Publications by authors named "Olivier Beauchet"

256 Publications

Cortical Volume, Thickness, and Surface Area in the Motoric Cognitive Risk Syndrome.

J Alzheimers Dis 2021 Apr 13. Epub 2021 Apr 13.

Departments of Medicine Albert Einstein College of Medicine, Bronx, NY, USA.

Background: The motoric cognitive risk (MCR) syndrome is a pre-clinical stage of dementia characterized by slow gait and cognitive complaint. Yet, the brain substrates of MCR are not well established.

Objective: To examine cortical thickness, volume, and surface area associated with MCR in the MCR-Neuroimaging Consortium, which harmonizes image processing/analysis of multiple cohorts.

Methods: Two-hundred MRIs (M age 72.62 years; 47.74%female; 33.17%MCR) from four different cohorts (50 each) were first processed with FreeSurfer 6.0, and then analyzed using multivariate and univariate general linear models with 1,000 bootstrapped samples (n-1; with resampling). All models adjusted for age, sex, education, white matter lesions, total intracranial volume, and study site.

Results: Overall, cortical thickness was lower in individuals with MCR than in those without MCR. There was a trend in the same direction for cortical volume (p = 0.051). Regional cortical thickness was also lower among individuals with MCR than individuals without MCR in prefrontal, insular, temporal, and parietal regions.

Conclusion: Cortical atrophy in MCR is pervasive, and include regions previously associated with human locomotion, but also social, cognitive, affective, and motor functions. Cortical atrophy in MCR is easier to detect in cortical thickness than volume and surface area because thickness is more affected by healthy and pathological aging.
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http://dx.doi.org/10.3233/JAD-201576DOI Listing
April 2021

Publisher Correction: Pre-symptomatic Caspase-1 inhibitor delays cognitive decline in a mouse model of Alzheimer disease and aging.

Nat Commun 2021 Apr 9;12(1):2271. Epub 2021 Apr 9.

Bloomfield Center for Research in Aging, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.

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http://dx.doi.org/10.1038/s41467-021-22789-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8035171PMC
April 2021

Effect of Memantine Treatment and Combination with Vitamin D Supplementation on Body Composition in the APP/PS1 Mouse Model of Alzheimer's Disease Following Chronic Vitamin D Deficiency.

J Alzheimers Dis 2021 ;81(1):375-388

Centre for Functional and Metabolic Mapping, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.

Background: Vitamin D deficiency and altered body composition are common in Alzheimer's disease (AD). Memantine with vitamin D supplementation can protect cortical axons against amyloid-β exposure and glutamate toxicity.

Objective: To study the effects of vitamin D deprivation and subsequent treatment with memantine and vitamin D enrichment on whole-body composition using a mouse model of AD.

Methods: Male APPswe/PS1dE9 mice were divided into four groups at 2.5 months of age: the control group (n = 14) was fed a standard diet throughout; the remaining mice were started on a vitamin D-deficient diet at month 6. The vitamin D-deficient group (n = 14) remained on the vitamin D-deficient diet for the rest of the study. Of the remaining two groups, one had memantine (n = 14), while the other had both memantine and 10 IU/g vitamin D (n = 14), added to their diet at month 9. Serum 25(OH)D levels measured at months 6, 9, 12, and 15 confirmed vitamin D levels were lower in mice on vitamin D-deficient diets and higher in the vitamin D-supplemented mice. Micro-computed tomography was performed at month 15 to determine whole-body composition.

Results: In mice deprived of vitamin D, memantine increased bone mineral content (8.7% increase, p < 0.01) and absolute skeletal tissue mass (9.3% increase, p < 0.05) and volume (9.2% increase, p < 0.05) relative to controls. This was not observed when memantine treatment was combined with vitamin D enrichment.

Conclusion: Combination treatment of vitamin D and memantine had no negative effects on body composition. Future studies should clarify whether vitamin D status impacts the effects of memantine treatment on bone physiology in people with AD.
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http://dx.doi.org/10.3233/JAD-201137DOI Listing
January 2021

Motoric cognitive risk syndrome: what's new?

Aging (Albany NY) 2021 03 26;13(6):7711-7712. Epub 2021 Mar 26.

Department of Neurology, Geneva University Hospital and University of Geneva, Geneva, Switzerland.

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http://dx.doi.org/10.18632/aging.202899DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8034922PMC
March 2021

Pre-Dementia Stages and Incident Dementia in the NuAge Study.

J Alzheimers Dis 2021 ;80(4):1465-1470

Department of Neurology, Geneva University Hospital and University of Geneva, Switzerland.

Background: Motoric cognitive risk syndrome (MCR) and mild cognitive impairment (MCI) are two pre-dementia stages with an overlap, which may influence the risk for dementia.

Objective: The study aims to examine the association of MCR, MCI, and their combination with incident dementia in Quebec community-dwelling older adults.

Methods: 1,063 older adults (i.e., ≥65) were selected from a population-based observational cohort study known as the "Nutrition as a determinant of successful aging: The Quebec longitudinal study" (NuAge). Participants were separated into four groups at the baseline assessment: those without MCR and MCI (i.e., cognitively healthy individual; CHI), those with MCR alone, those with MCI alone, and those with MCR plus MCI. Incident dementia was recorded at each annual visit during a 3-year follow-up.

Results: The prevalence of CHI was 87.2%, MCR 3.0%, MCI 8.8%, and MCR plus MCI 0.9%. The overall incidence of dementia was 2.4% and was significantly associated with MCR alone (Odd Ratio (OR) = 5.00 with 95% Confidence interval (CI) = [1.01;24.59] and p = 0.049), MCI alone (OR = 6.04 with 95% CI = [2.36;15.47] and p≤0.001), and the combination of MCR and MCI (OR = 25.75 with 95% CI = [5.32;124.66] and p≤0.001).

Conclusion: Combining MCR and MCI increased the risk for incident dementia. These results also demonstrated that this combination is a better predictor of dementia than MCI or MCR alone.
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http://dx.doi.org/10.3233/JAD-201571DOI Listing
January 2021

SARS-CoV-2: To be or not to be vaccinated?

Authors:
Olivier Beauchet

Maturitas 2021 05 30;147:64-65. Epub 2021 Jan 30.

Departments of Medicine and Geriatrics, University of Montreal, Montreal, Quebec, Canada; Research Center of the Geriatric University Institute of Montreal, Montreal, Quebec, Canada; Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. Electronic address:

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http://dx.doi.org/10.1016/j.maturitas.2021.01.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847189PMC
May 2021

Prognosis tools for short-term adverse events in older emergency department users: result of a Québec observational prospective cohort.

BMC Geriatr 2021 01 22;21(1):73. Epub 2021 Jan 22.

Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, 3755 chemin de la Côte Sainte-Catherine, Montreal, Quebec, H3T 1E2, Canada.

Background: The "Program of Research on the Integration of Services for the Maintenance of Autonomy" (PRISMA-7) and "Emergency room evaluation and recommendations" (ER) are both clinical tools used in Québec Emergency Departments (EDs) for screening of older ED users at higher risk of poor outcomes, such as prolonged length of stay (LOS) in EDs and in hospital. The study aimed to: 1) examine whether the PRISMA-7 and ER risk levels were associated with length of stays in ED and hospital, as well as hospital admission; and 2) compare the criteria performance (i.e., sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratios and area under receiver operating characteristic curve) of the PRISMA-7 and ER2 high-risk levels for these three ED adverse events in Québec older patients visiting ED on a stretcher.

Methods: A total of 1905 older patients who visited the ED of the Jewish General Hospital (Montreal, Québec, Canada) on stretchers were recruited in this prospective observational cohort. Upon their ED arrival, PRISMA-7 and ER were performed. The outcomes were LOS in ED and in hospital, and hospital admission.

Results: The PRISMA-7 and ER risk levels were associated with length of stay in ED and hospital as well as with hospital admission. Prolonged stays and higher hospitalization rates were associated with high-risk levels, whereas those in low-risk level groups had significantly shorter LOS and a lower rate of hospital admission (P < 0.006). While performance measures were poor for both assessment tools, ER had a greater prognostic testing accuracy compared with PRISMA-7.

Conclusion: PRISMA-7 and ER were both associated with incidental short-term ED adverse events but their overall prognostic testing accuracy was low, suggesting that they cannot be used as prognostic tools for this purpose.
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http://dx.doi.org/10.1186/s12877-020-01999-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7821522PMC
January 2021

Connecting During COVID-19: A Protocol of a Volunteer-Based Telehealth Program for Supporting Older Adults' Health.

Front Psychiatry 2020 2;11:598356. Epub 2020 Dec 2.

Department of Psychiatry and Harvard Medical School, Boston, MA, United States.

Social-distancing due to COVID-19 has led to social isolation, stress, and mental health issues in older adults, while overwhelming healthcare systems worldwide. Telehealth involving phone calls by trained volunteers is understudied and may be a low-cost, scalable, and valuable preventive tool for mental health. In this context, from patient participatory volunteer initiatives, we have adapted and developed an innovative volunteer-based telehealth intervention program for older adults (TIP-OA). To evaluate TIP-OA, we are conducting a mixed-methods longitudinal observational study. TIP-OA clients are older adults (age ≥ 60) recruited in Montreal, Quebec. TIP-OA volunteers make weekly friendly phone calls to seniors to check in, form connections, provide information about COVID-19, and connect clients to community resources as needed. Perceived stress, fear surrounding COVID-19, depression, and anxiety will be assessed at baseline, and at 4- and 8-weeks. Semi-structured interviews and focus groups will be conducted to assess the experiences of clients, volunteers, and stakeholders. As of October 15th, 2020, 150 volunteers have been trained to provide TIP-OA to 305 older clients. We will consecutively select 200 clients receiving TIP-OA for quantitative data collection, plus 16 volunteers and 8 clinicians for focus groups, and 15 volunteers, 10 stakeholders, and 25 clients for semi-structured interviews. During COVID-19, healthcare professionals' decreased availability and increased needs related to geriatric mental health are expected. If successful and scalable, volunteer-based TIP-OA may help prevent and improve mental health concerns, improve community participation, and decrease healthcare utilization. : ClinicalTrials.gov NCT04523610; https://clinicaltrials.gov/ct2/show/NCT04523610?term=NCT04523610&draw=2&rank=1.
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http://dx.doi.org/10.3389/fpsyt.2020.598356DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7738321PMC
December 2020

Telemedicine and the rural dementia population: A systematic review.

Maturitas 2021 Jan 24;143:105-114. Epub 2020 Sep 24.

Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Department of Medicine, Faculty of Medicine, University of Montreal, Quebec, Canada; Centre of Research of "Institut Universitaire de Montreal", Quebec, Canada; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. Electronic address:

Background: Telemedicine is a timely solution for the restrictions that COVID-19 social distancing places upon conventional modalities of healthcare provision. Geriatric populations affected by dementia require greater access to healthcare services, particularly in rural areas. As such, the aim of this systematic review is to examine the impact of telemedicine on health outcomes in elderly individuals with dementia living in rural areas.

Methods: A systematic review was completed using Ovid Medline, Web of Science and ACM Digital Libraries. The keywords for the selection of articles were: (telemedicine OR Telehealth) AND (Rural) AND (Age* OR Eld*) AND (Dementia) and (Telemedicine) AND (Rural Health OR Rural Population OR Hospitals, Rural OR Rural Health Services) AND (Aged OR Aging) AND (Dementia OR Multi-Infarct Dementia OR Vascular Dementia OR Frontotemporal Dementia). Among the 94 articles identified, 79 (84.0 %) were screened, 58 (61.7 %) were assessed and 12 (12.8 %) were included.

Results: The studies had diverse populations. Two were conducted in Australia, five in Canada, one in Korea, and four in the United States of America. The studies used a variety of cognitive tests and reported mixed results regarding the differences in patient performance when assessed in-person as compared to telemedicine consultation. Overall, both patients and physicians reported satisfaction with telemedicine; however, there were mixed results regarding the reliability of cognitive tests and the infrastructure required. Convenience, satisfaction, comfort and recommending telemedicine were reported to be high in the telemedicine group and physicians reported they would use telemedicine again.

Conclusion: The testing conditions and the accessibility of telemedicine yield inconclusive results as to whether telemedicine can improve the management of dementia in geriatric individuals.
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http://dx.doi.org/10.1016/j.maturitas.2020.09.001DOI Listing
January 2021

Motoric cognitive risk syndrome and incident dementia in older adults from the Québec NuAge cohort.

Age Ageing 2021 May;50(3):969-973

Department of Neurology, Geneva University Hospital and University of Geneva, Switzerland.

Background: The co-occurrence of slow walking speed and subjective cognitive complaint (SCC) in non-demented individuals defines motoric cognitive risk syndrome (MCR), which is a pre-dementia stage. There is no information on the association between MCR and incident dementia in Québec's older population.

Objective: The study aims to examine the association of MCR and its individual components (i.e. SCC and slow walking speed) with incident dementia in community-dwelling older adults living in the province of Québec (Canada).

Design: Québec older people population-based observational cohort study with 3 years of follow-up.

Setting: Community dwellings.

Subjects: A subset of participants (n = 1,098) in 'Nutrition as a determinant of successful aging: The Québec longitudinal study' (NuAge).

Methods: At baseline, participants with MCR were identified. Incident dementia was measured at annual follow-up visits using the Modified Mini-Mental State (≤79/100) test and Instrumental Activity Daily Living scale (≤6/8) score values.

Results: The prevalence of MCR was 4.2% at baseline and the overall incidence of dementia was 3.6%. MCR (Hazard Ratio (HR) = 5.18, with 95% confidence interval (CI) = [2.43-11.03] and P ≤ 0.001) and SCC alone (HR = 2.54, with 95% CI = [1.33-4.85] and P = 0.005) were associated with incident dementia, but slow walking speed was not (HR = 0.81, with 95%CI = [0.25-2.63] and P = 0.736).

Conclusions: MCR and SCC are associated with incident dementia in NuAge study participants.
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http://dx.doi.org/10.1093/ageing/afaa235DOI Listing
May 2021

Telemedicine for housebound older persons during the Covid-19 pandemic.

Maturitas 2020 Dec 26;142:8-10. Epub 2020 Jun 26.

Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Centre of Excellence on Longevity of McGill Integrated University Health and Social Services Network, Quebec, Canada.

Targeting older at-risk patients with decision-making algorithms is a priority at a time when hospitals are receiving an influx of Covid-19 patients that may exceed their capacity. Such screening could likely be extended to primary care settings in order to identify older community dwellers with Covid-19, but also those experiencing the adverse consequences of prolonged home confinement. The Centre of Excellence on Longevity of McGill University (Quebec, Canada) designed a short assessment for Montreal's housebound community-dwelling older adults. It acts as the first step in connecting older community dwellers who are housebound during the Covid-19 outbreak to telemedicine.
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http://dx.doi.org/10.1016/j.maturitas.2020.06.024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319651PMC
December 2020

Accessible Virtual Arts Recreation for Wellbeing Promotion in Long-Term Care Residents.

J Appl Gerontol 2021 May 26;40(5):519-528. Epub 2020 Oct 26.

Baycrest Health Sciences and University of Toronto, Ontario, Canada.

The efficacy of a technology-driven visual arts recreation activity, delivered virtually, was evaluated for its potential to achieve positive impacts, similar to traditional arts-interventions, on wellbeing in long-term care residents. Thirty-one residents (average age 86.8 years; 9.4) engaged with the arts-intervention for 30-minutes, twice weekly, for 6 weeks with either a partner or as part of a group. Wellbeing indicators included self-reported psychological and health-related wellness, and attention capacity. Binomial tests of postintervention change revealed a significant above-chance probability of improvement in one or more wellbeing indicators ( < .05). Postparticipation feedback survey scores were positive ( < .05). Cognitive status did not influence outcome; however, other participant characteristics such as younger age, higher openness-to-experience (personality trait), and lower baseline mood were significantly associated with positive response to the intervention ( < .05). Findings demonstrate technology may be an effective platform for promoting accessibility to beneficial arts-interventions for older adults.
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http://dx.doi.org/10.1177/0733464820967195DOI Listing
May 2021

Long-term effects of the Montreal museum of fine arts participatory activities on frailty in older community dwellers: results of the A-Health study.

Eur Geriatr Med 2021 Apr 13;12(2):295-302. Epub 2020 Oct 13.

Division of Geriatric Medicine, Department of Medicine, Sir Mortimer B. Davis, Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, 3755 chemin de la Côte-Sainte-Catherine, Montreal, QC, H3T 1E2, Canada.

Purpose: The study aims (1) to examine the long-term effects (i.e., at 12 months) of the Montreal museum of fine arts (MMFA) participatory art-based activities on frailty in a subset of participants of the Art and Health (A-Health) study and (2) to compare these long-term effects with short-term effects (i.e., at 3 months).

Methods: The A-Health study is a pre-post intervention, single arm, prospective and longitudinal study. A subset of 101 participants (67.3%) who completed the 12-month follow-up assessment was selected for this study. The intervention consisted in one weekly structured participatory art-based workshop over a 3-month period. Participants were separated according to their frailty status: vigorous (i.e., no frailty) versus mild frailty, moderate frailty and frailty merging mild and moderate frailty. Frailty was assessed before the intervention (M0), at the end of the 3-month intervention (M3) and 12 months (M15) after the end of the intervention.

Results: The mean value of frailty score was lower after the intervention compared to the beginning, regardless of the time of the assessments (i.e., M3 and M15). The proportion of vigorous participants increased and the proportion of mild frail participants decreased at the end of the intervention (i.e., M3) but no long-term effect was shown (i.e., M15) compared to M0. The proportion of moderate frail participants and frail participants at M15 were significantly lower compared to M0.

Conclusion: The MMFA participatory art-based activities improved frailty at short and long terms, suggesting that it could be an effective way to promote an active and healthy aging.

Trial Registration: NCT03557723; Title: Effect of Art Museum Activity Program for the Elderly on Health: A Pilot Study; First submission date: January 31, 2018; First posted date: June 15, 2018; prospectively registered.
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http://dx.doi.org/10.1007/s41999-020-00408-wDOI Listing
April 2021

Pre-symptomatic Caspase-1 inhibitor delays cognitive decline in a mouse model of Alzheimer disease and aging.

Nat Commun 2020 09 11;11(1):4571. Epub 2020 Sep 11.

Bloomfield Center for Research in Aging, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.

Early therapeutic interventions are essential to prevent Alzheimer Disease (AD). The association of several inflammation-related genetic markers with AD and the early activation of pro-inflammatory pathways in AD suggest inflammation as a plausible therapeutic target. Inflammatory Caspase-1 has a significant impact on AD-like pathophysiology and Caspase-1 inhibitor, VX-765, reverses cognitive deficits in AD mouse models. Here, a one-month pre-symptomatic treatment of Swedish/Indiana mutant amyloid precursor protein (APP) J20 and wild-type mice with VX-765 delays both APP- and age-induced episodic and spatial memory deficits. VX-765 delays inflammation without considerably affecting soluble and aggregated amyloid beta peptide (Aβ) levels. Episodic memory scores correlate negatively with microglial activation. These results suggest that Caspase-1-mediated inflammation occurs early in the disease and raise hope that VX-765, a previously Food and Drug Administration-approved drug for human CNS clinical trials, may be a useful drug to prevent the onset of cognitive deficits and brain inflammation in AD.
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http://dx.doi.org/10.1038/s41467-020-18405-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7486940PMC
September 2020

Mental Health and Cognition in Older Cannabis Users: a Review.

Can Geriatr J 2020 Sep 1;23(3):242-249. Epub 2020 Sep 1.

Geri-PARTy Research Group, Department of Psychiatry, Jewish General Hospital, McGill University, Montreal, QC.

Background: The impact of cannabis use on mental health and cognition in older adults remains unclear. With the recent legalization of cannabis in Canada, physicians will need up-to-date information about the mental and cognitive effects of cannabis use in this specific population.

Method: A narrative review was conducted to summarize the literature on mental health and cognitive effects of cannabis use in older adults using Medline (OvidSP).

Results: A total of 16 studies were identified, including nine cross-sectional studies on mental health comorbidities reported by older cannabis users. The self-reported prevalence of mental and substance use disorders is approximately two to three times higher in older adults who report past-year cannabis use, compared to older adults who report using more than one year ago or never using. The remaining seven clinical trials found that short-term, low-dose medical cannabis was generally well-tolerated in older adults without prior serious mental illness. However, mental/cognitive adverse effects were not systematically assessed.

Conclusion: Although preliminary findings suggests that low-dose, short-term medical cannabis does not carry significant risk of serious mental health and cognitive adverse effects in older adults without prior psychiatric history, epidemiological studies find a correlation between past-year cannabis use and poor mental health outcomes in community-dwelling older adults. These findings may indicate that longer term cannabis use in this population is detrimental to their mental health, although a direct causal link has not been established. Larger, longitudinal studies on the safety of medical cannabis in older adults are needed.
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http://dx.doi.org/10.5770/cgj.23.399DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458597PMC
September 2020

Effects of participatory art-based painting workshops in geriatric inpatients: results of a non-randomized open label trial.

Aging Clin Exp Res 2020 Dec 13;32(12):2687-2693. Epub 2020 Aug 13.

Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital, McGill University, 3755 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1E2, Canada.

Background: Art-based activities like painting workshops demonstrated health benefits in older individuals living in home care facilities. Few studies examined the effects of painting workshops in geriatric inpatients.

Aim: The study aims to examine whether the participation in painting workshops performed in patients admitted to a geriatric acute care ward reduced the number of medications taken daily, use of psychoactive medications, the length of stay and inhospital mortality.

Methods: Based on a non-randomized open label trial, 79 inpatients who participated in painting workshops and 79 control inpatients were recruited in the geriatric acute care ward of the Jewish general hospital (Montreal, Quebec, Canada). Four outcomes were used: the number of medications taken daily and use of psychoactive medications the day of discharge to geriatric acute care ward, the length of hospital stay and inhospital mortality.

Results: The participation in Painting workshops were associated with a lower number of medications taken daily at discharge (Coefficient of regression β =  - 1.35 with P = 0.001) and lower inhospital mortality (odd ratio (OR) = 0.09 with P = 0.031). No significant association was reported with use of psychoactive medications and length of stay.

Conclusion: The participation in painting workshops reduced the number of medications taken daily and incident inhospital mortality in geriatric inpatients admitted to a geriatric acute care ward, suggested a positive effect on health condition of this participatory art-based activity.
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http://dx.doi.org/10.1007/s40520-020-01675-0DOI Listing
December 2020

Effects of "Thursdays at the Museum" at the Montreal Museum of Fine Arts on the mental and physical health of older community dwellers: the art-health randomized clinical trial protocol.

Trials 2020 Aug 12;21(1):709. Epub 2020 Aug 12.

Education and Wellness Department of the Montreal Museum of Fine Arts, Montreal, Quebec, Canada.

Background: Recently, we demonstrated that the Montreal Museum of Fine Arts' (MMFA) participatory art-based activity, known as "Thursdays at the Museum," improved the well-being, quality of life, and physical health (i.e., frailty) of older community dwellers by using a pre-post intervention, single arm, prospective and longitudinal experimental design. The present randomized clinical trial (RCT), known as the Art-Health RCT (A-Health RCT), aims to compare changes in well-being, quality of life, frailty, and physiological measures in older community dwellers who participate in "Thursdays at the Museum" (intervention group) and in their counterparts who do not participate in this art-based activity (control group).

Methods/design: The current unicenter, randomized, clinical, controlled, comparative trial recruits 150 older community dwellers to two parallel arms (75 participants in the intervention group and 75 participants in the control group). The intervention is a 3-month cycle of weekly "Thursdays at the Museum," which are structured 2-h-long art-based workshops performed in a group setting at the MMFA. The control group is composed of participants who do not take part in art-based activities, receive their usual health and/or social services, and commit to report any other activity practiced during the same time. Assessments of the primary outcome (well-being) and the secondary outcomes (quality of life, frailty, and physiological measures including heart rate, daily step count, sleep duration, and its phases) are performed on six occasions: at baseline, at the beginning of the second and third months, at the end of the third month, as well as 6 and 12 months after the last workshop. Statistical analyses are performed with the intention to treat and per protocol. Comparisons of changes in outcome measures between intervention and control groups use repeated measures tests.

Discussion: Art-based activities carried out at museums have been receiving increased interest from researchers and policy-makers because of their benefits to mental and physical health. There are few robust studies, such as RCTs, that focus on older community dwellers or assess the efficacy of these participatory museum activities. The A-Health RCT study provides an opportunity to confirm the benefits of a participatory art-based museum activity on the elderly population and to show the key role played by museums in public health promotion.

Trial Registration: NCT03679715 ; Title: A-Health RCT: Effects of Participatory Art-Based Activity on Health of Older Community Dwellers; First posted date: September 20, 2018; prospectively registered.
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http://dx.doi.org/10.1186/s13063-020-04625-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7422616PMC
August 2020

Relationship between motoric cognitive risk syndrome, cardiovascular risk factors and diseases, and incident cognitive impairment: Results from the "NuAge" study.

Maturitas 2020 Aug 16;138:51-57. Epub 2020 May 16.

Department of Neurology, Geneva University Hospital and University of Geneva, Geneva, Switzerland.

Background: Motoric Cognitive Risk syndrome (MCR), which combines Subjective Cognitive Complaint (SCC) and slow gait speed in individuals free of dementia and gait disability, is associated with cardiovascular risk factors and diseases as well as incident cognitive impairment. Little information on MCR exists in the Canadian population. This study aims to examine these associations in community-dwelling elderly people living in Quebec, which is a Canadian province.

Methods: Data was collected from the"Nutrition as a determinant of successful aging: The Quebec longitudinal study" (NuAge), which is a Quebec population-based observational cohort study with 3 years of follow-up. A subset of 1113 participants (age 73.8 ± 4.1 and 51.9% female; 63.5% of the initial NuAge sample) was selected. MCR, cardiovascular risk factors and disease were recorded at baseline. Incident cognitive impairment was considered if the Modified Mini-Mental State Examination (3MS) score was ≤79/100 at subsequent annual visits.

Results: The prevalence of MCR was 4.2% at baseline and was significantly associated with diabetes (P < 0.032), cerebrovascular disease (P < 0.043) and incident cognitive impairment (P ≤ 0.001). The overall incidence of cognitive impairment during the 3-year follow-up period was 4.6%. A greater decrease of the 3MS score was observed in participants with MCR compared to those without MCR, at each annual assessment (P ≤ 0.001).

Conclusion: MCR was associated with diabetes and cerebrovascular diseases at baseline, and incident cognitive impairment in NuAge study participants.
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http://dx.doi.org/10.1016/j.maturitas.2020.05.007DOI Listing
August 2020

The expert COVID-19 team for older persons of the Quebec Health and Social Services Ministry.

Authors:
Olivier Beauchet

Aging Clin Exp Res 2020 08 16;32(8):1625-1626. Epub 2020 Jun 16.

Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis-Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, 3755 chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1E2, Canada.

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http://dx.doi.org/10.1007/s40520-020-01623-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7297135PMC
August 2020

Participatory art-based activity, community-dwelling older adults and changes in health condition: Results from a pre-post intervention, single-arm, prospective and longitudinal study.

Maturitas 2020 Apr 13;134:8-14. Epub 2020 Jan 13.

Psychology Programme, School of Social Sciences, Nanyang Technological University, Singapore.

Background: Participatory art-based activities enhance the well-being and quality of life of patients. Few studies have examined the effects of these activities in community-dwelling older adults. This study aims to examine changes in well-being, quality of life and frailty associated with a weekly art-based activity, known as "Thursday at the Museum", performed at the Montreal Museum of Fine Arts (MMFA) in community-dwelling older adults.

Methods: Based on a pre-post intervention, single-arm, prospective and longitudinal design, 130 community-dwelling older adults (mean age 71.6 ± 4.9, 91.5 % female) were enrolled and completed this experimental study. The intervention was a participatory art-based activity carried out at the MMFA. Groups of participants (30-45 individuals) met for 2.3 h once a week for a 12-week period (defining a session). Before and after the first (M0), the fifth (M1), the ninth (M2) and the twelfth (M3) workshops, well-being was assessed. Quality of life, frailty, physician visits and hospitalizations were also assessed.

Results: The mean well-being score improved after each workshop compared with baseline (P ≤ 0.001), i.e., from M0 to M3. The magnitude of this change in well-being was significant at M3 when M0 was used as a reference value (coefficient of regression beta (ß) = 3.22 with P = 0.037). Quality of life gradually increased from M1 to M3 (ß increased from -0.50 to -2.1 with all P-values ≤0.003). The proportion of vigorous participants increased significantly, whereas the proportion of mild frail participants decreased at M3 only (ß=-0.70 with P = 0.001).

Conclusion: The MMFA participatory art-based activity session had multidimensional positive effects on mental and physical health outcomes. These results suggest that museums may become key partners in public health policy initiatives for health prevention in older populations.

Trialregistration: NCT03557723.
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http://dx.doi.org/10.1016/j.maturitas.2020.01.006DOI Listing
April 2020

Brain Gray Matter Volume Associations With Abnormal Gait Imagery in Patients With Mild Cognitive Impairment: Results of a Cross-Sectional Study.

Front Aging Neurosci 2019 21;11:364. Epub 2020 Jan 21.

Department of Neurology, Geneva University Hospital and University of Geneva, Geneva, Switzerland.

Individuals with mild cognitive impairment (MCI) have worse gait performance compared to cognitive healthy individuals (CHI). The discrepancy between imagined and performed timed up and go test (TUG), known as the TUG delta time, is a marker of brain gait control impairment in individuals with MCI. The study aims to examine the association between the TUG delta time and brain gray matter (GM) volumes in CHI and individuals with MCI. A total of 326 participants, 156 CHI and 170 MCI, with TUG delta time and a brain T1-weighted magnetic resonance imaging (MRI) were selected in this cross-sectional study. Individuals with MCI were older and had greater (i.e., worst performance) performed TUG and TUG delta time compared to CHI. The GM volume association with TUG delta time was examined in CHI and MCI assuming that increased TUG delta time would be associated with locally decreased GM volumes. No significant association was found in CHI, whereas TUG delta time was negatively associated with the GM volume of the right medial temporal lobe in individuals with MCI.
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http://dx.doi.org/10.3389/fnagi.2019.00364DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6985092PMC
January 2020

Methylene blue inhibits Caspase-6 activity, and reverses Caspase-6-induced cognitive impairment and neuroinflammation in aged mice.

Acta Neuropathol Commun 2019 12 16;7(1):210. Epub 2019 Dec 16.

Lady Davis Institute for Medical Research at Jewish General Hospital, 3999 Ch. Côte Ste-Catherine, Montreal, QC, H3T 1E2, Canada.

Activated Caspase-6 (Casp6) is associated with age-dependent cognitive impairment and Alzheimer disease (AD). Mice expressing human Caspase-6 in hippocampal CA1 neurons develop age-dependent cognitive deficits, neurodegeneration and neuroinflammation. This study assessed if methylene blue (MB), a phenothiazine that inhibits caspases, alters Caspase-6-induced neurodegeneration and cognitive impairment in mice. Aged cognitively impaired Casp6-overexpressing mice were treated with methylene blue in drinking water for 1 month. Methylene blue treatment did not alter Caspase-6 levels, assessed by RT-PCR, western blot and immunohistochemistry, but inhibited fluorescently-labelled Caspase-6 activity in acute brain slice intact neurons. Methylene blue treatment rescued Caspase-6-induced episodic and spatial memory deficits measured by novel object recognition and Barnes maze, respectively. Methylene blue improved synaptic function of hippocampal CA1 neurons since theta-burst long-term potentiation (LTP), measured by field excitatory postsynaptic potentials (fEPSPs) in acute brain slices, was successfully induced in the Schaffer collateral-CA1 pathway in methylene blue-treated, but not in vehicle-treated, Caspase-6 mice. Increased neuroinflammation, measured by ionized calcium binding adaptor molecule 1 (Iba1)-positive microglia numbers and subtypes, and glial fibrillary acidic protein (GFAP)-positive astrocytes, were decreased by methylene blue treatment. Therefore, methylene blue reverses Caspase-6-induced cognitive deficits by inhibiting Caspase-6, and Caspase-6-mediated neurodegeneration and neuroinflammation. Our results indicate that Caspase-6-mediated damage is reversible months after the onset of cognitive deficits and suggest that methylene blue could benefit Alzheimer disease patients by reversing Caspase-6-mediated cognitive decline.
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http://dx.doi.org/10.1186/s40478-019-0856-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915996PMC
December 2019

Effects of Vitamin D and Calcium Fortified Yogurts on Gait, Cognitive Performances, and Serum 25-Hydroxyvitamin D Concentrations in Older Community-Dwelling Females: Results from the GAit, MEmory, Dietary and Vitamin D (GAME-D2) Randomized Controlled Trial.

Nutrients 2019 Nov 26;11(12). Epub 2019 Nov 26.

Department of Neurology, Geneva University Hospital and University of Geneva, 1205 Genève, Switzerland.

Background: Vitamin D fortified food may improve serum vitamin D level, suggesting that the prevention of adverse consequences of hypovitaminosis D is possible with food fortification. The aim of this randomized controlled trial (RCT) was to examine the effects of vitamin D and calcium fortified yogurt on spatiotemporal gait parameters, cognitive performance, handgrip strength, and serum 25OHD levels in healthy older females.

Methods: Forty older community-dwelling females were recruited in a single-blind, randomized, controlled, superiority clinical trial in two parallel groups (20 participants in the intervention group and 20 in the control group) with intent-to-treat. The intervention group took fortified yogurts daily (i.e., 400 UI of vitamin D and 800 mg calcium) for 3 months. The non-fortified yogurts contained similar proteins, carbohydrates and lipids, as well as a lower dose of calcium (300 mg) and no vitamin D supplementation. Spatiotemporal gait parameters (mean value and coefficient of variation) were assessed using a computerized walkway. Handgrip strength was measured with hydraulic dynamometers. Cognitive performances, including global cognitive functioning assessed with the Mini Mental Status Examination (MMSE) were recorded. All the outcomes were assessed at baseline and at the end of follow-up. The primary outcome was the coefficient of variation of stride time.

Results: The intervention group maintained its global cognitive performance and serum 25OHD concentrations, whereas these outcomes decreased (i.e., worst performance) in the control group. The changes in the MMSE score ( = 0.022) and serum 25OHD concentrations were different ( ≤ 0.001) with better values reported in the intervention group compared to the control group. There was no significant change in gait parameters ( ≥ 0.518) and handgrip strength ( ≥ 0.600).

Conclusions: Fortified yogurts with vitamin D (i.e., 200 IU) and calcium (i.e., 400 mg) twice a day maintained global cognitive performance and vitamin D status in older females, but not gait performances, signifying that they mainly prevent hypovitaminosis D-related extra-skeletal disorders.
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http://dx.doi.org/10.3390/nu11122880DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6950501PMC
November 2019

Serum Vitamin D and Cingulate Cortex Thickness in Older Adults: Quantitative MRI of the Brain.

Curr Alzheimer Res 2019 ;16(11):1063-1071

Department of Geriatric Medicine, Angers University Hospital, Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, University of Angers, Angers, France.

Background: Vitamin D insufficiency is associated with brain changes, and cognitive and mobility declines in older adults.

Objective: Our objective was to investigate in older adults whether vitamin D insufficiency<50nmol/L was associated with thinner cingulate cortex, a brain area related to cognitive functions influenced by vitamin D.

Methods: Two hundred and fifteen Caucasian older community-dwellers (mean±SD, 72.1±5.5years; 40% female) received a blood test and brain MRI. The thickness of perigenual anterior cingulate cortex, midcingulate cortex and posterior cingulate cortex was measured using FreeSurfer from T1-weighted MR images. Age, gender, education, BMI, mean arterial pressure, comorbidities, use of vitamin D supplements or anti-vascular drugs, MMSE, GDS, IADL, serum calcium and vitamin B9 concentrations, creatinine clearance were used as covariables.

Results: Participants with vitamin D insufficiency (n=80) had thinner total cingulate thickness than the others (24.6±1.9mm versus 25.3±1.4mm, P=0.001); a significant difference found for all 3 regions. Vitamin D insufficiency was cross-sectionally associated with a decreased total cingulate thickness (β=- 0.49, P=0.028). Serum 25OHD concentration correlated positively with the thickness of perigenual anterior (P=0.011), midcingulate (P=0.013) and posterior cingulate cortex (P=0.021).

Conclusion: Vitamin D insufficiency was associated with thinner cingulate cortex in the studied sample of older adults. These findings provide insight into the pathophysiology of cognitive and mobility declines in older adults with vitamin D insufficiency.
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http://dx.doi.org/10.2174/1567205016666191113124356DOI Listing
October 2020

Optimizing Practices, Use, Care and Services-Antipsychotics (OPUS-AP) in Long-term Care Centers in Québec, Canada: A Strategy for Best Practices.

J Am Med Dir Assoc 2020 02 25;21(2):212-219. Epub 2019 Oct 25.

Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis, Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.

Objectives: Antipsychotic medications are often used for the first-line management of behavioral and psychological symptoms of dementia (BPSD) contrary to guideline recommendations. The Optimizing Practices, Use, Care and Services-Antipsychotics (OPUS-AP) strategy aims to improve the well-being of long-term care (LTC) residents with major neurocognitive disorder (MNCD) by implementing a resident-centered approach, nonpharmacologic interventions, and antipsychotic deprescribing in inappropriate indications.

Design: Prospective, closed cohort supplemented by a developmental evaluation.

Setting And Participants: Residents of designated wards in 24 LTC centers in Québec, Canada.

Methods: Provincial guidelines were disseminated, followed by the implementation of an integrated knowledge translation and mobilization strategy, including training, coaching, clinical tools, evaluation of clinical practices, and a change management strategy. Antipsychotic, benzodiazepine, and antidepressant prescriptions; BPSD; and falls were evaluated every 3 months, for 9 months, from January to October 2018. Semistructured interviews (n = 20) were conducted with LTC teams to evaluate the implementation of OPUS-AP.

Results: Of 1054 residents, 78.3% had an MNCD diagnosis and 51.7% an antipsychotic prescription. The cohort included 464 residents with both MNCD and antipsychotic prescription. Antipsychotic deprescribing (cessation or dose decrease) was attempted in 220 of the 344 residents still admitted at 9 months. Complete cessation was observed in 116 of these residents (52.7%) and dose reduction in 72 (32.7%), for a total of 188 residents (85.5%; 95% confidence interval: 80.1%, 89.8%). A decrease in benzodiazepine prescriptions and improvements in Cohen-Mansfield Agitation Inventory scores were observed among residents who had their antipsychotics deprescribed. Caregivers and clinicians expressed satisfaction as a result of observing an improved quality of life among residents.

Conclusions And Implications: Antipsychotic deprescribing was successful in a vast majority of LTC residents with MNCD without worsening of BPSD. Based on this success, phase 2 of OPUS-AP is now under way in 129 LTC centers in Québec.
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http://dx.doi.org/10.1016/j.jamda.2019.08.027DOI Listing
February 2020

Default mode network and the timed up and go in MCI: A structural covariance analysis.

Exp Gerontol 2020 01 18;129:110748. Epub 2019 Oct 18.

Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital, Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Centre of Excellence on Longevity of McGill integrated University Health Network, Quebec, Canada; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.

Background: The timed up and go (TUG) is a test used to assess mobility in older adults and patients with neurological conditions. This study aims to compare brain gray matter (GM) correlates and structural covariance networks associated with the TUG time in cognitively healthy individuals (CHI) and in patients with mild cognitive impairment (MCI).

Methods: The TUG time was measured in 326 non-demented older community-dwellers (age 71.3 ± 4.5; 42% female) - 156 CHI and 170 MCI. GM covariance networks were computed using voxel-based morphometry with the main neural correlates of TUG for each group as seed regions.

Results: Increased TUG time (i.e., poor performance) was associated with distinct brain volume reductions between CHI and MCI. The covariance analysis showed cortical regions involving the default mode network in CHI and bilateral cerebellar regions in MCI.

Conclusions: GM networks associated with the TUG vary between CHI and MCI, suggesting distinct brain control for locomotion between CHI and MCI patients.
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http://dx.doi.org/10.1016/j.exger.2019.110748DOI Listing
January 2020

The association of anxio-depressive disorders and depression with motoric cognitive risk syndrome: results from the baseline assessment of the Canadian longitudinal study on aging.

Geroscience 2019 08 28;41(4):409-418. Epub 2019 Aug 28.

Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, 3755 Chemin de la Côte-Sainte-Catherine, Montreal, QC, H3T 1E2, Canada.

Motoric cognitive risk syndrome (MCR), anxio-depressive disorders (ADD), and depression are associated with cognitive complaint and slow gait speed. The study aims to examine (1) the association of ADD and depression with MCR, and (2) the influence of the type and the severity of ADD and age on this association in older adults. A total of 29,569 participants free from cognitive impairment with walking speed measure recruited at baseline in the Canadian Longitudinal Study on Aging (CLSA) Comprehensive were selected in this cross-sectional study. They were separated into different sub-groups based on their age groups (i.e., 45-54, 55-64, 65-74, and ≥ 75) and the presence of MCR. Anxiety, mood, and depressive disorders (ADD) were assessed. Depression was defined by the Center for Epidemiological Studies Depression Scale (CES-D) score ≥ 10. The overall prevalence of MCR was 7.0 % and was greater in the youngest age group (8.9 %) as compared to the other age groups (P < 0.05). There was a higher prevalence of ADD and depression in individuals with MCR compared to those without MCR for all age groups (P ≤ 0.001). Depression was significantly associated with MCR regardless of age group (odds ratio ≥ 3.65 with P ≤ 0.001). The association of ADD with MCR depended on the accumulation of disorders and not their type, and was weaker and more inconstant in the oldest age group as compared to younger age groups. MCR is associated with ADD and depression in both younger and older individuals. This association is stronger for depression in younger individuals.
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http://dx.doi.org/10.1007/s11357-019-00093-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815301PMC
August 2019

Motoric cognitive risk syndrome and cardiovascular diseases and risk factors in the Canadian population: Results from the baseline assessment of the Canadian longitudinal study on aging.

Arch Gerontol Geriatr 2019 Nov - Dec;85:103932. Epub 2019 Aug 5.

Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Centre of Excellence on Longevity of McGill integrated University Health Network, Quebec, Canada; Faculty and Department of Medicine, Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada; Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. Electronic address:

Background: Motoric Cognitive Risk Syndrome (MCR) is a pre-dementia syndrome. The aim of this study was to examine whether there is: 1) an association between MCR and cardiovascular diseases and risk factors (CVDRF) in the Canadian population, and 2) a specific MCR-related CVDRF profile (i.e., cardiovascular diseases (CVD) versus cardiovascular risk factors (CVRF) versus both) when comparing different age groups.

Methods: A total of 29,569 participants free of dementia were recruited in the Canadian Longitudinal Study on Aging. Participants were categorized into groups by their age and MCR status (with MCR versus without MCR). Overweight/obese, smoking, waist to hip circumference ratio (WHCR), systolic blood pressure and diastolic blood pressure levels were CVRF. Diabetes type I and II, hypertension, heart disease and attack, peripheral vascular disease, angina, stroke and rhythmic disease were CVD.

Results: A higher prevalence of CVRF in MCR was shown in the youngest age groups (i.e., 45-54 and 55-64) compared to the other age groups. MCR was positively associated with CVDRF, except in the oldest age group (i.e., ≥75). In this group, the only significant association with CVRF was with diastolic blood pressure, which was negatively associated with MCR. Diabetes and hypertension were not associated with MCR.

Conclusions: MCR is associated with CVDRF in both younger and older individuals. A stronger association was present for CVRF factors in younger adults and for CVD in older adults.
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http://dx.doi.org/10.1016/j.archger.2019.103932DOI Listing
April 2020

Head over heels but I forget why: Disruptive functional connectivity in older adult fallers with mild cognitive impairment.

Behav Brain Res 2019 12 17;376:112104. Epub 2019 Jul 17.

Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada; Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada. Electronic address:

Disrupted functional connectivity has been highlighted as a neural mechanism by which impaired cognitive function and mobility co-exist in older adults with mild cognitive impairment (MCI). The objective of this study was to determine the independent and combined effects of MCI and faller status on functional connectivity of three functional networks: default mode network (DMN), fronto-parietal network (FPN) and sensorimotor network (SMN) between 4 groups of older adults: 1) Healthy; 2) MCI without Falls; 3) Fallers without MCI; and 4) Fallers with MCI.

Methods: Sixty-six adults aged 70-80 years old were included. Cognition was assessed using: 1) cognitive dual task; 2) Stroop Colour-Word Test; 3) Trail Making Tests (TMT); and 4) Digit Symbol Substitution Test (DSST). Postural sway was assessed with eyes opened and standing on the floor. Functional connectivity was measured using fMRI while performing a finger-tapping task.

Results: Differences in DMN-SMN connectivity were found for Fallers with MCI vs Fallers without MCI (p = .001). Fallers with MCI had significantly greater postural sway than the other groups. Both DMN-SMN connectivity (p = .03) and postural sway (p = .001) increased in a significantly linear fashion from Fallers without MCI, to MCI without Falls, to Fallers with MCI. Participants with MCI performed significantly worse on the DSST (p = .003) and TMT (p = .007) than those without MCI.

Conclusion: Aberrant DMN-SMN connectivity may underlie reduced postural stability. Having both impaired cognition and mobility is associated with a greater level of disruptive DMN-SMN connectivity and increased postural sway than singular impairment.
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http://dx.doi.org/10.1016/j.bbr.2019.112104DOI Listing
December 2019

Motoric Cognitive Risk Syndrome and Risk for Falls, Their Recurrence, and Postfall Fractures: Results From a Prospective Observational Population-Based Cohort Study.

J Am Med Dir Assoc 2019 10 11;20(10):1268-1273. Epub 2019 Jun 11.

Department of Neurology, Geneva University Hospital and University of Geneva, Geneva, Switzerland.

Objective: Motoric cognitive risk syndrome (MCR) is a predementia stage associated with increased risk for falls. There are conflicting results regarding its association with recurrent falls and no information about its association with postfall fractures. The aim of the study was to examine the association of MCR and its components [ie, slow walking speed and subjective cognitive complaint (SCC)] with the occurrence of falls, their recurrence, and postfall fractures in older community-dwelling adults.

Design: Observational prospective and longitudinal cohort study.

Setting And Participants: French community-dwelling older women (n = 5958) recruited in the EPIDémiologie de l'OStéoporose (EPIDOS) study.

Measures: MCR was defined as both the presence of SCC and slow walking speed in women free of major neurocognitive disorders. Falls (≥1), recurrent falls (≥2), and postfall fractures (any fractures and hip fractures) were prospectively recorded using mail and/or phone call questionnaires every 4 months over 4 years.

Results: At baseline, the prevalence of SCC was 43.1% (n = 2569), slow walking speed 5.7% (n = 341), and MCR 9.9% (n = 591). Overall, 25.7% (n = 1533) of participants reported any fall during the follow-up. The incidence of postfall hip fractures was higher in participants with MCR compared to healthy participants and those with SCC (P ≤ .001). Cox regression models revealed that only participants with MCR had a significantly high risk for falls [hazard ratio (HR) = 1.22, P = .021], recurrent falls (HR = 1.46 with P = .030), and postfall hip fractures (HR = 2.54, P ≤ .001).

Conclusions/implications: There is an increased risk for falls, their recurrence, and postfall hip fractures associated with MCR but not with its individual components. This finding underscores the clinical interest of MCR for the detection of older adults at risk for falls and their related adverse events in order to start early appropriate interventions for fall reduction.
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http://dx.doi.org/10.1016/j.jamda.2019.04.021DOI Listing
October 2019