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Tainta M, Iriondo A, Ecay-Torres M, Estanga A, de Arriba M, Barandiaran M, Clerigue M, Garcia-Sebastian M, Villanua J, Izagirre A, Saldias J, Aramburu A, Taboada J, Múgica J, Barandiaran A, Arrospide A, Mar J, Martinez-Lage P. Brief cognitive tests as a decision-making tool in primary care. A population and validation study. Neurologia 2022:S2173-5808(22)00082-7. [PMID: 35963538 DOI: 10.1016/j.nrleng.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/24/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Brief cognitive tests (BCT) are used in primary care (PC) for the detection of cognitive impairment (CI). Still, there are little data on their diagnostic utility (DU) in a community setting. This work evaluates the DU at the population level of Fototest, T@M, AD8 questionnaire and MMSE. It provides new cut-off points (CoP) validated in a CI early detection program. MATERIAL AND METHODS In the population and validation samples, the evaluation was carried out in two phases, a first of screening and administration of BCT and a second of clinical diagnosis, blinded to the results of the BCT, applying the current NIA-AA criteria. The DU of BCT in the population sample was evaluated with the area under the ROC curve (aROC). Youden index and the CoP with the best specificity that ensured a sensitivity of 80% were used to decide on the most appropriate CoP. The sensitivity, specificity, and predictive values for these CoP were calculated in the validation sample. RESULTS 260 participants (23.1% with CI) from the population sample and 177 (42.4% with CI) from the validation sample were included. The Fototest has the best UD at the population level (aROC 0.851), which improves with the combination of Fototest and AD8 (aROC 0.875). The proposed CoP are AD8 ≥ 1, Fototest ≤ 35, T@M ≤ 40, and MMSE ≤ 26. CONCLUSION BCT are helpful in detecting CI in PC. This work supports the use of more demanding PoC.
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Affiliation(s)
- M Tainta
- CITA Alzheimer, Donostia-San Sebastián, Guipúzcoa, Spain; Osakidetza, Organización Sanitaria Integrada (OSI) Goierri-Urola Garaia, Spain; Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Guipúzcoa, Spain.
| | - A Iriondo
- CITA Alzheimer, Donostia-San Sebastián, Guipúzcoa, Spain
| | - M Ecay-Torres
- CITA Alzheimer, Donostia-San Sebastián, Guipúzcoa, Spain
| | - A Estanga
- CITA Alzheimer, Donostia-San Sebastián, Guipúzcoa, Spain
| | - M de Arriba
- CITA Alzheimer, Donostia-San Sebastián, Guipúzcoa, Spain
| | - M Barandiaran
- CITA Alzheimer, Donostia-San Sebastián, Guipúzcoa, Spain; Osakidetza, Organización Sanitaria Integrada (OSI) Donostialdea, Spain; Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Guipúzcoa, Spain
| | - M Clerigue
- CITA Alzheimer, Donostia-San Sebastián, Guipúzcoa, Spain
| | | | - J Villanua
- Osatek SA, Hospital Donostia, Donostia-San Sebastián, Guipúzcoa, Spain
| | - A Izagirre
- Universidad del País Vasco (UPV-EHU), Facultad de Medicina y Enfermería, Donostia-San Sebastián, Guipúzcoa, Spain
| | - J Saldias
- CITA Alzheimer, Donostia-San Sebastián, Guipúzcoa, Spain
| | - A Aramburu
- Osakidetza, Organización Sanitaria Integrada (OSI) Debabarrena, Spain
| | - J Taboada
- Osakidetza, Organización Sanitaria Integrada (OSI) Bilbao Basurto, Spain
| | - J Múgica
- Osakidetza, Organización Sanitaria Integrada (OSI) Donostialdea, Spain
| | - A Barandiaran
- Osakidetza, Organización Sanitaria Integrada (OSI) Goierri-Urola Garaia, Spain
| | - A Arrospide
- Osakidetza, Organización Sanitaria Integrada (OSI) Debagoiena, Spain; Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Guipúzcoa, Spain
| | - J Mar
- Osakidetza, Organización Sanitaria Integrada (OSI) Debagoiena, Spain; Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Guipúzcoa, Spain; Instituto de Investigación en Servicios Sanitarios Kronikgune, Barakaldo, Vizcaya, Spain
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Tainta M, Iriondo A, Ecay-Torres M, Estanga A, de Arriba M, Barandiaran M, Clerigue M, Garcia-Sebastian M, Villanua J, Izagirre A, Saldias J, Aramburu A, Taboada J, Múgica J, Barandiaran A, Arrospide A, Mar J, Martinez-Lage P. Test cognitivos breves como herramienta de decisión en Atención Primaria. Estudio poblacional y de validación. Neurologia 2022. [DOI: 10.1016/j.nrl.2022.05.006] [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: 11/15/2022] Open
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Sanz B, Larrinaga G, Fernandez-Atucha A, Gil J, Fraile-Bermudez AB, Kortajarena M, Izagirre A, Martinez-Lage P, Irazusta J. Obesity parameters, physical activity, and physical fitness are correlated with serum dipeptidyl peptidase IV activity in a healthy population. Heliyon 2018; 4:e00627. [PMID: 29872761 PMCID: PMC5986540 DOI: 10.1016/j.heliyon.2018.e00627] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 04/14/2018] [Accepted: 05/09/2018] [Indexed: 12/12/2022] Open
Abstract
Objective To determine whether obesity, physical fitness, and physical activity parameters are associated with the enzymatic activity of serum dipeptidyl peptidase IV (sDPPIV) in a sample of healthy women and men. Design and methods We have correlated parameters of obesity, physical fitness, and physical activity with sDPPIV activity in 374 healthy subjects (age: 60.7 ± 6.9 years, body mass index: 26.1 ± 4.1 kg/m2). Enzymatic activity was analyzed using spectrofluorimetry, body composition was assessed by impedanciometry, physical fitness data were obtained using the Senior Fitness Test, and physical activity data were collected by accelerometer. Pearson's partial correlation analysis was applied to determine the relationship between DPPIV activity and the rest of parameters and significantly correlated variables were introduced into linear regression models to predict DPPIV. Results Serum DPPIV activity was negatively associated with obesity parameters such as body mass (r = -0.112), body mass index (BMI) (r = -0.147), waist circumference (r = -0.164), waist-to-hip ratio (-0.104), and percentage of fat mass (r = -0.185). Serum DPPIV activity was positively associated with cardiovascular fitness (r = 0.138), total amount of physical activity (r = 0.153), and time spent doing light exercise (r = 0.184). Regression models revealed sex differences in enzyme activity with overall activity higher in women than in men (β = 0.437, p < 0.001). Further, percent fat mass was an independent negative predictor of DPPIV activity (β = -0.184, p = 0.001). Serum DPPIV activity was positively predicted based on the amount of time spent doing light physical activity (β = 0.167, p = 0.001). Conclusion Our results demonstrate that sDPPIV activity is positively associated with healthier parameters regarding fatness, fitness and physical activity.
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Affiliation(s)
- B Sanz
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Bizkaia, Spain.,BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
| | - G Larrinaga
- BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain.,Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Bizkaia, Spain
| | - A Fernandez-Atucha
- Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Bizkaia, Spain
| | - J Gil
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Bizkaia, Spain.,BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - A B Fraile-Bermudez
- Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Bizkaia, Spain
| | - M Kortajarena
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country, Donostia, Gipuzkoa, Spain
| | - A Izagirre
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country, Donostia, Gipuzkoa, Spain.,Department of Neurology, CITA-Alzheimer Foundation, San Sebastian, Spain
| | - P Martinez-Lage
- Department of Neurology, CITA-Alzheimer Foundation, San Sebastian, Spain
| | - J Irazusta
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Bizkaia, Spain.,BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
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Fernández-Atucha A, Izagirre A, Fraile-Bermúdez AB, Kortajarena M, Larrinaga G, Martinez-Lage P, Echevarría E, Gil J. Sex differences in the aging pattern of renin-angiotensin system serum peptidases. Biol Sex Differ 2017; 8:5. [PMID: 28174624 PMCID: PMC5291971 DOI: 10.1186/s13293-017-0128-8] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 01/31/2017] [Indexed: 01/01/2023] Open
Abstract
Background Serum peptidases, such as angiotensin-converting enzyme (ACE), angiotensin-converting enzyme-2 (ACE2), neutral endopeptidase (NEP), aminopeptidase N (APN), and aminopeptidase A (APA), are important elements of the renin–angiotensin system (RAS). Dysregulation of these enzymes has been associated with hypertension and cardiovascular risk. In the present study, serum activities of RAS peptidases were analyzed to evaluate the existence of sexual differences, with a possible different pattern in pre- and post-andropausal/post-menopausal participants. Methods One hundred and eighteen healthy men and women between 41 and 70 years of age (58 women and 60 men) were recruited to participate in the study. Serum RAS-regulating enzymes were measured by spectrofluorimetry. Enzymatic activity was recorded as units of enzyme per milliliter of serum (U/mL). Results Significantly lower serum APA activity was observed in men with respect to women; no sex differences were detected for ACE, ACE2, NEP, or APN. Significantly lower APA and ACE serum activity were observed in older men compared to older women. In contrast, younger (<55 years) men had significantly higher values of NEP serum activity than younger women. Significantly lower ACE serum activity was detected in older men compared to younger men. In women, significantly higher ACE2 serum activity was observed in older women compared to younger women. Conclusions These results suggest a differential effect of aging on the activity of RAS enzymes in men and women, especially with respect to the breakpoint of andropausia/menopausia, on the critical serum enzymatic activities of the RAS, which could correlate with sexual differences in cardiovascular risk.
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Affiliation(s)
- A Fernández-Atucha
- Department of Nursing I, School of Nursing, University of the Basque Country (UPV/EHU), P.O. Box 699, E-48080 Bilbao, Bizkaia Spain
| | - A Izagirre
- Department of Neurology, CITA-Alzheimer Foundation, San Sebastian, Spain
| | - A B Fraile-Bermúdez
- Department of Nursing I, School of Nursing, University of the Basque Country (UPV/EHU), P.O. Box 699, E-48080 Bilbao, Bizkaia Spain
| | - M Kortajarena
- Department of Nursing I, School of Nursing, University of the Basque Country (UPV/EHU), P.O. Box 699, E-48080 Bilbao, Bizkaia Spain
| | - G Larrinaga
- Department of Nursing I, School of Nursing, University of the Basque Country (UPV/EHU), P.O. Box 699, E-48080 Bilbao, Bizkaia Spain
| | - P Martinez-Lage
- Department of Neurology, CITA-Alzheimer Foundation, San Sebastian, Spain
| | - E Echevarría
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Physiology, Faculty of Medicine, University of the Basque Country (UPV/EHU), P.O. Box 699, E-48080 Bilbao, Bizkaia Spain
| | - J Gil
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Physiology, Faculty of Medicine, University of the Basque Country (UPV/EHU), P.O. Box 699, E-48080 Bilbao, Bizkaia Spain
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Izagirre A, Ayesta U, Verloop IM. Sojourn Time Approximations for a Discriminatory Processor Sharing Queue. ACM Trans Model Perform Eval Comput Syst 2016. [DOI: 10.1145/2812807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We study a multiclass time-sharing discipline with relative priorities known as discriminatory processor sharing (DPS), which provides a natural framework to model service differentiation in systems. The analysis of DPS is extremely challenging, and analytical results are scarce. We develop closed-form approximations for the mean conditional (on the service requirement) and unconditional sojourn times. The main benefits of the approximations lie in its simplicity, the fact that it applies for general service requirements with finite second moments, and that it provides insights into the dependency of the performance on the system parameters. We show that the approximation for the mean conditional and unconditional sojourn time of a customer is decreasing as its relative priority increases. We also show that the approximation is exact in various scenarios, and that it is uniformly bounded in the second moments of the service requirements. Finally, we numerically illustrate that the approximation for exponential, hyperexponential, and Pareto service requirements is accurate across a broad range of parameters.
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