Fanny Matharan

What aspects of social network are protective for dementia? Not the quantity but the quality of social interactions is protective up to 15 years later.

Objective: To test the association between several social networks variables reflecting both structural characteristics and quality of relationships with the risk of dementia and Alzheimers disease 5 and up to 15 years later. Methods: The study sample is gathered from the Paquid cohort, a French population-based study of 3,777 elderly people evaluated at baseline and regularly revisited during a 15-year interval. The sample consisted of 2,089 subjects who completed the social network questionnaire and were free of dementia at the time of enrollment and also at the next two follow-ups to minimize the problem of reverse causality. The questionnaire collected at baseline included marital status, number of ties, nature of social network, satisfaction, perception of being understood/misunderstood, and reciprocity in relationships. Results: The incident cases of dementia considered were those diagnosed at 5-year and subsequent follow-ups, resulting in 461 dementia and 373 Alzheimers disease cases. The multivariate Cox model, including the six social network variables and adjusted for numerous potential confounders, showed significant associations with satisfaction and reciprocity in relationships. Participants who felt satisfied with their relations had a 23% reduced dementia risk. Participants who reported that they received more support than they gave over their lifetime had a 55% and 53% reduced risk for dementia and Alzheimers disease, respectively. Conclusion: The only variables associated with subsequent dementia or Alzheimers disease were those reflecting the quality of relationships. The delay between social network assessment and dementia diagnosis was from 5 up to 15 years, thus minimizing the problem of reverse causality. MMSE = Mini Mental Status Examination; IADL = Instrumental Activities of Daily Living; RR = relative risk; CI = confidence interval.

Trends in Prevalence of Dementia in French Farmers from Two Epidemiological Cohorts

To determine the prevalence of dementia and cognitive impairment in older people across generations.

Visual loss and subsequent activity limitations in the elderly: The French three-city cohort

Objectives To investigate the relationship between vision and disability in the elderly. Methods We used a baseline visual indicator (combining near acuity with Snellen equivalent < 20/30 and self-reported distance visual loss) to explore the association between visual loss and subsequent disability (mobility, instrumental activities of daily living [IADLs], ADLs, and participation restriction) from 1999 to 2007 in 8491 elderly participants of the French Three-City Cohort (Bordeaux, Dijon, and Montpellier). Results In multiadjusted analyses, near visual impairment, alone or associated with distance visual function loss, was associated with greater risk of developing ADL limitations (P = .027), IADL limitations (P = .002), and participation restriction (P < .001), but not mobility (P = .848). The disabling impact of visual loss was significant for 11 of the 15 activities, when analyzed one by one. Conclusions Both near and distance visual loss was associated with greater functional decline over time, and the combination of the two could be even worse. Public Health Implications In the context of rapid aging of the population, maintaining good vision in the elderly represents a promising prevention track, visual impairment being common in the elderly, largely undermanaged, and mostly reversible. Further research, especially trials, is necessary to estimate the public health impact of such interventions.

Psychological transition and adjustment processes related to retirement: influence on cognitive functioning

ABSTRACT Objective: To investigate the relationship between psychological transition and adjustment to retirement and cognitive performances in older adults. Methods: The studys sample was taken from the Approche Multidisciplinaire Intégrée cohort, a French prospective study of retirees from agriculture, aged 65 and over, living in rural settings in southwestern France. The cross-sectional analyses were conducted on a sample of 590 elderly people without dementia at baseline and for whom information on perception of the work setting, experience of the retirement transition and adaptation to retirement life (nine variables) as well as neuropsychological measures (global cognitive functioning, episodic memory, verbal fluency, attention and psychomotor speed) were available at first visit. Results: Multivariable linear regression analyses, including nine variables related to retirement and adjusted for potential confounding factors, indicated that three of them – positive consideration of former work situation, development of new activities during retirement and good adaptation to free time – were associated with better cognitive performances. Conclusions: We found that several factors proved to be determinants of good cognitive functioning at retirement and could serve as a basis for the development of more efficient intervention programs aimed at helping retirees to maintain good cognitive functioning after retirement.

[The DMS 48: norms and diagnostic proprieties for Alzheimer's disease in elderly population from the AMI cohort study].

UNLABELLED The DMS 48 is a visual recognition memory test designed to detect memory changes in early Alzheimers disease (AD). The aim of this study was to produce normative scores for this test and to assess its psychometric properties in the detection of AD by comparison with a widely used test of verbal episodic memory: the story recall task of the Wechsler memory scale. Methods. Data were collected in a sample of 1002 agricultural retirees, aged 65 years and over, included in the AMI study, a population-based cohort conducted in Southwestern France. The sample used to establish normative data included 750 non-demented elderly while the sample used to study the properties of the test to detect AD included 751 participants whose 34 with AD. To assess AD detection accuracy, DMS 48 was compared to the Wechsler story recall task. Results. Age, sex, and education were significantly associated with DMS 48 performances. Therefore, normative scores were calculated according to sex, age, and educational level, and described by percentiles. Regarding the test properties for AD detection, DMS 48 presented a good balance between sensitivity (Se) and specificity (Sp) both for immediate (Se=70.6%; Sp=79.6%) and delayed recall (Se=79.4%; Sp=72.9%). It also showed high negative predictive values, around 98.5% for both recalls. Detection values were roughly similar to that of Wechsler story recall task. CONCLUSION The DMS 48 seems to be as reliable as the Wechsler story recall task with similar detection properties. The DMS 48 is a test easy to administer in clinical situations and could be a helpful tool for AD screening.

Near Visual Impairment Incidence in Relation to Diabetes in Older People: The Three‐Cities Study

To characterize the relationship between diabetes mellitus (DM) and future risk of near vision impairment (VI) in a community‐dwelling population of older people.

Are conceptual abilities impaired in schizophrenia

Whereas semantic processing deficits are well-documented in schizophrenia, conceptual abilities have been poorly explored. This study aims at specifically exploring conceptualization abilities in 34 adults fulfilling schizophrenia according to DSM-IV and 34 healthy controls with similar socio-demographic characteristics. The 2 groups were assessed on the WAIS-R similarities test and the concept generation test (Raoux et al., 2014) consisting of free-sorting 6 cards of pictures of animals and geometric shapes to be separated in two groups or categories based on common attributes. After each sorting, the participant is asked to explain his/her sorting. Whereas the schizophrenic patients performed significantly poorer than the control participants in the semantic knowledge and lexico-semantic tests, there was no difference neither in the WAIS-R similarities test nor in the concept generation test, which supports the hypothesis of preserved high level conceptualization abilities in schizophrenia. However, qualitative differences in performing the concept generation test were evidenced. The patients used more often mixed criteria leading them to compare two different hierarchical levels (e.g., low-level physical attributes vs. high-level semantic criteria). Furthermore, the qualitative analysis based on the explanations provided by the participants shows that the categorizations achieved by schizophrenic patients are more often based on unexpected criteria.