several scales used for neuropsychological disorders; 2. After selecting and reducing the number of items by means of psychometric methods, they were applied to a sample of patients. At the same time, using the data obtained from the above mentioned procedure, the impact of the neuropsychological disorders on the QLC was evaluated with the Glozman scale. RESULT In Parkinson's disease some neuropsychological disorders are relatively frequent, unlike those observed in a control group (either because of their frequency or their intensity) and are significantly associated to other aspects of the disease. There was an overall deterioration of the QLC and this worsened significantly as PD progressed and the disability of the patient increased. With respect to the neuropsychological disorders, verbal communication (rS = -0.59), cognitive behavioural mental status (rS = -0.54) and depression (rS = -0.41) (p < 0.001) were the domains significantly linked to deterioration of the QLC. CONCLUSIONS The QLC of patients with Parkinson's disease is decreased and is correlated with the extent of the patient's motor disorders, functional status and neuropsychological disorders.
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Affiliation(s)
- P Martínez-Martín
- Area de Epidemiología Aplicada, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.
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