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Breining A, Silvestre JS, Dieudonné B, Vilar J, Faucounau V, Verny M, Néri C, Boulanger CM, Boddaert J. Biomarkers of vascular dysfunction and cognitive decline in patients with Alzheimer's disease: no evidence for association in elderly subjects. Aging Clin Exp Res 2016; 28:1133-1141. [PMID: 26803509 DOI: 10.1007/s40520-016-0535-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 01/08/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Several studies have suggested that vascular dysfunction plays an important role in Alzheimer's disease. AIMS We hypothesized that significant differences might be observed in the levels of blood endothelial biomarkers across elderly population of subjects with dementia. METHODS We analyzed, in a prospective monocentric study, three different endothelial biomarkers, endothelial microparticles (EMPs), endothelial progenitor cells (EPCs) and circulating endothelial cells (CECs) in 132 older patients who underwent a full evaluation of a memory complaint. RESULTS There was no difference in specific EMP, EPC or CEC levels between demented or non-demented patients, nor considering cognitive decline. DISCUSSION Blood endothelial biomarkers may be too sensitive and it is likely that the multimorbidity observed in our patients may lead to opposite and confounding effects on endothelial biomarkers levels. CONCLUSION Unlike younger AD patients, our results suggest that endothelial biomarkers are not valuable for the diagnosis of dementia in elderly patients.
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Affiliation(s)
- Alice Breining
- Centre de Gériatrie, Groupe Hospitalier Pitié Salpêtrière-Charles Foix, APHP, DHU FAST, 75013, Paris, France.
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, UMR 8256 B2A, 75005, Paris, France.
| | - Jean-Sébastien Silvestre
- INSERM, U970, Paris Cardiovascular Research Center-PARCC, Université Paris Descartes, Sorbonne Paris Cité, UMR-S970, Paris, France
| | - Bénédicte Dieudonné
- Centre de Gériatrie, Groupe Hospitalier Pitié Salpêtrière-Charles Foix, APHP, DHU FAST, 75013, Paris, France
| | - José Vilar
- INSERM, U970, Paris Cardiovascular Research Center-PARCC, Université Paris Descartes, Sorbonne Paris Cité, UMR-S970, Paris, France
| | - Véronique Faucounau
- Centre de Gériatrie, Groupe Hospitalier Pitié Salpêtrière-Charles Foix, APHP, DHU FAST, 75013, Paris, France
| | - Marc Verny
- Centre de Gériatrie, Groupe Hospitalier Pitié Salpêtrière-Charles Foix, APHP, DHU FAST, 75013, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, UMR 8256 B2A, 75005, Paris, France
| | - Christian Néri
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, UMR 8256 B2A, 75005, Paris, France
| | - Chantal M Boulanger
- INSERM, U970, Paris Cardiovascular Research Center-PARCC, Université Paris Descartes, Sorbonne Paris Cité, UMR-S970, Paris, France
| | - Jacques Boddaert
- Centre de Gériatrie, Groupe Hospitalier Pitié Salpêtrière-Charles Foix, APHP, DHU FAST, 75013, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, UMR 8256 B2A, 75005, Paris, France
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Mora L, Sagot C, Dieudonné B, Faucounau V, Barrou Z, Breining A, Greffard S, Cohen-Bittan J, Verny M. [Link between non hypoxemic chronic obstructive pulmonary disease and executive functioning in oldest old]. Geriatr Psychol Neuropsychiatr Vieil 2015; 13:335-342. [PMID: 26395307 DOI: 10.1684/pnv.2015.0560] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
COPD (chronic obstructive pulmonary disease) may result in cognitive disorders (mainly executive) even without hypoxemia. The aim of this descriptive study was to highlight a deficit in task-switching in non-hypoxemic patient with COPD and mild cognitive impairment (MCI) or Alzheimer disease (AD). The main judgment criterion was patients' performances on the TMTA and B. COPD patients were recruited via the database (CogDisCo) of the geriatric medicine department at Pitié Salpêtrière hospital in Paris. 7 patients had Alzheimer's disease (AD), and 11 mild cognitive impairment (MCI): they were matched for age, sex, MMSE, education level with controls subjects without COPD. There was no significant difference between the two groups. However, patients with COPD and MCI required, on average, an extra 13 seconds compared with patient without COPD for the TMTA and 18 seconds for the TMTB. Patients with COPD and AD needed, on average, an extra 63 seconds for TMTA and 97 seconds for TMTB. The number of errors for the TMTB was the same in the both groups. This preliminary study does not show statistically significant results but the time for achieving TMT was longer in the population with COPD whether AD or MCI. These results encourage us to continue with prospective studies on larger samples.
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Affiliation(s)
- Lucie Mora
- Centre de gériatrie, Groupe hospitalier Pitié Salpêtrière - Charles Foix, APHP, DHU FAST, Paris, France
| | - Catherine Sagot
- Centre de gériatrie, Groupe hospitalier Pitié Salpêtrière - Charles Foix, APHP, DHU FAST, Paris, France, Sorbonne Universités, UPMC Université Paris 6, UMR 8256 B2A, Paris, France
| | - Bénédicte Dieudonné
- Centre de gériatrie, Groupe hospitalier Pitié Salpêtrière - Charles Foix, APHP, DHU FAST, Paris, France
| | - Véronique Faucounau
- Centre de gériatrie, Groupe hospitalier Pitié Salpêtrière - Charles Foix, APHP, DHU FAST, Paris, France
| | - Zina Barrou
- Centre de gériatrie, Groupe hospitalier Pitié Salpêtrière - Charles Foix, APHP, DHU FAST, Paris, France
| | - Alice Breining
- Centre de gériatrie, Groupe hospitalier Pitié Salpêtrière - Charles Foix, APHP, DHU FAST, Paris, France, Sorbonne Universités, UPMC Université Paris 6, UMR 8256 B2A, Paris, France
| | - Sandrine Greffard
- Centre de gériatrie, Groupe hospitalier Pitié Salpêtrière - Charles Foix, APHP, DHU FAST, Paris, France
| | - Judith Cohen-Bittan
- Centre de gériatrie, Groupe hospitalier Pitié Salpêtrière - Charles Foix, APHP, DHU FAST, Paris, France
| | - Marc Verny
- Centre de gériatrie, Groupe hospitalier Pitié Salpêtrière - Charles Foix, APHP, DHU FAST, Paris, France, Sorbonne Universités, UPMC Université Paris 6, UMR 8256 B2A, Paris, France, CNRS, UMR 8256 B2A, Paris, France
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Wu YH, Cristancho-Lacroix V, Fassert C, Faucounau V, de Rotrou J, Rigaud AS. The Attitudes and Perceptions of Older Adults With Mild Cognitive Impairment Toward an Assistive Robot. J Appl Gerontol 2014; 35:3-17. [DOI: 10.1177/0733464813515092] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 11/04/2013] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to explore perceived difficulties and needs of older adults with mild cognitive impairment (MCI) and their attitudes toward an assistive robot to develop appropriate robot functionalities. Twenty subjects were recruited to participate in either a focus group or an interview. Findings revealed that although participants reported difficulties in managing some of their daily activities, they did not see themselves as needing assistance. Indeed, they considered that they were capable of coping with difficulties with some compensatory strategies. They therefore declared that they did not need or want a robot for the moment but that they considered it potentially useful either for themselves in the future or for other older adults suffering from frailty, loneliness, and disability. Factors underlying unwillingness to adopt an assistive robot were discussed. These issues should be carefully addressed in the design and diffusion processes of an assistive robot.
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Affiliation(s)
- Ya-Huei Wu
- Assistance Publique-Hôpitaux de Paris, Broca hospital, Paris, France
- EA 4468, Paris Descartes University, France
| | - Victoria Cristancho-Lacroix
- Assistance Publique-Hôpitaux de Paris, Broca hospital, Paris, France
- EA 4468, Paris Descartes University, France
| | - Christine Fassert
- French Institute of Radioprotection and Nuclear Safety, Clamart, France
| | - Véronique Faucounau
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière hospital, Paris, France
| | - Jocelyne de Rotrou
- Assistance Publique-Hôpitaux de Paris, Broca hospital, Paris, France
- EA 4468, Paris Descartes University, France
| | - Anne-Sophie Rigaud
- Assistance Publique-Hôpitaux de Paris, Broca hospital, Paris, France
- EA 4468, Paris Descartes University, France
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Barrou Z, Boddaert J, Faucounau V, Habert MO, Greffard S, Dieudonné B, Verny M. Utility of 123I-FP-CIT SPECT for dementia diagnoses and therapeutic strategies in elderly patients. J Nutr Health Aging 2014; 18:50-3. [PMID: 24402389 DOI: 10.1007/s12603-013-0346-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 11/26/2022]
Abstract
OBJECTIVES Evaluation of the influence of single photon emission computed tomography (SPECT) of the dopamine transporter (123I-FP-CIT) on diagnosis and treatment strategies in elderly patients with mild dementia. DESIGN Retrospective study. SETTING Geriatrics memory clinic. PARTICIPANTS Consecutive ambulatory patients who had 123I-FP-CIT SPECT for a suspicion of DLB. MEASUREMENTS Clinical diagnoses before SPECT were compared with imaging results. RESULTS 46 patients were included. Pre imaging clinical hypotheses were probable DLB in 14, possible DLB in 21 and alternate diagnoses in 11. Rates of abnormal imaging in these groups were respectively 71%, 43% and 18%. Overall, diagnoses were revised in 37% of the cases. Four patients with probable DLB had normal imaging. Their number of core criteria did not differ from the remainder (2.75 ± 0.5 vs. 2.1 ± 0.6), but hallucinations in 2 patients were not well formed and detailed as usual in DLB. Among 38 patients free of antipsychotics, rates of abnormal scans were 36% in patients with questionable parkinsonism, 57% in definite parkinsonism, 67% in patients with no parkinsonism. Among 9 patients on Levodopa, 6 had normal scans and Levodopa was stopped. CONCLUSION We show a significant impact of 123I-FP-CIT SPECT on diagnoses, even in cases of definite parkinsonism or probable DLB. In the latter, scarcity of hallucinations, especially if there are not well formed and detailed, should prompt 123I-FP-CIT SPECT.
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Affiliation(s)
- Z Barrou
- Zina Barrou, MD, Groupe Hospitalier Pitié-Salpêtrière. Centre de Gériatrie, 47-83 Bd de l'hôpital, 75651 cedex 13 Paris. France. Phone: (33) 1 42 16 02 76, Fax: (33) 1 42 16 06 26,
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Legrain S, Delpierre S, Lacaille S, Duc P, Lieberherr D, Bonnet D, Lahjibi-Paulet H, Gouronnec A, Boddaert J, Durand-Gasselin B, Roy C, Faucounau V, Steg PG, Tubach F. Systematic re-evaluation of the diagnosis and treatment of coronary artery disease in hospitalized elderly: Impact on medication underuse. The multicenter IRIDIA study. Eur Geriatr Med 2012. [DOI: 10.1016/j.eurger.2012.04.001] [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: 11/25/2022]
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de Rotrou J, Cantegreil I, Faucounau V, Wenisch E, Chausson C, Jegou D, Grabar S, Rigaud AS. Do patients diagnosed with Alzheimer's disease benefit from a psycho-educational programme for family caregivers? A randomised controlled study. Int J Geriatr Psychiatry 2011; 26:833-42. [PMID: 20922772 DOI: 10.1002/gps.2611] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2010] [Accepted: 07/06/2010] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The Aide dans la Maladie d'Alzheimer (AIDMA) study was conducted to determine whether a psycho-educational programme (PEP) for primary caregivers in addition to standard anti-dementia drugs for patients improves caregivers' psychological condition and patients' activities of daily life. METHOD Multicentre randomised controlled intervention trial. One hundred and sixty-seven dyads 'patient-caregiver' were recruited from 15 French memory clinics and randomised in two parallel groups. The intervention group was offered the PEP in 12 group sessions for 3 months. The control group had usual care. Patients in both groups with mild to moderate Alzheimer's disease (AD) were diagnosed and treated with pharmacotherapy. Patients' primary efficacy variable was functional status assessed with the Disability Assessment Scale for Dementia (DAD) scale. Alzheimer Disease Assessment Scale (ADAS-Cog) and Neuropsychiatric Inventory (NPI) were secondary criteria. Caregivers' first outcome measure was depressive symptoms assessed with the Montgomery and Asberg Depression Rating Scale (MADRS) scale. Zarit scale, Sense of Competence Questionnaire (SCQ) and Visual Analogue Scales (VAS) were secondary criteria. Assessment was done at baseline, 3 months (M3, end of intervention) and 6 months (M6). RESULTS Patients' stabilisation was observed in both groups. In caregivers, significant improvement in disease understanding at M3 (p = 0.007) and M6 (p = 0.0001) and in ability to cope with care-recipients' disease at M6 (0.02) was evidenced. CONCLUSION The PEP had no additional impact on patients but carers developed more effective disease understanding and ability of coping. Results support the idea that the PEP although improving caregivers' condition is not sufficient to improve patients' activities in daily life which requires additional individually tailored interventions provided by professionals.
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Wu YH, Faucounau V, Boulay M, Maestrutti M, Rigaud AS. Robotic agents for supporting community-dwelling elderly people with memory complaints. Health Informatics J 2011; 17:33-40. [DOI: 10.1177/1460458210380517] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Researchers in robotics have been increasingly focusing on robots as a means of supporting older people with cognitive impairment at home. The aim of this study is to explore the elderly’s needs and preferences towards having an assistive robot in the home. In order to ensure the appropriateness of this technology, 30 subjects aged 60 and older with memory complaints were recruited from the Memory Clinic of the Broca Hospital. We conducted an interview-administered questionnaire that included questions about their needs and preferences concerning robot functions and modes of action. The subjects reported a desire to retain their capacity to manage their daily activities, to maintain good health and to stimulate their memory. Regarding robot functions, the cognitive stimulation programme earned the highest proportion of positive responses, followed by the safeguarding functions, fall detection and the automatic help call.
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Affiliation(s)
- Ya-Huei Wu
- Hôpital Broca, Assistance Publique-Hôpitaux de Paris & Research Team 4468, University Paris Descartes, Paris, France
| | - Véronique Faucounau
- Hôpital Broca, Assistance Publique-Hôpitaux de Paris & Research Team 4468, University Paris Descartes, Paris, France
| | - Mélodie Boulay
- Hôpital Broca, Assistance Publique-Hôpitaux de Paris & Research Team 4468, University Paris Descartes, Paris, France
| | | | - Anne-Sophie Rigaud
- Hôpital Broca, Assistance Publique-Hôpitaux de Paris & Research Team 4468, University Paris Descartes, Paris, France on behalf of the QuoVADis project
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Faucounau V, Wu YH, Boulay M, De Rotrou J, Rigaud AS. Cognitive intervention programmes on patients affected by Mild Cognitive Impairment: a promising intervention tool for MCI? J Nutr Health Aging 2010; 14:31-5. [PMID: 20082051 DOI: 10.1007/s12603-010-0006-0] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [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: 12/21/2022]
Abstract
PURPOSE This paper examines and reviews studies on the efficacy of computer-based cognitive intervention programmes in the elderly affected by Mild Cognitive Impairment (MCI). MCI patients are at higher risk to progress to dementia. Recent effort has been made to slow the cognitive decline and delay the onset of dementia in this population. METHOD MEDLINE sources were searched with the following subject headings: computer-based cognitive intervention, cognitive stimulation, cognitive training, aging, elderly, cognitive impairment. Selected studies were quality assessed and data extracted by two reviewers. RESULTS Several studies reported encouraging results on cognitive interventions programmes as a means to improve cognitive abilities and emotional states and to decrease subjective memory complaints in MCI patients. CONCLUSION Though both traditional and computer-based cognitive intervention programmes seem to be effective, the computer-based ones present more advantages: 1) they could individualize the programme tailored to the patient's neuropsychological pattern and needs. 2) they permit the user to make an immediate objective comparison with data collected earlier and thus help in setting up a systematic training plan by providing instant value-free feedback. 3) they offer a possibility of a widescale dissemination.
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Faucounau V, Riguet M, Orvoen G, Lacombe A, Rialle V, Extra J, Rigaud AS. Electronic tracking system and wandering in Alzheimer's disease: a case study. Ann Phys Rehabil Med 2009; 52:579-87. [PMID: 19744906 DOI: 10.1016/j.rehab.2009.07.034] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Revised: 06/05/2009] [Accepted: 07/10/2009] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Wandering is a behavioural disorder, which occurs in Alzheimer's disease or other dementia. People who wander are at risk of physical harm and untimely death. Moreover, wandering behaviour causes a lot of stress to the caregivers. In the last few years, different geolocation devices have been developed in order to minimise risk and manage unsafe wandering. These detection systems rarely meet patients and caregivers' needs because they are not involved in the devices building process. AIM The aim is to explore the needs and perceptions of wandering persons and their caregivers towards existing tracking devices as well as their acceptability and usability. This paper reports a dyad case. MATERIALS The tracking system tested is presented as a mobile Global Positioning System (GPS) receiver-shaped, including function of telephony and data transfer via GSM/GPRS. METHOD Dyad patient/caregiver expressed their needs and perceptions towards tracking devices and gave their impressions about the functioning of the tested device at the end of the test. RESULTS The patient focused on the device's shape which he found too voluminous and unaesthetic, and was unable to give an opinion about the device's functioning. The spouse highlighted malfunctions and usage difficulties, which made the device not appropriate to her needs. CONCLUSION Involving end-users in the co-design of new technologies is necessary for building tailored devices. Moreover, in this area of dementia care, the person-centred approach is essential to a tailored wandering management.
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Affiliation(s)
- V Faucounau
- Service de gérontologie 2, hôpital Broca, 54-56, rue Pascal, 75013 Paris, France.
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Faucounau V, Wu YH, Boulay M, Maestrutti M, Rigaud AS. Caregivers' requirements for in-home robotic agent for supporting community-living elderly subjects with cognitive impairment. Technol Health Care 2009; 17:33-40. [DOI: 10.3233/thc-2009-0537] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Ya-Huei Wu
- Assistance Publique-Hópitaux de Paris Hôpital Broca 54-56, Paris, France
| | - Mélodie Boulay
- Assistance Publique-Hópitaux de Paris Hôpital Broca 54-56, Paris, France
| | | | - Anne-Sophie Rigaud
- Assistance Publique-Hópitaux de Paris Hôpital Broca 54-56, Paris, France
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Rigaud AS, Faucounau V, De Rotrou J, De Sant'Anna M. [New technologies and cognitive stimulation]. Soins Gerontol 2008:29-32. [PMID: 19110871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Abstract
A study was realized on 130 healthy and autonomous volunteers (60-80 years old) who met specific medical and functional inclusion criteria. A comprehensive battery of neuropsychological tests was performed at baseline (M0), 6 and 12 months (M6, M12). At M0 the results indicated that 65% were cognitively normal on each of all the neuropsychological tests, whereas 35% presented a cognitive deficit on one or more tests. At M12, 52% of the subjects who had a cognitive deficit at M0 remained impaired, whereas 48% normalized their scores: they performed as well as the subjects classified normal at M0. The results also indicated that the subjects who remained impaired at M12, had at M0 low scores on three tests or more, whereas the ones who normalized their scores had one or two failed tests. This study focuses on the risk of false positive cases and shows that low scores can be accidental. The authors propose decision rules allowing to reduce the risk of false positive cases. The observation of accidental impairment invites to be cautious and makes this 1-year follow-up study particularly relevant, since a 1-year follow-up is generally needed to diagnose very mild dementia.
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Affiliation(s)
- J de Rotrou
- Service de Gérontologie Clinique Hôpital Broca, rue Pascal, Paris, France.
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Legrain S, Massien C, Lahlou N, Roger M, Debuire B, Diquet B, Chatellier G, Azizi M, Faucounau V, Porchet H, Forette F, Baulieu EE. Dehydroepiandrosterone replacement administration: pharmacokinetic and pharmacodynamic studies in healthy elderly subjects. J Clin Endocrinol Metab 2000; 85:3208-17. [PMID: 10999810 DOI: 10.1210/jcem.85.9.6805] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [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: 11/19/2022]
Abstract
Dehydroepiandrosterone (DHEA; 50 and 25 mg) and placebo tablets were orally administered daily to 24 healthy aging men and women (67.8 +/- 4.3 yr) for 8 days according to a balanced incomplete block design. Nine blood tests on both the first and eighth days allowed the measurement of DHEA, its sulfate DHEAS, and metabolites: testosterone, 5alpha-androstan-3alpha,17beta-diol glucuronide, estradiol, and estrone. Relatively low background levels of DHEA(S) were observed, and with the reestablishment of "young" levels, four important results were obtained. 1) Blood DHEA had an apparent terminal half-life of more than 20 h, the same order of magnitude as that of blood DHEAS, a result explainable by back-hydrolysis of the large amount of DHEAS formed after oral administration of DHEA, a mechanism providing long-lived unconjugated DHEA and metabolites. 2) The metabolic conversion of DHEAS to DHEA was significantly greater in women than in men. 3) No accumulation of steroids was observed. 4) No worrying transformation to androgen and estrogen was recorded; indeed, the limited increased estradiol in aged women could be predicted to be beneficial. These results suggested that daily oral administration of DHEA (25/50 mg) is safe in elderly subjects. The 50-mg dose was chosen for a 1 yr, double blind, placebo-controlled trial of daily oral administration of DHEA in 60- to 80-yr-old individuals (DHEAge).
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Affiliation(s)
- S Legrain
- Service de Gériatrie, Hôpital Bichat, Le Kremlin-Bicêtre, France
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Baulieu EE, Thomas G, Legrain S, Lahlou N, Roger M, Debuire B, Faucounau V, Girard L, Hervy MP, Latour F, Leaud MC, Mokrane A, Pitti-Ferrandi H, Trivalle C, de Lacharrière O, Nouveau S, Rakoto-Arison B, Souberbielle JC, Raison J, Le Bouc Y, Raynaud A, Girerd X, Forette F. Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: contribution of the DHEAge Study to a sociobiomedical issue. Proc Natl Acad Sci U S A 2000; 97:4279-84. [PMID: 10760294 PMCID: PMC18228 DOI: 10.1073/pnas.97.8.4279] [Citation(s) in RCA: 345] [Impact Index Per Article: 14.4] [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: 11/18/2022] Open
Abstract
The secretion and the blood levels of the adrenal steroid dehydroepiandrosterone (DHEA) and its sulfate ester (DHEAS) decrease profoundly with age, and the question is posed whether administration of the steroid to compensate for the decline counteracts defects associated with aging. The commercial availability of DHEA outside the regular pharmaceutical-medical network in the United States creates a real public health problem that may be resolved only by appropriate long-term clinical trials in elderly men and women. Two hundred and eighty healthy individuals (women and men 60-79 years old) were given DHEA, 50 mg, or placebo, orally, daily for a year in a double-blind, placebo-controlled study. No potentially harmful accumulation of DHEAS and active steroids was recorded. Besides the reestablishment of a "young" concentration of DHEAS, a small increase of testosterone and estradiol was noted, particularly in women, and may be involved in the significantly demonstrated physiological-clinical manifestations here reported. Bone turnover improved selectively in women >70 years old, as assessed by the dual-energy x-ray absorptiometry (DEXA) technique and the decrease of osteoclastic activity. A significant increase in most libido parameters was also found in these older women. Improvement of the skin status was observed, particularly in women, in terms of hydration, epidermal thickness, sebum production, and pigmentation. A number of biological indices confirmed the lack of harmful consequences of this 50 mg/day DHEA administration over one year, also indicating that this kind of replacement therapy normalized some effects of aging, but does not create "supermen/women" (doping).
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Affiliation(s)
- E E Baulieu
- Institut National de la Santé et de la Recherche Médicale Unit 488 and Collège de France, 94276 Le Kremlin-Bicêtre, France.
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