1
|
Jiskoot LC, van den Berg E, Vollebergh H, de Haan R, de Boer L, Poos JM, Franzen S, van Hemmen J, Seelaar H. Occupational differences in a Dutch sample of patients with primary progressive aphasia, behavioral variant frontotemporal dementia, and Alzheimer's dementia. Appl Neuropsychol Adult 2024:1-7. [PMID: 38615690 DOI: 10.1080/23279095.2024.2339514] [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] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
BACKGROUND Cognitive reserve is a potential mechanism to cope with brain damage as a result of dementia, which can be defined by indirect proxies, including education level, leisure time activities, and occupational attainment. In this study we explored the association between dementia diagnosis and type of occupation in a retrospective Dutch outpatient memory clinic sample of patients with primary progressive aphasia (PPA), behavioral variant frontotemporal dementia (bvFTD), and Alzheimer's Dementia (AD). METHODS We included data from 427 patients (bvFTD n = 87, PPA n = 148, AD n = 192) and compared the frequency of occupations (11 categories) between patients and data from the Dutch census using Pearson Χ2 tests and we calculated odds ratios (OR) by means of multinomial logistic regression analyses. We also investigated patient group differences in age, sex, education, disease duration, and global cognition. RESULTS The frequency of teachers in patients with PPA was significantly higher than the frequency of teachers in patients with bvFTD [OR = 4.79, p = .007] and AD [OR = 2.04, p = .041]. The frequency of teachers in patients with PPA (16%) was also significantly higher than the frequency of teachers in the Dutch census [5.3%; OR = 3.27, p < .001]. The frequency of teachers in both bvFTD and AD groups were not significantly different from the frequency of teachers in the Dutch census (p = .078 and p = .513, respectively). CONCLUSIONS A potential explanation for our results is the so called "wear and tear" hypothesis, suggesting that teachers have a communication-wise demanding occupation - and therefore are at higher risk to develop PPA. Alternatively, teaching requires continuous communication, hence teachers are more sensitive to subtle changes in their speech and language abilities. Our findings broaden our understanding of the relationship between occupational activity and cognitive reserve in the development of dementia.
Collapse
Affiliation(s)
- Lize C Jiskoot
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Esther van den Berg
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Hannah Vollebergh
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Romy de Haan
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Liset de Boer
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Jackie M Poos
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Sanne Franzen
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Judy van Hemmen
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Harro Seelaar
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
2
|
Jiskoot LC, Poos JM, van Boven K, de Boer L, Giannini LAA, Satoer DD, Visch-Brink EG, van Hemmen J, Franzen S, Pijnenburg YAL, van den Berg E, Seelaar H. The ScreeLing: Detecting Semantic, Phonological, and Syntactic Deficits in the Clinical Subtypes of Frontotemporal and Alzheimer's Dementia. Assessment 2023; 30:2545-2559. [PMID: 36799220 PMCID: PMC10623607 DOI: 10.1177/10731911231154512] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
The ScreeLing is a screening instrument developed to assess post-stroke aphasia, via the linguistic levels Syntax, Phonology, and Semantics. It could also be a useful test for the clinical subtypes of frontotemporal dementia (FTD) and Alzheimer's dementia (AD), as specific and often selective disorders are expected. Its ability to differentiate between the clinical subtypes of FTD and AD is, however, still unknown. We investigated differences in ScreeLing total and subscores, linguistic-level disorders' relationship with disease severity, and classification abilities, in patients with behavioral variant FTD (bvFTD; n = 46), patients with primary progressive aphasia (PPA; n = 105) (semantic variant primary progressive aphasia [svPPA], non-fluent variant primary progressive aphasia [nfvPPA], and logopenic variant primary progressive aphasia [lvPPA], AD [n = 20] and controls [n = 35]). We examined group differences in ScreeLing total and subscores, and one-, two- or three-level linguistic disorders using one-way analyses of covariance (ANCOVAs) or Quade's rank ANCOVA. We used frequency analyses to obtain the occurrence of the linguistic-level disorders. We determined sensitivity and specificity by the area under the curve by receiver-operating characteristics analyses to investigate classification abilities. The total score was lower in patients (bvFTD: 63.8 ± 8.5, svPPA: 58.8 ± 11.3, nfvPPA: 63.5 ± 8.4, lvPPA: 61.7 ± 6.6, AD: 63.8 ± 5.5) than controls (71.3 ± 1.0) (p < .001). Syntax subscores were lower in svPPA (19.4 ± 4.6; p < .001) and lvPPA (20.3 ± 3.2; p = .002) than controls (23.8 ± 0.4). Phonology subscores were lower in lvPPA (19.8 ± 2.6) than bvFTD (21.7 ± 2.8) (p = .010). Semantics subscores were lowest in svPPA (17.8 ± 5.0; p < .002). A selective phonological disorder was most prevalent in lvPPA (34.9%). The higher the disease severity, the more linguistic-level disorders. The optimal cutoff for the total score was 70, and 23 for all three subscores. Good classification abilities were found for the Semantics (svPPA vs. bvFTD), Phonology (lvPPA vs. svPPA), and Syntax (nfvPPA vs. lvPPA) subscores. This easy to administer test gives information about language processing with the potential to improve differential diagnosis in memory clinics and in the future potentially also clinical trial planning.
Collapse
Affiliation(s)
- Lize C. Jiskoot
- Erasmus University Medical Center, Rotterdam, the Netherlands
- University College London, UK
| | - Jackie M. Poos
- Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | - Liset de Boer
- Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | | | | | - Judy van Hemmen
- Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Sanne Franzen
- Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | | | - Harro Seelaar
- Erasmus University Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
3
|
Jiskoot LC, van den Berg E, Laenen SAAM, Poos JM, Giannini LAA, Satoer DD, van Hemmen J, Pijnenburg YAL, Vonk JMJ, Seelaar H. Longitudinal changes in qualitative aspects of semantic fluency in presymptomatic and prodromal genetic frontotemporal dementia. J Neurol 2023; 270:5418-5435. [PMID: 37462752 PMCID: PMC10576727 DOI: 10.1007/s00415-023-11845-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND The semantic fluency test is one of the most widely used neuropsychological tests in dementia diagnosis. Research utilizing the qualitative, psycholinguistic information embedded in its output is currently underexplored in presymptomatic and prodromal genetic FTD. METHODS Presymptomatic MAPT (n = 20) and GRN (n = 43) mutation carriers, and controls (n = 55) underwent up to 6 years of neuropsychological assessment, including the semantic fluency test. Ten mutation carriers became symptomatic (phenoconverters). Total score and five qualitative fluency measures (lexical frequency, age of acquisition, number of clusters, cluster size, number of switches) were calculated. We used multilevel linear regression modeling to investigate longitudinal decline. We assessed the co-correlation of the qualitative measures at each time point with principal component analysis. We explored associations with cognitive decline and grey matter atrophy using partial correlations, and investigated classification abilities using binary logistic regression. RESULTS The interrater reliability of the qualitative measures was good (ICC = 0.75-0.90). There was strong co-correlation between lexical frequency and age of acquisition, and between clustering and switching. At least 4 years pre-phenoconversion, GRN phenoconverters had fewer but larger clusters (p < 0.001), and fewer switches (p = 0.004), correlating with lower executive function (r = 0.87-0.98). Fewer switches was predictive of phenoconversion, correctly classifying 90.3%. Starting at least 4 years pre-phenoconversion, MAPT phenoconverters demonstrated an increase in lexical frequency (p = 0.009) and a decline in age of acquisition (p = 0.034), correlating with lower semantic processing (r = 0.90). Smaller cluster size was predictive of phenoconversion, correctly classifying 89.3%. Increase in lexical frequency and decline in age of acquisition were associated with grey matter volume loss of predominantly temporal areas, while decline in the number of clusters, cluster size, and switches correlated with grey matter volume loss of predominantly frontal areas. CONCLUSIONS Qualitative aspects of semantic fluency could give insight into the underlying mechanisms as to why the "traditional" total score declines in the different FTD mutations. However, the qualitative measures currently demonstrate more fluctuation than the total score, the measure that seems to most reliably deteriorate with time. Replication in a larger sample of FTD phenoconverters is warranted to identify if qualitative measures could be sensitive cognitive biomarkers to identify and track mutation carriers converting to the symptomatic stage of FTD.
Collapse
Affiliation(s)
- Lize C. Jiskoot
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Room NF-331, Post Box 2040, 3000 CA Rotterdam, The Netherlands
- Dementia Research Centre, University College London, London, UK
| | - Esther van den Berg
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Room NF-331, Post Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Sascha A. A. M. Laenen
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Room NF-331, Post Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Jackie M. Poos
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Room NF-331, Post Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Lucia A. A. Giannini
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Room NF-331, Post Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Djaina D. Satoer
- Department of Neurosurgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Judy van Hemmen
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Room NF-331, Post Box 2040, 3000 CA Rotterdam, The Netherlands
| | | | - Jet M. J. Vonk
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA USA
- Department of Epidemiology, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Harro Seelaar
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Room NF-331, Post Box 2040, 3000 CA Rotterdam, The Netherlands
| |
Collapse
|
4
|
Franzen S, van den Berg E, Bossenbroek W, Kranenburg J, Scheffers EA, van Hout M, van de Wiel L, Goudsmit M, van Bruchem-Visser RL, van Hemmen J, Jiskoot LC, Papma JM. Neuropsychological assessment in the multicultural memory clinic: Development and feasibility of the TULIPA battery. Clin Neuropsychol 2023; 37:60-80. [PMID: 35225154 DOI: 10.1080/13854046.2022.2043447] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Neuropsychological assessment of culturally diverse populations is hindered by barriers in language, culture, education, and a lack of suitable tests. Furthermore, individuals from diverse backgrounds are often unfamiliar with being cognitively tested. The aim of this study was to develop a new neuropsychological test battery and study its feasibility in multicultural memory clinics. Composition of the TULIPA battery (Towards a Universal Language: Intervention and Psychodiagnostic Assessment) entailed a literature review and consultation with experts and individuals from diverse backgrounds. Feasibility was investigated by examining administration and completion rates and the frequency of factors complicating neuropsychological assessment in 345 patients from 37 countries visiting four multicultural memory clinics in the Netherlands. The test battery included existing tests such as the Cross-Cultural Dementia screening (CCD), Rowland Universal Dementia Assessment Scale (RUDAS), tests from the European Cross-Cultural Neuropsychological Test Battery, and newly developed tests. Completion rates for the test battery were generally high (82%-100%), except for CCD Dots subtest B (58%). Although tests of the "core" TULIPA battery were administered often (median: 6 of 7, IQR: 5-7), supplementary tests were administered less frequently (median: 1 of 9; IQR: 0-3). The number of administered tests correlated with disease severity (RUDAS, ρ=.33, adjusted p < .001), but not with other patient characteristics. Complicating factors were observed frequently, e.g. suboptimal effort (29%-50%), fatigue (29%), depression (37%-57%). The TULIPA test battery is a promising new battery to assess culturally diverse populations in a feasible way, provided that complicating factors are taken into account. Supplemental data for this article is available online at https://doi.org/10.1080/13854046.2022.2043447 .
Collapse
Affiliation(s)
- Sanne Franzen
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Esther van den Berg
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Willemijn Bossenbroek
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.,Department of Medical Psychology, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Judi Kranenburg
- Department of Internal Medicine, Haaglanden Medical Center, The Hague, The Netherlands
| | - Esther A Scheffers
- Department of Internal Medicine, Haaglanden Medical Center, The Hague, The Netherlands
| | - Moniek van Hout
- Department of Medical Psychology, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Lotte van de Wiel
- Department of Medical Psychology, Maasstad Ziekenhuis, Rotterdam, The Netherlands
| | - Miriam Goudsmit
- Department of Psychiatry and Medical Psychology, OLVG, Amsterdam, The Netherlands
| | | | - Judy van Hemmen
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Lize C Jiskoot
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Janne M Papma
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
5
|
Franzen S, van den Berg E, Bossenbroek W, Kranenburg J, Scheffers E, van Hout M, van de Wiel L, Goudsmit M, van Bruchem‐Visser RL, van Hemmen J, Jiskoot LC, Papma JM. Neuropsychological assessment in the multicultural memory clinic: development and feasibility of the TULIPA battery. Alzheimers Dement 2022. [DOI: 10.1002/alz.063842] [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: 12/24/2022]
Affiliation(s)
- Sanne Franzen
- Erasmus MC ‐ University Medical Center Rotterdam Netherlands
| | | | | | | | | | | | | | | | | | - Judy van Hemmen
- Erasmus MC ‐ University Medical Center Rotterdam Netherlands
| | - Lize C. Jiskoot
- Erasmus MC ‐ University Medical Center Rotterdam Netherlands
| | - Janne M. Papma
- Erasmus MC ‐ University Medical Center Rotterdam Netherlands
| |
Collapse
|
6
|
Eikelboom WS, den Teuling A, Pol DE, Coesmans M, Franzen S, Jiskoot LC, van Hemmen J, Singleton EH, Ossenkoppele R, de Jong FJ, van den Berg E, Papma JM. Biweekly fluctuations of neuropsychiatric symptoms according to the Neuropsychiatric Inventory: Erratic symptoms or scores? Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5770. [PMID: 35702994 PMCID: PMC9327507 DOI: 10.1002/gps.5770] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 06/01/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study investigates the stability of neuropsychiatric symptoms (NPS) assessed biweekly using the Neuropsychiatric Inventory (NPI) in a memory clinic population during a 6 week period. METHODS Twenty-three spousal caregivers (mean [SD] age = 69.7 [8.8], 82.6% female) of 23 patients (43.5% had dementia) completed all assessments. The NPI was assessed four times during 6 weeks. We examined whether NPI domains were present during all four assessments, studied within-person variation for each NPI domain, and calculated Spearman's correlations between subsequent time-points. Furthermore, we associated repeated NPI assessments with repeated measures of caregiver burden to examine the clinical impact of changes in NPI scores over time. RESULTS The course of NPS was highly irregular according to the NPI, with only 35.8% of the NPI domains that were present at baseline persisted during all 6 weeks. We observed large within-person variation in the presence of individual NPI domains (61.3%, range 37.5%-83.9%) and inconsistent correlations between NPI assessments (e.g., range rs = 0.20-0.57 for agitation, range rs = 0.29-0.59 for anxiety). Higher NPI total scores were related to higher caregiver burden (rs = 0.60, p < 0.001), but changes in NPI total scores were unrelated to changes in caregiver burden (rs = 0.16, p = 0.20). CONCLUSIONS We observed strong fluctuations in NPI scores within very short time windows raising the question whether this represents erratic symptoms and/or scores. Further studies are needed to investigate the origins of these fluctuations.
Collapse
Affiliation(s)
- Willem S. Eikelboom
- Department of Neurology and Alzheimer Center Erasmus MCErasmus MC University Medical CenterRotterdamThe Netherlands
| | - Amy den Teuling
- Department of Neurology and Alzheimer Center Erasmus MCErasmus MC University Medical CenterRotterdamThe Netherlands
| | - Daphne E. Pol
- Department of Neurology and Alzheimer Center Erasmus MCErasmus MC University Medical CenterRotterdamThe Netherlands
| | - Michiel Coesmans
- Department of PsychiatryErasmus MC University Medical CenterRotterdamThe Netherlands
| | - Sanne Franzen
- Department of Neurology and Alzheimer Center Erasmus MCErasmus MC University Medical CenterRotterdamThe Netherlands
| | - Lize C. Jiskoot
- Department of Neurology and Alzheimer Center Erasmus MCErasmus MC University Medical CenterRotterdamThe Netherlands
| | - Judy van Hemmen
- Department of Neurology and Alzheimer Center Erasmus MCErasmus MC University Medical CenterRotterdamThe Netherlands
| | - Ellen H. Singleton
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam University Medical CentersAmsterdamThe Netherlands
| | - Rik Ossenkoppele
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam University Medical CentersAmsterdamThe Netherlands,Clinical Memory Research UnitLund UniversityMalmöSweden
| | - Frank Jan de Jong
- Department of Neurology and Alzheimer Center Erasmus MCErasmus MC University Medical CenterRotterdamThe Netherlands
| | - Esther van den Berg
- Department of Neurology and Alzheimer Center Erasmus MCErasmus MC University Medical CenterRotterdamThe Netherlands
| | - Janne M. Papma
- Department of Neurology and Alzheimer Center Erasmus MCErasmus MC University Medical CenterRotterdamThe Netherlands
| |
Collapse
|
7
|
Overbeek FCMS, Goudzwaard JA, van Hemmen J, van Bruchem-Visser RL, Papma JM, Polinder-Bos HA, Mattace-Raso FUS. The Multidimensional Prognostic Index Predicts Mortality in Older Outpatients with Cognitive Decline. J Clin Med 2022; 11:jcm11092369. [PMID: 35566497 PMCID: PMC9103737 DOI: 10.3390/jcm11092369] [Citation(s) in RCA: 1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/03/2022] [Accepted: 04/19/2022] [Indexed: 02/03/2023] Open
Abstract
Since the heterogeneity of the growing group of older outpatients with cognitive decline, it is challenging to evaluate survival rates in clinical shared decision making. The primary outcome was to determine whether the Multidimensional Prognostic Index (MPI) predicts mortality, whilst assessing the MPI distribution was considered secondary. This retrospective chart review included 311 outpatients aged ≥65 years and diagnosed with dementia or mild cognitive impairment (MCI). The MPI includes several domains of the comprehensive geriatric assessment (CGA). All characteristics and data to calculate the risk score and mortality data were extracted from administrative information in the database of the Alzheimer’s Center and medical records. The study population (mean age 76.8 years, men = 51.4%) was divided as follows: 34.1% belonged to MPI category 1, 52.1% to MPI category 2 and 13.8% to MPI category 3. Patients with dementia have a higher mean MPI risk score than patients with MCI (0.47 vs. 0.32; p < 0.001). The HRs and corresponding 95% CIs for mortality in patients in MPI categories 2 and 3 were 1.67 (0.81−3.45) and 3.80 (1.56−9.24) compared with MPI category 1, respectively. This study shows that the MPI predicts mortality in outpatients with cognitive decline.
Collapse
Affiliation(s)
- Femke C. M. S. Overbeek
- Department of Geriatric Medicine, Erasmus MC University Medical Center, 3015 GD Rotterdam, The Netherlands; (F.C.M.S.O.); (J.A.G.); (R.L.v.B.-V.); (H.A.P.-B.)
| | - Jeannette A. Goudzwaard
- Department of Geriatric Medicine, Erasmus MC University Medical Center, 3015 GD Rotterdam, The Netherlands; (F.C.M.S.O.); (J.A.G.); (R.L.v.B.-V.); (H.A.P.-B.)
| | - Judy van Hemmen
- Department of Neurology, Erasmus MC University Medical Center, 3015 GD Rotterdam, The Netherlands; (J.v.H.); (J.M.P.)
| | - Rozemarijn L. van Bruchem-Visser
- Department of Geriatric Medicine, Erasmus MC University Medical Center, 3015 GD Rotterdam, The Netherlands; (F.C.M.S.O.); (J.A.G.); (R.L.v.B.-V.); (H.A.P.-B.)
| | - Janne M. Papma
- Department of Neurology, Erasmus MC University Medical Center, 3015 GD Rotterdam, The Netherlands; (J.v.H.); (J.M.P.)
| | - Harmke A. Polinder-Bos
- Department of Geriatric Medicine, Erasmus MC University Medical Center, 3015 GD Rotterdam, The Netherlands; (F.C.M.S.O.); (J.A.G.); (R.L.v.B.-V.); (H.A.P.-B.)
| | - Francesco U. S. Mattace-Raso
- Department of Geriatric Medicine, Erasmus MC University Medical Center, 3015 GD Rotterdam, The Netherlands; (F.C.M.S.O.); (J.A.G.); (R.L.v.B.-V.); (H.A.P.-B.)
- Correspondence: ; Tel.: +31-10-7035979
| |
Collapse
|
8
|
Franzen S, Eikelboom WS, van den Berg E, Jiskoot LC, van Hemmen J, Papma JM. Caregiver Burden in a Culturally Diverse Memory Clinic Population: The Caregiver Strain Index-Expanded. Dement Geriatr Cogn Disord 2021; 50:333-340. [PMID: 34700324 DOI: 10.1159/000519617] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/10/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Although qualitative studies have highlighted substantial barriers to dementia diagnosis and care in culturally diverse populations in Europe, quantitative studies examining the level of caregiver burden in these populations have been lacking thus far and are urgently needed. METHODS We compared the caregiver burden levels on the Caregiver Strain Index (CSI)-Expanded of 63 culturally diverse patient-caregiver dyads from a multicultural memory clinic with 30 native Dutch patient-caregiver dyads and examined the association between caregiver burden and determinants of burden. RESULTS Informal caregivers in the multicultural memory clinic cohort experienced a high level of caregiver burden (mean CSI-score multicultural cohort: 6.1 [SD: 3.3]; mean CSI-score native Dutch cohort: 4.8 [SD: 3.2]). Burden was significantly associated with impairment on proxy-rated and objective measures of cognitive functioning, such as the Informant Questionnaire on Cognitive Decline and the Rowland Universal Dementia Assessment Scale, and with instrumental activities of daily living. Burden was the highest in spousal caregivers. The positive subscale of the CSI-Expanded provided limited additional information. CONCLUSION Caregivers of culturally diverse patients experience a high level of caregiver burden, in particular at more advanced disease stages. This study highlights the need to screen culturally diverse caregivers in European memory clinics on caregiver burden to identify those in need of caregiver support.
Collapse
Affiliation(s)
- Sanne Franzen
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Willem S Eikelboom
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Esther van den Berg
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Lize C Jiskoot
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Judy van Hemmen
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Janne M Papma
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
9
|
Jiskoot LC, Poos JM, Vollebergh ME, Franzen S, van Hemmen J, Papma JM, van Swieten JC, Kessels RPC, van den Berg E. Emotion recognition of morphed facial expressions in presymptomatic and symptomatic frontotemporal dementia, and Alzheimer's dementia. J Neurol 2021; 268:102-113. [PMID: 32728945 PMCID: PMC7815624 DOI: 10.1007/s00415-020-10096-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 07/10/2020] [Accepted: 07/20/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The emotion recognition task (ERT) was developed to overcome shortcomings of static emotion recognition paradigms, by identifying more subtle deficits in emotion recognition across different intensity levels. In this study, we used the ERT to investigate emotion recognition deficits across the frontotemporal (FTD) and Alzheimer's Dementia (AD) spectrum. METHODS With the ERT, we assessed the recognition of facial emotional expressions (anger-disgust-fear-happiness-sadness-surprise) across four intensities (40-60-80-100%) in patients with behavioural variant FTD (bvFTD; n = 32), and AD (n = 32), presymptomatic FTD mutation carriers (n = 47) and controls (n = 49). We examined group differences using multilevel linear regression with age, sex and education level as covariates, and performed post hoc analyses on presymptomatic (MAPT, GRN and C9orf72) mutation carriers. Classification abilities were investigated by means of logistic regression. RESULTS Lowest ERT total scores were found in patients with bvFTD and AD, whereas equal highest performance was found in presymptomatic mutation carriers and controls. For all emotions, significantly lower subscores were found in patients with bvFTD than in presymptomatic mutation carriers and in controls (highest p value = 0.025). Patients with bvFTD performed lower than patients with AD on anger (p = 0.005) and a trend towards significance was found for a lower performance on happiness (p = 0.065). Task performance increased with higher emotional intensity, and classification was better at the lowest than at the highest intensity. C9orf72 mutation carriers performed worse on recognizing anger at the lowest intensity than GRN mutation carriers (p = 0.047) and controls (p = 0.038). The ERT differentiated between patients with bvFTD and controls, and between patients with AD and controls (both p < 0.001). DISCUSSION Our results demonstrate emotion recognition deficits in both bvFTD and AD, and suggest the presence of subtle emotion recognition changes in presymptomatic C9orf72-FTD. This highlights the importance of incorporating emotion recognition paradigms into standard neuropsychological assessment for early differential diagnosis, and as clinical endpoints in upcoming therapeutic trials.
Collapse
Affiliation(s)
- Lize C. Jiskoot
- Department of Neurology, Erasmus Medical Center, NF-331, Post box 2040, 3000 CA Rotterdam, The Netherlands
- Dementia Research Centre, University College London, London, UK
| | - Jackie M. Poos
- Department of Neurology, Erasmus Medical Center, NF-331, Post box 2040, 3000 CA Rotterdam, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Manon E. Vollebergh
- Department of Neurology, Erasmus Medical Center, NF-331, Post box 2040, 3000 CA Rotterdam, The Netherlands
| | - Sanne Franzen
- Department of Neurology, Erasmus Medical Center, NF-331, Post box 2040, 3000 CA Rotterdam, The Netherlands
| | - Judy van Hemmen
- Department of Neurology, Erasmus Medical Center, NF-331, Post box 2040, 3000 CA Rotterdam, The Netherlands
| | - Janne M. Papma
- Department of Neurology, Erasmus Medical Center, NF-331, Post box 2040, 3000 CA Rotterdam, The Netherlands
| | - John C. van Swieten
- Department of Neurology, Erasmus Medical Center, NF-331, Post box 2040, 3000 CA Rotterdam, The Netherlands
| | - Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
- Department of Medical Psychology, Radboudumc Alzheimer Center, Nijmegen, The Netherlands
| | - Esther van den Berg
- Department of Neurology, Erasmus Medical Center, NF-331, Post box 2040, 3000 CA Rotterdam, The Netherlands
| |
Collapse
|
10
|
van Hemmen J, Cohen-Kettenis PT, Steensma TD, Veltman DJ, Bakker J. Do sex differences in CEOAEs and 2D:4D ratios reflect androgen exposure? A study in women with complete androgen insensitivity syndrome. Biol Sex Differ 2017; 8:11. [PMID: 28413602 PMCID: PMC5389183 DOI: 10.1186/s13293-017-0132-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 03/24/2017] [Indexed: 01/30/2023] Open
Abstract
Background Studies investigating the influence of perinatal hormone exposure on sexually differentiated traits would greatly benefit from biomarkers of these early hormone actions. Click-evoked otoacoustic emissions show sex differences that are thought to reflect differences in early androgen exposure. Women with complete androgen insensitivity syndrome (CAIS), who lack androgen action in the presence of XY-chromosomes, enabled us to study the effect of complete androgen inaction. The main goal was to investigate a possible link between click-evoked otoacoustic emissions and effective androgen exposure and, thus, whether this can be used as a biomarker. In addition, we aimed to replicate the only previous 2nd vs 4th digit-ratio study in women with CAIS, because despite the widely expressed criticisms of the validity of this measure as a biomarker for prenatal androgen exposure, it still is used for this purpose. Methods Click-evoked otoacoustic emissions and digit ratios from women with CAIS were compared to those from control men and women. Results The typical sex differences in click-evoked otoacoustic emissions and digit ratios were replicated in the control groups. Women with CAIS showed a tendency towards feminine, i.e., larger, click-evoked otoacoustic emission amplitudes in the right ear, and a significant female-typical, i.e., larger, digit ratio in the right hand. Although these results are consistent with androgen-dependent development of male-typical click-evoked otoacoustic emission amplitude and 2nd to 4th digit ratios, the within-group variability of these two measures was not reduced in women with CAIS compared with control women. Conclusions In line with previous studies, our findings in CAIS women suggest that additional, non-androgenic, factors mediate male-typical sexual differentiation of digit ratios and click-evoked otoacoustic emissions. Consequently, use of these measures in adults as retrospective markers of early androgen exposure is not recommended.
Collapse
Affiliation(s)
- Judy van Hemmen
- Netherlands Institute for Neuroscience, Amsterdam, The Netherlands.,Department of Medical Psychology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Peggy T Cohen-Kettenis
- Department of Medical Psychology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Thomas D Steensma
- Department of Medical Psychology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Dick J Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Julie Bakker
- Netherlands Institute for Neuroscience, Amsterdam, The Netherlands.,Department of Medical Psychology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.,GIGA Neurosciences, University of Liège, Avenue Hippocrate 15, 4000 Liège, Belgium
| |
Collapse
|
11
|
Bakker J, van Hemmen J. [Female-typical neural activation in women with complete androgen insensitivity syndrome]. Med Sci (Paris) 2016; 32:668-71. [PMID: 27615164 DOI: 10.1051/medsci/20163208003] [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: 11/14/2022] Open
Affiliation(s)
- Julie Bakker
- Neuroendocrinologie, GIGA Neurosciences, université de Liège, Avenue Hippocrate 15, 4000 Liège, Belgique
| | - Judy van Hemmen
- Netherlands Institute for Neurosciences, Meibergdreef 47, Amsterdam, Pays-Bas
| |
Collapse
|
12
|
van Hemmen J, Veltman DJ, Hoekzema E, Cohen-Kettenis PT, Dessens AB, Bakker J. Neural Activation During Mental Rotation in Complete Androgen Insensitivity Syndrome: The Influence of Sex Hormones and Sex Chromosomes. Cereb Cortex 2014; 26:1036-45. [DOI: 10.1093/cercor/bhu280] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
|