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1. Effectiveness and cost-effectiveness of a telemedicine programme for preventing unplanned hospitalisations of older adults living in nursing homes: the GERONTACCESS cluster randomized clinical trial

Author

Caroline Gayot, Cécile Laubarie-Mouret, Kevin Zarca, Maroua Mimouni, Noelle Cardinaud, Sandrine Luce, Isabelle Tovena, Isabelle Durand-Zaleski, Marie-Laure Laroche, Pierre-Marie Preux, and Achille Tchalla

Subjects
Nursing home, Multimorbidity, Telemedicine, Telehealth, Hospitalisation, Hospital readmission, Geriatrics, RC952-954.6
Abstract

Abstract Objective The GERONTACCESS trial evaluated the utility and cost-effectiveness of a gerontological telemedicine (TLM) programme for preventing unplanned hospitalisation of residents living in nursing homes (NHs) in regions lacking medical facilities and/or qualified medical providers (“medical deserts”). Design GERONTACCESS was a 12-month, multicentre, prospective cluster-randomised trial conducted in NHs. The intervention group underwent TLM assessments every 3 months. The control group received the usual care. In both groups, comprehensive on-site assessments were conducted at baseline and the final visit. Care requirements were documented throughout the study. Setting and participants NH residents aged ≥ 60 years with multiple chronic diseases. Methods The study outcomes were the proportion of patients who experienced avoidable and unplanned hospitalisation, and the incremental cost savings per quality-adjusted life years from baseline to the 12-month follow-up. Results Of the 426 randomised participants (mean ± standard deviation age, 87.2 ± 7.6 years; 311 [73.0%] women), 23.4% in the intervention group and 32.5% in the control group experienced unplanned hospitalisation (odds ratio [OR] = 0.73, 95% confidence interval [CI] 0.43 to 0.97; p = 0.034). Each avoided hospitalisation in the intervention group saved $US 3,846. Conclusions and implications The results of GERONTACCESS revealed that our gerontological, preventative TLM program significantly reduced unplanned hospitalisations. This innovative intervention limited disease progression and promoted a healthy lifestyle among NH residents. Trial registration Clinicaltrials.gov, NCT02816177, registered June 28, 2016.

Published
2022
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2. Risk factors of frailty and functional disability in community-dwelling older adults: a cross-sectional analysis of the FREEDOM-LNA cohort study

Author

Achille Tchalla, Cécile Laubarie-Mouret, Noëlle Cardinaud, Caroline Gayot, Marion Rebiere, Nathalie Dumoitier, Karen Rudelle, Michel Druet-Cabanac, Marie-Laure Laroche, and Sophie Boyer

Subjects
Aging, Dependence, Disability, Frailty, Physical functioning, Geriatrics, RC952-954.6
Abstract

Abstract Background Frailty is a geriatric syndrome associated with disability and negative health outcome. To determine the factors associated with frailty and functional disability in older participants living in community in France. We included 753 community-dwelling old participants with available frailty data at baseline. Results Overall, 31.9% were frail, 58.3% were prefrail, and 9.8% were robust. The SMAF (French acronym for Functional Autonomy Measurement System) score was significantly lower (mean ± standard deviation: -25.8 ± 11.2) in frail participants compared to prefrail (-14.3 ± 9.7) or robust participants (-8.1 ± 7.0); 82% of frail older participants had limitation in at least one ADL and 97.5% in at least one IADL compared to 54.2 and 76.8%, respectively of pre-frail and 29.7 and 47.3% of robust participants. Age, depression, impaired cognition and diabetes were significantly associated with higher odds of frailty. These variables were also strongly associated with functional disability. Female gender, polypharmacy, and smoking were additional variables significantly associated with degraded SMAF and/or ADL/IADL. Conclusions This study showed that functional disability increased proportionally to frailty, and depression, cognitive decline and diabetes are modifiable risk factors significantly associated with frailty and functional disability.

Published
2022
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3. Frailty and functional dependence in older population: lessons from the FREEDOM Limousin – Nouvelle Aquitaine Cohort Study

Author

Sophie Boyer, Justine Trimouillas, Noëlle Cardinaud, Caroline Gayot, Cécile Laubarie-Mouret, Nathalie Dumoitier, Karen Rudelle, Michel Druet-Cabanac, Marie-Laure Laroche, and Achille Tchalla

Subjects
Aging, autonomy, disability, elderly, frailty, independence, Geriatrics, RC952-954.6
Abstract

Abstract Background Monitoring frailty indicators in elderly people is recommended to identify those who could benefit from disability prevention programs. To contribute to the understanding of the development of frailty in the elderly, we have created the FREEDOM-LNA cohort constituting an observational study of ageing in general population. Here, we described the characteristics of a cohort of elderly subjects who are followed for determination of frailty and loss of independence trajectories. Results The cohort was composed of 1085 subjects in advanced age (mean: 83.7 ± 6.0 years) and of women in majority (68.3%). Cardiovascular risk factors were present in 88.4% of subjects. Abnormal musculoskeletal signs were reported in 44.0% and neurologic signs in 31.9%. There were 44.8% of subjects at risk of malnutrition (MNA 9); 31.8% (240/753) were frail and 58.3% were pre-frail. Most subjects had at least one disability in ADL (66.9%) and IADL (85.1%). The SMAF indicated a loss of independence in 59.6%. Overall, 59.9% of subjects could not stay at home without at least some help. Consequently, a medical consultation was proposed in 68.2 and 42.1% social supports. Conclusions A large part of this cohort was frail or pre-frail and presented signs of loss of independence, which may be explained by multiple factors including impaired health status, poor physical performance, cognition, isolation, depression, or nutrition. This cohort will help to determine factors that adversely influence the trajectory of physical frailty over time.

Published
2022
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4. Impact of multidomain preventive strategies on functional brain connectivity in older adults with cognitive complaint: Subset from the Montpellier center of the ancillary MAPT-MRI study

Author

Lisa Perus, Jean-François Mangin, Jérémy Deverdun, Laure-Anne Gutierrez, Emmanuelle Gourieux, Clara Fischer, Liesjet E. H. Van Dokkum, Clara Manesco, Germain Busto, Sophie Guyonnet, Bruno Vellas, Audrey Gabelle, Emmanuelle Le Bars, The MAPT/DSA group, Isabelle Carrié, Lauréne Brigitte, Catherine Faisant, Françoise Lala, Julien Delrieu, Hélène Villars, Emeline Combrouze, Carole Badufle, Audrey Zueras, Sandrine Andrieu, Christelle Cantet, Christophe Morin, Gabor Abellan Van Kan, Charlotte Dupuy, Yves Rolland, Céline Caillaud, Pierre-Jean Ousset, Sherry Willis, Sylvie Belleville, Brigitte Gilbert, Francine Fontaine, Jean-François Dartigues, Isabelle Marcet, Fleur Delva, Alexandra Foubert, Sandrine Cerda, Marie-Noëlle-Cuffi, Corinne Costes, Olivier Rouaud, Patrick Manckoundia, Valérie Quipourt, Sophie Marilier, Evelyne Franon, Lawrence Bories, Marie-Laure Pader, Marie-France Basset, Bruno Lapoujade, Valérie Faure, Michael Li Yung Tong, Christine Malick-Loiseau, Evelyne Cazaban-Campistron, Françoise Desclaux, Colette Blatge, Thierry Dantoine, Cécile Laubarie-Mouret, Isabelle Saulnier, Jean-Pierre Clément, Marie-Agnès Picat, Laurence Bernard-Bourzeix, Stéphanie Willebois, Iléana Désormais, Noëlle Cardinaud, Marc Bonnefoy, Pierre Livet, Pascale Rebaudet, Claire Gédéon, Catherine Burdet, Flavien Terracol, Alain Pesce, Stéphanie Roth, Sylvie Chaillou, Sandrine Louchart, Kristel Sudres, Nicolas Lebrun, Nadège Barro-Belaygues, Jacques Touchon, Karim Bennys, Aurélia Romano, Lynda Touati, Cécilia Marelli, Cécile Pays, Philippe Robert, Franck Le Duff, Claire Gervais, Sébastien Gonfrier, Yannick Gasnier, Serge Bordes, Danièle Begorre, Christian Carpuat, Khaled Khales, Jean-François Lefebvre, Samira Misbah El Idrissi, Pierre Skolil, Jean-Pierre Salles, Carole Dufouil, Stéphane Lehéricy, Marie Chupin, Ali Bouhayia, Michèle Allard, Frédéric Ricolfi, Dominique Dubois, Marie Paule Bonceour Martel, François Cotton, Alain Bonafé, Stéphane Chanalet, Françoise Hugon, Fabrice Bonneville, Christophe Cognard, François Chollet, Pierre Payoux, Thierry Voisin, Sophie Peiffer, Anne Hitzel, Michel Zanca, Jacques Monteil, Jacques Darcourt, Laurent Molinier, Hélène Derumeaux, Nadège Costa, Bertrand Perret, Claire Vinel, Sylvie Caspar-Bauguil, Pascale Olivier-Abbal, and Nicola Coley

Subjects
magnetic resonance imaging (MRI), resting-state functional MRI (rs-fMRI), multidomain intervention, exercise, cognitive training, omega-3 fatty acids, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

IntroductionThe impact of multi-domain preventive interventions on older adults, in particular on those with higher risk to develop Alzheimer's disease (AD), could be beneficial, as it may delay cognitive decline. However, the precise mechanism of such positive impact is not fully understood and may involve brain reserve and adaptability of brain functional connectivity (FC).MethodsTo determine the effect of multidomain interventions (involving physical activity, cognitive training, nutritional counseling alone or in combination with omega-3 fatty acid supplementation and vs. a placebo) on the brain, longitudinal FC changes were assessed after 36 months of intervention on 100 older adults (above 70 year-old) with subjective cognitive complaints.ResultsNo global change in FC was detected after uni or multidomain preventive interventions. However, an effect of omega-3 fatty acid supplementation dependent on cognitive decline status was underlined for frontoparietal, salience, visual and sensorimotor networks FC. These findings were independent of the cortical thickness and vascular burden.DiscussionThese results emphasize the importance of patient stratification, based on risk factors, for preventive interventions.

Published
2023
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5. Patterns and predictive factors of loss of the independence trajectory among community-dwelling older adults

Author

Charlotte Bimou, Michel Harel, Cécile Laubarie-Mouret, Noëlle Cardinaud, Marion Charenton-Blavignac, Nassima Toumi, Justine Trimouillas, Caroline Gayot, Sophie Boyer, Réjean Hebert, Thierry Dantoine, and Achille Tchalla

Subjects
Independence, Functional decline, Prevention, Trajectory, Older adults, Semi-parametric model, Geriatrics, RC952-954.6
Abstract

Abstract Background Independence is related to the aging process. Loss of independence is defined as the inability to make decisions and participate in activities of daily living (ADLs). Independence is related to physical, psychological, biological, and socioeconomic factors. An enhanced understanding of older people’s independence trajectories and associated risk factors would enable the develop early intervention strategies. Methods Independence trajectory analysis was performed on patients identified in the Unité de Prévention de Suivi et d’Analyse du Vieillissement (UPSAV) database. UPSAV cohort is a prospective observational study. Participants were 221 community-dwelling persons aged ≥75 years followed for 24 months between July 2011–November 2013 and benefits from a prevention strategy. Data were collected prospectively using a questionnaire. Independence was assessed using the “Functional Autonomy Measurement System (Système de Mesure de l’Autonomie Fonctionnelle (SMAF))”. Group-based trajectory modeling (GBTM) was performed to identify independence trajectories, and the results were compared with those of k-means and hierarchical ascending classifications. A multinomial logistic regression was performed to identify predictive factors of the independence trajectory. Results Three distinct trajectories of independence were identified including a “Stable functional autonomy (SFA) trajectory” (53% of patients), a “Stable then decline functional autonomy decline (SDFA) trajectory” (33% of patients) and a “Constantly functional autonomy decline (CFAD) trajectory” (14% of patients). Not being a member of an association, and previous fall were significantly associated of a SDFA trajectory (P

Published
2021
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6. Effectiveness of light paths coupled with personal emergency response systems in preventing functional decline among the elderly

Author

Florent Lachal, Achille Edem Tchalla, Noëlle Cardinaud, Isabelle Saulnier, Hichem Nessighaoui, Cécile Laubarie-Mouret, and Thierry Dantoine

Subjects
Medicine (General), R5-920
Abstract

Introduction: The elderly population is at high risk of functional decline, which will induce significant costs due to long-term care. Dependency could be delayed by preventing one of its major determinants: falls. Light paths coupled with personal emergency response systems could prevent the functional decline through fall prevention. Methods: This study aimed to evaluate the effectiveness of light paths coupled with personal emergency response systems on the functional decline in an elderly population living at home. It is a secondary analysis on data from a previous cohort. In all, 190 older adults (aged 65 years or more) living at home participated. Participants in the exposed group were equipped with home-based technologies: light paths coupled with personal emergency response systems. The participants’ functional status was assessed using the Functional Autonomy Measurement System scale at baseline (T0) and at the end of the study (T12-month). Baseline characteristics were evaluated by a comprehensive geriatric assessment. Results: After 1 year, 43% of the unexposed group had functional decline versus 16% of the exposed group. Light paths coupled with personal emergency response systems were significantly associated with a decrease in the functional decline (Δ Functional Autonomy Measurement System ⩾ 5) at home (odds ratio = 0.24, 95% confidence interval (0.11–0.54), p = 0.002). Discussion: This study suggests that light paths coupled with personal emergency response systems prevent the functional decline over 12 months. This result may encourage the prescription and use of home-based technologies to postpone dependency and institutionalization, but they need a larger cost-effectiveness study to demonstrate the efficiency of these technologies.

Published
2016
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7. Effectiveness of a home-based telesurveillance program in reducing hospital readmissions in older patients with chronic disease: The eCOBAHLT randomized controlled trial

Author

Achille Tchalla, Delphine Marchesseau, Noëlle Cardinaud, Cécile Laubarie-Mouret, Thomas Mergans, Patrick-Joël Kajeu, Sandrine Luce, Patrick Friocourt, Didier Tsala-Effa, Isabelle Tovena, Pierre-Marie Preux, and Caroline Gayot

Subjects
Health Informatics
Abstract

Introduction Given that chronic, long-term conditions are increasingly common in older patients, the impact of telesurveillance program on clinical outcomes is uncertain. This study aimed to evaluate the feasibility and effectiveness of a 12-month remote monitoring program in preventing rehospitalizations in older patients with two or more chronic diseases returning home after hospitalization. Methods We conducted a multicenter randomized controlled trial in two parallel groups to evaluate the remote monitoring system. Elderly patients with chronic diseases (at least two comorbidities) aged 65 years or older and discharged home after acute hospital care for a chronic disease were randomized to receive a home telemonitoring program (intervention group, n = 267) or conventional care (control group, n = 267). The remote home monitoring program was an online biometric home life analysis technology (e-COBAHLT) with tele-homecare/automation and biometric sensors. The eCOBALTH intervention group received the automation sensors containing chronic disease clinical factor trackers to monitor their biometric parameters and detect any abnormal prodromal disease decompensation by remote monitoring and providing geriatric expertise to general practitioners. The usual care group received no eCOBALTH program. In both groups, baseline visits were conducted at baseline and the final visit at 12 months. The primary outcome was the incidence of unplanned hospitalizations for decompensation during the 12-month period. Results Among 534 randomized participants (mean [SD] age, 80.3 [8.1] years; 280 [52.4%] women), 492 (92.1%) completed the 12-month follow-up; 182 (34.1) had chronic heart failure, 115 (21.5%) had stroke, and 77 (14.4%) had diabetes. During the 12-month follow-up period, 238 patients had at least one unplanned hospitalization for decompensation of a chronic disease: 108 (40.4%) in the intervention group versus 130 (48.7%) in the control group (P = 0.04). The risk of rehospitalization was significantly reduced in the intervention group (age- and sex-adjusted relative risk: 0.72, 95% 95% confidence intervals 0.51-0.94). Conclusion A 12-month home telemonitoring program with online biometric analysis using Home life technology combining telecare and biometric sensors is feasible and effective in preventing unplanned hospitalizations for chronic disease decompensation in elderly patients with chronic diseases at high risk for hospitalizations.

Published
2023

8. Meal-related difficulties and weight loss in older people: Longitudinal data from MAPT study

Author

Gaëlle Soriano, Philippe De Souto Barreto, Kelly Virecoulon Giudici, Christelle Cantet, Sophie Guyonnet, Bruno Vellas, Yves Rolland, Sandrine Andrieu, Isabelle Carrié, Lauréane Brigitte, Catherine Faisant, Françoise Lala, Julien Delrieu, Hélène Villars, Emeline Combrouze, Carole Badufle, Audrey Zueras, Christophe Morin, Gabor Abellan Van Kan, Charlotte Dupuy, Céline Caillaud, Pierre-Jean Ousset, Bertrand Fougère, Sherry Willis, Sylvie Belleville, Brigitte Gilbert, Francine Fontaine, Jean-François Dartigues, Isabelle Marcet, Fleur Delva, Alexandra Foubert, Sandrine Cerda Marie-Noëlle-Cuffi, Corinne Costes, Olivier Rouaud, Patrick Manckoundia, Valérie Quipourt, Sophie Marilier, Evelyne Franon, Lawrence Bories, Marie-Laure Pader, Marie-France Basset, Bruno Lapoujade, Valérie Faure, Michael Li Yung Tong, Christine Malick-Loiseau, Evelyne Cazaban-Campistron, Françoise Desclaux, Colette Blatge, Thierry Dantoine, Cécile Laubarie-Mouret, Isabelle Saulnier, Jean-Pierre Clément, Marie-Agnès Picat, Laurence Bernard-Bourzeix, Stéphanie Willebois, Iléana Désormais, Noëlle Cardinaud, Marc Bonnefoy, Pierre Livet, Pascale Rebaudet, Claire Gédéon, Catherine Burdet, Flavien Terracol, Alain Pesce, Stéphanie Roth, Sylvie Chaillou, Sandrine Louchart, Kristelle Sudres, Nicolas Lebrun, Nadège Barro-Belaygues, Jacques Touchon, Karim Bennys, Audrey Gabelle, Aurélia Romano, Lynda Touati, Cécilia Marelli, Cécile Pays, Philippe Robert, Franck Le Duff, Claire Gervais, Sébastien Gonfrier, Yannick Gasnier, Serge Bordes, Danièle Begorre, Christian Carpuat, Khaled Khales, Jean-François Lefebvre, Samira Misbah El Idrissi, Pierre Skolil, Jean-Pierre Salles, Carole Dufouil, Stéphane Lehéricy, Marie Chupin, Jean-François Mangin, Ali Bouhayia, Michèle Allard, Frédéric Ricolfi, Dominique Dubois, Marie Paule Bonceour Martel, François Cotton, Alain Bonafé, Stéphane Chanalet, Françoise Hugon, Fabrice Bonneville, Christophe Cognard, François Chollet, Pierre Payoux, Thierry Voisin, Sophie Peiffer, Anne Hitzel, Michel Zanca, Jacques Monteil, Jacques Darcourt, Laurent Molinier, Hélène Derumeaux, Nadège Costa, Christian Vincent, Bertrand Perret, Claire Vinel, Pascale Olivier-Abbal, Nicola Coley, Laboratoire de Gérontechnologie [Hôpital La Grave-CHU de Toulouse], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Gérontopôle, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Institut Jean Lamour (IJL), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), CHU Toulouse [Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut du Vieillissement, MAPT DSA Study Group: Bruno Vellas, Sophie Guyonnet, Isabelle Carrié, Lauréane Brigitte, Catherine Faisant, Françoise Lala, Julien Delrieu, Hélène Villars, Emeline Combrouze, Carole Badufle, Audrey Zueras, Sandrine Andrieu, Christelle Cantet, Christophe Morin, Gabor Abellan Van Kan, Charlotte Dupuy, Yves Rolland, Céline Caillaud, Pierre-Jean Ousset, Bertrand Fougère, Sherry Willis, Sylvie Belleville, Brigitte Gilbert, Francine Fontaine, Jean-François Dartigues, Isabelle Marcet, Fleur Delva, Alexandra Foubert, Sandrine Cerda Marie-Noëlle-Cuffi, Corinne Costes, Olivier Rouaud, Patrick Manckoundia, Valérie Quipourt, Sophie Marilier, Evelyne Franon, Lawrence Bories, Marie-Laure Pader, Marie-France Basset, Bruno Lapoujade, Valérie Faure, Michael Li Yung Tong, Christine Malick-Loiseau, Evelyne Cazaban-Campistron, Françoise Desclaux, Colette Blatge, Thierry Dantoine, Cécile Laubarie-Mouret, Isabelle Saulnier, Jean-Pierre Clément, Marie-Agnès Picat, Laurence Bernard-Bourzeix, Stéphanie Willebois, Iléana Désormais, Noëlle Cardinaud, Marc Bonnefoy, Pierre Livet, Pascale Rebaudet, Claire Gédéon, Catherine Burdet, Flavien Terracol, Alain Pesce, Stéphanie Roth, Sylvie Chaillou, Sandrine Louchart, Kristelle Sudres, Nicolas Lebrun, Nadège Barro-Belaygues, Jacques Touchon, Karim Bennys, Audrey Gabelle, Aurélia Romano, Lynda Touati, Cécilia Marelli, Cécile Pays, Philippe Robert, Franck Le Duff, Claire Gervais, Sébastien Gonfrier, Yannick Gasnier, Serge Bordes, Danièle Begorre, Christian Carpuat, Khaled Khales, Jean-François Lefebvre, Samira Misbah El Idrissi, Pierre Skolil, Jean-Pierre Salles, Carole Dufouil, Stéphane Lehéricy, Marie Chupin, Jean-François Mangin, Ali Bouhayia, Michèle Allard, Frédéric Ricolfi, Dominique Dubois, Marie Paule Bonceour Martel, François Cotton, Alain Bonafé, Stéphane Chanalet, Françoise Hugon, Fabrice Bonneville, Christophe Cognard, François Chollet, Pierre Payoux, Thierry Voisin, Julien Delrieu, Sophie Peiffer, Anne Hitzel, Michel Zanca, Jacques Monteil, Jacques Darcourt, Laurent Molinier, Hélène Derumeaux, Nadège Costa, Christian Vincent, Bertrand Perret, Claire Vinel, Pascale Olivier-Abbal, Sandrine Andrieu, Christelle Cantet, Nicola Coley, and CCSD, Accord Elsevier

Subjects
0301 basic medicine, Gerontology, Male, Meal preparation, Weight loss, Activities of daily living, [SDV]Life Sciences [q-bio], Health Behavior, 030209 endocrinology & metabolism, (financial or non-financial) related to the study, Disease, Critical Care and Intensive Care Medicine, Body Mass Index, Preparing meals, 03 medical and health sciences, Eating, Food Preferences, 0302 clinical medicine, Cognition, Elderly, Shopping, medicine, Humans, Longitudinal Studies, Prospective Studies, Cooking, Meals, Aged, Randomized Controlled Trials as Topic, 2. Zero hunger, Aged, 80 and over, Meal, 030109 nutrition & dietetics, Nutrition and Dietetics, Proportional hazards model, business.industry, Depression, 3. Good health, [SDV] Life Sciences [q-bio], Cross-Sectional Studies, Functional Status, Female, Independent Living, medicine.symptom, business
Abstract

International audience; BACKGROUND: Difficulties with meal-related activities (preparing meals and food shopping) may influence food intake, and contribute to nutritional risk among elderly people. All known studies on this topic had a cross-sectional design, thereby no causal relationships could be derived. We aim to investigate if difficulties with meal-related activities can contribute to subsequent weight loss in community-dwelling older people. METHODS: We used data of older subjects from the MAPT Study (n = 1531, median age = 74 years, 64% women), who provided prospective data on weight every 6 months and cognitive, physical condition, and functional capacities every year during a 3-year period. Difficulties preparing meals and shopping were evaluated each year with the Alzheimer's Disease Cooperative Study-Activities of Daily Living Prevention Instrument (ADCS ADL-PI) Scale. The risk of losing weight (≥5% or ≥ 3 kg in the following year) was estimated using a time-dependent Cox regression model. RESULTS: During the 3-year follow-up, a total of 851 subjects experienced at least a 5% or 3 kg weight loss. Two hundred thirty-seven subjects declared having difficulties with meal preparation at least once, and 133 declared having difficulties shopping. Subjects reporting any meal-related difficulties were older (p \textless 0.001), had more depressive symptoms (p \textless 0.001), and a lower physical function (p \textless 0.001) compared to those without difficulties. They also had a lower cognitive score (preparing meals: p \textless 0.001; shopping: p = 0.005) and a lower body mass index (preparing meals: p = 0.005; shopping: p = 0.023) at the end of the study. Meal-related activities were not associated with weight loss in unadjusted analysis and after adjustment for sex, age, depression, physical and cognitive status. CONCLUSION: Difficulties preparing meals and shopping had no effect on weight loss in community-dwelling older people, despite their association with advanced age, functional decline, and depressive symptoms.

Published
2020

9. Associations Between Physical Activity, Blood-Based Biomarkers of Neurodegeneration, and Cognition in Healthy Older Adults: The MAPT Study

Author

Randall J. Bateman, Jean-Pierre Salles, Pascale Rebaudet, Jacques Touchon, Christian Carpuat, Claire Vinel, Dominique Dubois, Aurélia Romano, Flavien Terracol, Emeline Combrouze, Marc Bonnefoy, Philipe de Souto Barreto, Thierry Dantoine, Sylvie Caspar-Bauguil, Stéphane Chanalet, Marie-Laure Pader, Isabelle Saulnier, Sandrine Andrieu, Philippe Robert, Mapt, Céline Caillaud, Michèle Allard, Christelle Cantet, Pierre Payoux, Christine Malick-Loiseau, Sandrine Louchart, Nicola Coley, Lynda Touati, Françoise Hugon, Charlotte Dupuy, Alexandra Foubert, Olivier Rouaud, Kristel Sudres, Alain Bonafe, Geetika Aggarwal, Audrey Gabelle, Sophie Peiffer, Karim Bennys, Francine Fontaine, H. Villars, N. Costa, Evelyne Franon, Jean-François Dartigues, Jean-François Lefebvre, Carole Badufle, Sandrine Cerda, Catherine Burdet, Pierre Livet, Frédéric Ricolfi, Jean-François Mangin, Andrew D. Nguyen, Michael Li Yung Tong, Sylvie Chaillou, Lawrence Bories, Jérémy Raffin, Yan Li, Samira Misbah El Idrissi, Sophie Marilier, Nadège Barro-Belaygues, Bruno Vellas, Marie-Agnès Picat, Catherine Faisant, Françoise Desclaux, Bertrand Perret, Serge Bordes, Pierre-Jean Ousset, Laurent Molinier, Cécile Pays, Yves Rolland, Jean-Pierre Clément, Stéphanie Willebois, Patrick Manckoundia, Michel Zanca, Yannick Gasnier, Valérie Quipourt, Isabelle Carrié, Valérie Faure, Christophe Morin, Christophe Cognard, Claire Gédéon, Lauréane Brigitte, Colette Blatge, Julien Delrieu, Claire Gervais, Pascale Olivier-Abbal, Hélène Derumeaux, Carole Dufouil, Ali Bouhayia, Danièle Begorre, Alain Pesce, Marie Chupin, Françoise Lala, Fabrice Bonneville, Brigitte Gilbert, Franck Le Duff, Laurence Bernard-Bourzeix, Evelyne Cazaban-Campistron, Isabelle Marcet, Jacques Darcourt, François Cotton, Bruno Lapoujade, Gabor Abellan van Kan, John E. Morley, Sophie Guyonnet, Corinne Costes, Sebastien Gonfrier, Audrey Zueras, Anne Hitzel, Stéphanie Roth, Cecilia Marelli, Fleur Delva, Stéphane Lehéricy, Nicolas Lebrun, Pierre Skolil, Khaled Khales, Cécile Laubarie-Mouret, Jacques Monteil, Marie-France Basset, Thierry Voisin, François Chollet, Noëlle Cardinaud, Marie Paule Bonceour Martel, and Ileana Desormais

Subjects
0301 basic medicine, Oncology, Male, medicine.medical_specialty, Aging, Amyloid, Physical exercise, Neuropsychological Tests, Logistic regression, 03 medical and health sciences, 0302 clinical medicine, Cognition, Alzheimer Disease, Neurofilament Proteins, Internal medicine, Medicine, Humans, Cognitive Dysfunction, Cognitive decline, Correlation of Data, Exercise, Geriatric Assessment, Aged, Amyloid beta-Peptides, business.industry, Peptide Fragments, Cognitive test, 030104 developmental biology, Cross-Sectional Studies, Quartile, Concomitant, Female, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery, Biomarkers
Abstract

Physical activity (PA) demonstrated benefits on brain health, but its relationship with blood biomarkers of neurodegeneration remains poorly investigated. We explored the cross-sectional associations of PA with blood concentrations of neurofilament light chain (NFL) and beta amyloid (Aβ)42/40. We further examined whether the interaction between PA and these biomarkers was longitudinally related to cognition. Four-hundred and sixty-five nondemented older adults engaged in an interventional study and who had a concomitant assessment of PA levels and blood measurements of NFL (pg/mL) and Aβ 42/40 were analyzed. A composite Z-score combining 4 cognitive tests was used for cognitive assessment up to a 4-year follow-up. Multiple linear regressions demonstrated that people achieving 500–999 and 2000+ MET-min/week of PA had lower (ln)NFL concentrations than their inactive peers. Logistic regressions revealed that achieving at least 90 MET-min/week of PA was associated with a lower probability of having high NFL concentrations (ie, ≥91.961 pg/mL [third quartile]). PA was not associated with (Aβ)42/40. Mixed-model linear regressions demonstrated that the reverse relationship between PA and cognitive decline tended to be more pronounced as Aβ 42/40 increased, while it was dampened with increasing levels of (ln)NFL concentrations. This study demonstrates that PA is associated with blood NFL but not with Aβ 42/40. Furthermore, it suggests that PA may attenuate the negative association between amyloid load and cognition, while having high NFL levels mitigates the favorable relationship between PA and cognition. More investigations on non demented older adults are required for further validation of the present findings.

Published
2020

10. Adherence to multidomain interventions for dementia prevention: Data from the FINGER and MAPT trials

Author

Noëlle Cardinaud, Francine Fontaine, Marie Paule Bonceour Martel, Danièle Begorre, Claire Vinel, Dominique Dubois, Serge Bordes, Charlotte Dupuy, Jean-François Dartigues, Lars Bäckman, Marie-Laure Pader, Colette Blatge, Jacques Touchon, Julien Delrieu, Karim Bennys, Miia Kivipelto, Pierre Payoux, Christian Vincent, Ileana Desormais, Françoise Hugon, Isabelle Saulnier, Michèle Allard, Pascale Olivier-Abbal, Patrick Manckoundia, Audrey Gabelle, Yannick Gasnier, Olivier Rouaud, Christine Malick-Loiseau, Carole Badufle, Christian Carpuat, Sophie Marilier, Sophie Peiffer, Stéphane Chanalet, Riitta Antikainen, Jean-Pierre Salles, Stéphanie Roth, Catherine Burdet, Pierre Livet, Nadège Barro-Belaygues, François Cotton, Tiia Ngandu, Pim van Gool, Alexandra Foubert, Eric P. Moll van Charante, Khaled Khales, Pierre-Jean Ousset, Hilkka Soininen, Valérie Faure, Sandrine Andrieu, Corinne Costes, Marie-Noelle-Cuffi, Frédéric Ricolfi, Pascale Rebaudet, Samira Misbah El Idrissi, Céline Caillaud, Marie Chupin, Alain Pesce, Françoise Lala, N. Costa, Emeline Combrouze, Carol Brayne, Bertrand Fougère, Michel Zanca, H. Villars, Sebastien Gonfrier, Fabrice Bonneville, Lynda Touati, Sandrine Cerda, Katri Hemio, Esko Levälahti, Jacques Darcourt, Philippe Robert, Christophe Morin, Brigitte Gilbert, Alain Bonafe, Catherine Faisant, Jacques Monteil, Lawrence Bories, Bram van de Groep, Edo Richard, Gabor Abellan van Kan, Valérie Quipourt, Marc Bonnefoy, Françoise Desclaux, Kristelle Sudres, Thierry Voisin, Timo E. Strandberg, Yves Rolland, Evelyne Franon, Susan Jongstra, Anna Stigsdotter-Neely, Marie-France Basset, Thierry Dantoine, Laurent Molinier, Tiina Laatikainen, Audrey Zueras, Jean-François Lefebvre, Claire Gédéon, Christelle Cantet, Jean-Pierre Clément, Jean-François Mangin, Aurélia Romano, François Chollet, Tuomo Hänninen, Yannick Meiller, Marie-Agnès Picat, Satu Havulinna, Tessa van Middelaar, Jenni Lehtisalo, Isabelle Marcet, Stéphanie Willebois, Christophe Cognard, Hélène Derumeaux, Cécile Pays, Laurence Bernard-Bourzeix, Sylvie Belleville, Anne Hitzel, Cathrien Beishuizen, Ali Bouhayia, Sylvie Chaillou, Bruno Lapoujade, Franck Le Duff, Bruno Vellas, Michael Li Yung Tong, Marieke P. Hoevenaar-Blom, Cecilia Marelli, Rainer Rauramaa, Flavien Terracol, Marko Gronholm, Fleur Delva, Mariagnese Barbera, Sandrine Louchart, Isabelle Carrié, Lauréane Brigitte, Alina Solomon, Bertrand Perret, Claire Gervais, Jaakko Tuomilehto, Carole Dufouil, Sherry L. Willis, Lennard L. van Wanrooij, Cécile Laubarie-Mouret, Nicolas Lebrun, Pierre Skolil, Francesca Mangiasche, Stéphane Lehéricy, Sophie Guyonnet, Jaana Lindström, Evelyne Cazaban-Campistron, Markku Peltonen, Antti Jula, Juliette Guillemont, Nicola Coley, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Karolinska Institutet [Stockholm], University of Helsinki, Faculty of Health Sciences [UEF, Kuopio, Finland], University of Eastern Finland, Vrije Universiteit Amsterdam [Amsterdam] (VU), Nijmegen Medical Centre [Nijmegen], Centre d'investigation clinique de Toulouse (CIC 1436), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), General practice, Public and occupational health, ACS - Diabetes & metabolism, APH - Health Behaviors & Chronic Diseases, APH - Personalized Medicine, APH - Aging & Later Life, Graduate School, Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Pôle Santé publique et médecine publique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CCSD, Accord Elsevier, Department of Public Health, Oral and Maxillofacial Surgery, Department of Medicine, Timo Strandberg / Principal Investigator, and HUS Internal Medicine and Rehabilitation

Subjects
Epidemiology, LIFE-STYLE INTERVENTIONS, [SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Psychological intervention, 3124 Neurology and psychiatry, Trial, 0302 clinical medicine, Risk Factors, Outcome Assessment, Health Care, 030212 general & internal medicine, PREDICTORS, Cognitive impairment, Finland, Depression (differential diagnoses), Clinical Trials as Topic, Health Policy, DEPRESSION, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Cognitive training, Exercise Therapy, 3. Good health, ALZHEIMERS-DISEASE, Psychiatry and Mental health, Female, medicine.medical_specialty, DISABILITY FINGER, Physical activity, Intervention, Placebo, EXERCISE ADHERENCE, 03 medical and health sciences, Cellular and Molecular Neuroscience, Developmental Neuroscience, Intervention (counseling), Fatty Acids, Omega-3, medicine, Humans, Dementia, OLDER-ADULTS, Life Style, Aged, Cognitive Behavioral Therapy, business.industry, Prevention, [SCCO.NEUR]Cognitive science/Neuroscience, [SCCO.NEUR] Cognitive science/Neuroscience, 3112 Neurosciences, COGNITIVE IMPAIRMENT, medicine.disease, Multidomain, FINNISH GERIATRIC INTERVENTION, PHYSICAL-ACTIVITY, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Adherence, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Physical therapy, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), Geriatrics and Gerontology, business, 030217 neurology & neurosurgery
Abstract

Introduction: Multidomain interventions, targeting multiple risk factors simultaneously, could be effective dementia prevention strategies, but may be burdensome and not universally acceptable. Methods: We studied adherence rates and predictors in the Finnish Geriatric Intervevntion Study to Prevent Cognitive Impairment and Disability and Multidomain Alzheimer Preventive Trial prevention trials, for all intervention components (separately and simultaneously). Finnish Geriatric Intervevntion Study to Prevent Cognitive Impairment and Disability participants received a 2-year multidomain lifestyle intervention (physical training, cognitive training, nutritional counseling, and cardiovascular monitoring). Multidomain Alzheimer Preventive Trial participants received a 3-year multidomain lifestyle intervention (cognitive training, physical activity counseling, and nutritional counseling) with either an omega-3 supplement or placebo. Results: Adherence decreased with increasing intervention complexity and intensity: it was highest for cardiovascular monitoring, nutritional counseling, and the omega-3 supplement, and lowest for unsupervised computer-based cognitive training. The most consistent baseline predictors of adherence were smoking and depressive symptoms. Discussion: Reducing participant burden, while ensuring that technological tools are suitable for older individuals, maintaining face-to-face contacts, and taking into account participant characteristics may increase adherence in future trials. (C) 2019 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Published
2019

11. Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): a randomised, placebo-controlled trial

Author

Sandrine Andrieu, Sophie Guyonnet, Nicola Coley, Christelle Cantet, Marc Bonnefoy, Serge Bordes, Lawrence Bories, Marie-Noëlle Cufi, Thierry Dantoine, Jean-François Dartigues, Françoise Desclaux, Audrey Gabelle, Yannick Gasnier, Alain Pesce, Kristel Sudres, Jacques Touchon, Philippe Robert, Olivier Rouaud, Philippe Legrand, Pierre Payoux, Jean-Paul Caubere, Michael Weiner, Isabelle Carrié, Pierre-Jean Ousset, Bruno Vellas, Lauréane Brigitte, Catherine Faisant, Françoise Lala, Julien Delrieu, Hélène Villars, Emeline Combrouze, Carole Badufle, Audrey Zueras, Christophe Morin, Gabor Abellan Van Kan, Charlotte Dupuy, Yves Rolland, Céline Caillaud, Bertrand Fougère, Sherry Willis, Sylvie Belleville, Brigitte Gilbert, Francine Fontaine, Isabelle Marcet, Fleur Delva, Alexandra Foubert, Sandrine Cerda, Marie Noëlle-Cuffi, Corinne Costes, Patrick Manckoundia, Valérie Quipourt, Sophie Marilier, Evelyne Franon, Marie-Laure Pader, Marie-France Basset, Bruno Lapoujade, Valérie Faure, Michael Li, Yung Tong, Christine Malick-Loiseau, Evelyne Cazaban-Campistron, Colette Blatge, Cécile Laubarie-Mouret, Isabelle Saulnier, Jean-Pierre Clément, Marie-Agnès Picat, Laurence Bernard-Bourzeix, Stéphanie Willebois, Iléana Désormais, Noëlle Cardinaud, Pierre Livet, Pascale Rebaudet, Claire Gédéon, Catherine Burdet, Flavien Terracol, Stéphanie Roth, Sylvie Chaillou, Sandrine Louchart, Nicolas Lebrun, Nadège Barro-Belaygues, Karim Bennys, Aurélia Romano, Lynda Touati, Cécilia Marelli, Cécile Pays, Franck Le Duff, Claire Gervais, Sébastien Gonfrier, Danièle Begorre, Christian Carpuat, Khaled Khales, Jean-François Lefebvre, Samira Misbah El Idrissi, Pierre Skolil, Jean-Pierre Salles, Carole Dufouil, Stéphane Lehéricy, Marie Chupin, Jean-François Mangin, Ali Bouhayia, Michèle Allard, Frédéric Ricolfi, Dominique Dubois, Marie Paule, Bonceour Martel, François Cotton, Alain Bonafé, Stéphane Chanalet, Françoise Hugon, Fabrice Bonneville, Christophe Cognard, François Chollet, Thierry Voisin, Sophie Peiffer, Anne Hitzel, Michel Zanca, Jacques Monteil, Jacques Darcourt, Laurent Molinier, Hélène Derumeaux, Nadège Costa, Christian Vincent, Bertrand Perret, Claire Vinel, Pascale Olivier-Abbal, Institut National de la Santé et de la Recherche Médicale (INSERM), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, CHU Toulouse [Toulouse], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hopital de Tarbes, Service de Gériatrie (CHARLES FOIX - Gériatrie), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Hopital de castres, CHU Limoges, CHU Bordeaux [Bordeaux], Hopital Lavaur, Département de neurologie [Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier]-Université de Montpellier (UM), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Hôpital Princesse Grace [Monaco], Centre hospitalier de Montauban, Neuropsychiatrie : recherche épidémiologique et clinique, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Cognition Behaviour Technology (CobTek), Université Nice Sophia Antipolis (... - 2019) (UNS), Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA)-Institut Claude Pompidou [Nice] (ICP - Nice)-Centre Hospitalier Universitaire de Nice (CHU Nice), Centre Mémoire Ressources et Recherche [Dijon] (CMRR Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Institut National de la Recherche Agronomique (INRA), Department of Nuclear Medicine, CHU de Toulouse (CHU), Centre de Recherche Pierre Fabre, University of California [San Francisco] (UCSF), University of California, Service d'Etudes du Comportement des Matériaux de Conditionnement (SECM), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Interactions, transferts, ruptures artistiques et culturels - EA 6301 (InTRu), Université de Tours, École de sages-femmes Baudelocque (ESF Baudelocque), Université Paris Descartes - Paris 5 (UPD5), Gérontopôle, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Genetique medicale, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de médecine gériatrique (CHU de Dijon - Centre gériatrique de Champmaillot - EHPAD), Cabinet médical [Dijon], Cabinet médical, Handicap, Activité, Vieillissement, Autonomie, Environnement (HAVAE), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Sciences et Société, Historicité, Éducation et Pratiques (EA S2HEP), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Centre de Mémoire de Ressources et de Recherches [Limoges] (CMRR Limoges), CHU Limoges-CH Esquirol [Limoges] (CH Esquirol), Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], Centre d'EPistémologie et d'ERgologie Comparatives - UMR 7304 (CEPERC), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Centre de droit privé fondamental (CDPF), Université de Strasbourg (UNISTRA)-L'europe en mutation : histoire, droit, économie et identités culturelles, Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière (CRICM), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Service de Neurologie, Université Montpellier 1 (UM1)-Hôpital Guy de Chauliac-Centre Mémoire Ressources Recherche Languedoc - Roussillon, Laboratoire d'Informatique Médicale (LIM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), The Smithsonian Museum Conservation Institute, Chercheur indépendant, Centre Léon Bérard [Lyon], Neuroépidémiologie, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [APHP], Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Service de neuroradiologie, imagerie des urgences [CHU de Dijon], Urgence et post-urgence psychiatrique, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital Pasteur [Nice] (CHU), Imagerie cérébrale et handicaps neurologiques, Institut des sciences du cerveau de Toulouse. (ISCT), Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs (INM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7), Service de Médecine Nucléaire [Toulouse], CHU Toulouse [Toulouse]-Hôpital Rangueil, Hôpital Gui de Chauliac, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Transporteurs en Imagerie et Radiothérapie en Oncologie (TIRO - UMR E4320), Service Hospitalier Frédéric Joliot (SHFJ), Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-UMR E4320 (TIRO-MATOs), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Nice Sophia Antipolis (... - 2019) (UNS), Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Nice Sophia Antipolis (... - 2019) (UNS), Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA), Service de l'Information Médicale, CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], Centre de Physiopathologie Toulouse Purpan ex IFR 30 et IFR 150 (CPTP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS), Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université de Toulouse (UT), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Charles Foix [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [CHU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université de Montpellier (UM), Centre hospitalier de Montauban (CH Montauban), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Centre Hospitalier Universitaire de Nice (CHU Nice)-Institut Claude Pompidou [Nice] (ICP - Nice)-Université Côte d'Azur (UCA), Service de Médecine Nucléaire - Rangueil [CHU Toulouse], Pôle imagerie médicale [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre de Recherche Pierre Fabre (Centre de R&D Pierre Fabre), PIERRE FABRE, University of California [San Francisco] (UC San Francisco), University of California (UC), Université de Tours (UT), Université Paris Descartes - École de sages-femmes Baudelocque (UPD ESF Baudelocque), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Centre d'EPistémologie et d'ERgologie Comparatives (CEPERC), Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Montpellier 1 (UM1)-Hôpital Gui de Chauliac [CHU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Mémoire Ressources Recherche Languedoc - Roussillon, Université de Rennes (UR), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Institut des Neurosciences de Montpellier (INM), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Médecine Nucléaire - Pierre-Paul Riquet [CHU Toulouse], Hôpital Gui de Chauliac [CHU Montpellier], Transporteurs et Imagerie, Radiothérapie en Oncologie et Mécanismes biologiques des Altérations du Tissu Osseux (TIRO-MATOs - UMR E4320), Université Paris-Saclay-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-UMR E4320 (TIRO-MATOs), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Côte d'Azur (UCA)-Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Côte d'Azur (UCA), Département d'Information Médicale [CHU Toulouse], Pôle Santé publique et médecine publique [CHU Toulouse], Centre de Physiopathologie Toulouse Purpan (CPTP), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), French Ministry of Health, Pierre Fabre Research Institute, Gerontopole, Exhonit Therapeutics, Avid Radiopharmaceuticals, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute [Basel], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Gérontopôle, Department of Geriatrics, Centre Hospitalier Universitaire de Toulouse, Geriatrics Department, Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), hopital de Foix, U897, Memory Research Resource Center for Alzheimer's Disease, Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Centre Hospitalier Princesse Grace, Hopital Montauban, Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA)-Centre Hospitalier Universitaire de Nice (CHU Nice)-Institut Claude Pompidou [Nice] (ICP - Nice), Memory Research Resource Center, Neurology Department, Laboratoire de Biochimie et Nutrition Humaine, AGROCAMPUS OUEST, Department of Nuclear Medicine, National Institute of Neurosurgery, Toulouse NeuroImaging Centre, Centre Hospitalier Universitaire de Purpan (CHU Purpan), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Toulouse [Toulouse], Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), UMR E4320 (TIRO-MATOs), Université Côte d'Azur (UCA)-Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Côte d'Azur (UCA)-Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Service Hospitalier Frédéric Joliot (SHFJ), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Hôpital Gui de Chauliac [Montpellier]-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), and Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)

Subjects
Male, [SDV]Life Sciences [q-bio], Placebo-controlled study, Neuropsychological Tests, decline, law.invention, 0302 clinical medicine, Cognition, Randomized controlled trial, prevention, law, Medicine, 030212 general & internal medicine, Cognitive decline, alzheimers-disease, risk, chemistry.chemical_classification, Aged, 80 and over, education.field_of_study, Eicosapentaenoic acid, 3. Good health, Exercise Therapy, Treatment Outcome, Female, performance, Polyunsaturated fatty acid, medicine.medical_specialty, brain, Population, Placebo, 03 medical and health sciences, Double-Blind Method, Fatty Acids, Omega-3, Humans, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, education, plasma, Aged, clinical-trials, Memory Disorders, Cognitive Behavioral Therapy, business.industry, Clinical trial, chemistry, Dietary Supplements, Physical therapy, Neurology (clinical), business, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, gait speed, 030217 neurology & neurosurgery, dementia
Abstract

Summary Background No large trials have been done to investigate the efficacy of an intervention combining a specific compound and several lifestyle interventions compared with placebo for the prevention of cognitive decline. We tested the effect of omega 3 polyunsaturated fatty acid supplementation and a multidomain intervention (physical activity, cognitive training, and nutritional advice), alone or in combination, compared with placebo, on cognitive decline. Methods The Multidomain Alzheimer Preventive Trial was a 3-year, multicentre, randomised, placebo-controlled superiority trial with four parallel groups at 13 memory centres in France and Monaco. Participants were non-demented, aged 70 years or older, and community-dwelling, and had either relayed a spontaneous memory complaint to their physician, limitations in one instrumental activity of daily living, or slow gait speed. They were randomly assigned (1:1:1:1) to either the multidomain intervention (43 group sessions integrating cognitive training, physical activity, and nutrition, and three preventive consultations) plus omega 3 polyunsaturated fatty acids (ie, two capsules a day providing a total daily dose of 800 mg docosahexaenoic acid and 225 mg eicosapentaenoic acid), the multidomain intervention plus placebo, omega 3 polyunsaturated fatty acids alone, or placebo alone. A computer-generated randomisation procedure was used to stratify patients by centre. All participants and study staff were blinded to polyunsaturated fatty acid or placebo assignment, but were unblinded to the multidomain intervention component. Assessment of cognitive outcomes was done by independent neuropsychologists blinded to group assignment. The primary outcome was change from baseline to 36 months on a composite Z score combining four cognitive tests (free and total recall of the Free and Cued Selective Reminding test, ten Mini-Mental State Examination orientation items, Digit Symbol Substitution Test, and Category Naming Test) in the modified intention-to-treat population. The trial was registered with ClinicalTrials.gov (NCT00672685). Findings 1680 participants were enrolled and randomly allocated between May 30, 2008, and Feb 24, 2011. In the modified intention-to-treat population (n=1525), there were no significant differences in 3-year cognitive decline between any of the three intervention groups and the placebo group. Between-group differences compared with placebo were 0·093 (95% CI 0·001 to 0·184; adjusted p=0·142) for the combined intervention group, 0·079 (−0·012 to 0·170; 0·179) for the multidomain intervention plus placebo group, and 0·011 (−0·081 to 0·103; 0·812) for the omega 3 polyunsaturated fatty acids group. 146 (36%) participants in the multidomain plus polyunsaturated fatty acids group, 142 (34%) in the multidomain plus placebo group, 134 (33%) in the polyunsaturated fatty acids group, and 133 (32%) in the placebo group had at least one serious emerging adverse event. Four treatment-related deaths were recorded (two in the multidomain plus placebo group and two in the placebo group). The interventions did not raise any safety concerns and there were no differences between groups in serious or other adverse events. Interpretation The multidomain intervention and polyunsaturated fatty acids, either alone or in combination, had no significant effects on cognitive decline over 3 years in elderly people with memory complaints. An effective multidomain intervention strategy to prevent or delay cognitive impairment and the target population remain to be determined, particularly in real-world settings. Funding French Ministry of Health, Pierre Fabre Research Institute, Gerontopole, Exhonit Therapeutics, Avid Radiopharmaceuticals.

Published
2017

12. Plasma Aβ and neurofilament light chain are associated with cognitive and physical function decline in non-dementia older adults

Author

He, L., Souto Barreto, P., Aggarwal, G., Nguyen, A. D., Morley, J. E., Li, Y., Bateman, R. J., Vellas, B., Bonnefoy, M., Gabelle, Audrey, Gérontopôle, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université Fédérale Toulouse Midi-Pyrénées, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Saint Louis University School of Medicine [St Louis], Washington University School of Medicine in St. Louis, Washington University in Saint Louis (WUSTL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut des Neurosciences de Montpellier (INM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), MAPT/DSA Group: Bruno Vellas, Sophie Guyonnet, Isabelle Carrié, Lauréane Brigitte, Catherine Faisant, Françoise Lala, Julien Delrieu, Hélène Villars, Emeline Combrouze, Carole Badufle, Audrey Zueras, Sandrine Andrieu, Christelle Cantet, Christophe Morin, Gabor Abellan Van Kan, Charlotte Dupuy, Yves Rolland, Céline Caillaud, Pierre-Jean Ousset, Françoise Lala, Sherry Willis, Sylvie Belleville, Brigitte Gilbert, Jean-François Dartigues, Isabelle Marcet, Fleur Delva, Alexandra Foubert, Sandrine Cerda, Corinne Costes, Olivier Rouaud, Patrick Manckoundia, Valérie Quipourt, Sophie Marilier, Evelyne Franon, Lawrence Bories, Marie-Laure Pader, Marie-France Basset, Bruno Lapoujade, Valérie Faure, Michael Li Yung Tong, Christine Malick-Loiseau, Evelyne Cazaban-Campistron, Françoise Desclaux, Colette Blatge, Thierry Dantoine, Cécile Laubarie-Mouret, Isabelle Saulnier, Jean-Pierre Clément, Marie-Agnès Picat, Laurence Bernard-Bourzeix, Stéphanie Willebois, Iléana Désormais, Noëlle Cardinaud, Marc Bonnefoy, Pierre Livet, Pascale Rebaudet, Claire Gédéon, Catherine Burdet, Flavien Terracol, Alain Pesce, Stéphanie Roth, Sylvie Chaillou, Sandrine Louchart, Kristelle Sudres, Nicolas Lebrun, Nadège Barro-Belaygues, Jacques Touchon, Karim Bennys, Audrey Gabelle, Aurélia Romano, Lynda Touati, Cécilia Marelli, Cécile Pays, Philippe Robert, Franck Le Duff, Claire Gervais, Sébastien Gonfrier, Yannick Gasnier, Serge Bordes, Danièle Begorre, Christian Carpuat, Khaled Khales, Jean-François Lefebvre, Samira Misbah El Idrissi, Pierre Skolil, Jean-Pierre Salles, Carole Dufouil, Stéphane Lehéricy, Marie Chupin, Jean-François Mangin, Ali Bouhayia, Michèle Allard, Frédéric Ricolfi, Dominique Dubois, Marie Paule Bonceour Martel, François Cotton, Alain Bonafé, Stéphane Chanalet, Françoise Hugon, Fabrice Bonneville, Christophe Cognard, François Chollet, Pierre Payoux, Thierry Voisin, Julien Delrieu, Sophie Peiffer, Anne Hitzel, Michèle Allard, Michel Zanca, Jacques Monteil, Jacques Darcourt, Laurent Molinier, Hélène Derumeaux, Nadège Costa, Bertrand Perret, Claire Vinel, Sylvie Caspar-Bauguil, Pascale Olivier-Abbal, Sandrine Andrieu, Christelle Cantet, Nicola Coley, CarMeN, laboratoire, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Toulouse [Toulouse], Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), and Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs (INM)

Subjects
medicine.medical_specialty, Neurology, Cognitive Neuroscience, Neurofilament light, [SDV]Life Sciences [q-bio], Intermediate Filaments, Physical function, Audiology, Neurofilament light chain, lcsh:RC346-429, lcsh:RC321-571, 03 medical and health sciences, Cognition, 0302 clinical medicine, Humans, Medicine, Dementia, Amyloid-β, Cognitive Dysfunction, Prospective Studies, lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry, lcsh:Neurology. Diseases of the nervous system, Aged, 030304 developmental biology, 2. Zero hunger, 0303 health sciences, Amyloid beta-Peptides, business.industry, Research, Cognitive function, medicine.disease, Cognitive training, Cognitive test, [SDV] Life Sciences [q-bio], Cross-Sectional Studies, Neurology (clinical), business, Body mass index, 030217 neurology & neurosurgery
Abstract

BackgroundCognition is closely associated with physical function. Although high brain amyloid-β (Aβ) deposition and neurofilament light chain (NfL) are associated with cognitive and gait speed decline, relationships of combined plasma Aβ and NfL profiles with cognitive and physical functions in older adults remain unknown. The research aim of this study was to investigate the prospective associations of combined plasma Aβ and NfL profiles with cognitive and physical functions in older adults.MethodsParticipants (n = 452, aged 76 ± 5 years) who had both plasma Aβ and NfL data collected from the Multidomain Alzheimer’s Preventive Trial (MAPT, May 2008 to April 2016) were included in the current study. These participants were from four MAPT groups (multidomain interventions [physical activity and nutritional counselling, and cognitive training], omega-3 supplementation, multidomain plus omega-3 supplementation and control group) and had received a 3-year intervention, followed by a 2-year observational follow-up. Cognitive function was evaluated as Mini-Mental State Examination and composite cognitive score (CCS, a meanZ-score combining four cognitive tests). Physical function was evaluated as gait speed (4-m usual-pace walk test) and chair-stand time (5-time maximal chair-stand test). Cognitive and physical function data measured at the time of and after blood Aβ and NfL tests were used for analysis. Participants with plasma Aβ42/Aβ40ratios lower than 0.107 and NfL levels greater than 93.04 pg/ml were classified as Aβ+ and NfL+. Multivariable regressions and mixed-effects linear models were used for the analysis.ResultsAt the cross-sectional level, no significant association was found between Aβ+NfL+ and cognitive or physical function after controlling for age, sex, body mass index, education level and MAPT group. Evaluating longitudinal changes, participants with Aβ+NfL+ had greater annual declines in the CCS (β = − 0.11, 95%CI [− 0.17, − 0.05]) and gait speed (β = − 0.03, 95%CI [− 0.05, − 0.005]). After adjusting for APOE ɛ4 genotype, Aβ+NfL+ was associated with a greater decline only in the CCS (β = − 0.09, 95%CI [− 0.15, − 0.02]).ConclusionsCombined low plasma Aβ42/Aβ40ratio and high plasma NfL level was associated with greater declines in cognition and gait speed over time, providing further evidence of the links between cognitive and physical function.Trial registrationwww.clinicaltrials.gov[NCT00672685].

Published
2020

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