Jean Bouisson

Routinization preferences, anxiety, and depression in an elderly French sample.

Abstract The relationship of routinization preferences to age and clinical variables was examined in a sample of 80 elderly French participants living independently or in residential facilities. Consistent with previous findings, age explained a major portion of the variance in routinization preferences. However, hierarchical multiple regression analyses revealed that the association of anxiety and depression to routinization preferences also remained significant even after controlling for the effects of age and other individual difference variables. These findings are discussed for their implications in understanding inconsistencies in previous research and demonstrating the independent importance of clinical variables in understanding age-related behavioral change.

Nutritional status of community‐dwelling older people with dementia: associations with individual and family caregivers' characteristics

The objective of this study was to explore the associations of individual characteristics of both older people with dementia and family caregivers with the nutritional status of older people with dementia.

Norms and associated factors of the STAI-Y State anxiety inventory in older adults: results from the PAQUID study.

BACKGROUND The latest version of the State-Trait Anxiety Inventory (STAI-Y) is commonly used in older adults, even though this anxiety scale was developed in and for young adults. Norms and associated factors of the STAI-Y are lacking for older adults in the general population. The objectives of the present study were to produce norms on the STAI-Y State scale for older adults using a large sample of older adults selected from a general population and to examine the sociodemographic and health-related factors associated with the STAI-Y State score. METHODS 993 community-dwelling individuals aged 66 years and over from the PAQUID study were evaluated at home by a psychologist for the following variables: age, education, marital status, proximity of relatives, self-assessment of income sufficiency, occupation during active life, depressive symptomatology, objective and subjective health, objective and subjective cognitive functioning, adverse life events, activities of daily living, drug use, and cigarette consumption. RESULTS Norms were stratified for age, sex, and education and were produced separately for older adults with and without depressive symptomatology. Multivariate analyses revealed that younger age (66-79 years), female sex, lower education, perception of income insufficiency, depressive symptomatology, poor subjective health, subjective cognitive complaints, psychotropic drugs use, and recent adverse life events were independently associated with higher STAI-Y State score. CONCLUSIONS This study provides norms for the STAI-Y State anxiety inventory in a general population of older adults and indicates the specific factors linked with state anxiety. Such factors should be taken into account by clinicians in order to better understand state anxiety in older adults.

Gender-related Differences in Visuospatial Memory Persist in Alzheimer's Disease

Gender differences in visuospatial cognition favoring men are larger in tasks requiring active information manipulation than in tasks requiring passive storage. This study was designed to determine whether male advantage in active manipulation of visuospatial information can still be evidenced in Alzheimers disease (AD). Twenty male and 20 female AD patients with equivalent age, education, dementia severity (Mini-Mental State Examination and Mattis Dementia Rating Scale), and visual discrimination abilities were recruited. We administered the forward span of Corsi block-tapping task and Vecchis matrix memory task involving passive temporary retention of stimuli location. Active manipulation of visuospatial information was assessed with the backward span of Corsi block-tapping task and Vecchis pathway task in which patients were required to mentally generate a pathway within a matrix. The results showed that scores on the tasks involving passive storage of visuospatial information were equivalent between the two groups of patients, whereas men performed significantly better than women in tasks requiring active manipulation of visuospatial information. This result was limited to visuospatial processing since no difference between male and female patients was evidenced in the verbal short-term memory tasks, neither when the task involved passive storage nor when the task required active processing. Therefore, this study suggests that, besides other variables such as education or lifestyle factors, gender might also modulate the cognitive manifestation of AD.

Restriction in instrumental activities of daily living in older persons: association with preferences for routines and psychological vulnerability.

Disabilities in the Instrumental Activities of Daily Living (IADL) are frequently observed in older adults. A restriction in the daily life activities in the elderly may be related to a process of routinization induced by homogenization of activities, in addition to its association with emotional states. The relationship between level of functional disability for IADLs and preferences for routines was explored in 207 non-demented French participants (Mage = 84.2 years, age range: 78–96 years) from the PAQUID cohort study. Multinomial regressions analyses showed that preferences for routines were significantly associated with a higher risk of restriction for at least two functional activities, after adjusting for sociodemographic and psychological variables. However, this association was non significant after controlling for cognitive variables. These findings add new elements for understanding the effect of routinization in the disability process in older persons in that preferences for routines could constitute a risk factor of IADL restriction, similar to cognitive decline.

Vieillesse et routinisation : une revue de la question

The concept of routinization in the elderly is defined as the performance of environmental, behavioral, and social activities, in the same manner over time. First, routines are described from a developmental point of view and a multidisciplinary approach. Second, the development of this concept in recent studies is analyzed. Different functions of routinization are discussed as a general model of disability. Based on the results of the PAQUID epidemiological investigation, routinization of behaviors and activities in older persons appears as a complex phenomenon that cannot only be understood in terms of adaptive functioning. Various relationships were found between preference for routines and vulnerability factors in psychological, functional or cognitive domains. Finally, the theoretical issues and clinical implications are discussed with regard to distinct dimensions of the routinization concept, including its relevance for identifying the vulnerability markers in the elderly, and improving early detection, prevention and management of adaptation difficulties in this population.

Encoding processes influence word-stem completion priming in Alzheimer's disease: a meta-analysis.

Despite the numerous studies focused on priming performances in Alzheimers disease (AD), the question of whether word-stem completion priming persists in AD is still prone to controversy. Methodological variations, such as encoding instructions, have been proposed to explain the discrepancy of word-stem completion priming results in AD. We conducted a meta-analysis on 678 AD patients and 640 controls to assess whether word-stem completion priming in AD differs according to instructions provided at encoding. When the data across the different encoding instructions were combined, the results showed that AD patients manifest significant completion priming, even though the magnitude of priming is reduced. Taking into account the different encoding conditions, the results suggested that whereas completion priming is impaired in AD when encoding conditions consist in reading or rating words, priming is equivalent to that of controls when encoding conditions require semantic judgments or generating words. In this latter condition in particular, self-generating a word at encoding may provide an aid to partially overcome conceptual deficits of the patients and increase the degree of adequacy between cognitive operations employed at encoding phase and those triggering implicit retrieval.

Short STAI-Y anxiety scales: validation and normative data for elderly subjects

Objectives: The aim of this study was to develop short forms of the STAI-Y trait and state scales and associated norms suitable for the screening of anxiety in elderly populations. Method: This study was based on population-based cohorts of older persons from two epidemiological French studies that each included one subscale of the STAI-Y, i.e. state and trait anxiety scales. For both scales, the most discriminative items were retained and their factorial structure was examined using principal components analysis. Internal consistency (Cronbach’s alpha) was estimated and cut-offs and norms were computed. Results: A 10-item STAI-Y version produced scores similar to those obtained with the full form of the STAI-Y. The factorial structure of the shortened form is comparable to that of the full scales. Results showed good internal consistency (alpha coefficients were 0.92 and 0.85 for short STAI-Y state and trait scales, respectively). Moreover, both short STAI-Y state and trait scales correctly classified 88% of the participants using a cut-off point of 23. Norms for both short trait and state anxiety scales are provided according to age, gender, educational level and depressive symptoms. Conclusion: Both shortened scales have similar factorial structure and internal consistency to the longer scales and classify anxious/non-anxious elderly with acceptable accuracy. The shorter form is likely to be more acceptable to elderly persons through reduction of fatigue effects.

Daily life functioning of community‐dwelling elderly couples: an investigation of the feasibility and validity of Ecological Momentary Assessment

Although ambulatory data collection techniques have been used in elderly populations, their feasibility and validity amongst elderly individuals with cognitive impairment and amongst couples remains unexplored. The main objective of this study is to examine the validity of Ecological Momentary Assessment (EMA) in elderly persons with or without cognitive impairment and their spouses. The sample included 58 retired farmers (mean 77.3 years, standard deviation [SD] 5.5) with or without cognitive impairment, recruited within a French cohort and 60 spouses (mean 73.4 years, SD 6.9). The presence of cognitive impairment determining by a panel of specialized neurologists permitted to define two groups: “The Cognitive Impairment Group” and “The Control Group”. EMA procedures consisted of repeated telephone interviews five times per day during four days for each spouse. Our results demonstrate the validity of EMA procedures through a 92.1% level of compliance, the absence of fatigue effects, and the lack of evidence for major reactivity to the methods. However, the specificity of our sample may explain the acceptance (42%) and response (75%) rates and may reduce the generalizability of the results to the general population of elderly individuals. Finally, the validation of such techniques may contribute to future research examining community‐dwelling elderly individuals and their spouses. Copyright

Anxiété, dépression et comportement chez les personnes âgées : Étude en vie quotidienne

Resume L’elaboration des TCC chez les personnes âgees necessite des informations relatives a l’influence des troubles psychologiques sur le fonctionnement en vie quotidienne. Les relations entre la severite des symptomes anxieux et depressifs et la frequence de comportements quotidiens specifiques ont ete etudiees chez 47 sujets âges, vivant a domicile ou en institution. A partir d’une approche relativement nouvelle, fondee sur une collecte ambulatoire d’informations (ESM), les resultats montrent que la severite de l’anxiete et de la depression serait liee a un fonctionnement quotidien que l’on pourrait qualifier de plus passif, avec des activites et des contextes environnementaux moins varies. Cette etude souligne l’importance de mieux connaitre le fonctionnement quotidien des personnes âgees, en vue notamment de developper les prises en charge cognitives et comportementales les plus appropriees.