Three-hundred fifty-two randomly selected residents, aged over 65 years, of 42 representative long-term care institutions in a defined geographic area of south-western France, were assessed for demographic characteristics, drug intake, and motor and cognitive status. Neuroleptic drug intake is described and demographic variables and motor and cognitive status are analyzed according to exposure to neuroleptics and presence of parkinsonism. Exposure to neuroleptics was considered as a "risk factor" for parkinsonism, and the risk (proportion) of parkinsonism attributable to neuroleptics calculated. Twenty-one percent of subjects were exposed to neuroleptics, of whom 27% took more than one. Subjects taking neuroleptics were significantly younger and more cognitively impaired. About 30% of subjects taking neuroleptics had parkinsonism (6.25% of the sample). Postural and action tremors were more frequent than resting tremor, and asymmetry of parkinsonian signs was found in 25%. The mean dosage taken by exposed subjects with parkinsonism was found to be twice that of those without. The proportion of cases of parkinsonism attributable to neuroleptics in institutions was 19%. Our results clearly show that neuroleptic drug use in institutionalized elderly persons is associated with a high risk for parkinsonism.

Academies and Institutes↗

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Relationships between cholesterol, apolipoprotein E polymorphism and dementia: a cross-sectional analysis from the PAQUID study.

This study assesses the cross-sectional relationship between serum cholesterol level and dementia, controlling for apolipoprotein E (apoE) genotype, in a nested case-control study of 334 elderly French subjects aged 73 and over who participated in the PAQUID study (37 demented subjects and 297 nondemented controls). A diagnosis of dementia was established by two-step screening: (1) psychometric testing and DSM-III-R criteria and (2) neurologist's confirmation. Cholesterol, its fractions and apoE genotype were determined from a blood sample. Elevated high-density lipoprotein cholesterol was associated with a significantly decreased risk of dementia, independent of apoE status and other potential confounding variables, suggesting that cholesterol fractions could be involved in both Alzheimer's disease and vascular dementia.

Aged↗

PubMedDate not supplied

[French epidemiological bases for the treatment of dementia syndromes and cognitive impairment in the elderly].

Epidemiological studies of Dementia have major methodological problems, particularly in France: selection of the studied sample, difficulties for contact with elderly people, heterogeneity of place of residence, inaccuracy of the diagnostic procedures. In spite of these problems, the Paquid Research program allowed to give estimations of prevalence and incidence rate of dementia in the French population. On the basis of these results, one can estimate that there are actually about 360,000 prevalent cases of dementia in France, of whom 270,000 are of Alzheimer type. There were also 150,000 annual-incident cases of dementia. However, many of these cases were not considered as demented by the medical system because of the absence of cognitive complaints.

Aged↗

PubMedDate not supplied

[Epidemiology of memory disorders].

To study the predictive value of memory complaints resulting in consultation with a GP as to the risk of subsequent dementia, we analysed the data from the follow-up of the Paquid cohort study carried out around Bordeaux. A sample of 1503 elderly people over 65, living at home and non-demented at the baseline screening, was considered. The risk of dementia was measured two and four years after the baseline screening: 60.8 per cent of subjects themselves perceived a memory impairment and 15.6 per cent expressed this complaint to their GP. Forty-eight developed a subsequent dementia. Taking the group without memory complaint as the reference set, three groups of elderly people could be recognized as at high risk of dementia: subjects with self-perceived memory impairment, consulting a GP with low memory performance or with normal memory performances, and subjects with memory complaints not resorting to a GP but with low memory performance. In non-demented elderly people, memory complaints expressed to the GP may be a strong predictor of dementia and should not be neglected.

Aged↗