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1.
J Public Health (Oxf) ; 43(4): 695-702, 2021 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-33693905

RESUMO

BACKGROUND: During the Covid-19 pandemic fake news has been circulating impacting on the general population's opinion about a vaccine against the SARS-CoV-2. Health literacy measures the capacity of navigating health information. METHODS: We used data from a prospective national online cohort of 1647 participants. Descriptive statistics, Chi2 and ANOVA independence tests and two multivariable multinomial regression models were performed. Interactions between each variable were tested. RESULTS: Detection of fake news and health literacy scores were associated with intention to get vaccinated against SARS-CoV-2 (p < 0.01). The risk of being "anti-vaccination" or "hesitant", rather than "pro-vaccination", was higher among individuals reporting bad detection of fake news, respectively OR = 1.93 (95%CI = [1.30;2.87]) and OR = 1.80 (95%CI = [1.29;2.52]). The risk of being in "hesitant", rather than "pro-vaccination" was higher among individuals having a bad health literacy score (OR = 1.44; 95%CI = [1.04;2.00]). No interaction was found between detection of fake news and health literacy. CONCLUSIONS: To promote acceptance of a vaccine against SARS-CoV-2, it is recommended to increase individuals' ability to detect fake news and health literacy through education and communication programs.


Assuntos
COVID-19 , Letramento em Saúde , Vacinas contra COVID-19 , Desinformação , Humanos , Pandemias , Estudos Prospectivos , SARS-CoV-2
2.
Rev Neurol (Paris) ; 176(9): 642-648, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32145981

RESUMO

Neurological diseases refer to the diseases that target the nervous system (brain, spine or nerves). They are the second leading cause of death, and the first cause of severe long-term disability in the world. The prevalence of most neurological diseases increases sharply with age, and age also modulates the impact of risk factors, clinical presentation and the natural course of these diseases. Longitudinal population-based studies provide useful insights for a better understanding of the specificities of neurological diseases in older adults by assessment of a wide range of risk factors. Rapid population aging, especially in low-income countries, presents challenges in terms of health and social care. A multidisciplinary approach is necessary to find solutions to tackle the burden of neurological diseases in older adults.


Assuntos
Doenças do Sistema Nervoso , Idoso , Envelhecimento , Pessoas com Deficiência , Humanos , Prevalência , Fatores de Risco
3.
Int Psychogeriatr ; 31(1): 139-145, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29798742

RESUMO

ABSTRACTObjectives:To examine the longitudinal risk of vision loss (VL) or hearing loss (HL) for experiencing suicidal ideation in older adults. DESIGN: The Three-City study, examining data from three waves of follow-up (2006-2008, 2008-2010, and 2010-2012). SETTING: Community-dwelling older French adults. PARTICIPANTS: N = 5,438 adults aged 73 years and over. MEASUREMENTS: Suicidality was assessed by the Mini-International Neuropsychiatric Interview, Major Depressive Disorder module. Mild VL was defined as Parinaud of 3 or 4 and severe VL as Parinaud >4. Mild HL was self-reported as difficulty understanding a conversation and severe HL as inability to understand a conversation. RESULTS: Severe VL was associated with an increased risk of suicidal ideation at baseline (OR = 1.59, 95% CIs = 1.06-2.38) and over five years (OR = 1.65, 95% CIs = 1.05-2.59). Mild and severe HL were associated with an increased risk of suicidal ideation, both at baseline (OR = 1.29, 95% CIs = 1.03-1.63; OR = 1.78, 95% CIs = 1.32-2.40) and over five years (OR = 1.47, 95% CIs = 1.17-1.85; OR = 1.97, 95% CIs = 1.44-2.70). CONCLUSION: Sensory losses in late life pose a risk for suicidal ideation. Suicidality requires better assessment and intervention in this population.


Assuntos
Transtorno Depressivo Maior/diagnóstico , Perda Auditiva/psicologia , Ideação Suicida , Transtornos da Visão/psicologia , Idoso , Idoso de 80 Anos ou mais , Transtorno Depressivo Maior/etiologia , Feminino , Humanos , Vida Independente , Modelos Logísticos , Estudos Longitudinais , Masculino , Saúde Mental , Análise Multivariada , Escalas de Graduação Psiquiátrica , Fatores de Risco
4.
Psychol Med ; 48(9): 1444-1453, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-28950920

RESUMO

BACKGROUND: Accumulating evidence links blood pressure variability (BPV) with white matter hyperintensities (WMH) and stroke. The longitudinal association between BPV with late onset depression (LOD) and cognitive decline remains unexplored. METHODS: Prospective cohort study of 2812 participant's age ⩾65 years (median age 72 years, 63.6% female) without dementia or stroke. Serial clinic visits assessed blood pressure, cognitive function, depression disorder, and depressive symptoms. A brain magnetic resonance imaging (MRI) substudy was performed in 1275 persons to examine possible associations with WMH. RESULTS: The interaction between symptomatic LOD and systolic BPV was associated with cognitive decline on the Isaac Set Test [slope -4.45; 95% confidence interval (CI) -8.92 to -0.16, p = 0.04], Benton Visual Retention Test (slope -0.89; 95% CI -1.77 to -0.01, p = 0.049), Mini Mental State Examination (slope -1.08; 95% CI -1.86 to -0.30, p = 0.007) and Finger Tapping Test (slope -7.53; 95% CI -13.71 to -1.34, p = 0.017) but not Trail Making Test-A or -B/A. The MRI substudy demonstrated that systolic BPV was associated with cognitive decline via interactions with depression and total WMH volume, but this was not dependent on either deep or periventricular WMH volumes. CONCLUSIONS: The findings show that the interaction between systolic BPV with symptomatic depression and WMH increases cognitive decline in persons ⩾65 years of age. Future work could extend these findings by examining systolic BPV in relation to cognitive decline and WMH in older populations with depression.


Assuntos
Pressão Sanguínea , Disfunção Cognitiva/fisiopatologia , Depressão/fisiopatologia , Substância Branca/patologia , Idade de Início , Idoso , Cidades , Cognição , Feminino , França , Psiquiatria Geriátrica , Humanos , Imageamento por Ressonância Magnética , Masculino , Testes de Estado Mental e Demência , Estudos Prospectivos , Sístole
5.
Osteoporos Int ; 27(11): 3187-3195, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27311722

RESUMO

In this population-based elderly cohort, participants using selective serotonin reuptake inhibitor (SSRI) antidepressants have an increased risk of falls and fractures notably when the treatment was continued over 4 years. Among the various SSRI types, citalopram only was at significant risk for falls and fluoxetine for fractures. INTRODUCTION: Increased risk of falls and fractures has been reported in elderly users of SSRIs. However, biases were insufficiently addressed notably temporality between exposure and outcome and confounding by residual depression. Our objective was to examine the associations between SSRIs and fall or fracture incidence focusing on their chronic use and different types of SSRIs. METHODS: The population-based cohort included participants aged 65 years and above, who had not fallen before inclusion (n = 6599) or were free of recent fracture (n = 6823) and were followed up twice over 4 years. New fall and fracture events were self-reported and defined as at least two falls and one fracture, respectively, during the previous 2 years. SSRI users were compared with those taking no antidepressants. Hazard ratios (HRs) were estimated using Cox models with delayed entry and adjusted for many confounders including residual depressive symptoms. RESULTS: Incidence of falls was 19.3 % over 4 years and that of fractures 9.5 %. After multi-adjustment, SSRI intake was significantly associated with a higher risk of falls (HR, 95 % CI = 1.58, 1.23-2.03) and fractures (HR, 95 % CI = 1.61, 1.16-2.24). The risks were significantly increased by 80 % in those continuing the treatment over 4 years. Citalopram intake only was at significant risk for falls and fluoxetine for fractures. CONCLUSIONS: In this large community-dwelling elderly sample, SSRI users were at higher risk of falls and fractures. This association was not due to reverse causality or residual depressive symptoms. Different SSRI drugs may have specific adverse effects on falls and fractures.


Assuntos
Acidentes por Quedas , Antidepressivos/administração & dosagem , Fraturas Ósseas/epidemiologia , Inibidores Seletivos de Recaptação de Serotonina/administração & dosagem , Idoso , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Modelos de Riscos Proporcionais , Fatores de Risco
6.
Mol Psychiatry ; 20(10): 1173-8, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26033242

RESUMO

Several genetic polymorphisms have been associated with Late Onset Alzheimer's Disease (LOAD), but there has been limited evidence on whether these polymorphisms predict intermediary stage outcomes such as cognitive changes in prospective community-based studies. Our aim was to evaluate whether polymorphisms previously established as predictors of LOAD also predict worse cognitive function and accelerated decline across multiple cognitive domains. We analyzed data from the 3C-Dijon study, in which 4931 respondents aged 65+ were examined up to 5 times over 10 years with a neuropsychological assessment. We evaluated the associations of polymorphisms in APOE, CR1, BIN1, CLU, PICALM, ABCA7, MS4A6A, CD33, MS4A4E and CD2AP with level and change in 5 neuropsychological tests, assuming a dominant effect model. To optimize measurement, we used a mixed regression model with a latent process for each cognitive domain: global cognition (Mini Mental State Examination); verbal fluency (Isaac's Set Test); visual memory (Benton Visual Retention Test); information processing (Trail Making Test B) and literacy (National Adult Reading Test). APOE was associated with accelerated decline in global cognition and verbal fluency. Only two non-APOE genetic polymorphisms were associated with cognitive decline: CR1 was associated with rate of change in verbal fluency and BIN1 was associated with rate of change in global cognition. In a large prospective population-based study of dementia-free individuals, only a few cognitive domains were associated with established LOAD risk alleles. The most consistent associations were for global cognition and verbal fluency.


Assuntos
Doença de Alzheimer/genética , Transtornos Cognitivos/genética , Proteínas Adaptadoras de Transdução de Sinal/genética , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/psicologia , Apolipoproteínas E/genética , Apolipoproteínas E/metabolismo , Transtornos Cognitivos/psicologia , Estudos de Coortes , Feminino , Estudos de Associação Genética , Predisposição Genética para Doença , Humanos , Estudos Longitudinais , Masculino , Memória , Proteínas Nucleares/genética , Polimorfismo Genético , Estudos Prospectivos , Receptores de Complemento 3b/genética , Fatores de Risco , Proteínas Supressoras de Tumor/genética
7.
Psychol Med ; 45(9): 1931-44, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25896060

RESUMO

BACKGROUND: Several studies have reported smaller hippocampal volume (HcV) in depression patients; however, the temporality of the association remains unknown. One proposed hypothesis is that depression may cause HcV loss. This study evaluates whether previous depression and recent depressive symptoms are associated with HcV and HcV loss. METHOD: We used a prospective cohort of older adults (n = 1328; age = 65-80 years) with two cerebral magnetic resonance imaging examinations at baseline and 4-year follow-up. Using multivariable linear regression models, we estimated, in stratified analyses by gender, the association between indicators of history of depression and its severity (age at onset, recurrence, hospitalization for depression), proximal depressive symptoms [Center for Epidemiologic Studies-Depression (CES-D) scale], baseline antidepressant use, and the outcomes: baseline HcV and annual percentage change in HcV. RESULTS: At baseline, women with more depressive symptoms had smaller HcV [-0.05 cm3, 95% confidence interval (CI) -0.1 to -0.01 cm3 per 10-unit increase in CES-D scores]. History of depression was associated with a 0.2% faster annual HcV loss in women (95% CI 0.01-0.36%). More baseline depressive symptoms and worsening of these symptoms were also associated with accelerated HcV loss in women. No associations were observed in men. Treatment for depression was associated with slower HcV loss in women and men. CONCLUSIONS: While only concomitant depressive symptoms were associated with HcV, both previous depression and more proximal depressive symptoms were associated with faster HcV loss in women.


Assuntos
Depressão/patologia , Transtorno Depressivo/patologia , Hipocampo/patologia , Idoso , Idoso de 80 Anos ou mais , Antidepressivos/uso terapêutico , Atrofia , Estudos de Coortes , Depressão/tratamento farmacológico , Transtorno Depressivo/tratamento farmacológico , Progressão da Doença , Feminino , Humanos , Modelos Lineares , Estudos Longitudinais , Imageamento por Ressonância Magnética , Masculino , Análise Multivariada , Estudos Prospectivos , Índice de Gravidade de Doença , Fatores Sexuais
8.
Mol Psychiatry ; 19(12): 1326-35, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24535457

RESUMO

Amyloid beta (Aß) peptides are the major components of senile plaques, one of the main pathological hallmarks of Alzheimer disease (AD). However, Aß peptides' functions are not fully understood and seem to be highly pleiotropic. We hypothesized that plasma Aß peptides concentrations could be a suitable endophenotype for a genome-wide association study (GWAS) designed to (i) identify novel genetic factors involved in amyloid precursor protein metabolism and (ii) highlight relevant Aß-related physiological and pathophysiological processes. Hence, we performed a genome-wide association meta-analysis of four studies totaling 3 528 healthy individuals of European descent and for whom plasma Aß1-40 and Aß1-42 peptides levels had been quantified. Although we did not observe any genome-wide significant locus, we identified 18 suggestive loci (P<1 × 10(-)(5)). Enrichment-pathway analyses revealed canonical pathways mainly involved in neuronal functions, for example, axonal guidance signaling. We also assessed the biological impact of the gene most strongly associated with plasma Aß1-42 levels (cortexin 3, CTXN3) on APP metabolism in vitro and found that the gene protein was able to modulate Aß1-42 secretion. In conclusion, our study results suggest that plasma Aß peptides levels are valid endophenotypes in GWASs and can be used to characterize the metabolism and functions of APP and its metabolites.


Assuntos
Envelhecimento/sangue , Envelhecimento/genética , Peptídeos beta-Amiloides/sangue , Fragmentos de Peptídeos/sangue , Precursor de Proteína beta-Amiloide/genética , Precursor de Proteína beta-Amiloide/metabolismo , Estudo de Associação Genômica Ampla , Células HEK293 , Humanos , Proteínas de Membrana/genética , Proteínas de Membrana/metabolismo , Polimorfismo de Nucleotídeo Único , População Branca/genética
9.
Mol Psychiatry ; 18(4): 461-70, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22430674

RESUMO

Recently, several genome-wide association studies (GWASs) have led to the discovery of nine new loci of genetic susceptibility in Alzheimer's disease (AD). However, the landscape of the AD genetic susceptibility is far away to be complete and in addition to single-SNP (single-nucleotide polymorphism) analyses as performed in conventional GWAS, complementary strategies need to be applied to overcome limitations inherent to this type of approaches. We performed a genome-wide haplotype association (GWHA) study in the EADI1 study (n=2025 AD cases and 5328 controls) by applying a sliding-windows approach. After exclusion of loci already known to be involved in AD (APOE, BIN1 and CR1), 91 regions with suggestive haplotype effects were identified. In a second step, we attempted to replicate the best suggestive haplotype associations in the GERAD1 consortium (2820 AD cases and 6356 controls) and observed that 9 of them showed nominal association. In a third step, we tested relevant haplotype associations in a combined analysis of five additional case-control studies (5093 AD cases and 4061 controls). We consistently replicated the association of a haplotype within FRMD4A on Chr.10p13 in all the data set analyzed (OR: 1.68; 95% CI: (1.43-1.96); P=1.1 × 10(-10)). We finally searched for association between SNPs within the FRMD4A locus and Aß plasma concentrations in three independent non-demented populations (n=2579). We reported that polymorphisms were associated with plasma Aß42/Aß40 ratio (best signal, P=5.4 × 10(-7)). In conclusion, combining both GWHA study and a conservative three-stage replication approach, we characterised FRMD4A as a new genetic risk factor of AD.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/genética , Doença de Alzheimer/genética , Predisposição Genética para Doença/genética , Estudo de Associação Genômica Ampla , Haplótipos/genética , Doença de Alzheimer/sangue , Peptídeos beta-Amiloides/sangue , Estudos de Casos e Controles , Humanos , Polimorfismo de Nucleotídeo Único/genética
10.
Neuroepidemiology ; 41(1): 20-8, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23548733

RESUMO

BACKGROUND/AIMS: This study was designed to develop a practical risk score for predicting 5-year survival after the diagnosis of dementia. METHODS: Using the Paquid Study (prospective, population-based, long-term cohort study), we created a prognosis score with incident cases of dementia and validated it in another prospective, population-based, long-term cohort study, the Three City Study. - RESULTS: Among the 3,777 subjects enrolled in the Paquid Study, 454 incident cases of dementia were included in this study. After a 5-year follow-up period, 319 (70.3%) were deceased. The score was constructed from three independent prognostic variables (gender, age at diagnosis and number of ADL restricted). The discriminant ability of the score was good with a c index of 0.754. Sensitivity was 64.7% and specificity 76.3%. In the validation cohort, the discriminant ability of the prognostic score with c statistics was 0.700. Sensitivity was 26.3% and specificity 95.4%. CONCLUSIONS: The prognostic factors selected in the predictive model are easily assessable, so this simple score could provide helpful information for the management of dementia, particularly to identify patients with duration of the disease greater than 5 years.


Assuntos
Demência/epidemiologia , Atividades Cotidianas , Idoso , Demência/diagnóstico , Demência/mortalidade , Feminino , Humanos , Incidência , Masculino , Prognóstico , Estudos Prospectivos , Fatores de Risco , Sensibilidade e Especificidade , Taxa de Sobrevida
11.
Rev Neurol (Paris) ; 168(4): 321-7, 2012 Apr.
Artigo em Francês | MEDLINE | ID: mdl-22129475

RESUMO

RATIONALE AND AIM: The INTERACT pilot study demonstrated the feasibility of the protocol, safety of early intensive blood pressure (BP) lowering, and effects on hematoma expansion within 6hours of onset of intracerebral hemorrhage (ICH). This article describes the design of the second, main phase, INTERACT2. INTERACT2 aims to compare the effects of a management strategy of early intensive BP lowering with a more conservative guideline-based BP management policy in patients with acute ICH. This article also compares the baseline characteristics of the patients included in France with the baseline characteristics of the patients included in the pilot study INTERACT1. DESIGN OF THE STUDY: INTERACT2 is an international, prospective, multicentre, open, assessor-blinded outcome (PROBE), randomised, controlled trial. Patients with a systolic BP greater than 150mmHg are centrally randomised to either to an intensive BP lowering treatment (Systolic BP≤140mmHg within 1hour) or to a conservative treatment strategy (target systolic BP of 180mmHg). A projected 2800 subjects are to be enrolled from approximately 140 centres worldwide to provide 90% power (α 0.05) to detect a beneficial effect of early treatment on the primary outcome. STUDY OUTCOMES: The primary outcome is the combined endpoint of death and dependency according to the modified Rankin Scale (mRS) at 90 days. The key secondary outcome is the primary endpoint in those patients treated within 4hours of ICH. Other predefined secondary outcomes are the separate components of the primary endpoint, grades of physical function on the mRS, health-related quality of life on the EuroQoL, recurrent stroke and other vascular events, days of hospitalisation, requirement for permanent residential care, and unexpected serious adverse events. The study is registered under NCT00716079, ISRCTN73916115, and ACTRN12608000362392. POPULATION: As of early July, 152 patients have been included in France. When compared with the patients randomised in the INTERACT1 pilot study, these patients are older, less likely to have had a previous ICH, more often on antiplatelet or warfarin therapy, have a lower diastolic BP, arere more severe clinically (higher NIHSS) and experience their first ICH.


Assuntos
Anti-Hipertensivos/administração & dosagem , Hipertensão/tratamento farmacológico , Hemorragia Intracraniana Hipertensiva/tratamento farmacológico , Seleção de Pacientes , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Anti-Hipertensivos/efeitos adversos , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Protocolos Clínicos , Relação Dose-Resposta a Droga , Regulação para Baixo/efeitos dos fármacos , Esquema de Medicação , Definição da Elegibilidade/métodos , Feminino , França , Humanos , Hipertensão/etiologia , Hemorragia Intracraniana Hipertensiva/complicações , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Resultado do Tratamento
12.
Eur J Cardiovasc Prev Rehabil ; 18(3): 488-97, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21450655

RESUMO

OBJECTIVES: To investigate the association between resting heart rate (RHR) and mortality and incident coronary heart disease (CHD) in the elderly. METHODS: Data derived from the Three-City Study, a French multicentre prospective study including 9294 community-dwelling elderly subjects aged ≥65 years at baseline examination between 1999 and 2001. The study population comprised 7147 participants (61% women) who were free of a pacemaker or any cardiac arrhythmias at baseline. RHR was measured twice at baseline in a seated position using an electronic tensiometer. Participants were then followed up bi-annually for vascular morbidity and mortality over 6 years. CHD events and cardiovascular death were adjudicated by an independent expert committee. RESULTS: After 6 years of follow-up, 615 subjects died including 17.9% from cardiovascular causes. Subjects from the top quintile of RHR (>79 bpm) had respectively a 74% (95% CI, 1.3-2.3), a 87% (95% CI: 0.98-3.6, p = 0.06) and a 72% (95% CI, 1.3-2.3) increased risk of total, cardiovascular and non-cardiovascular mortality compared to those from the lowest quintile (<62 bpm), after adjustment for cardiovascular risk factors and beta-blocker (BB) use in a Cox regression analysis. Associations with total mortality were consistent according to age, gender, BB use, diabetes and hypertension status (all p values for interaction >0.10). Conversely, RHR was not predictive of incident CHD (n = 228 events; top vs lowest quintile: HR: 1.0; 95% CI: 0.6-1.5). CONCLUSIONS: RHR is an independent risk marker of mortality but not of incident CHD events in community-dwelling elderly. Its routine measurement may help identify those who are at increased risk of mortality in the short term.


Assuntos
Doença das Coronárias/epidemiologia , Frequência Cardíaca/fisiologia , Descanso/fisiologia , População Urbana , Fatores Etários , Idoso , Doença das Coronárias/fisiopatologia , Feminino , Seguimentos , França/epidemiologia , Humanos , Incidência , Masculino , Prognóstico , Estudos Prospectivos , Fatores de Risco , Taxa de Sobrevida/tendências
13.
Mol Psychiatry ; 14(11): 1004-16, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19204726

RESUMO

The only recognized genetic determinant of the common forms of Alzheimer's disease (AD) is the epsilon 4 allele of the apolipoprotein E gene (APOE). To identify new candidate genes, we recently performed transcriptomic analysis of 2741 genes in chromosomal regions of interest using brain tissue of AD cases and controls. From 82 differentially expressed genes, 1156 polymorphisms were genotyped in two independent discovery subsamples (n=945). Seventeen genes exhibited at least one polymorphism associated with AD risk, and following correction for multiple testing, we retained the interleukin (IL)-33 gene. We first confirmed that the IL-33 expression was decreased in the brain of AD cases compared with that of controls. Further genetic analysis led us to select three polymorphisms within this gene, which we analyzed in three independent case-control studies. These polymorphisms and a resulting protective haplotype were systematically associated with AD risk in non-APOE epsilon 4 carriers. Using a large prospective study, these associations were also detected when analyzing the prevalent and incident AD cases together or the incident AD cases alone. These polymorphisms were also associated with less cerebral amyloid angiopathy (CAA) in the brain of non-APOE epsilon 4 AD cases. Immunohistochemistry experiments finally indicated that the IL-33 expression was consistently restricted to vascular capillaries in the brain. Moreover, IL-33 overexpression in cellular models led to a specific decrease in secretion of the A beta(40) peptides, the main CAA component. In conclusion, our data suggest that genetic variants in IL-33 gene may be associated with a decrease in AD risk potentially in modulating CAA formation.


Assuntos
Doença de Alzheimer/diagnóstico , Doença de Alzheimer/genética , Interleucinas/genética , Interleucinas/metabolismo , Doença de Alzheimer/patologia , Peptídeos beta-Amiloides/metabolismo , Animais , Apolipoproteína E4/genética , Encéfalo/metabolismo , Células COS , Estudos de Casos e Controles , Linhagem Celular Transformada , Angiopatia Amiloide Cerebral/genética , Angiopatia Amiloide Cerebral/metabolismo , Angiopatia Amiloide Cerebral/patologia , Chlorocebus aethiops , Feminino , Seguimentos , Carga Genética , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Genótipo , Humanos , Interleucina-33 , Cooperação Internacional , Masculino , Neuroblastoma , Análise de Sequência com Séries de Oligonucleotídeos/métodos , Fragmentos de Peptídeos/metabolismo , Polimorfismo de Nucleotídeo Único , Modelos de Riscos Proporcionais , RNA Mensageiro/metabolismo , Estudos Retrospectivos , Transfecção/métodos
14.
J Neurol Neurosurg Psychiatry ; 80(11): 1271-4, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19864660

RESUMO

BACKGROUND: The risk factors of progressive supranuclear palsy (PSP), a rare but severe Parkinsonian syndrome, are poorly known. OBJECTIVE: To study the risk factors of PSP in a case control study among French patients. METHOD: The study was conducted between April 2000 and December 2003. Cases were in- or outpatients of five large hospitals and fulfilled the Golbe criteria. Controls were relatives of patients from the same hospitals, free of Parkinsonian syndrome and dementia, and matched to cases for age, gender and living area. Data on demographic characteristics, occupation history, diet habits, anti-inflammatory drugs use, alcohol consumption, smoking habits, gardening and leisure activities, and exposure to pesticides were collected through a face-to-face questionnaire. A conditional logistic regression was used to analyse matched data and estimate OR. RESULTS: 79 cases and 79 controls were included. Only a few comparisons were significant. Cases reached a lower education attainment than controls (odds ratio (OR) = 2.6 (1.3 to 5.3), p = 0.01). Analysis of diet habits did not show any major difference although cases ate meat or poultry more frequently. Conversely, controls ate fruits more frequently than did cases. No association was found between PSP and occupation, use of pesticides, gardening, alcohol consumption, smoking habits and anti-inflammatory agent use. CONCLUSION: In this case-control study, we did not find any strong environmental risk factors for PSP.


Assuntos
Paralisia Supranuclear Progressiva/etiologia , Idoso , Estudos de Casos e Controles , Poluentes Ambientais/toxicidade , Comportamento Alimentar , Feminino , França/epidemiologia , Humanos , Fatores de Risco
15.
J Affect Disord ; 243: 477-484, 2019 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-30273886

RESUMO

BACKGROUND: The established relationship between vision impairment and depression is limited by the examination of depression only as a unidimensional construct. The present study explores the vision-depression relationship using a dimensional approach. METHODS: 9036 participants aged 65 years and above enrolled in the Three-City study were included. Relationships between baseline near Vision Impairment (VI) or self-reported distance Visual Function (VF) loss with trajectory of four dimensions of depression - depressed affect, positive affect, somatic symptoms and interpersonal problems - over 12 years were examined using mixed-effects models. Depression dimensions were determined using the four-factor structure of the Centre for Epidemiology Studies-Depression Scale (CESD). RESULTS: In the fully adjustment models, mild near VI predicted poorer depressed affect (b = 0.04, p = .002) and positive affect (b = -0.06, p < 0.001) over time, with evidence of longer term adjustment. Distance VF loss was associated with poorer depressed affect (b = 0.27, p ≤ .001), positive affect (b = -0.15, p = .002), and somatic symptoms (b = 0.18, p ≤ .001) at baseline, although only the association with depressed affect was significant longitudinally (b = 0.01, p = .001). Neither near VI nor distance VF loss was associated with interpersonal problems. LIMITATIONS: This paper uses a well-supported model of depression dimensions, however, there remains no definite depression dimension model. Distance VF loss was self-reported, which can be influenced by depression symptoms. CONCLUSIONS: Vision impairment in older adults is primarily associated with affective dimensions of depression. A reduction in social connectedness and ability to engage in pleasurable activities may underlie the depression-vision relationship. Older adults with vision impairment may benefit from targeted treatment of affective symptoms, and pleasant event scheduling.


Assuntos
Depressão/epidemiologia , Índice de Gravidade de Doença , Transtornos da Visão/epidemiologia , Acuidade Visual , Idoso , Idoso de 80 Anos ou mais , Causalidade , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Incidência , Masculino , Fatores de Risco , Autorrelato , Transtornos da Visão/psicologia
16.
J Neurol Neurosurg Psychiatry ; 79(9): 979-84, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18450788

RESUMO

OBJECTIVE: To examine risk factors for mild cognitive impairment (MCI) and progression to dementia in a prospective community-based study of subjects aged 65 years and over. METHODS: 6892 participants who were over 65 and without dementia were recruited from a population-based cohort in three French cities. Cognitive performance, clinical diagnosis of dementia, and clinical and environmental risk factors were evaluated at baseline and 2-year and 4-year follow-ups. RESULTS: 42% of the population were classified as having MCI at baseline. After adjustment for confounding with logistic regression models, men and women classified as having MCI were more likely to have depressive symptomatology and to be taking anticholinergic drugs. Men were also more likely to have a higher body mass index, diabetes and stroke, whereas women were more likely to have poor subjective health, to be disabled, to be socially isolated, and to suffer from insomnia. The principal adjusted risk factors for men for progression from MCI to dementia in descending order were ApoE4 allele (OR = 3.2, 95% CI 1.7 to 5.7), stroke (OR = 2.8, 95% CI 1.2 to 6.9), low level of education (OR = 2.3, 95% CI 1.3 to 4.1), loss of Instrumental Activities of Daily Living (IADL) (OR = 2.2, 95% CI 1.1 to 4.5) and age (OR = 1.2, 95% CI 1.1 to 1.2). In women, progression is best predicted by IADL loss (OR = 3.5, 95% CI 2.1 to 5.9), ApoE4 allele (OR = 2.3, 95% CI 1.4 to 4.0), low level of education (OR = 2.2, 95% CI 1.3 to 3.6), subclinical depression (OR = 2.0, 95% CI 1.1 to 3.6), use of anticholinergic drugs (OR = 1.8, 95% CI 1.0 to 3.0) and age (OR = 1.1, 95% CI 1.1 to 1.2). CONCLUSIONS: Men and women have different risk profiles for both MCI and progression to dementia. Intervention programmes should focus principally on risk of stroke in men and depressive symptomatology and use of anticholinergic medication in women.


Assuntos
Transtornos Cognitivos/diagnóstico , Demência/diagnóstico , Transtornos Cognitivos/epidemiologia , Demência/epidemiologia , Progressão da Doença , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Medição de Risco , Fatores Sexuais
17.
Eur Psychiatry ; 45: 221-226, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28957791

RESUMO

BACKGROUND: The contribution of mental health to the risk of smoking is increasingly acknowledged but still insufficiently studied during the key period of student life. In particular, the simultaneous action of stress and Attention Deficit Hyperactivity Disorder (ADHD) symptoms on the risk of smoking remains poorly understood. AIMS: To assess the effects of stress and ADHD symptoms on tobacco smoking. METHOD: Multivariate modeling was conducted on the French i-Share study (n=8110, median age 20.3 years, 74.8% females, 32.9% regular/occasional smokers) to evaluate the associations between stress, ADHD symptoms and tobacco smoking, adjusting for potential family/socio-demographic confounders. RESULTS: Students with high levels of stress were more likely to smoke>10 cigarettes/day (adjusted odds ratio (aOR): 1.48, 95% CI: 1.12-1.96) than those with low levels of stress. Students with high levels of ADHD symptoms were more likely to smoke>10 cigarettes/day (aOR: 2.08, 95% CI: 1.58-2.75) than those with low levels of ADHD symptoms. CONCLUSIONS: Stress and ADHD contribute independently to the risk of smoking. Interventions targeting each condition are likely to reduce the burden of tobacco use in students.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Nível de Saúde , Fumar/epidemiologia , Adolescente , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Comorbidade , Feminino , França , Inquéritos Epidemiológicos , Humanos , Masculino , Fatores de Risco , Fumar/psicologia , Adulto Jovem
18.
Stroke ; 34(10): 2333-8, 2003 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12958329

RESUMO

BACKGROUND AND PURPOSE: We sought to quantify the effects of blood pressure lowering on long-term disability and dependency among patients with cerebrovascular disease. METHODS: We performed a randomized, double-blind, placebo-controlled trial. A total of 6105 participants with a history of stroke or transient ischemic attack in the past 5 years were recruited from 172 hospital outpatient clinics in 10 countries. Subjects were randomly assigned to the following groups: active treatment (angiotensin-converting enzyme inhibitor perindopril [4 mg/d] for all patients, with the diuretic indapamide added at the discretion of treating physicians) or matching placebo(s). Measurements were disability (defined as a Barthel Index score < or =99/100) and dependency (a positive response to the following question: "In the last 2 weeks has the patient required regular help with everyday activities?"). RESULTS: The median duration of follow-up was 4 years. At the last available assessment, 19% of the active treatment group and 22% of the placebo group were disabled (adjusted odds ratio, 0.76; 95% CI, 0.65 to 0.89; P<0.001). Twelve percent of the active treatment group and 14% of the placebo group were dependent (adjusted odds ratio, 0.84; 95% CI, 0.71 to 0.99; P=0.04). The effects of treatment appeared to be mediated primarily through the prevention of disability and dependency associated with recurrent stroke. Four-year treatment with the study drug regimen would be expected to result in the avoidance of 1 case of long-term disability for every 30 (95% CI, 19 to 79) patients. CONCLUSIONS: Among individuals with cerebrovascular disease, a perindopril-based blood pressure-lowering regimen not only reduced the risk of stroke and major vascular events but also substantially reduced the risks of associated long-term disability and dependency.


Assuntos
Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Transtornos Cerebrovasculares/tratamento farmacológico , Perindopril/uso terapêutico , Atividades Cotidianas , Dependência Psicológica , Diuréticos/uso terapêutico , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Indapamida/uso terapêutico , Ataque Isquêmico Transitório/tratamento farmacológico , Ataque Isquêmico Transitório/prevenção & controle , Masculino , Pessoa de Meia-Idade , Razão de Chances , Pacientes Ambulatoriais , Perindopril/efeitos adversos , Medição de Risco , Prevenção Secundária , Acidente Vascular Cerebral/tratamento farmacológico , Acidente Vascular Cerebral/prevenção & controle , Tempo , Resultado do Tratamento
19.
Neurology ; 53(9): 1948-52, 1999 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-10599763

RESUMO

OBJECTIVE: To examine whether baseline high blood pressure and antihypertensive treatment predicts cognitive decline in elderly individuals. METHODS: A longitudinal population-based study of elderly individuals (n = 1,373) in Nantes (western France) was undertaken. Individuals 59 to 71 years of age were selected from electoral rolls. High blood pressure at baseline was defined as systolic blood pressure > or =160 mm Hg or diastolic blood pressure > or =95 mm Hg. Cognitive decline was defined as a drop of 4 points or more on the Mini-Mental State Examination between baseline and the 4-year assessment. RESULTS: There is an association between high blood pressure at baseline and cognitive decline at the 4-year assessment (odds ratio, 2.8; 95% CI, 1.6 to 5.0). In participants with high blood pressure, the risk of cognitive decline was 4.3 (95% CI, 2.1 to 8.8) in those without antihypertensive therapy and 1.9 (95% CI, 0.8 to 4.4) in those being treated. In participants with high blood pressure both at baseline and at the 2-year assessment, the risk for untreated participants was 6.0 (95% CI, 2.4 to 15.0) compared with 1.3 (95% CI, 0.3 to 4.9) in treated participants. CONCLUSIONS: High blood pressure was associated with cognitive decline. In individuals with high blood pressure, cognitive decline occurred in a relatively short time period and the risk was highest in untreated hypertensive patients.


Assuntos
Doença de Alzheimer/diagnóstico , Transtornos Cognitivos/diagnóstico , Encefalopatia Hipertensiva/diagnóstico , Idoso , Doença de Alzheimer/tratamento farmacológico , Doença de Alzheimer/psicologia , Anti-Hipertensivos/administração & dosagem , Pressão Sanguínea/efeitos dos fármacos , Transtornos Cognitivos/tratamento farmacológico , Transtornos Cognitivos/psicologia , Feminino , Seguimentos , Humanos , Encefalopatia Hipertensiva/tratamento farmacológico , Encefalopatia Hipertensiva/psicologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Razão de Chances , Risco
20.
Neurology ; 56(5): 673-5, 2001 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-11245725

RESUMO

The association between aldosterone synthase (CYP11B2) gene polymorphism and white matter hyperintensities seen on cerebral MRI was studied in a population-based sample of 829 individuals aged 63 to 75 years. The T allele was associated with the risk of severe white matter hyperintensities. Compared with the CC genotype, the adjusted OR for severe white matter hyperintensities was 4.61 (95% CI, 1.46 to 14.55) for the TT genotype and 2.45 (95% CI, 0.81 to 7.46) for the TC genotype in men. This association was independent of hypertension.


Assuntos
Encefalopatias/genética , Citocromo P-450 CYP11B2/genética , Polimorfismo Genético/genética , Idoso , Pressão Sanguínea/genética , Pressão Sanguínea/fisiologia , Encefalopatias/fisiopatologia , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade
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