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1.
Heliyon ; 9(8): e19012, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37636399

ABSTRACT

Annona senegalensis Pers is a multipurpose tree species valued for food and medicinal uses in Africa. Although there have been attempts to document the proximate composition of fruits and leaves, little is known about the relative role of soil, climate, and genotype on the nutritional quality. The present study evaluated the variation of the proximate composition of fruits and leaves in populations from Benin and Mozambique. It further assessed the impact of soil, climate and genotype on the proximate composition. Data were collected from four populations genetically different and analyzed using descriptive statistics, analysis of variance (ANOVA), principal component analysis, redundancy analysis (RDA), and variance partitioning. Results revealed significant variation in the proximate composition of fruits and leaves among the studied populations. Ashes and fibers in fruits, and lipids in leaves were 4.8-fold, 2.5- fold, and 1.25-fold higher respectively, in populations from Mozambique. Fruits moisture and lipids content were rather 1.4-fold and 1.10-fold higher in populations from Benin. Moisture and lipids were respectively 6-fold and 1.27-fold higher in fruits than in leaves, while ashes, fibers and proteins were approximately twice higher in the leaves than in the fruits. Genetic groups, climate and soils were found to influence this variation. All three factors explained 74.4% of the variation of nutritional value of fruits and leaves, 31.9% of which was exclusively due to genetic variation, 2.8% to the interaction of climate and soils, 24.1% to the interaction of soil and genetic variation, and 15.5% to the interaction of all three factors. Our study shows that genetic variation and soil properties better than climate, explain the variation of nutritional value of A. senegalensis fruits and leaves and further provides essential information that could be harnessed in the domestication and breeding program of the species for its edible parts.

2.
AoB Plants ; 13(4): plab036, 2021 Aug.
Article in English | MEDLINE | ID: mdl-34234937

ABSTRACT

Our understanding of the role of fire and effect of ant species composition, beyond their diversity and abundance, on the effectiveness of mutualism defence is limited. Most of our knowledge of ant-plant defence in tropical Africa is biased towards East African savannas which have richer soil, higher primary productivity and a more diverse arthropods and mammal community than West African savannas. We assessed the diversity of ant species associated with Acacia species in the Pendjari Biosphere Reserve in the Dahomey Gap, and their impacts on elephant damage. Elephant damage, ant diversity and abundance were measured in stands of five Acacia species. Eleven ant species were identified in the Acacia stands. The composition of these ant communities varied across Acacia species. Pair of ant species co-occurred in only 2 % of sampled trees, suggesting a strong competitive exclusion. Within this annually burnt environment, ants were rare on small trees. The intensity of elephant-caused branch breaking did not vary between trees with ants and trees without ants, suggesting limited Acacia-ant mutualism. Such limited biotic defence may mask strong physical and chemical defence mechanisms of Acacia trees against elephant damage. Ant assemblages in West Africa, unlike those in the more productive East Africa, are particularly species-poor. However, there is a convergence between these two regions in low rate of ant co-occurrence which might indicate strong competitive exclusion. Our study suggests that such low ant species richness while limiting the efficacy of mutualism in controlling mega-herbivore damage may mask a strong defence syndrome.

3.
PLoS One ; 15(12): e0243997, 2020.
Article in English | MEDLINE | ID: mdl-33347495

ABSTRACT

BACKGROUND: Cetuximab improves progression-free survival (PFS) and overall survival (OS) in patients with KRAS wild type (wt) metastatic colorectal cancer (mCRC). Few data are available on factors impacting both efficacy and compliance to cetuximab treatment, which is, in combination with chemotherapy, a standard-of-care first-line treatment regimen for patients with KRAS wt mCRC. PATIENTS AND METHODS: PREMIUM is a prospective, French multicenter, observational study that recruited patients with KRAS wt mCRC scheduled to receive cetuximab, with or without first-line chemotherapy, as part of routine clinical practice, between October 28, 2009 and April 5, 2012 (ClinicalTrials.gov Identifier: NCT01756625). The main endpoints were the factors impacting on efficacy and compliance to cetuximab treatment. Predefined efficacy endpoints were PFS and safety. RESULTS: A total of 493 patients were recruited by 94 physicians. Median follow-up was 12.9 months. Median progression-free survival was 11 months [9.6-12]. In univariate analyses, ECOG performance status (PS), smoking status, primary tumor location, number of metastatic organs, metastasis resectability, surgery, folliculitis, xerosis and paronychia maximum grade, and acne preventive treatment were statistically significant. In multivariate analysis (Hazard Ratios of multivariate stepwise Cox models), ECOG PS, surgery, xerosis and folliculitis were positive prognostics factors for longer PFS. Among all patients, 69 (14%) were non-compliant. In multivariate analysis, no variables were statistically significant. The safety profile of cetuximab was consistent with previous studies. CONCLUSIONS: ECOG PS <2, surgical treatment performed, and maximum grade xerosis or folliculitis developed were predictive factors of cetuximab efficacy on KRAS wt mCRC patients. Unfortunately, we failed in identifying predictive factors for compliance in these patients.


Subject(s)
Antineoplastic Agents, Immunological/therapeutic use , Cetuximab/therapeutic use , Colorectal Neoplasms/drug therapy , Folliculitis/epidemiology , Paronychia/epidemiology , Smoking/epidemiology , Adult , Aged , Aged, 80 and over , Antineoplastic Agents, Immunological/administration & dosage , Antineoplastic Agents, Immunological/adverse effects , Cetuximab/administration & dosage , Cetuximab/adverse effects , Colorectal Neoplasms/epidemiology , Colorectal Neoplasms/genetics , Colorectal Neoplasms/pathology , Compliance , Female , Humans , Male , Middle Aged , Neoplasm Metastasis , Proto-Oncogene Proteins p21(ras)/genetics , Treatment Outcome
4.
PLoS One ; 15(9): e0238984, 2020.
Article in English | MEDLINE | ID: mdl-32966312

ABSTRACT

Garcinia kola (Heckel) is a versatile tree indigenous to West and Central Africa. All parts of the tree have value in traditional medicine. Natural populations of the species have declined over the years due to overexploitation. Assessment of genetic diversity and population structure of G. kola is important for its management and conservation. The present study investigates the genetic diversity and population structure of G. kola populations in Benin using ultra-high-throughput diversity array technology (DArT) single nucleotide polymorphism (SNP) markers. From the 102 accessions sampled, two were excluded from the final dataset owing to poor genotyping coverage. A total of 43,736 SNPs were reported, of which 12,585 were used for analyses after screening with quality control parameters including Minor allele frequency (≥ 0.05), call rate (≥ 80%), reproducibility (≥ 95%), and polymorphic information content (≥ 1%). Analysis revealed low genetic diversity with expected heterozygosity per population ranging from 0.196 to 0.228. Pairwise F-statistics (FST) revealed low levels of genetic differentiation between populations while an Analysis of molecular variance (AMOVA) indicated that the majority of variation (97.86%) was within populations. Population structure analysis through clustering and discriminant analysis on principal component revealed two admixed clusters, implying little genetic structure. However, the model-based maximum likelihood in Admixture indicated only one genetic cluster. The present study indicated low genetic diversity of G. kola, and interventions are needed to be tailored towards its conservation.


Subject(s)
Garcinia kola/genetics , Alleles , Benin , Gene Frequency/genetics , Genetic Variation/genetics , Genetics, Population/methods , Genome/genetics , High-Throughput Nucleotide Sequencing/methods , Phylogeny , Polymorphism, Single Nucleotide/genetics , Reproducibility of Results
5.
Dement Geriatr Cogn Disord ; 45(1-2): 56-65, 2018.
Article in English | MEDLINE | ID: mdl-29684916

ABSTRACT

BACKGROUND/AIMS: Alzheimer disease (AD) is particularly devastating, with no cure, no means of prevention, and no proven way to slow progression. AD is associated with the worsening of cognitive function attributable to a variety of factors of which little is known. Our main objective was to determine factors associated with rapid cognitive decline (RCD) in older AD patients. METHODS: We conducted a 12-month, prospective, multi-centre cohort study. Community-living individuals aged ≥65 years with mild-to-moderate AD were included. RCD was defined as the loss of ≥3 points/year in the Mini-Mental State Examination (MMSE) score. Potential individual-level predictors were collected at baseline. RESULTS: A total of 521 individuals were included. The mean age was 80.8 ± 9.0 years and 66.0% were females. The average baseline MMSE score was 20.5 ± 4.5. The incidence of RCD was 40.9% (95% confidence interval [CI], 36.7-45.1). RCD was more common in patients with moderate (53.5%) than mild (22.3%) AD. The factors associated with RCD were: a parental history of dementia (odds ratio [OR], 2.32 [95% CI, 1.24-4.21], p = 0.011), psychotic symptoms (OR, 2.06 [95% CI, 1.22-3.48], p = 0.007), malnutrition (OR, 1.61 [95% CI, 1.06-2.63], p = 0.028), and the female gender (OR, 1.48 [95% CI, 1.03-2.15], p = 0.036). An MMSE score < 20 at treatment onset was also associated with RCD (p < 0.001). CONCLUSION: The factors associated with RCD were an MMSE score < 20 at treatment onset, female gender, psychotic symptoms, malnutrition, and a family history of dementia. These results may be directly relevant to patients, their families, and their physicians, enabling early anticipation of difficult clinical trajectories and poor functional outcomes.


Subject(s)
Alzheimer Disease/psychology , Aged , Aged, 80 and over , Ambulatory Care Facilities , Cohort Studies , Disease Progression , Female , Follow-Up Studies , Humans , Incidence , Male , Malnutrition/complications , Malnutrition/psychology , Mental Status and Dementia Tests , Predictive Value of Tests , Prognosis , Prospective Studies , Psychotic Disorders/complications , Psychotic Disorders/psychology , Risk Factors , Sex Factors
6.
J Gerontol A Biol Sci Med Sci ; 72(4): 560-566, 2017 Apr 01.
Article in English | MEDLINE | ID: mdl-27317684

ABSTRACT

BACKGROUND: Elevated plasma soluble vascular cell adhesion molecule-1 (sVCAM-1) is a presumed marker of endothelial dysfunction, both in the brain and systemic circulation. Impairments in memory and cognition have been associated with cardiovascular diseases, but little is known about their relationships to abnormal cerebral endothelial function. METHODS: We studied the cross-sectional association between sVCAM-1 and markers of cerebrovascular hemodynamics and cognitive function in 680 community-dwelling participants in the MOBILIZE Boston Study, aged 65 years and older. Cognitive function was assessed using the Hopkins Verbal Learning Memory Test and Trail Making Tests (TMTs) A and B. Global cognitive impairment was defined as Mini-Mental State Examination (MMSE) score less than 24. sVCAM-1 was measured by ELISA assay. Beat-to-beat blood flow velocity (BFV) and cerebrovascular resistance (CVR = mean arterial pressure / BFV) in the middle cerebral artery were assessed at rest by transcranial Doppler ultrasound. RESULTS: sVCAM-1 concentrations were higher among participants with an MMSE score <24 versus ≥24 (1,201±417 vs 1,122±494ng/mL). In regression models adjusted for sociodemographic characteristics and health conditions, increasing levels of sVCAM-1 were linearly associated with higher resting CVR (p = .006) and lower performance on the Hopkins Verbal Learning Memory (immediate recall and delayed recall) and adjusted TMT B tests (p < .05). Higher levels of sVCAM-1 were also associated with global cognitive impairment on the MMSE (odds ratio = 3.9; 95% confidence interval: 1.4-10.9; p = .011). CONCLUSIONS: In this cohort of elderly participants, we observed a cross-sectional association between elevated sVCAM-1 levels and both cognitive impairment and increased cerebrovascular resistance. Longitudinal studies are needed to determine whether elevated sVCAM-1 is a cause or consequence of cerebrovascular damage.


Subject(s)
Cerebrovascular Circulation , Cognition Disorders/blood , Cognition Disorders/physiopathology , Vascular Cell Adhesion Molecule-1/blood , Vascular Resistance , Aged , Blood Flow Velocity , Cognition , Cross-Sectional Studies , Female , Humans , Male
8.
J Am Geriatr Soc ; 64(2): 365-8, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26783046

ABSTRACT

OBJECTIVES: To determine the concordance between falls recorded using an investigational fall detection device and falls reported by nursing staff in a nursing home. DESIGN: Six-month prospective study. SETTING: Hebrew SeniorLife nursing home units in Boston, Massachusetts. PARTICIPANTS: Nursing home residents with a documented history of at least one fall within 12 months before consent (N = 62, mean age 86.2 ± 8.1, 66% female). INTERVENTION: Subjects continuously wore an automated falls detection device on a pendant around their neck. The device contained triaxial accelerometers set to detect a rapid change in position that was interpreted as a fall. MEASUREMENTS: Healthcare staff reported daily falls, defined as unexpected events in which residents were found on the floor, and the number of these falls was compared with the number of falls recorded according to the device. RESULTS: Seven of 37 residents whom nursing staff found on the floor had a fall recorded according to the device (19%). The device did not identify any of the clinical fall events in 23 of the 37 fallers (62%). The device detected 17 of 89 total falls that nursing staff recorded (sensitivity 19%) within an 8-hour time window. Of 128 fall events that the device recorded, 17 were concordant with nursing reports (13%) within an 8-hour time window, and 111 (87%) were false positives. CONCLUSION: There is poor concordance between falls recorded using the investigational fall detection device and falls to the floor that nursing home staff report.


Subject(s)
Accidental Falls , Monitoring, Ambulatory/instrumentation , Nursing Homes , Aged, 80 and over , Boston , Comorbidity , Female , Humans , Male , Prospective Studies
9.
Ecol Evol ; 6(20): 7546-7557, 2016 10.
Article in English | MEDLINE | ID: mdl-28725419

ABSTRACT

The relationship between biodiversity and ecosystem function has increasingly been debated as the cornerstone of the processes behind ecosystem services delivery. Experimental and natural field-based studies have come up with nonconsistent patterns of biodiversity-ecosystem function, supporting either niche complementarity or selection effects hypothesis. Here, we used aboveground carbon (AGC) storage as proxy for ecosystem function in a South African mistbelt forest, and analyzed its relationship with species diversity, through functional diversity and functional dominance. We hypothesized that (1) diversity influences AGC through functional diversity and functional dominance effects; and (2) effects of diversity on AGC would be greater for functional dominance than for functional diversity. Community weight mean (CWM) of functional traits (wood density, specific leaf area, and maximum plant height) were calculated to assess functional dominance (selection effects). As for functional diversity (complementarity effects), multitrait functional diversity indices were computed. The first hypothesis was tested using structural equation modeling. For the second hypothesis, effects of environmental variables such as slope and altitude were tested first, and separate linear mixed-effects models were fitted afterward for functional diversity, functional dominance, and both. Results showed that AGC varied significantly along the slope gradient, with lower values at steeper sites. Species diversity (richness) had positive relationship with AGC, even when slope effects were considered. As predicted, diversity effects on AGC were mediated through functional diversity and functional dominance, suggesting that both the niche complementarity and the selection effects are not exclusively affecting carbon storage. However, the effects were greater for functional diversity than for functional dominance. Furthermore, functional dominance effects were strongly transmitted by CWM of maximum plant height, reflecting the importance of forest vertical stratification for diversity-carbon relationship. We therefore argue for stronger complementary effects that would be induced also by complementary light-use efficiency of tree and species growing in the understory layer.

10.
Dement Geriatr Cogn Dis Extra ; 5(3): 350-60, 2015.
Article in English | MEDLINE | ID: mdl-26557134

ABSTRACT

BACKGROUND: Exercise programs are presumed to rehabilitate gait disorders and to reduce the risk of falling in dementia patients. This study aimed to analyze the specific effects of multicomponent exercise on gait disorders and to determine the association between gait impairments and the risk of falling in dementia patients before and after intervention. METHODS: We conducted an 8-week multicomponent exercise program in 16 dementia patients (age 86.7 ± 5.4 years). All participants were assessed several times for gait analysis (Locométrix®), Tinetti score and physical activity (Body Media SenseWear® Pro armband). RESULTS: After 8 weeks of the exercise program, the mean gait speed was 0.12 m/s faster than before the intervention (0.55 ± 0.17 vs. 0.67 ± 0.14 m/s). The multicomponent exercise program improved gait performance and Tinetti score (p < 0.05). Gait performance (gait speed, stride length) was correlated with the Tinetti score (p < 0.05). CONCLUSION: Analysis of spatiotemporal gait parameters using an accelerometer method provided a quick and easy tool to estimate the benefits of an exercise program and the risk of falling.

11.
BMC Geriatr ; 15: 62, 2015 Jun 04.
Article in English | MEDLINE | ID: mdl-26040277

ABSTRACT

BACKGROUND: Circulating vascular adhesion molecule-1 (sVCAM-1) is a presumed marker of endothelial activation and dysfunction, but little is known about its association with mood. We hypothesized that elevated plasma concentrations of sVCAM-1 may be a marker of depressive symptoms due to cerebral vascular disease. METHODS: We studied 680 community-dwelling participants in the MOBILIZE Boston Study, aged 65 years and older. sICAM-1 and sVCAM-1 were measured by ELISA assay and depressive symptoms were assessed during home interviews using the Revised Center for Epidemiological Studies Depression Scale (CESD-R). Cerebral White Matter Hyperintensities (WMHs) were quantified by MRI in a subgroup of 25 participants. RESULTS: One hundred seventy nine (27 %) subjects had a CESD-R Score ≥ 16, indicative of depressive symptoms. The mean sVCAM-1 concentration (±SD) was 1176 ± 417 ng/mL in a group with CESD-R Scores <16 and 1239 ± 451 ng/mL in those with CESD-R Scores ≥16 (p = 0.036). CESD-R Score was positively associated with sVCAM-1 (r = 0.11, p = 0.004). The highest quintile of sVCAM-1, which is indicative of endothelial dysfunction, was significantly associated with depressive symptoms compared to the lowest quintile (OR = 1.97 (1.14-3.57) p = 0.015). In a subset of subjects, sVCAM-1 concentration was positively correlated with cerebral WMHs volume (p = 0.018). CONCLUSIONS: The association between high levels of sVCAM-1 and depressive symptoms may be due to endothelial dysfunction from cerebral microvascular damage. Future longitudinal studies are needed to determine whether sVCAM-1 can serve as a biomarker for cerebrovascular causes of depression.


Subject(s)
Depression/blood , Depression/pathology , Vascular Cell Adhesion Molecule-1/blood , White Matter/pathology , Aged , Aged, 80 and over , Biomarkers/blood , Boston , Female , Humans , Independent Living , Magnetic Resonance Imaging , Male , Psychiatric Status Rating Scales
12.
Hypertension ; 66(2): 340-6, 2015 Aug.
Article in English | MEDLINE | ID: mdl-26056332

ABSTRACT

Soluble vascular cell adhesion molecule-1 (sVCAM-1) is associated with hypertension, vascular inflammation, and systemic endothelial dysfunction. We evaluated whether elevated plasma sVCAM-1 is associated with impaired cerebrovascular function and mobility impairments in elderly people. We studied the cross-sectional relationships between plasma sVCAM-1 level, gait speed, and cerebrovascular hemodynamics, and its longitudinal relationship with falls in 680 community-dwelling participants aged ≥65 years in the Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly (MOBILIZE) Boston Study. Falls were recorded prospectively for 1 year on daily calendars. sVCAM-1 was measured by ELISA assay and beat-to-beat blood flow velocity in the middle cerebral artery during rest and in response to changes in end-tidal CO2 was measured by transcranial Doppler ultrasound. sVCAM-1 concentration was 1094±340 ng/mL in normotensives, 1195±438 ng/mL in controlled hypertensives, and 1250±445 ng/mL in uncontrolled hypertensives (P=0.008). The mean resting blood flow velocity and cerebral vasomotor range were, respectively, 41.0±10.3 cm/s and 1.3±0.4 cm/s per millimeter of mercury. Elevated sVCAM-1 levels indicative of endothelial dysfunction were associated with reduced resting blood flow velocity (P=0.017) and cerebral vasomotor range (P=0.0048). Elevated sVCAM-1 levels were associated with slower gait speed (<0.8 m/s; odds ratio, 3.01; 95% confidence interval, 1.56-5.83; P=0.0011) and an increased odds of injurious falls (odds ratio, 2.4; 95% confidence interval, 1.4-4.2; P=0.0028). An elevated sVCAM-1 level may be a marker of cerebral blood flow dysregulation because of endothelial damage from hypertension. It may also signal the presence of cerebral microvascular disease and its clinical consequences, including slow gait speed and falls.


Subject(s)
Accidental Falls/statistics & numerical data , Brain/blood supply , Cerebrovascular Circulation/physiology , Mobility Limitation , Regional Blood Flow/physiology , Vascular Cell Adhesion Molecule-1/blood , Age Factors , Aged , Aged, 80 and over , Biomarkers/blood , Cohort Studies , Cross-Sectional Studies , Female , Gait/physiology , Humans , Hypertension/physiopathology , Incidence , Male , Middle Cerebral Artery/physiology , Prospective Studies , Risk Factors
13.
Hypertension ; 66(1): 183-9, 2015 Jul.
Article in English | MEDLINE | ID: mdl-25941341

ABSTRACT

Conflicting data on the relationship between antihypertensive medications and falls in elderly people may lead to inappropriate undertreatment of hypertension in an effort to prevent falls. We aimed to clarify the relationships between the chronic use of different classes of antihypertensive medications and different types of falls, to determine the effect of medication dose, and to assess whether the risk of falls is associated with differences in cerebral blood flow. We assessed demographics, clinical characteristics, and chronic antihypertensive medication use in 598 community-dwelling people with hypertension, aged 70 to 97 years, then followed them prospectively for self-reported falls using monthly calendar postcards and telephone interviews. Antihypertensive medication use was not associated with an increased risk of falls. Participants reporting use of angiotensin-converting enzyme inhibitors had a significantly decreased 1-year risk of injurious falls (odds ratio, 0.62; 95% confidence interval, 0.39-0.96), whereas those using calcium channel blockers had a decreased risk of all falls (odds ratio, 0.62; 95% confidence interval, 0.42-0.91) and indoor falls (odds ratio, 0.57; 95% confidence interval, 0.36-0.91), compared with participants not taking these drugs. Larger doses of these classes were associated with a lower fall risk. Participants taking calcium channel blockers had higher cerebral blood flow than those not taking these medications. In relatively healthy community-dwelling elderly people, high doses of antihypertensive agents are not associated with an increased risk of falls.


Subject(s)
Accidental Falls/prevention & control , Antihypertensive Agents/adverse effects , Antihypertensive Agents/therapeutic use , Cerebrovascular Circulation/drug effects , Accidents, Home/prevention & control , Adrenergic beta-Antagonists/administration & dosage , Adrenergic beta-Antagonists/adverse effects , Adrenergic beta-Antagonists/pharmacology , Adrenergic beta-Antagonists/therapeutic use , Aged , Aged, 80 and over , Angiotensin II Type 1 Receptor Blockers/administration & dosage , Angiotensin II Type 1 Receptor Blockers/adverse effects , Angiotensin II Type 1 Receptor Blockers/pharmacology , Angiotensin II Type 1 Receptor Blockers/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Angiotensin-Converting Enzyme Inhibitors/adverse effects , Angiotensin-Converting Enzyme Inhibitors/pharmacology , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Antihypertensive Agents/pharmacology , Blood Pressure/drug effects , Calcium Channel Blockers/administration & dosage , Calcium Channel Blockers/adverse effects , Calcium Channel Blockers/pharmacology , Calcium Channel Blockers/therapeutic use , Cardiovascular Diseases/epidemiology , Cognition Disorders/epidemiology , Comorbidity , Diabetes Mellitus/epidemiology , Disease Susceptibility , Diuretics/administration & dosage , Diuretics/adverse effects , Diuretics/pharmacology , Diuretics/therapeutic use , Dose-Response Relationship, Drug , Female , Humans , Male
14.
PLoS One ; 9(9): e106363, 2014.
Article in English | MEDLINE | ID: mdl-25184785

ABSTRACT

BACKGROUND: Falls may occur as unpredictable events or in patterns indicative of potentially modifiable risks and predictive of adverse outcomes. Knowing the patterns, risks, and outcomes of falls trajectories may help clinicians plan appropriate preventive measures. We hypothesized that clinically distinct trajectories of falls progression, baseline predictors and their coincident clinical outcomes could be identified. METHODS: We studied 765 community-dwelling participants in the MOBILIZE Boston Study, who were aged 70 and older and followed prospectively for falls over 5 years. Baseline demographic and clinical data were collected by questionnaire and a comprehensive clinic examination. Falls, injuries, and hospitalizations were recorded prospectively on daily calendars. Group-Based Trajectory Modeling (GBTM) was used to identify trajectories. RESULTS: We identified 4 distinct trajectories: No Falls (30.1%), Cluster Falls (46.1%), Increasing Falls (5.8%) and Chronic Recurring Falls (18.0%). Predictors of Cluster Falls were faster gait speed (OR 1.69 (95CI, 1.50-2.56)) and fall in the past year (OR 3.52 (95CI, 2.16-6.34)). Predictors of Increasing Falls were Diabetes Mellitus (OR 4.3 (95CI, 1.4-13.3)) and Cognitive Impairment (OR 2.82 (95CI, 1.34-5.82)). Predictors of Chronic Recurring Falls were multi-morbidity (OR 2.24 (95CI, 1.60-3.16)) and fall in the past year (OR 3.82 (95CI, 2.34-6.23)). Symptoms of depression were predictive of all falls trajectories. In the Chronic Recurring Falls trajectory group the incidence rate of Hospital visits was 121 (95% CI 63-169) per 1,000 person-years; Injurious falls 172 (95% CI 111-237) per 1,000 person-years and Fractures 41 (95% CI 9-78) per 1,000 person-years. CONCLUSIONS: Falls may occur in clusters over discrete intervals in time, or as chronically increasing or recurring events that have a relatively greater risk of adverse outcomes. Patients with multiple falls, multimorbidity, and depressive symptoms should be targeted for preventive measures.


Subject(s)
Accidental Falls , Depression/epidemiology , Physical Therapy Modalities , Postural Balance , Aged , Aged, 80 and over , Depression/pathology , Female , Follow-Up Studies , Gait , Humans , Male , Risk Factors
15.
Springerplus ; 3: 338, 2014.
Article in English | MEDLINE | ID: mdl-25045613

ABSTRACT

BACKGROUND: The worldwide population is ageing and the proportion of elderly aged 60 and over is expected to dramatically rise in Low and Middle Income Countries (LMIC). The epidemic of dementia will not spare those countries, where the largest increases in numbers of people affected are estimated. Besides, dementia is still understudied in sub-Saharan Africa (SSA) compared to other regions. This paper describes the protocol for the 'Epidemiology of Dementia in Central Africa' population-based study, which aims at estimating the prevalence of dementia in two countries of Central Africa and investigating possible risk factors. METHODS/DESIGN: A multicenter population-based study was carried out in Central African Republic and Republic of Congo between 2011 and 2012 including both urban and rural sites in each country. Around 2000 participants aged ≥65 years old were interviewed in total using the Community Screening Interview for Dementia (CSI-D), the GMS-AGECAT and the CERAD's 10-word list. Elderly with low performance to the cognitive part of the CSI-D (COGSCORE ≤ 24.5) were then clinically assessed by neurologists and underwent further psychometrical tests. DSM-IV and NINCDS-ADRDA criteria were required for dementia and Alzheimer's disease (AD) diagnoses respectively. The algorithmic 10/66 dementia diagnosis was also determined. Petersen's criteria were required for the diagnosis of Mild Cognitive Impairment. Sociodemographic, and environmental factors including vascular, nutritional, biological, psychosocial and lifestyle factors were collected in each setting in order to investigate factors associated with dementia. Blood sampling was realized to investigate genetic variations that could modify the risk of dementia. DISCUSSION: For now, no large epidemiological study has been undertaken to compare the prevalence of dementia in both rural and urban areas within SSA countries. This programme will provide further evidence regarding the prevalence of dementia in SSA, and also the possible rural/urban disparities existing with associated factors. Furthermore, the genetics of AD in those populations will be addressed.

16.
Dement Geriatr Cogn Disord ; 36(3-4): 251-61, 2013.
Article in English | MEDLINE | ID: mdl-23949277

ABSTRACT

BACKGROUND: Alzheimer's disease (AD) is known to increase the risk of falls. We aim to determine the effectiveness of home-based technologies coupled with teleassistance service (HBTec-TS) in older people with AD. METHODS: A study of falls and the HBTec-TS system (with a light path combined with a teleassistance service) was conducted in the community. The 96 subjects, drawn from a random population of frail elderly people registered as receiving an allocation for lost autonomy from the county, were aged 65 or more and had mild-to-moderate AD with 1 year of follow-up; 49 were in the intervention group and 47 in the control group. RESULTS: A total of 16 (32.7%) elderly people fell in the group with HBTec-TS versus 30 (63.8%) in the group without HBTec-TS. The use of HBTec-TS was significantly associated with a reduction in the number of indoor falls among elderly people with mild-to-moderate AD (OR = 0.37, 95% CI = 0.15-0.88, p = 0.0245). CONCLUSION: The use of the HBTec-TS significantly reduced the incidence of primary indoor falling needing GP intervention or attendance at an emergency room among elderly people with AD and mild-to-moderate dementia.


Subject(s)
Accidental Falls/prevention & control , Alzheimer Disease/complications , Aged , Aged, 80 and over , Female , Follow-Up Studies , Frail Elderly , Home Care Services , Humans , Incidence , Logistic Models , Male , Physicians , Pilot Projects , Prospective Studies , Sample Size , Social Work , Technology , Telecommunications , Treatment Outcome
17.
J Ethnobiol Ethnomed ; 7: 42, 2011 Dec 07.
Article in English | MEDLINE | ID: mdl-22152043

ABSTRACT

BACKGROUND: African locust bean tree (Parkia biglobosa) is a multipurpose species used widely in arid Africa by local communities. The present study focused on ethnic differences in use values and use patterns of P. biglobosa in Northern Benin, where the species widely grows. The use values according to the various ethnic groups in the study area have been evaluated in detail for P. biglobosa. METHODS: From 13 ethnic groups, 1587 people were interviewed in the study area using semi-structured questionnaires. Principal Component Analysis was applied to analyze the use value and the use patterns of P. biglobosa for the different ethnic groups. RESULTS: All interviewees in the study area knew at least one use of P. biglobosa. The various uses identified were medicinal (47%), handicraft and domestic (3%), medico-magic (1%), veterinary (1%), cultural (1%), food (25%) and commercial (22%). The various parts involved in these types of uses were: fruits [shell (2%), pulp (22%) and seeds (36%)], bark (17%), leaves (9%), roots (3%), flowers (1%) and branches (10%). The ethnic group consensus values for P. biglobosa parts showed that the seeds are used the most. The interviewees diversity value (ID) and equitability value (IE) indicated that knowledge concerning P. biglobosa use was distributed homogeneously among the ethnic groups. CONCLUSIONS: P. biglobosa is well-known and used in different ways by the local populations in the study area. Local knowledge on the species is diversified and influenced by ethnic group. Ethnic differences in use values and use patterns of the species were evident in this study.


Subject(s)
Commerce , Diet , Fabaceae , Health Knowledge, Attitudes, Practice , Medicine, Traditional , Phytotherapy , Adult , Benin , Diet/ethnology , Ethnobotany , Female , Humans , Interviews as Topic , Male , Middle Aged , Plant Structures , Principal Component Analysis , Surveys and Questionnaires
18.
J Ethnobiol Ethnomed ; 7: 8, 2011 Feb 01.
Article in English | MEDLINE | ID: mdl-21284847

ABSTRACT

BACKGROUND: Growing interest is on food tree species in general, and particularly indigenous fruit tree species in developing countries since they are inherent to most tropical landscapes and serve the dual function of local livelihood support and biodiversity conservation. It is therefore relevant to assess the level of integration of these species in local cultures and the factors affecting them. This study aims at assessing knowledge and uses of Sclerocarya birrea subsp. birrea and factors affecting the use values within and between communities. METHODS: This study combines quantitative and qualitative ethnobotanical approaches to investigate uses and factors affecting the use value of S. birrea subsp. birrea. Nine group discussions as well as 161 individual interviews were held in the dry and typical Sudanian zones. Seven different ethnic groups were involved and the survey focused on local uses and perception of factors affecting the dynamics of S. birrea. RESULTS: The species has a multitude of uses; all organs are used for more than 20 different purposes. The study highlights how gender, local availability, ethnicity and community location interact to influence the utilization value of the species. People living in drier areas with high occurrence of the S. birrea use it more than those living in wetter areas with low occurrence. While domestic and subsistence uses do not appear to threaten the species, carving, clearing and drought stand out as the major causes of its decline. CONCLUSIONS: Many factors and their interactions influence the use pattern of the species within and between communities. When compared to the level of exploitation of S. birrea subsp. caffra in southern Africa, the subspecies birrea is at this point relatively underutilized. A high commercial potential exists due to its simple propagation ability and makes it an interesting agroforestry resource.


Subject(s)
Anacardiaceae , Conservation of Natural Resources , Health Knowledge, Attitudes, Practice , Benin , Ethnicity , Ethnobotany , Female , Food , Humans , Male , Plants, Medicinal , Qualitative Research , Residence Characteristics
19.
Am J Bot ; 96(5): 950-7, 2009 May.
Article in English | MEDLINE | ID: mdl-21628247

ABSTRACT

This study evaluates the spatial genetic structure of baobab (Adansonia digitata) populations from West African agroforestry systems at different geographical scales using AFLP fingerprints. Eleven populations from four countries (Benin, Ghana, Burkina Faso, and Senegal) had comparable levels of genetic diversity, although the two populations in the extreme west (Senegal) had less diversity. Pairwise F(ST) ranged from 0.02 to 0.28 and increased with geographic distance, even at a regional scale. Gene pools detected by Bayesian clustering seem to be a byproduct of the isolation-by-distance pattern rather than representing actual discrete entities. The organization of genetic diversity appears to result essentially from spatially restricted gene flow, with some influences of human seed exchange. Despite the potential for relatively long-distance pollen and seed dispersal by bats within populations, statistically significant spatial genetic structuring within populations (SGS) was detected and gave a mean indirect estimate of neighborhood size of ca. 45. This study demonstrated that relatively high levels of genetic structuring are present in baobab at both large and within-population level, which was unexpected in regard to its dispersal by bats and the influence of human exchange of seeds. Implications of these results for the conservation of baobab populations are discussed.

20.
Spine (Phila Pa 1976) ; 28(19): E405-7, 2003 Oct 01.
Article in English | MEDLINE | ID: mdl-14520054

ABSTRACT

STUDY DESIGN: This is a report of a case. OBJECTIVE: To document the clinical, radiographic, and histologic characteristics of a lumbar extraforaminal juxtafacet cyst. SUMMARY OF BACKGROUND DATA: Spinal juxtafacet cysts develop most frequently at the dorsal aspect of the zygapophysial joint, sometimes in the posterolateral area of the canal. In one case, they have been described in the foraminal and extraforaminal region. METHODS: Description of the case report. RESULT: The authors report one case of a strictly extraforaminal juxtafacet cyst responsible for L5 sciatica. CONCLUSIONS: Juxtafacet cysts of the spine represent an infrequent cause of sciatica, usually when they grow in the canal, or more exceptionally when they occupy the foraminal or extraforaminal areas.


Subject(s)
Bone Cysts/diagnosis , Lumbar Vertebrae , Radiculopathy/etiology , Zygapophyseal Joint , Bone Cysts/complications , Bone Cysts/pathology , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Sciatica/etiology
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