Effectiveness of a specific care plan in patients with Alzheimer’s disease: cluster randomised trial (PLASA study)

Objective To test the effectiveness of a comprehensive specific care plan in decreasing the rate of functional decline in patients with mild to moderate Alzheimer’s disease compared with usual care in memory clinics

Neuroinflammatory processes in cognitive disorders:Is there a role for flavonoids and n-3 polyunsaturated fatty acids in counteracting their detrimental effects?

Neuroinflammatory processes are known to contribute to the cascade of events culminating in the neuronal damage that underpins neurodegenerative disorders such as Parkinson's and Alzheimer's disease. With the ageing population and increased cases of neurodegenerative diseases, there is a crucial need for the development of new strategies capable to prevent, delay the onset or treat brain dysfunction and associated cognitive decline. Growing evidence sheds light on the use of dietary polyphenols and n-3 long chain polyunsaturated fatty acids to improve cognitive performances and reduce the neuroinflammatory and oxidative stress responses occurring with age and neurodegenerative pathologies. This review will summarise the most recent information related to the impact and mechanisms underlying the neuroinflammatory processes in neurodegenerative disorders. We will also detail the current evidence indicating that flavonoids and n-3 polyunsaturated fatty acids are strong candidate in preventing neuroinflammation and modulating age-related memory decline, and will describe the potential mechanisms of action underlying their neuroprotective effects. As such, these dietary bioactives represent important precursor molecules in the quest to develop of a new generation of drugs capable of counteracting neuroinflammation and neurodegenerative diseases

Perte de poids et maladie d'alzheimer (facteurs associés et prise en charge)

TOULOUSE3-BU Sciences (315552104) / SudocSudocFranceF

Commentary on "A roadmap for the prevention of dementia II. Leon Thal Symposium 2008." The Multidomain Alzheimer Preventive Trial (MAPT): a new approach to the prevention of Alzheimer's disease.

International audienceBACKGROUND: Because no effective curative approaches are available, preventive approaches in the field of Alzheimer's disease (AD) are needed. We present the design of the ongoing Multidomain Alzheimer Preventive Trial (MAPT) Study. Several previous studies suggested that many factors may be involved in the occurrence of AD at late ages. Because of the probable multifactorial nature of AD, it seems logical to initiate multidomain interventions to examine their potential synergistic effects. The MAPT Study aims to evaluate the efficacy of a multidomain intervention (nutritional, physical, and cognitive training) and omega 3 treatment in the prevention of cognitive decline in frail elderly persons aged 70 years or over. The study also collects imaging and biological data that could be used in future AD prevention and treatment trials. METHODS: The MAPT Study is a 3-year, randomized, controlled trial conducted by university hospital practitioners specializing in memory disorders in four French cities (Bordeaux, Limoges, Montpellier, and Toulouse). The study plans to enroll 1200 frail elderly subjects on the basis of at least one of the following criteria: subjective memory complaint spontaneously expressed to a general practitioner, limitation in one instrumental activity of daily living (IADL), and slow walking speed. To demonstrate the protective effect of interventions, subjects are randomized into one of the following four groups: omega 3 alone, multidomain intervention alone, omega 3 plus multidomain intervention, or placebo (n = 300 each). The principal outcome measure is a change in cognitive function at 3 years, as determined by the Grober and Buschke Test. CONCLUSIONS: The MAPT Study is the first preventive trial involving multidomain interventions. Final results should be available in 2013

Gait speed, body composition, and dementia. The EPIDOS-Toulouse cohort

International audienceBACKGROUND: Slow gait speed (GS) predicts dementia, but this association might be mediated by body composition parameters like total fat mass (TFM) or total lean mass (TLM). The aim of the study was to evaluate whether GS, TLM, and TFM were associated factors with an increased risk for subsequent dementia in community-dwelling older women.METHODS: A case-control study was nested in the EPIDemiologie de l'OSteoporose cohort. GS (at usual pace more than 6 m), TLM, and TFM (assessed by dual energy x-ray absorptiometry) were measured at baseline. Cognitive performance was evaluated at baseline and at 7 years of follow-up. The presence of dementia was assured by two blinded memory experts based on best practice and validated criteria. Multivariate logistic regression models assessed the association of GS, TLM, and TFM with dementia risk. RESULTS: Of the initial 1,462 women, 75 years old and older, 647 (43.4%) were cognitively intact at baseline and had a full cognitive assessment at 7 years (145 of them developed dementia). Controlled for covariates (demographics, physical activity, self-reported disabilities, and comorbidities), GS was an independent associated factor for subsequent dementia as a continuous variable (odds ratio [OR] 2.28, 95% CI: 1.32-3.94) and as a categorized variable (OR 2.38, 95% CI: 1.28-4.43 highest vs lowest quartile). Neither interaction with GS nor a statistically significant association with dementia risk was found for TLM and TFM. CONCLUSIONS: GS was an independent associated factor for subsequent dementia not mediated by TLM or TFM.</p

Comparison of Informal Care Time and Costs in Different Age-Related Dementias: A Review

Objectives. Age-related dementia is a progressive degenerative brain syndrome whose prevalence increases with age. Dementias cause a substantial burden on society and on families who provide informal care. This study aims to review the relevant papers to compare informal care time and costs in different dementias. Methods. A bibliographic search was performed on an international medical literature database (MEDLINE). All studies which assessed the social economic burden of different dementias were selected. Informal care time and costs were analyzed in three care settings by disease stages. Results. 21 studies met our criteria. Mean informal care time was 55.73 h per week for Alzheimer disease and 15.8 h per week for Parkinson disease (P=0.0076), and the associated mean annual informal costs were $17,492 versus$3,284, respectively (P=0.0393). Conclusion. There is a lack of data about informal care time and costs among other dementias than AD or PD. Globally, AD is the most costly in terms of informal care costs than PD, $17,492 versus$3,284, respectively

Associated Factors With Antipsychotic Use in Long-Term Institutional Care in Eight European Countries: Results From the RightTimePlaceCare Study.

To determine factors associated with the antipsychotic (AP) prescription for people with dementia (PwD) recently admitted to institutional long-term care facilities (LTCFs) and to ascertain differences in the use of this medication in 8 European countries

Recruitment strategies for preventive trials. The MAPT study (MultiDomain Alzheimer Preventive Trial

International audienc

Recruitment strategies for preventive trials. The MAPT study (MultiDomain Alzheimer Preventive Trial)

International audienc