Validation of the Dépistage Cognitif de Québec in the Oldest Old

Objective We aimed to validate the Dépistage Cognitif de Québec (DCQ; www.dcqtest.org) , a new cognitive screening tool for atypical degenerative syndromes, in the oldest old. Methods The DCQ was developed by expert behavioural neurologists and clinical neuropsychologists based on updated criteria for Alzheimer’s disease, primary progressive aphasia, and behavioural variant frontotemporal dementia. It targets five relevant cognitive domains: Memory, Visuospatial, Executive, Language, and Behaviour. Validation was performed using a prospective community-based sample consisting of 53 healthy French-speaking Canadian volunteers aged between 80 and 94 years old. Normative data were derived from participants with no history of cognitive difficulties and a Montreal Cognitive Assessment (MoCA) score ≥ 24. Results The mean DCQ total score (out of 100) was 84.65 (SD = 6.33). Pearson’s correlation coefficient showed a moderate, but significant, correlation (r = 0.36, p < .01) with the MoCA. Normative data shown in percentiles were stratified by age and education for DCQ total score and for each of the five cognitive domains. Conclusions This study suggests that the DCQ is a valid cognitive screening test in the oldest old. It is proposed that the DCQ can help early identification of atypical degenerative syndromes.

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Association of Hemoglobin A1C With TDP-43 Pathology in Community-Based Elders

Neurology ◽

10.1212/wnl.0000000000012025 ◽

2021 ◽

pp. 10.1212/WNL.0000000000012025

Author(s):

Shahram Oveisgharan ◽

Ana W. Capuano ◽

Sukriti Nag ◽

Sonal Agrawal ◽

Lisa L. Barnes ◽

...

Keyword(s):

Severity Score ◽

Hemoglobin A1c ◽

Oldest Old ◽

Brain Regions ◽

Inverse Association ◽

Community Based ◽

Cytoplasmic Inclusions ◽

The Mean ◽

High Level ◽

Relationship Of

Objective.We tested the hypothesis that an inverse association exists between diabetes mellitus (DM) and hemoglobin A1C (A1C) with Transactive response DNA binding protein 43 (TDP-43) levels in older adults.Methods.We leveraged antemortem and postmortem data of decedents from three community-based clinical-pathological studies. DM status, A1C levels, and medications for DM were documented annually. TDP-43 cytoplasmic inclusions, evaluated in 6 brain regions using immunohistochemistry, were used to obtain a semiquantitative TDP-43 score (0-5) in each region, and scores were averaged across regions to obtain a TDP-43 severity score. We used linear regressions to test the association of DM and A1C with the TDP-43 severity score.Results.On average, participants (n=817) were 90 years old at the time of death, three fourth were women, and one fourth had DM. The mean A1C was 6.0% (SD=0.6). TDP-43 was observed in 54% of participants, and the mean TDP-43 score was 0.7 (range 0-4.5). A higher level of A1C was associated with a lower TDP-43 score (estimate=-0.156, S.E.=0.060, p=0.009) while DM had a borderline inverse association with the TDP-43 score (estimate=-0.163, S.E.=0.087, p=0.060). The association of higher levels of A1C with lower TDP-43 scores persisted after further adjustment by Apolipoprotein ε4, vascular risk factors, stroke, and hypoglycemic medications. Exclusion of the oldest old participants did not change the results.Conclusion.Overall, the results suggest that a high level of A1C is associated with less TDP-43 proteinopathy in older persons while the relationship of DM with TDP-43 needs further study.

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Statin Initiation: Guideline Concordance and Characteristics of New Users in Quebec, Canada

Journal of Population Therapeutics and Clinical Pharmacology ◽

10.15586/jptcp.v27i3.676 ◽

2020 ◽

Vol 27 (3) ◽

pp. e69-e77

Author(s):

Sarasa M.A. Johnson ◽

Manon Choinière ◽

Michèle Bally ◽

Marie-Pierre Dubé ◽

Jean-Claude Tardif ◽

...

Keyword(s):

High Risk ◽

Health Behaviours ◽

Sociodemographic Characteristics ◽

Biological Parameters ◽

National Guidelines ◽

French Speaking ◽

Risk Patients ◽

History Of ◽

The Mean ◽

Statin Use

Statins are widely prescribed for the prevention of cardiovascular (CV) events. Our objective was to describe the characteristics of patients newly prescribed a statin by general practitioners and assess the concordance of prescribing with national guidelines. Patients who were 18 years or older, French-speaking, available for the 2-year study duration, and had no history of statin use were recruited. Biological parameters were measured, and medical history, sociodemographic characteristics, and health behaviours were recorded using structured questionnaires. Patients’ eligibility for a statin was assessed using the Canadian Cardiovascular Society’s dyslipidemia guidelines. Of the 1631 new statin-users enrolled, 47.6% were women. The mean age for all patients was 57.4 years. According to the Canadian guidelines, 50.6% of patients were considered at high risk for a CV event or had a statin-indicated condition. Moderate and low-risk patients represented 26.7 and 22.7% of patients, respectively.

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Determining Filipino Normative Data for a Battery of Neuropsychological Tests: The Filipino Norming Project (FNP)

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000500519 ◽

2019 ◽

Vol 9 (2) ◽

pp. 260-270

Author(s):

Jacqueline Cotoong Dominguez ◽

Thien Kieu Thi Phung ◽

Ma. Fe Payno de Guzman ◽

Krizelle Cleo Fowler ◽

Macario Reandelar Jr ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Neuropsychological Tests ◽

Normative Data ◽

Neuropsychological Test ◽

Test Battery ◽

Cognitive Domains ◽

Neuropsychological Test Battery ◽

The Mean ◽

Effect Of Age

Background: Filipino normative data for neuropsychological tests are lacking. Objectives: This study aimed to determine the Filipino normative data for the Filipino Norming Project (FNP) Neuropsychological Battery, combining the Alzheimer’s Disease Assessment Scale – Cognitive (ADAS-Cog) and the Neuropsychological Test Battery from the Uniform Dataset of Alzheimer’s Disease Center (UDS-ADC). Methods: We recruited participants 60 years and older with normal cognition (MMSE score of 25 and above and did not fulfill criteria for dementia according to DSM-IV criteria). Psychologists administered the tests to the study participants. We conducted multivariate analyses to study the effect of age, gender, and education on test performance. Results: A total of 191 participants underwent the FNP Neuropsychological Test Battery. The mean age was 68.8 years (SD 5.4). The majority were female (84.1%). The mean score of ADAS-Cog was 9.98 (SD 4.74). The effect of education was prominent throughout the cognitive domains tested while the effect of age was limited to a few cognitive domains. The mean ADAS-Cog scores were 11.80 ± 4.40 for primary education, 9.93 ± 5.08 for secondary, and 8.15 ± 3.95 for tertiary. On average, women scored 2.75 points lower than men and performed better on the verbal components. Men performed better on the constructional praxis component. The same effect of education and gender was observed for the UDS-ADC. Conclusion: For the first time, normative data are available for the ADAS-Cog and UDS-ADC for a Filipino older population. This study stresses the importance of establishing population-specific normative data, taking into account the specific sociocultural and linguistic context of that population.

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Parental anxiety among children undergoing cardiac catheterisation

Cardiology in the Young ◽

10.1017/s1047951117002074 ◽

2017 ◽

Vol 28 (2) ◽

pp. 315-321 ◽

Cited By ~ 3

Author(s):

Daisuke Kobayashi ◽

Daniel R. Turner ◽

Thomas J. Forbes ◽

Sanjeev Aggarwal

Keyword(s):

Trait Anxiety ◽

State Anxiety ◽

Normative Data ◽

The State ◽

Anxiety Level ◽

Cardiac Catheterisation ◽

Self Report ◽

History Of ◽

The Mean ◽

State Score

AbstractBackgroundParents may experience anxiety and stress when their children undergo cardiac catheterisation. The goal of this study was to assess the level of anxiety in parents of children undergoing cardiac catheterisation and to identify factors that were associated with level of anxiety.MethodsThis was a cross-sectional survey of parents of children who underwent cardiac catheterisation. Anxiety levels were measured using a validated self-report questionnaire – State-Trait Anxiety Inventory, which generates state anxiety scores on the current state of anxiety and trait anxiety scores on the stable aspects of anxiety proneness. One sample t-test was used to compare the data with normative data. Multiple linear regression was used to assess the factors associated with the state score.ResultsA total of 113 parents completed the survey. The mean age of parents was 34.0±7.7 years and the mean age of children undergoing catheterisation was 6.7±5.7 years. Compared with normative data, mean state score was significantly higher in our cohort (p<0.05) despite no difference in the trait score. Final multivariate model showed that the state score was significantly associated with child age group (<1 year [coefficient β 7.2] and 10–18 years [6.3], compared to 1 to <10 years of age [reference]) and history of previous catheterisation (−5.2) (p<0.05).ConclusionsConcurrent state anxiety level was high among parents of children undergoing cardiac catheterisation, whereas trait anxiety level was not. Higher anxiety was experienced by parents of infants and adolescents without a history of previous catheterisation.

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Italian version and normative data of Addenbrooke's Cognitive Examination III

International Psychogeriatrics ◽

10.1017/s104161021800073x ◽

2018 ◽

Vol 31 (2) ◽

pp. 241-249 ◽

Cited By ~ 1

Author(s):

Martina Pigliautile ◽

Francesca Chiesi ◽

Franca Stablum ◽

Sonia Rossetti ◽

Caterina Primi ◽

...

Keyword(s):

Normative Data ◽

Linear Regression Analysis ◽

Italian Population ◽

Cognitive Screening ◽

Performance Score ◽

Italian Version ◽

Cognitive Domains ◽

Visuospatial Abilities ◽

Gender And Education ◽

Addenbrooke’S Cognitive Examination

ABSTRACTObjectives:Addenbrooke's Cognitive Examination III (ACE-III) is a brief cognitive screening tool to assess five cognitive domains: attention/orientation, verbal fluency, memory, language, and visuospatial abilities. This study aimed to provide normative data (for total score and subscale scores) of the Italian version of ACE-III for gender, age, and education.Methods:A total of 574 healthy Italian participants (mean age 68.70 ± 9.65; mean education 9.15 ± 4.04) were recruited from the community and included in the study. Linear regression analysis was performed to evaluate the effects of age, gender, and education on the ACE-III total performance score.Results:Age and education exerted a significant effect on total and subscale ACE-III scores, whereas gender was on attention/orientation, language, and visuospatial subscale scores. From the derived linear equation, correction grids to adjust raw scores and equivalent scores (ESs) with cut-off values were provided.Conclusions:The present study provided normative data, correction grids, and ESs for ACE-III in an Italian population.

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General practitioners’ deprescribing decisions in older adults with polypharmacy: a case vignette study in 31 countries

BMC Geriatrics ◽

10.1186/s12877-020-01953-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Katharina Tabea Jungo ◽

Sophie Mantelli ◽

Zsofia Rozsnyai ◽

Aristea Missiou ◽

Biljana Gerasimovska Kitanovska ◽

...

Keyword(s):

General Practitioners ◽

Online Survey ◽

Oldest Old ◽

Case Vignette ◽

Old Patients ◽

Usual Practice ◽

Vignette Study ◽

History Of ◽

The Mean ◽

Multimorbid Patients

Abstract Background General practitioners (GPs) should regularly review patients’ medications and, if necessary, deprescribe, as inappropriate polypharmacy may harm patients’ health. However, deprescribing can be challenging for physicians. This study investigates GPs’ deprescribing decisions in 31 countries. Methods In this case vignette study, GPs were invited to participate in an online survey containing three clinical cases of oldest-old multimorbid patients with potentially inappropriate polypharmacy. Patients differed in terms of dependency in activities of daily living (ADL) and were presented with and without history of cardiovascular disease (CVD). For each case, we asked GPs if they would deprescribe in their usual practice. We calculated proportions of GPs who reported they would deprescribe and performed a multilevel logistic regression to examine the association between history of CVD and level of dependency on GPs’ deprescribing decisions. Results Of 3,175 invited GPs, 54% responded (N = 1,706). The mean age was 50 years and 60% of respondents were female. Despite differences across GP characteristics, such as age (with older GPs being more likely to take deprescribing decisions), and across countries, overall more than 80% of GPs reported they would deprescribe the dosage of at least one medication in oldest-old patients (> 80 years) with polypharmacy irrespective of history of CVD. The odds of deprescribing was higher in patients with a higher level of dependency in ADL (OR =1.5, 95%CI 1.25 to 1.80) and absence of CVD (OR =3.04, 95%CI 2.58 to 3.57). Interpretation The majority of GPs in this study were willing to deprescribe one or more medications in oldest-old multimorbid patients with polypharmacy. Willingness was higher in patients with increased dependency in ADL and lower in patients with CVD.

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Norms and equivalences for MoCA-30, MoCA-22, and MMSE in the oldest-old

Aging Clinical and Experimental Research ◽

10.1007/s40520-021-01886-z ◽

2021 ◽

Author(s):

Zarui A. Melikyan ◽

Michael Malek-Ahmadi ◽

Kathleen O’Connor ◽

Alireza Atri ◽

Claudia H. Kawas ◽

...

Keyword(s):

Healthy Aging ◽

Oldest Old ◽

Screening Tests ◽

Cognitive Tests ◽

Cognitive Screening ◽

Maximum Score ◽

Cognitive Domains ◽

Linear Smoothing ◽

Log Linear ◽

State Examination

Abstract Background Cognitive screening is important for the oldest-old (age 90 +). This age group is the fastest growing and has the highest risk of dementia. However, norms and score equivalence for screening tests are lacking for this group. Aims To provide norms and score equivalence for commonly used cognitive screening tests for the oldest-old. Methods Data on 157 participants of the Center for Healthy Aging Longevity Study aged 90 + were analyzed. First, we derived norms for (1) subtests and cognitive domains of the in-person Montreal Cognitive Assessment having a maximum score of 30 (MoCA-30) and (2) the total MoCA-22 score, obtained from the in-person MoCA-30 by summing the subtests that do not require visual input to a maximum score of 22. These norms were derived from 124 participants with a Mini-Mental State Examination (MMSE) ≥ 27. Second, we derived score equivalences for MMSE to MoCA-30 and MoCA-22, and MoCA-30 to MoCA-22 using equipercentile equating method with log-linear smoothing, based on all 157 participants. Results MoCA-22 total score norms are: mean = 18.3(standard deviation = 2.2). An MMSE score of 27 is equivalent to a MoCA-30 score of 22 and a MoCA-22 score of 16. Discussion and conclusions Subtest, domain and MoCA-22 norms will aid in evaluation of the oldest-old who cannot complete the MoCA-30 or are tested over the phone. The equivalences of the three cognitive tests (MMSE, MoCA-30, MoCA-22) in the oldest-old will facilitate continuity of cognitive tracking of individuals tested with different tests over time and comparison of the studies that use different cognitive tests.

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Occult Laryngeal Pathology in a Community-Based Cohort

Otolaryngology ◽

10.1067/mhn.2001.114256 ◽

2001 ◽

Vol 124 (4) ◽

pp. 448-450 ◽

Cited By ~ 72

Author(s):

Todd R. Reulbach ◽

Peter C. Belafsky ◽

P. David Blalock ◽

James A. Koufman ◽

Gregory N. Postma

Keyword(s):

Head And Neck ◽

Vocal Fold ◽

Laryngopharyngeal Reflux ◽

Voice Disorders ◽

Community Based ◽

Laryngeal Pathology ◽

History Of ◽

The Mean ◽

Over 40 Years ◽

Laryngeal Examination

BACKGROUND: Little information is available regarding the prevalence of laryngeal pathology in adults. PURPOSE: To estimate the prevalence of occult laryngeal pathology in a community-based cohort of adults over 40 years of age. METHODS: One hundred consecutive volunteers over age 40 with no history of voice disorders were enrolled. All completed a self-administered laryngeal symptom questionnaire and underwent a comprehensive head and neck examination including transnasal fiberoptic laryngoscopy. RESULTS: The mean age of the cohort was 61 years. Vocal fold bowing (presbylaryngis) was present in 72% of the patients, and findings of laryngopharyngeal reflux were present in 64% of the cohort. In addition, other laryngeal pathology were identified in 21%. Only 12% had a completely normal laryngeal examination. CONCLUSIONS: Occult laryngeal pathology is very common in persons over 40. Findings suggestive of laryngopharyngeal reflux are present in 64%, and vocal fold bowing is present in 72% of persons over 40.

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Normative and Equated Data of the Original and Basic Versions of the Montreal Cognitive Assessment among Community Dwelling Saudi Arabians

Behavioural Neurology ◽

10.1155/2021/5395627 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Taim A. Muayqil ◽

Nada K. Alamri ◽

Awyshah M. Alqahtani ◽

Sarah S. Julaidan ◽

Raya Alsuhaibani ◽

...

Keyword(s):

Cognitive Assessment ◽

Multivariate Regression ◽

Normative Data ◽

Demographic Data ◽

Community Dwelling ◽

Community Based ◽

Educational Achievements ◽

Expected Performance ◽

The Mean ◽

Saudi Arabians

Introduction. Currently, there are standard and basic versions of the MoCA, the latter designed for those with lower educational achievements. Community-based normative data on these versions of the MoCA from Arabic populations are deficient, and there is little data demonstrating how both scales perform in comparison. We aim to obtain normative performances from both versions and equate the measures of both scales. Methods. Community-based recruitment of healthy volunteers ≥ 18 years of age. Participants underwent testing with both versions. Demographic data was collected with regard to age, gender, years of education, diabetes, and hypertension. Regression analysis was performed to determine significance of variables, and the circle-arc equating method was used to equate the two scores from each scale. Results. 311 participants were included in the study. The mean (sd) age was 45.8 (15.96), females were 184 (59.16%), and the duration of education was 12.7 (5.67) years. The mean scores on the MoCA-A and MoCA-B were 21.47 (4.53) and 24.37 (4.71) ( P < 0.0001 ), respectively. Multivariate regression showed significance of age and years of education in both versions (both variables with P < 0.0001 ). Correlation coefficient between the two scales was 0.77 ( P < 0.0001 ). The largest equated difference between both MoCA versions was four points in those scoring from 10-20 on the MoCA-A. Conclusion. We present normative data from a large Saudi Arabian community-based sample with two different MoCA tests, and an equating graph is presented to determine the corresponding expected performance between the two scales.

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Revisiting the Natural History of Chronic Scaphoid Nonunions: A Retrospective Study of 20 Cases

Journal of Wrist Surgery ◽

10.1055/s-0040-1721435 ◽

2021 ◽

Author(s):

J. Terrence Jose Jerome

Keyword(s):

Retrospective Study ◽

Natural History ◽

Functional Outcome ◽

Grip Strength ◽

Scaphoid Nonunion ◽

Proximal Pole ◽

Degenerative Arthritis ◽

Level Of Evidence ◽

History Of ◽

The Mean

Abstract Background The natural history of scaphoid nonunion is the development of degenerative arthritis. A lot of information is still unclear about this progression. The purpose of this study is to analyze patients with scaphoid nonunions who had not received any kind of treatment and to assess the functional outcome. Materials and Methods This is a retrospective study that analyzed the patients with chronic scaphoid nonunions between 2009 and 2019. None of the patients received any treatment. The age at the time of injury, examination, pattern of fracture, types of scaphoid nonunion, symptoms, and duration of nonunion were noted. Diagnosis was confirmed by radiographs, computed tomography (CT) scan, and magnetic resonance imaging (MRI). Scapholunate and radiolunate angles were recorded. Pain score, modified mayo wrist score, grip strength, range of movement, and the functional outcome of these scaphoid nonunions were analyzed. A statistical correlation between the scaphoid nonunion presentations and the functional outcome was assessed. Results The mean age of the patients was 62 years (range: 35–82 years.). There were 17 male and 3 female patients. There were 9 waist and 11 proximal pole scaphoid nonunions. The mean duration of scaphoid nonunion was 34 years (range: 10–62 years). None of the patients had avascular necrosis (AVN) of the proximal scaphoid. The age at examination, gender, side of injury, fracture pattern (waist/proximal pole), fracture displacement ≤ 1 mm or > 1 mm, nonunion duration, and radiographic arthritic parameters had no significant impact on the functional outcome. Conclusions Untreated chronic scaphoid nonunion leads to the development of degenerative arthritis over a period of years, which is still unpredictable. Most of the patients become aware of the nonunion following a precedent injury or other reasons. Most of the patients have fair/good functional outcome despite reduced range of movements and grip strength. Many do not favor surgical intervention in the course of nonunion. Chronic nonunions open a lot of unanswered questions. Clinical relevance There have been numerous studies on the treatment aspects of scaphoid nonunion, with little knowledge about certain people with nonunion who did not have any kind of treatment. The demographics, clinical findings, and radiological parameters do confirm the progression of these nonunion to arthritis, but most of them had fair-to-good outcome throughout their life. It opens our thinking about the real need of treatment in such nonunions and raises numerous questions about the disease. Level of evidence This is a Level IV study.

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