Michèle Gagnon

Instrumental Activities of Daily Living as a Screening Tool for Cognitive Impairment and Dementia in Elderly Community Dwellers

To identify which Instrumental Activities of Daily Living (IADL) are related to cognitive impairment, independent of age, sex, and education; to assess the performance of an IADL score using these items in screening for cognitive impairment and dementia in elderly community dwellers.

The Paquid Epidemiological Program on Brain Ageing

Paquid is an epidemiological study designed to gather and follow-up a cohort of 3,777 elderly subjects (65 years and older) living at home. In order to study normal and pathological brain ageing, these subjects were randomly chosen in the general population of 75 communities of Gironde and Dordogne, two administrative areas of South-Western France. The subjects were interviewed at home by trained psychologists and followed-up with the same procedure at 1, 3 and 5 years after the initial data collection. The identification of the demented cases is made with a two-stage design: the first stage is a systematic screening by the psychologists with application of the DSM-IIIR criteria and the second stage consists in a confirmation of the diagnosis by a neurologist according to the NINCDS-ADRDA criteria. Paquid is complemented by the study of a random sample of 357 subjects living in institutions in Gironde.

Self-Reported Memory Complaints and Memory Performance in Elderly French Community Residents: Results of the PAQUID Research Program

An epidemiological survey of self-reported memory complaints and memory performance [assessed with Bentons visual-retention test (BVRT) and the Wechsler paired-associates test (WPAT)] was undertaken in a community sample of 2,726 noninstitutionalized subjects aged 65 and over living in Gironde (southwestern France). A significant relationship was observed between the presence of self-reported memory problems and lower performance on the BVRT and the WPAT. However, beyond this relationship, there was significant discordance between the two evaluations, explained in part by the fact that the correlates of memory functioning were not related with similar strength to self reports and to actual performance. In general, females and subjects who scored above the depressive symptomatology threshold reported more problems, while lower performances were related to older age and low educational level. The discordance between self reports and actual performance may suggest anosognosia of mild memory deficits and could possibly be a predictor of future intellectual deterioration.

Visuo-spatial attention and psychomotor performance in elderly community residents: effects of age, gender, and education

In cross-sectional analysis of 1,799 subjects of the Paquid Research Program, an epidemiological study on brain aging conducted in the Bordeaux area (France), we have studied the effects of age, gender, and education level on psychometric tests requiring visuo-spatial focused attention and psychomotor performance. Although previous studies suggest that normal aging produces no significant change in focused attention, we did observe lower attentional abilities and lower speed of execution with increasing age. Female gender and low education level were also related to poorer attention and psychomotor performance. As the effects of these individual factors are difficult to disentangle from each other on the small samples of subjects used in group studies, epidemiological surveys seem useful to provide a better understanding of the neuropsychology of aging.

Prevalence and Risk Factors of Recurrent Cervical Pain Syndrome in a Working Population

The prevalence and risk factors of recurrent cervical pain syndrome (CPS) was studied in 990 workers examined while undergoing their systematic annual visit of occupational medicine. A prevalence rate of 10.2% was obtained. Using a tree-structured logistic regression analysis, a strong association between age, sex, previous head trauma extension of the neck and strenuous muscular activity during work, and the risk of recurrent CPS was obtained. Finally, an inverse association between strenuous muscular activity during leisure time and the risk of recurrent CPS was found.

Predictors of Non-Bedridden Survival in Dementia

The present study examined non-bedridden survival in 105 patients diagnosed as demented (Alzheimers disease, multi-infarct dementia, mixed dementia) in a neurological ward. Follow-up observations were made. During the first year, the cumulative mortality rate was 69% compared to a rate of 44% in the second year. The initial disability stage, as assessed by the Dementia Disability Scale, was found to be the only significant predictor of non-bedridden survival. The type of dementia, age, type of diagnosis, and post-hospitalization placement in an institution have not been found to be significant predictors of this evolution.