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Yao C, Wolfson C, Pelletier A, Postuma R. Is trauma-associated sleep disorder a sub-form REM sleep behavior disorder? a Canadian longitudinal study on aging cohort study. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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2
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Wolfson C, Fereshtehnejad SM, Pasquet R, Postuma R, Keezer MR. High burden of neurological disease in the older general population: results from the Canadian Longitudinal Study on Aging. Eur J Neurol 2018; 26:356-362. [DOI: 10.1111/ene.13823] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 10/04/2018] [Indexed: 01/06/2023]
Affiliation(s)
- C. Wolfson
- Neuroepidemiology Research Unit; Research Institute of the McGill University Health Centre; Montreal QC
- Department of Epidemiology, Biostatistics and Occupational Health; McGill University; Montreal QC
- Department of Medicine; McGill University; Montreal QC
- Department of Neurology and Neurosurgery; McGill University; Montreal General Hospital; Montreal QC
| | - S.-M. Fereshtehnejad
- Department of Neurology and Neurosurgery; McGill University; Montreal General Hospital; Montreal QC
| | - R. Pasquet
- Centre de Recherche du Centre hospitalier de l'Université de Montréal; Montreal QC
| | - R. Postuma
- Department of Neurology and Neurosurgery; McGill University; Montreal General Hospital; Montreal QC
| | - M. R. Keezer
- Centre de Recherche du Centre hospitalier de l'Université de Montréal; Montreal QC
- Department of Neurosciences; Université de Montréal; Montreal QC Canada
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3
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Yao C, Fereshtehnejad SM, Keezer M, Wolfson C, Pelletier A, Postuma R. Prevalence and associated factors for REM sleep behaviour disorder: a nation-wide population-based study of 30,097 Canadian adults. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.1044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Affiliation(s)
- S. Karunananthan
- Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - C. Wolfson
- Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
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Goulden R, Riise T, Myhr KM, Pugliatti M, Wolfson C. Does low socioeconomic status in early life protect against multiple sclerosis? A multinational, case-control study. Eur J Neurol 2015; 23:168-74. [DOI: 10.1111/ene.12830] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 08/03/2015] [Indexed: 11/29/2022]
Affiliation(s)
- R. Goulden
- Department of Epidemiology, Biostatistics and Occupational Health; McGill University; Montreal QC Canada
| | - T. Riise
- Department of Global Public Health and Primary Care; University of Bergen; Bergen Norway
| | - K.-M. Myhr
- Department of Neurology; Norwegian Multiple Sclerosis Competence Centre; Haukeland University Hospital; Bergen Norway
- The KG Jebsen Centre for MS Research; Department of Clinical Medicine; University of Bergen; Bergen Norway
| | - M. Pugliatti
- Department of Global Public Health and Primary Care; University of Bergen; Bergen Norway
- Department of Clinical and Experimental Medicine; University of Sassari; Sassari Italy
| | - C. Wolfson
- Department of Epidemiology, Biostatistics and Occupational Health; McGill University; Montreal QC Canada
- Department of Medicine; McGill University; Montreal QC Canada
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Fiest K, Fisk J, Patten S, Tremlett H, Wolfson C, Warren S, McKay K, Berrigan L, Marrie R. Comorbidity is associated with pain-related activity limitations in multiple sclerosis. Mult Scler Relat Disord 2015; 4:470-476. [DOI: 10.1016/j.msard.2015.07.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 06/25/2015] [Accepted: 07/23/2015] [Indexed: 01/10/2023]
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Bouma HK, Labos C, Gore GC, Wolfson C, Keezer MR. The diagnostic accuracy of routine electroencephalography after a first unprovoked seizure. Eur J Neurol 2015; 23:455-63. [DOI: 10.1111/ene.12739] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 03/30/2015] [Indexed: 01/06/2023]
Affiliation(s)
- H. K. Bouma
- Department of Neurology and Neurosurgery McGill University Montreal QCCanada
- Neuroepidemiology Research Unit Research Institute of the McGill University Health Centre Montreal QCCanada
| | - C. Labos
- Department of Epidemiology, Biostatistics and Occupational Health McGill University Montreal QCCanada
- Division of Cardiology McGill University Montreal QCCanada
| | - G. C. Gore
- Life Sciences Library McGill University Montreal QCCanada
| | - C. Wolfson
- Department of Neurology and Neurosurgery McGill University Montreal QCCanada
- Neuroepidemiology Research Unit Research Institute of the McGill University Health Centre Montreal QCCanada
- Department of Epidemiology, Biostatistics and Occupational Health McGill University Montreal QCCanada
- Department of Medicine McGill University Montreal QC Canada
| | - M. R. Keezer
- Neuroepidemiology Research Unit Research Institute of the McGill University Health Centre Montreal QCCanada
- Department of Epidemiology, Biostatistics and Occupational Health McGill University Montreal QCCanada
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Goulden R, Ibrahim T, Wolfson C. Is high socioeconomic status a risk factor for multiple sclerosis? A systematic review. Eur J Neurol 2014; 22:899-911. [DOI: 10.1111/ene.12586] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 08/29/2014] [Indexed: 11/27/2022]
Affiliation(s)
- R. Goulden
- Department of Epidemiology, Biostatistics and Occupational Health; McGill University; Montreal QC Canada
- Newcastle Medical School; Newcastle University; Newcastle UK
| | - T. Ibrahim
- Department of Medicine; McGill University; Montreal QC Canada
| | - C. Wolfson
- Department of Epidemiology, Biostatistics and Occupational Health; McGill University; Montreal QC Canada
- Department of Medicine; McGill University; Montreal QC Canada
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Marrie RA, Fisk JD, Stadnyk KJ, Tremlett H, Wolfson C, Warren S, Bhan V, Yu BN. Performance of administrative case definitions for comorbidity in multiple sclerosis in Manitoba and Nova Scotia. ACTA ACUST UNITED AC 2014. [DOI: 10.24095/hpcdp.34.2/3.09] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction
As the population ages and the prevalence of comorbid conditions increases, the need for feasible, validated methods of comorbidity surveillance in chronic diseases such as multiple sclerosis (MS) increases.
Methods
Using kappa (k) statistics, we evaluated the performance of administrative case definitions for comorbidities commonly observed in MS by comparing agreement between Manitoba (MB) administrative data and self-report (n = 606) and Nova Scotia (NS) administrative data and self-report (n = 1923).
Results
Agreement between the administrative definitions and self-report was substantial for hypertension (k = 0.69 [NS], 0.76 [MB]) and diabetes (k = 0.70 [NS], 0.66 [MB]); moderate for hyperlipidemia (k = 0.53 [NS], 0.51 [MB]) and heart disease (k = 0.42 [NS], 0.51 [MB]) and fair for anxiety (k = 0.27 [NS], 0.26 [MB]). In NS, agreement was substantial for inflammatory bowel disease (k = 0.71) and moderate for epilepsy (k = 0.48).
Conclusion
Administrative definitions for commonly observed comorbidities in MS performed well in 2 distinct jurisdictions. This suggests that they could be used more broadly across Canada and in national studies.
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Affiliation(s)
- RA Marrie
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - JD Fisk
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Capital District Health Authority, Halifax, Canada
| | - KJ Stadnyk
- Capital District Health Authority, Halifax, Canada
| | - H Tremlett
- Department of Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada
| | - C Wolfson
- Department of Epidemiology and Biostatistics and Occupational Health, McGill University, Montréal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montréal, Quebec, Canada
| | - S Warren
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - V Bhan
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Capital District Health Authority, Halifax, Canada
| | - BN Yu
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Marrie RA, Fisk JD, Stadnyk KJ, Tremlett H, Wolfson C, Warren S, Bhan V, Yu BN. Performance of administrative case definitions for comorbidity in multiple sclerosis in Manitoba and Nova Scotia. Chronic Dis Inj Can 2014; 34:145-153. [PMID: 24991777] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
INTRODUCTION As the population ages and the prevalence of comorbid conditions increases, the need for feasible, validated methods of comorbidity surveillance in chronic diseases such as multiple sclerosis (MS) increases. METHODS Using kappa (k) statistics, we evaluated the performance of administrative case definitions for comorbidities commonly observed in MS by comparing agreement between Manitoba (MB) administrative data and self-report (n = 606) and Nova Scotia (NS) administrative data and self-report (n = 1923). RESULTS Agreement between the administrative definitions and self-report was substantial for hypertension (k = 0.69 [NS], 0.76 [MB]) and diabetes (k = 0.70 [NS], 0.66 [MB]); moderate for hyperlipidemia (k = 0.53 [NS], 0.51 [MB]) and heart disease (k = 0.42 [NS], 0.51 [MB]) and fair for anxiety (k = 0.27 [NS], 0.26 [MB]). In NS, agreement was substantial for inflammatory bowel disease (k = 0.71) and moderate for epilepsy (k = 0.48). CONCLUSION Administrative definitions for commonly observed comorbidities in MS performed well in 2 distinct jurisdictions. This suggests that they could be used more broadly across Canada and in national studies.
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Affiliation(s)
- R A Marrie
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - J D Fisk
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Capital District Health Authority, Halifax, Canada
| | - K J Stadnyk
- Capital District Health Authority, Halifax, Canada
| | - H Tremlett
- Department of Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada
| | - C Wolfson
- Department of Epidemiology and Biostatistics and Occupational Health, McGill University, Montréal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montréal, Quebec, Canada
| | - S Warren
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - V Bhan
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Capital District Health Authority, Halifax, Canada
| | - B N Yu
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Makhani N, Morrow S, Fisk J, Evans C, Beland S, Kulaga S, Kingwell E, Marriott J, Dykeman J, Jetté N, Pringsheim T, Wolfson C, Marrie R, Koch M. MS incidence and prevalence in Africa, Asia, Australia and New Zealand: A systematic review. Mult Scler Relat Disord 2014; 3:48-60. [DOI: 10.1016/j.msard.2013.06.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 06/27/2013] [Indexed: 12/23/2022]
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12
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Rios Romenets S, Dauvilliers Y, Cochen De Cock V, Carlander B, Bayard S, Galatas C, Wolfson C, Postuma R. Restless legs syndrome outside the blood–brain barrier – Exacerbation by domperidone in Parkinson's disease. Parkinsonism Relat Disord 2013; 19:92-4. [DOI: 10.1016/j.parkreldis.2012.07.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 06/27/2012] [Accepted: 07/29/2012] [Indexed: 11/16/2022]
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Abstract
Decreasing research funding is in conflict with the increasing need to conduct large studies to examine rare risk factors and interactions between risk factors. As a result, investigators are searching for strategies to stretch research funds and to design studies that will maximize investments already made. Multiple sclerosis (MS) is generally accepted as a multifactorial disease, and the assessment of interactions between risk factors and the desire to assess risk factors within particular sub-groups requires a large number of participants. Harmonization is a methodology that may help address this problem. Harmonization is a methodological approach that aims to systematize the process of combining individual data that are collected in several observational studies. Combining data will increase sample size, but the quality of the harmonized result is only as high as the quality of the individual studies and the comparability of the constructs measured. In this short report, we introduce the concept of harmonization and provide examples where harmonization may be advantageous in MS research.
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Affiliation(s)
- S Magalhaes
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
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Pugliatti M, Casetta I, Drulovic J, Granieri E, Holmøy T, Kampman MT, Landtblom AM, Lauer K, Myhr KM, Parpinel M, Pekmezovic T, Riise T, Zhu B, Wolfson C. A questionnaire for multinational case-control studies of environmental risk factors in multiple sclerosis (EnvIMS-Q). Acta Neurol Scand 2012:43-50. [PMID: 23278656 DOI: 10.1111/ane.12032] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2012] [Indexed: 01/13/2023]
Abstract
OBJECTIVES The increasing incidence of multiple sclerosis (MS) worldwide, especially in women, points to the crucial role of environmental and lifestyle risk factors in determining the disease occurrence. An international multicentre case-control study of Environmental Risk Factors In Multiple Sclerosis (EnvIMS) has been launched in Norway, Sweden, Italy, Serbia and Canada, aimed to examine MS environmental risk factors in a large study population and disclose reciprocal interactions. To ensure equivalent methodology in detecting age-related past exposures in individuals with and without MS across the study sites, a new questionnaire (EnvIMS-Q) is presented. MATERIALS AND METHODS EnvIMS-Q builds on previously developed guidelines for epidemiological studies in MS and is a 6-page self-administered postal questionnaire. Participants are de-identified through the use of a numerical code. Its content is identical for cases and controls including 'core' and population-specific questions as proxies for vitamin D exposure (sun exposure, dietary habits and supplementation), childhood infections (including infectious mononucleosis) and cigarette smoking. Information on possible confounders or effect modifiers is also obtained. EnvIMS-Q was initially drafted in English and subsequently translated into Italian, Serbian, Norwegian, Swedish and French-Canadian. EnvIMS-Q has been tested for acceptability, feasibility and reliability. RESULTS AND CONCLUSIONS EnvIMS-Q has shown cross-cultural feasibility, acceptability and reliability in both patients with MS and healthy subjects from all sites. EnvIMS-Q is an efficient tool to ensure proper assessment of age-specific exposure to environmental factors in large multinational population-based case-control studies of MS risk factors.
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Affiliation(s)
| | - I. Casetta
- Department of Biomedical and Surgical Sciences; Section of Clinical Neurology; University of Ferrara; Ferrara; Italy
| | - J. Drulovic
- Clinic of Neurology; Faculty of Medicine; University of Belgrade; Belgrade; Serbia
| | - E. Granieri
- Department of Biomedical and Surgical Sciences; Section of Clinical Neurology; University of Ferrara; Ferrara; Italy
| | | | | | - A.-M. Landtblom
- Division of Neurology; Department of Clinical and Experimental Medicine; UHL, County Council; Linköping University; Linköping; Sweden
| | | | | | - M. Parpinel
- Unit of Hygiene and Epidemiology; Department of Medical and Biological Sciences; University of Udine; Udine; Italy
| | - T. Pekmezovic
- Institute of Epidemiology; Faculty of Medicine; University of Belgrade; Belgrade; Serbia
| | - T. Riise
- Department of Public Health and Primary Health Care; University of Bergen; Bergen; Norway
| | - B. Zhu
- Research Institute of the McGill University Health Centre; Montreal; QC; Canada
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Postuma RB, Montplaisir JY, Pelletier A, Dauvilliers Y, Oertel W, Iranzo A, Ferini-Strambi L, Arnulf I, Hogl B, Manni R, Miyamoto T, Mayer G, Stiasny-Kolster K, Puligheddu M, Ju Y, Jennum P, Sonka K, Santamaria J, Fantini ML, Zucconi M, Leu-Semenescu S, Frauscher B, Terzaghi M, Miyamoto M, Unger MM, Cochen De Cock V, Wolfson C. Environmental risk factors for REM sleep behavior disorder: a multicenter case-control study. Neurology 2012; 79:428-34. [PMID: 22744670 DOI: 10.1212/wnl.0b013e31825dd383] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Idiopathic REM sleep behavior disorder is a parasomnia characterized by dream enactment and is commonly a prediagnostic sign of parkinsonism and dementia. Since risk factors have not been defined, we initiated a multicenter case-control study to assess environmental and lifestyle risk factors for REM sleep behavior disorder. METHODS Cases were patients with idiopathic REM sleep behavior disorder who were free of dementia and parkinsonism, recruited from 13 International REM Sleep Behavior Disorder Study Group centers. Controls were matched according to age and sex. Potential environmental and lifestyle risk factors were assessed via standardized questionnaire. Unconditional logistic regression adjusting for age, sex, and center was conducted to investigate the environmental factors. RESULTS A total of 694 participants (347 patients, 347 controls) were recruited. Among cases, mean age was 67.7 ± 9.6 years and 81.0% were male. Cases were more likely to smoke (ever smokers = 64.0% vs 55.5%, adjusted odds ratio [OR] = 1.43, p = 0.028). Caffeine and alcohol use were not different between cases and controls. Cases were more likely to report previous head injury (19.3% vs 12.7%, OR = 1.59, p = 0.037). Cases had fewer years of formal schooling (11.1 ± 4.4 years vs 12.7 ± 4.3, p < 0.001), and were more likely to report having worked as farmers (19.7% vs 12.5% OR = 1.67, p = 0.022) with borderline increase in welding (17.8% vs 12.1%, OR = 1.53, p = 0.063). Previous occupational pesticide exposure was more prevalent in cases than controls (11.8% vs 6.1%, OR = 2.16, p = 0.008). CONCLUSIONS Smoking, head injury, pesticide exposure, and farming are potential risk factors for idiopathic REM sleep behavior disorder.
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Affiliation(s)
- R B Postuma
- Department of Neurology, McGill University, Montreal General Hospital, Montreal, Canada.
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Rios Romenets S, Wolfson C, Galatas C, Pelletier A, Altman R, Wadup L, Postuma R. Validation of the non-motor symptoms questionnaire (NMS-Quest). Parkinsonism Relat Disord 2012; 18:54-8. [DOI: 10.1016/j.parkreldis.2011.08.013] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 08/12/2011] [Accepted: 08/16/2011] [Indexed: 10/17/2022]
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Puts M, Monette J, Girre V, Wolfson C, Monette M, Batist G, Bergman H. A pilot study on frailty, health and functioning in older newly-diagnosed cancer patients, what have we learned? J Geriatr Oncol 2011. [DOI: 10.1016/j.jgo.2011.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Puts M, Monette J, Girre V, Wolfson C, Monette M, Batist G, Bergman H. Does frailty predict hospitalization, emergency department visits, and visits to the general practitioner in older newly-diagnosed cancer patients? Results of a prospective pilot study. Crit Rev Oncol Hematol 2010; 76:142-51. [DOI: 10.1016/j.critrevonc.2009.10.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Revised: 10/01/2009] [Accepted: 10/21/2009] [Indexed: 12/27/2022] Open
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Puts MTE, Monette J, Girre V, Wolfson C, Monette M, Batist G, Bergman H. Quality of life during the course of cancer treatment in older newly diagnosed patients. Results of a prospective pilot study. Ann Oncol 2010; 22:916-923. [PMID: 20924079 DOI: 10.1093/annonc/mdq446] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The aim of this prospective study was to report the quality of life (QoL) of older cancer patients during the first year after diagnosis and factors influencing QoL. PATIENTS AND METHODS Newly diagnosed patients aged ≥65 years were recruited for a pilot prospective cohort study at the Jewish General Hospital, Montreal, Canada. Participants were interviewed at baseline, and at 1.5, 3, 4.5, 6, and 12 months. QoL was assessed at each interview using the European Organization for the Research and Treatment of Cancer Quality of Life Core Questionnaire with 30 items. Logistic regression was conducted to determine which sociodemographic, health, and functional status characteristics were associated with decline in global health status/QoL between baseline and 12-month follow-up. RESULTS There were 112 participants at baseline (response rate 72%), median age of 74.1, and 70% were women. Between baseline and 12-month follow-up (n=78), 18 participants (23.1%) declined ≥10 points in global health status/QoL, while 34 participants (43.6%) remained stable and 23 participants (33.3%) improved ≥10 points. None of the sociodemographic, health, and functional status variables were associated with decline in logistic regression analyses. CONCLUSION Almost 25% of older adults experienced clinically relevant decline in their QoL. Further research is needed on which factors influence decline in QoL in older adults.
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Affiliation(s)
- M T E Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Solidage Research Group on Frailty and Aging, McGill University/Université de Montreal, Jewish General Hospital, Montreal.
| | - J Monette
- Solidage Research Group on Frailty and Aging, McGill University/Université de Montreal, Jewish General Hospital, Montreal; Division of Geriatric Medicine, Jewish General Hospital, McGill University, Montreal; Department of Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, Canada
| | - V Girre
- Solidage Research Group on Frailty and Aging, McGill University/Université de Montreal, Jewish General Hospital, Montreal; Department of Medical Oncology, Institut Curie, Paris, France
| | - C Wolfson
- Division of Clinical Epidemiology, McGill University Health Centre, McGill University, Montreal, Canada
| | - M Monette
- Solidage Research Group on Frailty and Aging, McGill University/Université de Montreal, Jewish General Hospital, Montreal
| | - G Batist
- Department of Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, Canada
| | - H Bergman
- Solidage Research Group on Frailty and Aging, McGill University/Université de Montreal, Jewish General Hospital, Montreal; Division of Geriatric Medicine, Jewish General Hospital, McGill University, Montreal; Department of Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, Canada
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Sourial N, Wolfson C, Zhu B, Quail J, Fletcher J, Karunananthan S, Bandeen-Roche K, Béland F, Bergman H. Erratum to “Correspondence analysis is a useful tool to uncover the relationships among categorical variables” [J Clin Epidemiol 2010;63:638-646]. J Clin Epidemiol 2010. [DOI: 10.1016/j.jclinepi.2010.04.003] [Citation(s) in RCA: 4] [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: 11/26/2022]
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Puts M, Monette J, Girre V, Pepe C, Monette M, Assouline S, Panasci L, Basik M, Miller W, Batist G, Wolfson C, Bergman H. P19 A novel way of assessing health and vulnerability in older newly-diagnosed cancer patients: results of a pilot study. Crit Rev Oncol Hematol 2009. [DOI: 10.1016/s1040-8428(09)70057-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Wolfson C, Kilborn S, Oskoui M, Genge A. Incidence and prevalence of amyotrophic lateral sclerosis in Canada: a systematic review of the literature. Neuroepidemiology 2009; 33:79-88. [PMID: 19494548 DOI: 10.1159/000222089] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Accepted: 04/05/2009] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a fatal progressive neurodegenerative disease of unknown etiology. Although known to be rare, precise information on the frequency of ALS is essential to anticipate future demands on health resources and as baseline information for epidemiological studies. As part of a new ALS epidemiological initiative in Canada, we conducted a systematic review of published incidence and prevalence research in Canada. METHODS Electronic searches and bibliographic reviews of pertinent publications were conducted. RESULTS We identified 6 published studies from 4 Canadian provinces conducted between 1974 and 2004; 2 were available only as abstracts. Reported annual incidence rates were similar and study quality was generally good, but there was insufficient detail to adequately assess the methodological quality of 3 of the studies. The most recent studies reported an annual ALS age-adjusted incidence of 2.13 per 100,000 in Nova Scotia (2003-2004) and a crude mean annual incidence of 2.4 per 100,000 in Newfoundland and Labrador (2000-2004). CONCLUSIONS There are limited data on the frequency of ALS in Canada. We found no studies from 6 of the Canadian provinces or from the territories. Future research is needed to estimate the frequency of occurrence of ALS in Canada.
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Affiliation(s)
- C Wolfson
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Canada.
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Puts MTE, Girre V, Monette J, Wolfson C, Monette M, Batist G, Bergman H. Clinical experience of cancer specialists and geriatricians involved in cancer care of older patients: A qualitative study. Crit Rev Oncol Hematol 2009; 74:87-96. [PMID: 19427228 DOI: 10.1016/j.critrevonc.2009.04.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Revised: 03/31/2009] [Accepted: 04/08/2009] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Cancer is an important health problem in older persons. The aim of this study was to explore how cancer specialists and geriatricians manage the treatment of older patients with cancer. METHODS Interviews using semi-structured open-ended questions. SAMPLE physicians working in oncology and geriatric medicine at McGill affiliated hospitals. ANALYSIS Grounded-theory approach. RESULTS 24 cancer specialists and 17 geriatricians participated. There was considerable variability with regard to assessment, treatment plan, and follow-up care and little collaboration between both specialists. The cancer specialists have more older cancer patients in their practice and collaborate with geriatricians mostly to deal with complications of cancer treatment. However, both groups of specialists expressed a desire to collaborate more and had similar research priorities. CONCLUSIONS There was considerable variability in the management of older patients with cancer. Care for older patients with cancer might be improved by more collaboration between cancer specialists and geriatricians.
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Affiliation(s)
- M T E Puts
- Centre for Clinical Epidemiology and Community Studies, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Canada.
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Puts M, Costa Lima B, Monette J, Girre V, Batist G, Wolfson C, Bergman H. Medication problems in older newly-diagnosed cancer patients in Canada, how often does it occur? Crit Rev Oncol Hematol 2008. [DOI: 10.1016/s1040-8428(08)70066-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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25
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Puts M, Monette J, Girre V, Pepe C, Monette M, Batist G, Wolfson C, Bergman H. Recruiting older newly-diagnosed cancer patients for an observational ongoing prospective cohort study: lessons learned. Crit Rev Oncol Hematol 2008. [DOI: 10.1016/s1040-8428(08)70065-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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26
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Puts M, Monette J, Girre V, Pepe C, Monette M, Panasci L, Basik M, Batist G, Wolfson C, Bergman H. A novel way of assessing health and vulnerability in older newly diagnosed cancer patients: An ongoing prospective pilot study. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.20707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
OBJECTIVES Multiple sclerosis (MS) likely results from an interaction between genetic and exogenous factors. While genetics shapes the overall population MS susceptibility, observed epidemiological patterns strongly suggest a role for the environment in disease initiation and modulation. RESULTS Findings from studies on seasonality in MS patients' birth, disease onset and exacerbations, as well as apparent temporal trends in incidence and gender ratio support an influential effect of viruses, metabolic and lifestyle factors on MS risk. Epstein-Barr virus, vitamin D status, and smoking are factors that may explain such epidemiological patterns. CONCLUSIONS Further epidemiological investigations are encouraged and opportunities to use data from existing cohort studies as well as the design of new studies should be pursued. In particular, the development of new large multicentre population-based case-control studies which incorporate the study of the role of environment and genetics, including epigenetic mechanisms, in determining MS risk is proposed.
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Affiliation(s)
- M Pugliatti
- Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway.
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28
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Puts M, Girre V, Monette J, Monette M, Wan-Chow-Wah D, Batist G, Wolfson C, Bergman H. P.32 Clinical experience of physicians involved in cancer treatment of older cancer patients: a qualitative interview study. Crit Rev Oncol Hematol 2007. [DOI: 10.1016/s1040-8428(13)70205-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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29
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Quail J, Wolfson C, Lippman A. Unmet Needs and Psychological Distress in the Community Dwelling Elderly. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s177-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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30
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Karunananthan S, Bergman H, Wolfson C, Quail J, Weiss D, Zhu B. 003: Frdata: Examining Candidate Components to Define Frailty in the Elderly Using Three Canadian Databases. Am J Epidemiol 2005. [DOI: 10.1093/aje/161.supplement_1.s1b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - H Bergman
- McGill University, Montreal, QC H3T 1E2
| | - C Wolfson
- McGill University, Montreal, QC H3T 1E2
| | - J Quail
- McGill University, Montreal, QC H3T 1E2
| | - D Weiss
- McGill University, Montreal, QC H3T 1E2
| | - B Zhu
- McGill University, Montreal, QC H3T 1E2
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Zunzunegui MV, Koné A, Johri M, Béland F, Wolfson C, Bergman H. Social networks and self-rated health in two French-speaking Canadian community dwelling populations over 65. Soc Sci Med 2004; 58:2069-81. [PMID: 15020020 DOI: 10.1016/j.socscimed.2003.08.005] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.2] [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: 11/29/2022]
Abstract
The objective was to evaluate the associations between older persons' health status and their social integration and social networks (family, children, friends and community), in two French-speaking, Canadian community dwelling populations aged 65 years and over, using the conceptual framework proposed by Berkman and Thomas. Data were taken from two 1995 surveys conducted in the city of Moncton (n = 1518) and the Montreal neighbourhood of Hochelaga-Maisonneuve (n = 1500). Social engagement (a cumulative index of social activities), networks consisting of friends, family and children and social support were measured using validated scales. Multiple logistic regressions based on structured inclusion of potentially mediating variables were fitted to estimate the associations between health status and social networks. Self-rated health was better for those with a high level of social integration and a strong network of friends in both locations. In addition, in Hochelaga-Maisonneuve family and children networks were positively associated with good health, though the effect of friend networks was attenuated in the presence of disability, good social support from children was associated with good health. Age, sex and education were included as antecedent variables; smoking, alcohol consumption, exercise, locus of control and depressive symptoms were considered intermediary variables between social networks and health. In conclusion, social networks, integration and support demonstrated unique positive associations with health. The nature of these associations may vary between populations and cultures.
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Affiliation(s)
- M V Zunzunegui
- SOLIDAGE, Université de Montréal, McGill University, Canada.
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Abstract
The Canadian Study of Health and Aging was a large, multidisciplinary, national core study--with a number of "add-on" investigations--of the epidemiology of dementia and the health of older people. This structure was a fiscally prudent way to balance between mandated and investigator-initiated inquiry. In hindsight, several important features of the study would be repeated. Future studies might profitably consider a longer funding period for analysis, and a more strategic approach to in-depth, supplementary studies.
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Affiliation(s)
- K Rockwood
- Division of Geriatric Medicine, Dalhousie University, Canada
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Abstract
In studies of dementia, the age at onset (AAO) of the disease is often described without indicating how it was obtained. We used the "CAMDEX algorithm," an ad hoc procedure, to compute the AAO of dementia from the CSHA database. An AAO could be calculated for 983 of 1,132 subjects with dementia. A similar procedure (the "clinical algorithm") was used to calculate a second AAO, which was compared to that obtained by the first algorithm. The CAMDEX and clinical algorithms produced mean AAOs of dementia of 80.5 years (SD = 9.2 years, n = 983) and 79.6 years (SD = 9.7 years, n = 829), respectively. The sample correlation coefficient between the CAMDEX and clinical algorithms was .899 while the intraclass correlation coefficient, ICC(2,1), was .898. This method could prove useful for researchers using the CSHA data who need an AAO for those subjects with dementia.
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Affiliation(s)
- F Rouah
- Centre for Clinical Epidemiology & Community Studies, Jewish General Hospital, Montreal, Quebec, Canada
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Correa JA, Perrault A, Wolfson C. Reliable individual change scores on the 3MS in older persons with dementia: results from the Canadian Study of Health and Aging. Int Psychogeriatr 2002; 13 Supp 1:71-8. [PMID: 11892977 DOI: 10.1017/s1041610202008001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We examined the degree of interrater agreement on the Modified Mini-Mental State Examination (3MS), administered both in the home and at the clinical examination, to determine the boundaries of reliable individual changes for 257 community-dwelling older persons who received a diagnosis of dementia at CSHA-1. Individual score differences were approximately normally distributed (mean of differences 0.2; SD 8.0; 95% confidence interval -16 to 16). The intraclass correlation coefficient was 0.85. Except for the language of testing, there was no relationship between score differences and the determinants investigated (i.e., age, education, type and severity of dementia). This study provides evidence that, in a time frame compatible with no change in cognition, the discrepancy between repeat 3MS scores can be as large as +/- 16. These limits represent the range of variability consistent with no change and should be considered when interpreting individual change scores.
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Affiliation(s)
- J A Correa
- Department of Mathematics and Statistics, McGill University, Montreal, Quebec
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Abstract
OBJECTIVES To systematically review the published evidence for a relationship between human herpes virus 6 (HHV-6) and multiple sclerosis (MS). MATERIALS AND METHODS The medical literature was searched using MEDLINE and the Cochrane database. Retrieved studies are presented according to the experimental technique(s) used. The studies are rated for quality using a priori defined criteria. RESULTS Twenty-eight studies were retrieved. A total of 12 different experimental techniques were used. Four of these techniques provided evidence for a relationship between HHV-6 and MS, but none were able to show a causative relationship. CONCLUSIONS The available literature provides some support for a relationship between HHV-6 and MS. The limitations of the available studies and directions for future research are discussed.
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Affiliation(s)
- F G A Moore
- Department of Nurology, McGill University, Montereal, Quebec, Canada.
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36
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Wolfson C, Perrault A, Moride Y, Esdaile JM, Abenhaim L, Momoli F. A case-control analysis of nonsteroidal anti-inflammatory drugs and Alzheimer's disease: are they protective? Neuroepidemiology 2002; 21:81-6. [PMID: 11901277 DOI: 10.1159/000048621] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [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: 11/19/2022] Open
Abstract
In many studies of nonsteroidal anti-inflammatory drugs (NSAIDs) and Alzheimer's disease (AD), the exposure to NSAIDs was concurrent with AD or based on self (or surrogate) report. We conducted a case-control analysis of the Québec participants in the Canadian Study of Health and Aging who received a diagnosis of AD (cases) or were found to be cognitively unimpaired on screening (controls). Information on drug use was obtained from the Québec Provincial Pharmaceutical Services Database. There was no significant difference in the proportion of cases and controls who had received any NSAID prescriptions in the 3 years prior to the onset of symptoms of dementia; amongst NSAID users, there was no difference in mean dose or duration. Our findings, using a measure of drug use prior to symptom onset and not subject to recall bias, do not support a protective effect for NSAIDs.
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Affiliation(s)
- C Wolfson
- Department of Epidemiology and Biostatistics, McGill University, Montréal, Que., Canada.
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Demers L, Monette M, Lapierre Y, Arnold DL, Wolfson C. Reliability, validity, and applicability of the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0) for adults with multiple sclerosis. Disabil Rehabil 2002; 24:21-30. [PMID: 11827151 DOI: 10.1080/09638280110066352] [Citation(s) in RCA: 127] [Impact Index Per Article: 5.8] [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: 10/17/2022]
Abstract
PURPOSE To investigate the measurement properties of the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0) with respect to test-retest stability, alternate form reliability, construct validity and applicability. METHOD Data on satisfaction and quality of life impacts of mobility devices were obtained from 81 community-based adults with Multiple Sclerosis, using the QUEST 2.0 and the Psychosocial Impact of Assistive Devices Scale (PIADS). Subjects were assigned to four groups and a second QUEST 2.0 was administered one week later. Groups differed with respect to the format and the order in which alternate forms were presented. Measures of association were calculated between QUEST 2.0 and PIADS (n = 81) and between QUEST 2.0 alternate forms (n = 48). Respondents' reactions were considered. RESULTS The device subscale, services subscale, and total QUEST 2.0 scores achieved good test-retest stability (ICC 0.82, 0.82, 0.91). Alternate-form equivalence (ICC 0.89, 0.76, 0.91) was lower for services. The positive correlations between QUEST 2.0 and the three PIADS dimensions were fair to moderate for device and total QUEST 2.0 (r(p) 0.34 to 0.45) and fair with services (r(p) 0.27 to 0.30). The tool was positively received, with some restrictions for the services subscale. CONCLUSIONS These findings on the psychometric properties of the QUEST 2.0 reinforce the relevance of the device subscale as an important outcome measure for assistive technology MS users. Further assessment of the services subscale is needed.
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Affiliation(s)
- L Demers
- Centre for Clinical Epidemiology and Community Studies, Lady Davis Institute for Medical Research, Montreal (Quebec), Canada.
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Hébert R, Dubois MF, Wolfson C, Chambers L, Cohen C. Factors associated with long-term institutionalization of older people with dementia: data from the Canadian Study of Health and Aging. J Gerontol A Biol Sci Med Sci 2001; 56:M693-9. [PMID: 11682577 DOI: 10.1093/gerona/56.11.m693] [Citation(s) in RCA: 140] [Impact Index Per Article: 6.1] [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: 01/13/2023] Open
Abstract
BACKGROUND In Canada, half the people with dementia live in institutions. Factors associated with institutionalization should be identified with the goal of implementing strategies not only to permit those with dementia to stay in their homes as long as is feasible but also to ensure that steps are taken for timely institutionalization when appropriate. METHODS Informal caregivers of 326 individuals with dementia living in the community were identified and interviewed as part of the Canadian Study of Health and Aging (CSHA). These subjects were contacted again 2.5 and 5 years after the baseline interview to collect information on the status of their care recipients. Survival analyses using clinical data for the individuals with dementia and data from the interviews with their informal caregivers were carried out using Cox proportional hazard modeling to estimate the hazard ratio (HR). RESULTS Over the 5-year period, 166 individuals with dementia (50.9%) were institutionalized and the median time to admission was 41 months. From the multivariate analysis, the factors significantly associated with institutionalization were: type of dementia (Alzheimer's disease: HR = 1.83), severity of disability (mild: 1.51; moderate: 2.34; total impairment: 4.02), caregiver's age over 60 (1.83), caregiver not a spouse or child (1.55), and severe caregiver burden (1.71). Caregiver's burden was associated with the care-receiver's behavioral disturbance (partial r =.55) and the caregiver's depressive mood (r =.55). CONCLUSIONS Screening caregivers for burden and depression and designing interventions to decrease the consequences of behavioral disturbance on caregivers would be relevant avenues to explore to decrease institutionalization of people with dementia.
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Affiliation(s)
- R Hébert
- Gerontology and Geriatrics Research Centre, Sherbrooke, Quebec, Canada.
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Abstract
We have evaluated the epidemiological evidence for an aetiological role of varicella zoster virus (VZV) infection in the development of multiple sclerosis (MS). A MEDLINE search of the English language literature for 1965-99 identified 40 studies. These studies were categorized as seroepidemiological (13), case-control (23), historical cohort (2) or ecological (2). One study used both case-control and historical cohort methodologies. Studies were then classified according to methodological rigour, using criteria derived from published guidelines for the epidemiological study of MS. There was a large variability in the quality of evidence. The five studies with the best methodology failed to show an increased risk of MS associated with varicella or zoster infections. At the present time there is insufficient evidence to support an important aetiological role of VZV infection in the development of MS.
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40
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Wentzel C, Rockwood K, MacKnight C, Hachinski V, Hogan DB, Feldman H, Østbye T, Wolfson C, Gauthier S, Verreault R, McDowell I. Progression of impairment in patients with vascular cognitive impairment without dementia. Neurology 2001; 57:714-6. [PMID: 11524488 DOI: 10.1212/wnl.57.4.714] [Citation(s) in RCA: 156] [Impact Index Per Article: 6.8] [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: 11/15/2022] Open
Abstract
Little is known about progression, short of dementia, in vascular cognitive impairment. In the Canadian Study of Health and Aging, 149 participants (79.3 +/- 6.7 years; 61% women) were found to have vascular cognitive impairment, no dementia (CIND). After 5 years, 77 participants (52%) had died and 58 (46%) had developed dementia. Women were at greater risk of dementia (OR 2.1, 1.0 to 4.5). Of 32 participants alive without dementia, cognition had deteriorated in seven and improved in four. Half of those with vascular CIND developed dementia within 5 years, suggesting a target for preventive interventions.
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Affiliation(s)
- C Wentzel
- Dalhousie University, Halifax, Nova Scotia, Canada
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Oremus M, Wolfson C, Perrault A, Demers L, Momoli F, Moride Y. Interrater reliability of the modified Jadad quality scale for systematic reviews of Alzheimer's disease drug trials. Dement Geriatr Cogn Disord 2001; 12:232-6. [PMID: 11244218 DOI: 10.1159/000051263] [Citation(s) in RCA: 297] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Drug therapies for Alzheimer's disease (AD) have been evaluated in clinical trials over the past 2 decades. Systematic reviews of AD drug trials can shed more light on the efficacy of pharmaceutical interventions. The modified Jadad scale can be used to assess the quality of trial reports that are candidates for inclusion in these systematic reviews. The interrater reliability of the modified Jadad scale was examined during such a review. Three blinded reviewers rated the quality of 42 AD drug trial reports: the intraclass correlation coefficient was 0.90. The modified Jadad scale appears to be a useful tool for AD research because of the very good interrater reliability. Also, it is composed of items that are well suited to the specific disease characteristics of AD. Further research should focus on the validity of this instrument.
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Affiliation(s)
- M Oremus
- Center for Clinical Epidemiology and Community Studies, S.M.B.D. Jewish General Hospital, Montreal, Canada
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42
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Affiliation(s)
- C Wolfson
- Centre for Clinical Epidemiology and Community Studies, Lady Davis Institute for Medical Research, 3755 Côte Ste Catherine Road, Montréal, Québec H3T 1E2
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Abstract
BACKGROUND Dementia shortens life expectancy; estimates of median survival after the onset of dementia have ranged from 5 to 9.3 years. Previous studies of people with existing dementia, however, may have underestimated the deleterious effects of dementia on survival by failing to consider persons with rapidly progressive illness who died before they could be included in a study (referred to as length bias). METHODS We used data from the Canadian Study of Health and Aging to estimate survival from the onset of symptoms of dementia; the estimate was adjusted for length bias. A random sample of 10,263 subjects 65 years old or older from throughout Canada was screened for cognitive impairment. For those with dementia, we ascertained the date of onset and conducted follow-up for five years. RESULTS We analyzed data on 821 subjects, of whom 396 had probable Alzheimer's disease, 252 had possible Alzheimer's disease, and 173 had vascular dementia. For the group as a whole, the unadjusted median survival was 6.6 years (95 percent confidence interval, 6.2 to 7.1). After adjustment for length bias, the estimated median survival was 3.3 years (95 percent confidence interval, 2.7 to 4.0). The median survival was 3.1 years for subjects with probable Alzheimer's disease, 3.5 years for subjects with possible Alzheimer's disease, and 3.3 years for subjects with vascular dementia. CONCLUSIONS Median survival after the onset of dementia is much shorter than has previously been estimated.
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Affiliation(s)
- C Wolfson
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada.
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Oremus M, Perrault A, Demers L, Wolfson C. Review of outcome measurement instruments in Alzheimer's disease drug trials: psychometric properties of global scales. J Geriatr Psychiatry Neurol 2001; 13:197-205. [PMID: 11128059 DOI: 10.1177/089198870001300404] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The use of global outcome measures with strong psychometric properties in Alzheimer's disease (AD) drug trials is encouraged. This article focuses on Clinician Global Impression of Change scales, the Clinical Dementia Rating, and the Global Deterioration Scale to provide (1) a review of psychometric properties, (2) a critique of how these properties are assessed in the literature, and (3) a basis for evaluating, from the standpoint of psychometric properties, the appropriateness of using a given global scale in a drug trial. Reported reliability and validity estimates for the aforementioned scales range from fair to very good, but small sample sizes and/or inappropriate measures of correlation weaken the quality of the evidence. There is also a dearth of published information on responsiveness to change. Researchers planning AD drug trials should consider these issues, along with the interval between test administrations for test-retest reliability, to help select appropriate global outcome measurement instruments.
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Affiliation(s)
- M Oremus
- Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Department of Epidemiology, McGill University, Montreal, Quebec
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Abstract
This article introduces a four-part series on outcome scales used in Alzheimer's disease drug trials. First, it discusses the division of scales into four domains: cognition, functional ability/quality of life, behavior/mood, and global. Within each domain, the shortcomings of existing literature reviews are outlined, and the need for a more coherent view of the psychometric properties of the scales is emphasized. Second, the key concepts of reliability, validity, and responsiveness to change are defined and explained. This explanation also provides an overview of the statistical techniques used to assess measurement properties. Finally, the methods used to select the scales for review in the subsequent articles are explained, and each article is briefly introduced.
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Affiliation(s)
- L Demers
- Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Department of Epidemiology, McGill University, Montreal, Quebec
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Perrault A, Oremus M, Demers L, Vida S, Wolfson C. Review of outcome measurement instruments in Alzheimer's disease drug trials: psychometric properties of behavior and mood scales. J Geriatr Psychiatry Neurol 2001; 13:181-96. [PMID: 11128058 DOI: 10.1177/089198870001300403] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article reviews the reliability and validity of eight scales for behavior and mood problems that were identified in a comparative analysis of Alzheimer's disease (AD) drug trials. The scales are the Brief Psychiatric Rating Scale, the Alzheimer's Disease Assessment Scale-noncognitive, the Relative's Assessment of Global Symptomatology, the Consortium to Establish a Registry for Alzheimer's Disease-Behavior Rating Scale for Dementia, the Dementia Behavior Disturbance scale, the Neuropsychiatric Inventory, and two scales for depressive symptoms, the Cornell Scale for Depression in Dementia and the Dementia Mood Assessment Scale. This article also examines methodological limitations in the way the published literature has assessed the psychometric properties of these scales. The aim is to help clinicians and potential trial investigators select appropriate measurement instruments with which to assess behavior and mood problems in AD and to assist AD researchers in the evaluation of the psychometric properties of such scales.
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Affiliation(s)
- A Perrault
- Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Quebec
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47
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Demers L, Oremus M, Perrault A, Champoux N, Wolfson C. Review of outcome measurement instruments in Alzheimer's disease drug trials: psychometric properties of functional and quality of life scales. J Geriatr Psychiatry Neurol 2001; 13:170-80. [PMID: 11128057 DOI: 10.1177/089198870001300402] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The psychometric properties of functional and quality of life outcome measures that were used for the purpose of showing changes in antidementia drug trials for Alzheimer's disease are described and critiqued. The seven functional scales reviewed for reliability, validity, and responsiveness to change included the Geriatric Evaluation by Relative's Rating Instrument, the Physical Self-Maintenance Scale, the Instrumental Activities of Daily Living, the Blessed Dementia Scale, Part 1 and its revised version, the Interview for Deterioration in Daily Living with Dementia, the Unified Activities of Daily Living, and the Dependence Scale. The Progressive Deterioration Scale and Quality of Life Assessment were classified as quality of life scales. The majority of the scales were found to exhibit serious limitations, such as incomplete reliability and validity assessment for the intended uses. The most pervasive problem was a lack of data on responsiveness to change. It is recommended that further research be conducted to develop new tools or enhance existing measures for the assessment of both quality of life and functional ability.
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Affiliation(s)
- L Demers
- Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Department of Epidemiology, McGill University, Montreal, Quebec
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Koutsavlis AT, Wolfson C. Elements of mobility as predictors of survival in elderly patients with dementia: findings from the Canadian Study of Health and Aging. Chronic Dis Can 2001; 21:93-103. [PMID: 11082345] [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] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
In order to identify elements of mobility that predict survival in elderly people with dementia, we conducted a two-year follow-up of a cohort of dementia subjects from the population-based Canadian Study of Health and Aging. There were 749 prevalent cases of Alzheimer's disease (AD) and 208 prevalent cases of vascular dementia. Elements of mobility that predicted death during the two-year follow-up period included difficulty in dressing (OR = 2.08, 95% CI 1.41 3.07), difficulty in getting about (OR = 1.69, 95% CI 1.18 2.40), history of falls (OR = 1.43, 95% CI 1.05 1.94), abnormal gait (OR = 1.61, 95% CI 1.08 2.40) and abnormal motor strength (OR = 1.51, 95% CI 1.07 2.15). Sociodemographic factors such as older age and male sex were also significant predictors of decreased survival. These associations are potentially useful to clinicians and health professionals by providing prognostic information to supply to families and suggesting areas in which interventions to improve survival might be focused
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Affiliation(s)
- A T Koutsavlis
- Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Quebec.
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Essebag V, Lutchmedial S, Wolfson C, Churchill-smith M. Crit Care 2001; 5:P3. [DOI: 10.1186/cc1336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abstract
OBJECTIVE To estimate the frequency and correlates of undetected dementia in community-dwelling older people. DESIGN Secondary analysis of data from the Canadian Study of Health and Aging (CSHA) prevalence survey of dementia. SETTING All 10 provinces of Canada excluding Indian reserves and military units. PARTICIPANTS A total of 252 community-dwelling older adults diagnosed with dementia in the CSHA survey. MAIN OUTCOME MEASURE Undetected dementia, defined as occurring in persons who meet standard diagnostic criteria for dementia but who report never having seen a doctor for memory problems. RESULTS Of the 252 subjects, 64% had undetected dementia. Subjects with mild functional impairment were significantly more likely to have undetected dementia (odds ratio = 2.4, 95% confidence interval 1.2, 5.0). Older subjects and those with mild cognitive impairment showed a trend toward undetected dementia, although the results did not achieve statistical significance. Educational level, number of comorbid conditions, and degree of social support were not significantly associated with undetected dementia. CONCLUSIONS A large number of older persons are living in the community with undetected dementia. These older people may be at significant risk for delirium, motor vehicle accidents, medication errors, and financial difficulties. As preventive strategies are developed and new cognitive enhancing therapies emerge, we need to reexamine our current guidelines about screening for cognitive impairment in older adults.
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Affiliation(s)
- S A Sternberg
- Department of Medicine, University of Chicago, Illinois 60637, USA
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