ABSTRACT
Neurodevelopmental disorders are frequent in the general population and are often lifelong conditions despite sometimes being masked by conscious or unconscious compensation and avoidance mechanisms. These conditions are often unknown or underestimated in adults, even when diagnosed in childhood. Neurodevelopmental disorders share similarities with and frequently interact in a complex way with neurodegenerative disorders. Considering these aspects during memory clinic assessments can provide a new perspective on lifelong neurocognitive trajectories. Assessing both neurodevelopmental and neurodegenerative dimensions is challenging but should improve diagnostic accuracy. It is therefore necessary to understand the lifelong specific neurocognitive trajectory of each patient in order to develop personalized and focused cognitive medicine and care.
Subject(s)
Neurodegenerative Diseases , Neurodevelopmental Disorders , Humans , Neurodegenerative Diseases/diagnosisABSTRACT
BACKGROUND AND AIMS: Diabetes and impaired fasting glucose, as well as cognitive impairment, are common in the elderly. Although several cross-sectional studies have demonstrated the influence of diabetes on cognitive impairment, only a few longitudinal studies have assessed the relationship between diabetes, impaired fasting glucose and cognitive decline in non-demented elderly community dwellers, by means of extensive neuropsychological batteries. The present study assesses the relationship between baseline diabetes, impaired fasting glucose (IFG) and 2- year evolution of memory, attention and executive performance in a sample of non-demented elderly subjects. DESIGN: Population-based cohort study [(PROgnostic indicator OF cardiovascular and cerebrovascular events (PROOF)]. PARTICIPANTS: One hundred and sixty-three community dwellers aged 65 years without dementia at recruitment. MAIN OUTCOME MEASURES: Memory, attention and executive performance. RESULTS: A significant association was observed between baseline diabetes mellitus and a higher 2-year decline in the Trial Making Test B and Stroop test exploring attention and executive function. This effect remained significant after adjusting for age, gender, education, anxiety and depressive symptoms, as well as other cardiovascular risk factors (F=2.41; p=0.007). Instead, no relationship was observed between IFG and cognitive decline. CONCLUSIONS: Our study showed that, in a sample of elderly non-demented community dwellers, diabetes mellitus (but not IFG) is associated with a higher decline in selective attention and executive functioning. These results emphasize the importance of detecting and man- aging diabetes and impaired fasting glucose, in order to prevent cognitive impairment and dementia.
Subject(s)
Blood Glucose/metabolism , Cognition Disorders/blood , Diabetes Complications/blood , Diabetes Mellitus/blood , Diabetes Mellitus/psychology , Fasting/blood , Age Factors , Aged , Attention/physiology , Cognition Disorders/psychology , Cohort Studies , Diabetes Complications/psychology , Female , Follow-Up Studies , Humans , Male , Memory/physiology , Outcome Assessment, Health Care , Risk FactorsABSTRACT
Public events and Flashbulb memories were investigated in 12 non-demented patients with Parkinson's disease (PD) and 12 controls. Knowledge of public events and flashbulbs memories were assessed using a Famous Events Test (EVE 30). Contributions of semantic, episodic, as well as executive functioning and anterograde memory were examined. Results primarily showed that the performances of patients with PD were lower than these of controls in 4 tasks: free recall, specific questions, dating events and date recognition. They also had difficulties in finding the temporal order of 8 events. In contrast, the PD group benefited from events recognition themselves to the same extent as the controls. Secondly, the recall of flashbulb memories (FBM) was lower in the PD group than in the controls. Finally, correlations appeared in PD between the detailed recall of the events with the "recall" abilities of the MATTIS scale, possibly reflect an impairment in rebuilding memories. A positive correlation is also observed with the initiation score of the MATTIS (executive component), suggesting that the difficulties of rebuilding can be related to a dysfunction in accessing information because of a certain degree of frontal amnesia.
Subject(s)
Famous Persons , Life Change Events , Memory Disorders/etiology , Parkinson Disease/complications , Parkinson Disease/physiopathology , Aged , Female , Humans , Male , Memory Disorders/diagnosis , Mental Recall , Neuropsychological Tests , Semantics , Severity of Illness IndexABSTRACT
UNLABELLED: Memory clinics, where cognitive impairment is diagnosed, have to deal with an increasing number of requests. In this context, this study was aimed to evaluate the feasibility of cognitive complaint assessment in a health check-up performed in preventive Health check-up centers. METHODS: The study population included 60-year and over subjects who were proposed a health check-up in the Health check-up centers of five French cities (Amiens, Nîmes, Longwy, Rennes and Sélestat). Cognitive complaint and anxio-depressive symptoms were collected for all participants. Subjects presenting a cognitive complaint fulfilled a neuropsychological screening including MMSE, 5-word test, Clock Drawing test, verbal fluencies and exploration of 4 Instrumental Activities of Daily Living. Subjects suspected to have cognitive impairment were then referred to a memory clinic. RESULTS: One thousand and twenty participants were included in the study; 31.5% had a cognitive complaint, and 12.3% of these subjects were referred to a memory clinic. A dementia was diagnosed in one third of them, corresponding to 1% of the study participants. However, all the patients with dementia were referred by the same check-up centre, which staff was well experienced in cognitive disorders. Moreover, 29.3% of the participants had a depressive symptomatology. CONCLUSION: exploration of cognitive functions in a preventive health check-up center for elderly people can be interesting, but requires a staff's former experience in cognitive disorders, especially for the diagnosis of Mild Cognitive Impairment. Moreover, depressive symptoms, which are frequent and can be cared for, should be explored in a health check-up for senior citizens.
