Mauro Colombo

IMPAIRED FACIAL EMOTION RECOGNITION AND PRESERVED REACTIVITY TO FACIAL EXPRESSIONS IN PEOPLE WITH SEVERE DEMENTIA

The ability of decoding the emotional facial expressions may be early damaged in frontotemporal dementia, but relatively well preserved in the Alzheimers disease (AD). Nevertheless, the data about the relationship of the dementia severity with the ability of recognizing the face emotions are conflicting and insufficient, mainly for the moderate-severe stage of the disease. The present study extends to the existing literature by: (1) assessing people in the moderate and severe stage of dementia, compared with people without cognitive impairment; (2) assessing not only recognition but also reactivity to the facial expression of emotion. The capability of understanding the facial emotions has been evaluated in 79 patients with dementia compared to 64 healthy elderly people. The test consisted in showing them 14 photographic representations of 7 emotions both from male and from female faces, representing happiness, sadness, fear, disgust, boredom, anger and surprise. Patients were asked to observe the face and to recognize the emotion either with a denomination or a description. Then the spontaneous reactivity to the face expressions was videotaped and classified as a congruous or incongruous reaction by two independent observers who showed a good inter-rater reliability. Of the patients, 53% with dementia recognized up to 5 emotions out of 14, while in the healthy controls this number of mean recognition raised to 8.4, a value reached by the patients who scored 16 at MMSE. The most identified emotion is happiness both for the patients and for the controls. In general, positive emotions are better recognized than the negative ones, confirming the literary data. About the reactions to face emotion stimuli, there is no significant difference for any of the face emotion between the control group and the people with dementia. These data show that patients with dementia can recognize and react to facial emotions also in the severe stage of the disease, suggesting the usefulness of a non-verbal, emotional communication and supporting the need for more emotional education for care givers, both relatives and professionals.

Subthreshold Depression and Clinically Significant Depression in an Italian Population of 70–74-Year-Olds: Prevalence and Association with Perceptions of Self

Estimates of depressive disorders in the elderly vary depending on how cases are defined. We estimated the prevalence of subthreshold depression (SD) and clinically significant depression (D) in a population of 70–74-year-olds. We also looked for associations with sociodemographic factors and perceptions of self. Participants underwent a multidimensional assessment (social, medical, and neuropsychological). The estimated prevalence of SD was 15.71% (95% CI: 13.70–17.72), while that of D was 5.58% (95% CI: 4.31–6.85). Multinomial logistic regression analysis revealed that female gender and dissatisfaction with family relationships were related to SD and D. A self-perception of physical age as older than actual age (but not comorbidity) and greater self-perceived stress caused by negative life events both increased the probability of SD. The likelihood of D was decreased in those who perceived their own health as good, whereas a self-perception of mental age as older than actual age and dissatisfaction with relationships with friends were both significantly associated with D. Both SD and D emerged as key problems in our population. Female gender and self-perceptions of various characteristics, which can be explored through simple questions, are associated with late-life depression in elderly people independently of their actual physical condition and other characteristics.

APOE4 ALLELE MODIFIES THE RISK-PROTECTIVE FACTORS OF DEMENTIA: RESULTS FROM THE INVECE.AB LONGITUDINAL STUDY

women. Methods: We analyzed data from 2009 through 2014 from the National Health Insurance System (NHIS) of Korea. A total of 4,485,775 women 40 to 84 years of agewho participated in both national health screening and breast cancer screening examination were included in this study. Medical information assessing hormone therapy status and any gynecologic and obstetric history was determined by self-reported questionnaires. In this study, we performed a cross-sectional analysis and usedmultivariable logistic regression analysis models. Results: Our analysis showed that HRT users had amaximal 19% lower risk of dementia in postmenopausal women when compared with non-HRT users. Significantly lower ORs (95% CI) were observed in individuals who had HRT 2 to 5 years (OR, 0.818; 95% CI, 0.7896-0.851), followed by those who had less than 2 years (OR, 0.861; 95% CI, 0.839-0.884) and then by those who had more than 5 years of treatment (OR 0.881; 95% CI, 0.786-0.851) after adjusting for age, parity, breast feeding, oral contraception, smoking status, alcohol intake, exercise habits, BMI, diabetes mellitus, hypertension, and lipid levels. These Ushaped patterns were similarly demonstrated in subgroup analysis for both Alzheimer’s disease(AD) and vascular dementia(VD) subjects. Conclusions: We found that the use of postmenopausal HRT for less than 5 years greatly reduced the risk of dementia in the general population of Korean women.