Cognitive complaints, neuropsychological performance and affective disorders in elderly community residents.

BACKGROUND: Previous studies have assessed the relationship between subjective cognitive complaints and objective impairment. While some of them found that cognitive complaints were explained by affective disorders, other researches found a relationship between cognitive complaints and neuropsychological performance. Most of them focused on memory functioning. However, elderly normal adults also display a decline in executive functions. This study aimed to assess the relationship between cognitive complaints, objective memory and executive performance and affective disorders. METHODS: This study was carried out with 937 community-dwelling elderly individuals recruited from the electoral list of the city of Saint-Etienne, France. Cognitive complaints were assessed using the MacNair scale. Cognitive performances were measured via a large battery of memory and executive-performance tests chosen for their capacity to detect subtle cognitive impairment. Anxiety and depressive symptoms were assessed using scales devised by Pichot and Goldberg. RESULTS: Cognitive complaints were associated with lower scores on verbal-memory tests and several executive-performance tests. Moreover, affective disorders were related to some of the executive-performance test scores, but they were not related to scores on the Free and Cued Selective Reminding Test, Digit Symbol Substitution Test and Trail Making B scores. CONCLUSIONS: Cognitive complaints of the elderly can reflect objective memory and executive-performance impairments, independent of affective disorders. Cognitive complaints should be assessed using both memory and executive-performance tests.

[The difficulty of prenatal diagnosis of Kniest's disease. Apropos of a case simulating congenital spondylo-epiphyseal dysplasia]. / La difficulté du diagnostic anténatal de la maladie de Kniest. A propos d'un cas simulant la dysplasie spondylo-épiphysaire congénitale.

The second antenatal diagnosis of Kniest's syndrome is described in this report. This skeletal dysplasia involving disproportional dwarfism and a flat facies is compatible with life and normal intelligence. The authors describe the observed sonographic imagery and emphasize the important role of ultrasonography for antenatal evaluation of the prognosis of the skeletal dysplasias. The main differential diagnosis is spondylo-epiphyseal dysplasia congenita.