Cognitive and functional patterns of nondemented subjects with equivocal visual amyloid PET findings.

Purpose: Despite good to excellent inter-reader agreement in the evaluation of amyloid load on PET scans in subjects with Alzheimer's disease, some equivocal findings have been reported in the literature. We aimed to describe the clinical characteristics of subjects with equivocal PET images.

Methods: Nondemented subjects aged 70 years or more were enrolled from the MAPT trial.

Living Alone with Alzheimer's Disease and the Risk of Adverse Outcomes: Results from the Plan de Soin et d'Aide dans la maladie d'Alzheimer Study.

Objectives: To examine whether living alone predicted hospitalizations, nursing home admission, weight loss, and death in individuals with mild to moderate Alzheimer's disease (AD) over 2 years of follow-up.

Design: Data are from the Plan de Soin et d'Aide dans la maladie d'Alzheimer study, a 24-month trial with a cluster randomization of memory clinics in two arms: a multidomain intervention and usual care.

Setting: Memory clinics in France (N = 50).

Associated factors with antipsychotic use in long-term institutional care in eight European countries: Results from the RightTimePlaceCare study.

Objectives: To determine factors associated with the antipsychotic (AP) prescription for people with dementia (PwD) recently admitted to institutional long-term care facilities (LTCFs) and to ascertain differences in the use of this medication in 8 European countries.

Design: An exploratory cross-sectional study.

Setting: LTCFs from 8 European countries (Estonia, Finland, France, Germany, The Netherlands, Spain, Sweden, and England).

MAPT STUDY: A MULTIDOMAIN APPROACH FOR PREVENTING ALZHEIMER'S DISEASE: DESIGN AND BASELINE DATA.

Objective: The Multidomain Alzheimer Preventive Trial (MAPT study) was designed to assess the efficacy of isolated supplementation with omega-3 fatty acid, an isolated multidomain intervention (consisting of nutritional counseling, physical exercise, cognitive stimulation) or a combination of the two interventions on the change of cognitive functions in frail subjects aged 70 years and older for a period of 3 years. Ancillary neuroimaging studies were additionally implemented to evaluate the impact of interventions on cerebral metabolism (FDG PET scans) and atrophy rate (MRIs), as well as brain amyloïd deposit (AV45 PET scans).

Design Patients: 1680 subjects (mean age: 75.

Cognitive frailty: rational and definition from an (I.A.N.A./I.A.G.G.) international consensus group.

The frailty syndrome has recently attracted attention of the scientific community and public health organizations as precursor and contributor of age-related conditions (particularly disability) in older persons. In parallel, dementia and cognitive disorders also represent major healthcare and social priorities. Although physical frailty and cognitive impairment have shown to be related in epidemiological studies, their pathophysiological mechanisms have been usually studied separately.

Angiotensin-converting enzyme inhibitors and Alzheimer's disease progression in older adults: results from the Réseau sur la Maladie d'Alzheimer Français cohort.

Objectives: To assess whether angiotensin-converting enzyme inhibitor (ACE-I) treatment is associated with less cognitive decline in older adults with Alzheimer's disease (AD) than in those using other hypertensive or no drugs.

Design: Four-year prospective multicenter cohort study with a biannual assessment.

Setting: Memory clinics from 16 university hospitals in France.

Looking for frailty in community-dwelling older persons: the Gérontopôle Frailty Screening Tool (GFST).

The frailty syndrome is a pre-disability condition suitable to be targeted by preventive interventions against disability. In order to identify frail older persons at risk of negative outcomes, general practitioners must be provided with an easy and quick screening tool for detecting frailty without special effort. In the present paper, we present the screening tool for frailty that the Gérontopôle of Toulouse (France) has developed and implemented in primary care in the region with the collaboration of the Department of Family Medicine of the University of Toulouse.

Association of a 7-year percent change in fat mass and muscle mass with subsequent cognitive dysfunction: the EPIDOS-Toulouse cohort.

Background: Cognitive dysfunction and changes in body composition share common pathophysiological pathways. The aim of the present paper was to evaluate whether changes in appendicular muscle mass (AMM) and fat mass (FM) are associated factors with an increased risk of cognitive dysfunction in community-dwelling older women.

Methods: A nested case-control study was performed in 181 women aged 75 years and older from a subsample of the Epidemiologie de l'Osteoporose participants from Toulouse.

Comparison of informal care time and costs in different age-related dementias: a review.

Objectives: Age-related dementia is a progressive degenerative brain syndrome whose prevalence increases with age. Dementias cause a substantial burden on society and on families who provide informal care. This study aims to review the relevant papers to compare informal care time and costs in different dementias.

Nutrition and neurodegeneration: epidemiological evidence and challenges for future research.

The prevention of dementias, such as Alzheimer's disease (AD), is a growing public health concern, due to a lack of effective curative treatment options and a rising global prevalence. Various potential risk or preventive factors have been suggested by epidemiological research, including modifiable lifestyle factors such as diet. Current epidemiological data are in favour of a protective role of certain micronutrients (B vitamins related to homocysteine metabolism, the anti-oxidant vitamins C and E, flavonoids, polyunsatured omega-3 fatty acids, vitamin D) and macronutrients (fish) in the prevention of cognitive decline and dementia/AD.

Multidisciplinary team meetings (MDTM) in detection of Alzheimer's disease: data from the IDEM study.

Introduction: The National Institute for Health and Clinical Excellence (NICE) in the United Kingdom, the Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWIG) in Germany and the Haute Autorité de Santé (HAS) in France have recently set out guidelines on prescription of anti-dementia medication. The HAS proposes in particular that continuation of these drugs for longer than one year should be decided in multidisciplinary team meetings (MDTM).

Objective: To assess the feasibility of MDTM and the satisfaction of coordinating physicians from institutions for the dependent elderly (nursing home, NH) and expert physicians from memory clinics who have participated in the meetings.

Sarcopenia and cognitive impairment in elderly women: results from the EPIDOS cohort.

Background: common pathophysiological pathways are shared between age-related body composition changes and cognitive impairment.

Objective: evaluate whether current operative sarcopenia definitions are associated with cognition in community-dwelling older women.

Design: cross-sectional analyses.

Weight changes in Alzheimer's disease patients with increased aberrant motor behavior.

Objective: Weight loss and behavioral disturbances are frequent over the course of Alzheimer's disease (AD) and are risk factors for poor outcome. We investigated the impact of aberrant motor behavior (AMB) on weight changes in older adults with AD. The hypothesis that patients with AMB are more likely to lose weight than patients without AMB was assessed.

The integration of frailty into clinical practice: preliminary results from the Gérontopôle.

Background: Disability is commonly considered as an irreversible condition of advanced age. Therefore, preventive actions need to be taken before the disabling cascade is fully established, that is in the pre-disability phase defined "frailty syndrome". The complexity and heterogeneity of frailty requires a clinical approach based on multidimensionality and multidisciplinary.

Recruitment strategies for preventive trials. The MAPT study (MultiDomain Alzheimer Preventive Trial).

1680 participants were randomized over the recruitment period in MAPT study. A total of 1290 participants were recruited in the 7 University Hospital centers, and 390 participants in the 6 memory clinics around Toulouse Gerontopole / Alzheimer Disease research clinical center. The first randomization was on May 30, 2008, and the targeted number of randomized participants was reached on February 24, 2011; 2595 subjects were finally screened, of which 1680 fulfilled the eligibility criteria which represents 64.

The Toulouse Gérontopôle Research Center: report of activities, 2007-2011.

The formation of the first Gerontopole in Toulouse was a response to a mission letter sent by French Ministers of Health on February 2007. The mission of the Toulouse Gerontopole is based around three major axes: 1) To facilitate the access of frail elderly people to innovative therapy and clinical research: the Gérontopôle set up the national network for clinical investigation into Alzheimer's disease (AD) funded through the CeNGEPS (National Centre For Management of Trials on Health Products) calls for proposals since July 2008. In addition, the Gérontopôle coordinates several national clinical trials with promising drugs with potential effect on the mechanisms and evolution of AD and actively participates in studies on biomarkers; 2) To develop health promotion actions and prevention trials for healthy elderly people, through the Institute of Aging: the Gérontopôle has implemented the GuidAge (Phase III trial concerning the efficiency of Ginkgo Biloba on the impact and delay of appearance of an Alzheimer type dementia) and MAPT (Multi-domain Alzheimer Preventive Trial) studies on prevention of AD and cognitive decline.

Long-term progression of Alzheimer's disease in patients under antidementia drugs.

Background: Patients with Alzheimer's disease (AD), even in the presence of symptomatic relief from medical intervention, face a persistent worsening of cognitive decline and performance in activities of daily living. Data regarding the long-term disease progression outside of therapeutic trials are lacking. We examined the effects of standard of care for AD patients on the prognosis of the disease in a real-life study over a 4-year period.

Weight loss and rapid cognitive decline in community-dwelling patients with Alzheimer's disease.

Weight loss is a frequent complication of Alzheimer's disease (AD) and a strong predictor of adverse outcomes in patients suffering from this disease. The aim of this study was to determine whether weight loss was a predictor of rapid cognitive decline (RCD) in AD. Four hundred fourteen community-dwelling ambulatory patients with a diagnosis of probable AD and a Mini-Mental State Examination (MMSE) score between 10 and 26 from the REAL.

Gait speed, body composition, and dementia. The EPIDOS-Toulouse cohort.

Background: Slow gait speed (GS) predicts dementia, but this association might be mediated by body composition parameters like total fat mass (TFM) or total lean mass (TLM). The aim of the study was to evaluate whether GS, TLM, and TFM were associated factors with an increased risk for subsequent dementia in community-dwelling older women.

Methods: A case-control study was nested in the EPIDemiologie de l'OStéoporose cohort.

IAGG workshop: health promotion program on prevention of late onset dementia.

IAGG, WHO, and SFGG organized a international workshop on Health promotion programs on prevention of late on-set dementia. Thirty world specialists coming from Europe, North America, Asia, South America, Africa and Australia, shared their experience on methods and results of large epidemiological interventions to reduce incidents of dementia or delay its on-set. Chaired by Laura FRATIGLIONI, an expert in Epidemiological studies on dementia issues, the workshop gave opportunity for discussions and controversies about the state-of-the-art.

Patterns of dementia treatment use in assisted living facilities: a cross-sectional study of 1975 demented residents.

Objectives: To report the associated factors with the nonuse of cholinesterase-inhibitors and memantine in residents from assisted living (AL) facilities suffering from dementia.

Design: A cross-sectional study.

Setting: The "Réseau de Recherche en Etablissement d'Hébergement pour Personnes Agées" (REHPA) network composed of 236 AL facilities in France.

How should we deal with missing data in clinical trials involving Alzheimer's disease patients?

Missing data are frequent in Alzheimer's disease (AD) trials due to the age of participants and the nature of the disease. This can lead to bias and decreased statistical power. We assessed the level and causes of missing data in a 2-year randomised trial of an AD patient management program (PLASA study), and conducted sensitivity analyses on the primary endpoint (functional decline), using various methods for handling missing data: complete case, LOCF, Z-score LOCF, longitudinal mixed effects model, multiple imputation.

Cachexia versus sarcopenia.

Purpose Of Review: The review summarizes and discusses the proposed new definitions for sarcopenia and cachexia. It also highlights the overlapping of both conditions and the fact that these conditions frequently occur in elderly patients.

Recent Findings: Sarcopenia is now recognized as a multifactorial geriatric syndrome.

Strontium ranelate and risk of vertebral fractures in frail osteoporotic women.

Aim: Therapies to treat osteoporosis remain underutilized and minimally evaluated in frail elderly patients. Our study determined and compared the risk of vertebral fractures in frail, intermediate and robust older patients being treated with strontium ranelate vs. placebo.