Incidence and lifetime risk of dementia and Alzheimer's disease in a Southern European population.

OBJECTIVE: To calculate both the incidence rates and the lifetime risk (LTR) of dementia and Alzheimer's disease (AD). METHODS: A two-phase case-finding procedure was implemented in a cohort of 4057 cognitively intact individuals 55+ years of age living in Zaragoza, Spain, and followed-up at 2.5 and 4.5 years. Age- and sex-specific incidence rates were calculated. A mortality-adjusted, multivariate model was used to document LTRs. RESULTS: The incidence rate of dementia continued to rise after the age of 90 years, but was slightly lower than in North and West European studies. Only a tendency for an increased LTR with age was observed. Thus, LTR was 19.7% for a 65-year-old woman and 20.4% at the age of 85 years, the corresponding figures for AD being 16.7% and 17.6%. The LTR of AD was higher in women and was about twice as high among illiterate individuals when compared with individuals with higher educational levels. CONCLUSIONS: The incidence rate of dementia in this Southern European city was slightly lower than in previous studies in North-West Europe. LTR of dementia and AD seems to be slightly increased with age. The association of illiteracy with higher LTR of AD is intriguing.

Diseño metodológico del proyecto ZARADEMP / No disponible

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Riesgo de depresión incidente y ACV en el estudio ZARADEMP / No disponible

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A mixed-signal multichip neural recording interface with bandwidth reduction.

We present a multichip structure assembled with a medical-grade stainless-steel microelectrode array intended for neural recordings from multiple channels. The design features a mixed-signal integrated circuit (IC) that handles conditioning, digitization, and time-division multiplexing of neural signals, and a digital IC that provides control, bandwidth reduction, and data communications for telemetry toward a remote host. Bandwidth reduction is achieved through action potential detection and complete capture of waveforms by means of onchip data buffering. The adopted architecture uses high parallelism and low-power building blocks for safety and long-term implantability. Both ICs are fabricated in a CMOS 0.18-mum process and are subsequently mounted on the base of the microelectrode array. The chips are stacked according to a vertical integration approach for better compactness. The presented device integrates 16 channels, and is scalable to hundreds of recording channels. Its performance was validated on a testbench with synthetic neural signals. The proposed interface presents a power consumption of 138 muW per channel, a size of 2.30 mm(2), and achieves a bandwidth reduction factor of up to 48 with typical recordings.

Transferencia de datos de investigación epidemiológica a la práctica clínica en psiquiatría geriátrica / No disponible

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Transferencia de datos de investigación epidemiológica a la práctica clínica en psiquiatría geriátrica / No disponible

No disponible

Prevalent and incident depression in community-dwelling elderly persons with diabetes mellitus: results from the ZARADEMP project.

AIMS/HYPOTHESIS: Although several studies have reported on the association between diabetes and depression, none have used both formal psychiatric criteria and a prospective, population-based design. Therefore, it remains unclear whether diabetes is a risk factor for the development of depression. Moreover, it is not clear if this effect is influenced by other chronic diseases and functional disabilities. METHODS: A large (n=4,803) representative community-based study in Spanish elderly subjects (at least 55 years of age) was conducted. The presence of major depression was assessed by means of a standardised psychiatric diagnostic interview (Automated Geriatric Examination for Computer Assisted Taxonomy). Subjects underwent a baseline assessment and a follow-up assessment after 2 and 5 years to determine the incidence of depression. RESULTS: At baseline 597 subjects (12.5%) were identified as having diabetes. Prevalence and incidence of depression in cases of diabetes were 15.4% and 16.5% respectively. Diabetes was associated with an increased risk of prevalent (odds ratio [OR]=1.47; 95% CI: 1.16-1.83) and incident (OR=1.40; 95% CI: 1.03-1.90) depression. Controlling for potential confounders did not essentially change these findings (prevalent depression: OR 1.41, 95% CI: 1.08-1.83; incident depression: OR 1.26, 95% CI: 0.90-1.77). CONCLUSIONS/INTERPRETATION: In a large, representative prospective population-based sample using strict psychiatric criteria, we confirmed previous findings that diabetes is associated with an increased risk of depression. The effect on the incidence of depression suggests that diabetes may play a role in the development of depression in the elderly. The presence of comorbid medical diseases seems to decrease the effects of diabetes on the risk of prevalent depression, but to increase the risk of incident depression.

Prospective comparison of nasal versus oral insertion of a thin video endoscope in healthy volunteers.

BACKGROUND AND STUDY AIMS: Attempts have been made to improve patient's tolerance of upper gastrointestinal endoscopy and to decrease the need for sedation, using thinner endoscopes and a nasal introduction route. We prospectively compared the oral and nasal routes in volunteers, using a thin prototype video endoscope. METHODS: Ten healthy volunteers underwent two upper gastrointestinal endoscopies in a random order on two different days, with the procedure being carried out by a single experienced endoscopist. Parameters assessed were the tolerance of scope insertion and the assessment of the entire procedure (0-10 scale), the method of insertion preferred by the volunteers, the completeness of the examination (assessed by an independent endoscopist), and the time required for the procedure. RESULTS: In one patient, nasal insertion failed, and she was excluded from further analysis. The insertion of the scope was easier via the oral route, as reflected in a shorter examination time (mean 165 vs. 210 seconds, p = 0.017) and patients' tolerance for the scope insertion (mean score: 8 for oral vs. 4 for nasal route; p = 0.03). On the other hand, gagging occurred more frequently during oral endoscopy (6/9 vs 1/9, p = 0.05). Three of the volunteers in each case preferred the oral or the nasal route, and three were not decided, in case of a repeated endoscopy. Similarly, the overall tolerance for the procedure did not between the two groups. CONCLUSION: Thin-diameter gastroscopes seem to improve patient's tolerance. In this small study in volunteers, nasal introduction showed no overall benefit over oral introduction. Modifications of the scope to achieve better nasal passage are necessary.