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Zaganas IV, Simos P, Basta M, Kapetanaki S, Panagiotakis S, Koutentaki I, Fountoulakis N, Bertsias A, Duijker G, Tziraki C, Scarmeas N, Plaitakis A, Boumpas D, Lionis C, Vgontzas AN. The Cretan Aging Cohort: Cohort Description and Burden of Dementia and Mild Cognitive Impairment. Am J Alzheimers Dis Other Demen 2019; 34:23-33. [PMID: 30259758 PMCID: PMC10852504 DOI: 10.1177/1533317518802414] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Our aim was to explore the burden of dementia in the Cretan Aging Cohort, comprised of 3140 persons aged ≥60 years (56.8% women, 5.8 ± 3.3 years formal education, 86.2% living in rural areas) who attended selected primary health-care facilities on the island of Crete, Greece. In the first study phase, a formal diagnosis of dementia had been reached in 4.0% of the participants. However, when selected 505 participants underwent thorough neuropsychiatric evaluation in the second phase of this study (344 with Mini-Mental State Examination [MMSE] <24 and 161 with MMSE ≥24), and results were extrapolated to the entire cohort, the prevalence of dementia and mild cognitive impairment was estimated at 10.8% (9.7%-11.9%) and 32.4% (30.8%-34.0%), respectively. Using both the field diagnostic data and the extrapolated data, the highest dementia prevalence (27.2%) was found in the 80- to 84-year-old group, who also showed the lowest educational level, apparently due to lack of schooling during World War II.
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Affiliation(s)
- Ioannis V. Zaganas
- Neurology Department, Medical School, Heraklion, University of Crete, Crete, Greece
| | - Panagiotis Simos
- Psychiatry Department, University of Crete, Medical School, Heraklion, Crete, Greece
- Foundation of Research and Technology, Institute of Computer Science, Heraklion, Greece
| | - Maria Basta
- Psychiatry Department, University of Crete, Medical School, Heraklion, Crete, Greece
| | - Stefania Kapetanaki
- Neurology Department, Medical School, Heraklion, University of Crete, Crete, Greece
| | - Symeon Panagiotakis
- Internal Medicine Department, Medical School, University of Crete, Heraklion, Crete, Greece
| | - Irini Koutentaki
- Psychiatry Department, University of Crete, Medical School, Heraklion, Crete, Greece
| | - Nikolaos Fountoulakis
- Internal Medicine Department, Medical School, University of Crete, Heraklion, Crete, Greece
| | - Antonios Bertsias
- Clinic of Social and Family Medicine, Medical School, University of Crete, Heraklion, Crete, Greece
| | - George Duijker
- Clinic of Social and Family Medicine, Medical School, University of Crete, Heraklion, Crete, Greece
| | - Chariklia Tziraki
- Research Department, Community Elders Club, Melabev, Jerusalem, Israel
| | - Nikolaos Scarmeas
- Department of Social Medicine, Psychiatry and Neurology, 1st Neurology Clinic, Aiginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas Plaitakis
- Neurology Department, Mount Sinai School of Medicine, New York, NY, USA
| | - Dimitrios Boumpas
- Internal Medicine Department, Medical School, University of Athens, Athens, Greece
| | - Christos Lionis
- Clinic of Social and Family Medicine, Medical School, University of Crete, Heraklion, Crete, Greece
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Karmiris K, Bossuyt P, Sorrentino D, Moreels T, Scarcelli A, Legido J, Dotan I, Naismith GD, Jussila A, Preiss JC, Kruis W, Li ACY, Bouguen G, Yanai H, Steinwurz F, Katsanos KH, Subramaniam K, Tarabar D, Zaganas IV, Ben-Horin S. Cerebrovascular events in inflammatory bowel disease patients treated with anti-tumour necrosis factor alpha agents. J Crohns Colitis 2015; 9:382-9. [PMID: 25740813 DOI: 10.1093/ecco-jcc/jjv042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Cerebrovascular accidents [CVA] have rarely been reported in inflammatory bowel disease [IBD] patients treated with anti-tumour necrosis alpha [anti-TNF alpha] agents. Our aim here was to describe the clinical course of CVA in these patients. METHODS This was a European Crohn's and Colitis Organisation [ECCO] retrospective observational study, performed as part of the CONFER [COllaborative Network For Exceptionally Rare case reports] project. A call to all ECCO members was made to report on IBD patients afflicted with CVA during treatment with anti-TNF alpha agents. Clinical data were recorded in a standardised case report form and analysed for event association with anti-TNF alpha treatment. RESULTS A total of 19 patients were identified from 16 centres: 14 had Crohn's disease, four ulcerative colitis and one IBD colitis unclassified [median age at diagnosis: 38.0 years, range: 18.6-62.5]. Patients received anti-TNF alpha for a median duration of 11.8 months [range: 0-62] at CVA onset; seven had previously been treated with at least one other anti-TNF alpha agent. Complete neurological recovery was observed in 16 patients. Anti-TNF alpha was discontinued in 16/19 patients. However, recurrent CVA or neurological deterioration was not observed in any of the 11 patients who received anti-TNF alpha after CVA [eight resumed after temporary cessation, three continued without interruption] for a median follow-up of 39.8 months [range: 5.6-98.2]. CONCLUSION These preliminary findings do not unequivocally indicate a causal role of anti-TNF alpha in CVA complicating IBD. Resuming or continuing anti-TNF alpha in IBD patients with CVA may be feasible and safe in selected cases, but careful weighing of IBD activity versus neurological status is prudent.
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Affiliation(s)
- Konstantinos Karmiris
- Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Crete, Greece
| | - Peter Bossuyt
- Imelda GI Clinical Research Center, Bonheiden, Belgium
| | - Dario Sorrentino
- IBD Center, Virginia Tech-Carilion School of Medicine, Roanoke, VA, USA and Department of Clinical and Experimental Medical Sciences, University of Udine School of Medicine, Udine, Italy
| | - Tom Moreels
- Department of Hepato-gastroenterology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Antonella Scarcelli
- Department of Gastroenterology, Azienda University Hospital, Policlinico di Modena, Italy
| | - Jesus Legido
- Gastroenterology Unit, Segovia General Hospital, Segovia, Spain
| | - Iris Dotan
- IBD Center, Department of Gastroenterology and Liver Diseases and the Sackler School of Medicine, Sourasky Medical Center, Tel Aviv, Israel
| | | | - Airi Jussila
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
| | | | | | - Andy C Y Li
- Department of Gastroenterology, Western Sussex Hospitals NHSFT, Worthing, UK
| | - Guillaume Bouguen
- Department of Gastroenterology, University Hospital Pontchaillou, Rennes, France
| | - Henit Yanai
- Gastroenterology Unit, Segovia General Hospital, Segovia, Spain
| | | | | | - Kavitha Subramaniam
- Gastroenterology and Hepatology Unit, Canberra Hospital, Canberra, Australia
| | - Dino Tarabar
- Department of Gastroenterology, MMA Belgrade, Serbia
| | - Ioannis V Zaganas
- Department of Neurology, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Shomron Ben-Horin
- Department of Gastroenterology, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel
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