Quality of Life in an Adult Population of More than 60 Years of Age without Cognitive Impairment.

OBJECTIVES: To analyse the quality of life (QoL) of persons over 60 years of age in Bizkaia (Basque Country, Spain), not institutionalised and without cognitive impairment, and the relation and possible influence of the perception of the state of health with the cognitive level and the activities that they carry out. SUBJECTS AND METHODS: Evaluation of a sample of 317 persons that belong to a longitudinal study. In 269 cases, there was a reliable informant. The general cognitive state was evaluated by means of the Mini-Mental State Examination (MMSE) and the Global Deterioration Scale (GDS). Two GDS, one of the family member (GDSf) and another of the evaluator (GDSe), were used and memory was evaluated by the Text Memory subtest of the Barcelona Test. The QoL was assessed with the SF-36 Health Survey and the mental, physical and social activities that they carry out were recorded. RESULTS: In the SF-36, the participants showed values that exceed the reference values of the Spanish population in all dimensions of the SF-36, except in that of bodily pain. There were low correlations between the dimensions of the SF-36 and the mental, physical and social activities. A low correlation was observed between the memory tests and the SF-36. In 59.3% of the cases, there were no differences between the GDSf and the GDSe. CONCLUSIONS: The participants of this study present a better perception of their state of health than the Spanish population, but this perception is not observed to be influenced by the type or by the quantity of activities that they carry out or by their cognitive state. The informants present a vision very close to the cognitive state of their family members.

Oestrogen receptor polymorphisms are an associated risk factor for mild cognitive impairment and Alzheimer disease in women APOE {varepsilon}4 carriers: a case-control study.

OBJECTIVES: Examine the role of single nucleotide polymorphisms (SNPs) in the oestrogen receptor (ER) genes: rs9340799, rs2234693, rs2228480 (in the ESR1 gene) and rs4986938 (in the ESR2 gene) as a risk factor for amnesic mild cognitive impairment (MCIa) and Alzheimer's disease (AD) and its possible association with the apolipoprotein E (APOE) gene. DESIGN: We have investigated the independent and combined association of different alleles of the oestrogen receptor genes and APOE*ε4 allele with cognitive impairment using a case-control design. SETTING: Participants were prospectively recruited from the neurology departments of several Basque Country hospitals. PARTICIPANTS: This study comprised 816 Caucasian participants who were aged 50 years and older: 204 MCIa, 350 sporadic patients with AD and 262 healthy controls. PRIMARY AND SECONDARY OUTCOME MEASURES: Clinical criteria and neuropsychological tests were used to establish the diagnostic groups (MCIa, AD and healthy controls). A dichotomous variable was used for each allele and genotype and the association with MCIa and AD was established using Logistic Regression Models. RESULTS: Neither alleles nor genotypes of SNPs rs9340799, rs2234693, rs2228480 and rs4986938 of oestrogen receptor genes (ESR1 and ESR2) are independently associated with the risk of MCIa or AD. However, the genetic profile created with the combination of the less represented alleles of these SNPs (expressed as XPAA) was associated with an increased risk for MCIa (OR=3.30, 95% CI 1.28 to 8.54, p=0.014) and AD (OR=5.16, 95% CI 2.19 to 12.14, p<0.001) in women APOE*ε4 allele carriers. CONCLUSIONS: The less represented alleles of SNPs studied are associated with MCIa and AD in APOE*E4 carriers. In particular, the genetic profile created with the less represented alleles of ESR1 and ESR2 SNPs are associated with an increased risk for MCIa and AD in women APOEε4 allele carriers.

Depresión y apatía en los accidentes cerebrovasculares agudos / Poststroke depression and apathy

A pesar de que la mayoría de los pacientes que han sufrido un ictus van a presentar algún tipo de alteración psicopatológica, no se le suele prestar una adecuada atención. La depresión post-ictus (DPI) es el síndrome psiquiátrico más frecuente, afecta a alrededor del 35 % de los pacientes, y su presencia acarrea a éstos un peor pronóstico funcional y vital. La fisiopatología de la DPI es aún desconocida, aunque se sospecha que el sistema serotoninérgico está implicado, y el uso de fármacos que estimulan dicho sistema parece ser útil en su tratamiento. La apatía post-ictus, también muy presente entre los pacientes con ictus y con una prevalencia del 25%, es mucho menos conocida(AU)

Despite the big prevalence of psychopatological disorders in stroke patients, these have received a very little attention. Poststroke depression (PSD) is the most frequent psychiatric complication of stroke, and its prevalence has been estimated to be around 35%. Stroke patients with PSD suffer higher mortality rates and show a worse functional outcomes and quality of life. PSD pathophysiology is still debated, but the serotoninergic hypothesis is the best choice, and the antidepressant therapy appear to be effective. Post-stroke apathy prevalence is around 25% but little is known about this(AU)