{"title":"[Epidemiology of Alzheimer's disease: methodological approaches and new perspectives].","authors":"Claudine Berr, Marie-Noël Vercambre, Tasnime Nassime Akbaraly","doi":"10.1684/pnv.2009.0191","DOIUrl":"https://doi.org/10.1684/pnv.2009.0191","url":null,"abstract":"<p><p>Over the last 20 years, a number of epidemiological studies on Alzheimer's disease (AD) have been conducted on large cohorts providing databases for studying the disease frequency, and leading to a more global overview of AD risk factors. However, precise identification of factors which potentiate or delay the pathological process of the disease is still incomplete. One of the major problems comes from difficulties for defining the cases and obtaining good clinical diagnoses in population-based studies. Moreover, it is difficult to determine the chronology of exposure-disease relationships whatever the factors studied: vascular factors, life habits (dietary habits, physical, social or intellectual activities...). Which life-course period is important for proposing interventions to modify these factors remains a central question. The longer follow-up of large cohorts and a better knowledge of potential risk factors constitute a research priority if we want to prevent efficiently AD in the near future.</p>","PeriodicalId":54537,"journal":{"name":"Psychologie & Neuropsychiatrie Du Vieillissement","volume":"7 Spec No 1 ","pages":"7-14"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/pnv.2009.0191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28635714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Psychology and neuropsychology of aging].","authors":"Christian Derouesné","doi":"10.1684/pnv.2009.0196","DOIUrl":"https://doi.org/10.1684/pnv.2009.0196","url":null,"abstract":"","PeriodicalId":54537,"journal":{"name":"Psychologie & Neuropsychiatrie Du Vieillissement","volume":"7 4","pages":"229"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/pnv.2009.0196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28611612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Unawareness in brain disorders: a complex and multifaceted phenomenon].","authors":"Christian Derouesné","doi":"10.1684/pnv.2009.0186","DOIUrl":"https://doi.org/10.1684/pnv.2009.0186","url":null,"abstract":"<p><p>Unawareness of the diseases or its consequences can be a protective mechanism against a traumatic event. However, it can also result in dangerous behaviors and hamper the care management. Still not well understood, unawareness is a very complex and multidimensional construct involving neurological, neuropsychological, psychopathological and psychosocial dimensions. Sometimes considered to be a categorical phenomenon, unawareness is actually partial and dimensional. Nevertheless, no or only weak correlation are found between the results of various methods used to its assessment. We propose that the usual opposition between neurological (anosognosia) and psychopathological (denial) conceptions should be replaced by an integrative approach of the various dimensions involved in unawareness to allow a better adaptation of the care management.</p>","PeriodicalId":54537,"journal":{"name":"Psychologie & Neuropsychiatrie Du Vieillissement","volume":"7 4","pages":"243-51"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/pnv.2009.0186","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28611615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Level of evidence for case management in Alzheimer's disease: a literature review].","authors":"Dominique Somme, Sébastien Carrier, Hélène Trouve, Dominique Gagnon, Olivier Dupont, Yves Couturier, Olivier Saint-Jean","doi":"10.1684/pnv.2009.0194","DOIUrl":"https://doi.org/10.1684/pnv.2009.0194","url":null,"abstract":"<p><p>Alzheimer's disease or related diseases patients are particularly vulnerable to fragmentation of the French system of care and support. The government has decided to implement a national plan from which two key steps are the implementation of integration and case management. We report results of a review of the literature on both the definition of these concepts and their impacts as reported in randomized controlled studies. Important differences are noticeable between studies concerning the spectrum of integration (acute and long-term care, social and health sectors, institutional and liberal sectors and financing mode notably). Case-management has multiple sense, and it must be paid attention to intensity and context of the intervention. According to available evidence, case management is likely to improve, for the person with Alzheimer's, quality of care, quality of life and quality of life of caregivers at least. Conditions for a program to be successful are adequate targeting of the target population, sufficient level of integration and adequate intensity of case management. The programs most successful and most intensive relate an effect on prevention of loss of autonomy, even death, and no extra cost. The effects on hospitalization or entry into the institution are currently hypothetical and should be further studied.</p>","PeriodicalId":54537,"journal":{"name":"Psychologie & Neuropsychiatrie Du Vieillissement","volume":"7 Spec No 1 ","pages":"29-39"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/pnv.2009.0194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28635598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Posterior cortical atrophy].","authors":"Didier Maillet, Christine Moroni, Catherine Belin","doi":"10.1684/pnv.2009.0169","DOIUrl":"https://doi.org/10.1684/pnv.2009.0169","url":null,"abstract":"<p><p>Posterior cortical atrophy belongs to the progressive focal atrophy group of neurodegenerative diseases. It is characterized by specific clinical deficits in visual perception, which can affect either visuo-spatial features or identity of objects. The posterior cortical atrophy, initially described by Pick in 1902, is a rare and not well known syndrome. While it is easy to differentiate posterior cortical atrophy from Alzheimer's disease, some cognitive deficits are common with those of Lewy body disease and corticobasal degeneration, which results in diagnostic mistakes. This paper proposes a synthetic review of the posterior cortical atrophy illustrated by a clinical case.</p>","PeriodicalId":54537,"journal":{"name":"Psychologie & Neuropsychiatrie Du Vieillissement","volume":"7 3","pages":"193-203"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/pnv.2009.0169","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28447343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[An experience of psychological support at home for aged and dependent people and their families. Assesment of the PsyAdom programme].","authors":"Ines Sta'm-Rad, Claudine Montani","doi":"10.1684/pnv.2009.0173","DOIUrl":"https://doi.org/10.1684/pnv.2009.0173","url":null,"abstract":"<p><p>The PsyAdom project has been initiated by the Clinical Psychologist Working in Gerontology Association. It consists in setting up an at home psychological follow-up for aged dependent subjects and their caregivers. Families are often isolated, and being kept up in their homes involves a risk of exhaustion. Psychological help is usually offered outside home, and cannot be available or very costly for some people. Eighteen couples were included in the study. Anxiety of the patients and caregivers was assessed by the Goldberg's anxiety scale, depression by the MADRS, experienced stress by the Mini-Zarit scale and attitude towards psychological help by the NPI. A qualitative assessment of the intervention was performed by recording semi-directed interviews of the involved psychologists to assess the patients and caregivers acceptance of the intervention, their compliance with participating, and reasons for stopping the intervention. No significant difference was found in the caregivers' burden and anxiety following the intervention. However, the results showed a lower level of depression in the caregivers, and a better attitude of the patients towards the caregivers. Analysis of the initial application for help and acceptance of the follow-up shows that possibility and relevance of psychological intervention at home depend on accurate indications. Initial application should be very unequivocal and the therapy protocol clearly explicited from the start to allow a good understanding of the goals of the therapy by the patients and caregivers.</p>","PeriodicalId":54537,"journal":{"name":"Psychologie & Neuropsychiatrie Du Vieillissement","volume":"7 3","pages":"205-11"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/pnv.2009.0173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28447345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Psychology and neuropsychiatry of aging].","authors":"Christian Derouesné","doi":"10.1684/pnv.2009.0179","DOIUrl":"https://doi.org/10.1684/pnv.2009.0179","url":null,"abstract":"","PeriodicalId":54537,"journal":{"name":"Psychologie & Neuropsychiatrie Du Vieillissement","volume":"7 3","pages":"149-50"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/pnv.2009.0179","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28372923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Loss of identity in Alzheimer's disease: a psychoanalytic approach].","authors":"Pierre-Marie Charazac","doi":"10.1684/pnv.2009.0177","DOIUrl":"https://doi.org/10.1684/pnv.2009.0177","url":null,"abstract":"<p><p>Loss of identity in Alzheimer's disease concerns successively mind and body. The disturbance of the body image is emphasized from the first stage of the disease to that of physical dependency. Identity disorder is also implicated in the caring relationship through the attack of identity of the formal and informal caregivers.</p>","PeriodicalId":54537,"journal":{"name":"Psychologie & Neuropsychiatrie Du Vieillissement","volume":"7 3","pages":"169-74"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/pnv.2009.0177","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28372925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Philippe Nubukpo, Paola Revue, Cecil Herrmann, Jean-Pierre Clément
{"title":"[Ethnopsychiatry in the elderly].","authors":"Philippe Nubukpo, Paola Revue, Cecil Herrmann, Jean-Pierre Clément","doi":"10.1684/pnv.2009.0176","DOIUrl":"https://doi.org/10.1684/pnv.2009.0176","url":null,"abstract":"<p><p>Ethnopsychiatry is defined as an approach aimed to understand the ethnic and cultural dimensions of mental illnesses. The triple interest of cross-cultural approach in psychiatry in the elderly is highlighted by a review of the literature and five clinical vignettes. The first interest is to help the diagnosis of mental disorders in aged immigrants. The second is to take into account the ethnopsychogeriatric specificities by the sanitary and social systems. The third involves some aspects of psychiatry in the elderly in Sub-Saharan Africa. With aging, the immigrant has to reinvent, successfully or not, new rationalizations of his/her presence. Moreover, he/she often presents a premature physical over-deterioration linked to difficult existing conditions. Caring for the elderly from an ethnopsychiatric approach supposes firstly, to grant him correct life and physical health conditions; secondly, training of professionals to consider their specific cultural dimensions and at last, adapting the care and help services. Ethnopsychiatry or cultural psychiatry in the elderly must take into account the social and cultural representations of the diseases. Presently, depression among the elderly is common in Africa and dementia is not rare.</p>","PeriodicalId":54537,"journal":{"name":"Psychologie & Neuropsychiatrie Du Vieillissement","volume":"7 3","pages":"175-83"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/pnv.2009.0176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28372926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Safety at home for people with dementia: Preliminary evaluation of situations-at-risk in a French geriatric memory clinic].","authors":"Julie Bourgeois, Pascal Couturier, Jeanne Tyrrell","doi":"10.1684/pnv.2009.0174","DOIUrl":"https://doi.org/10.1684/pnv.2009.0174","url":null,"abstract":"<p><p>Community-dwelling people with Alzheimer's disease are exposed to situations-at-risk at home, but this phenomenon has rarely been studied empirically. The purpose of this pilot study was to describe the safety problems experienced at home in a sample of patients with dementia seen in a memory clinic, and also to identify the factors associated with these situations-at-risk. Study participants were 38 demented persons who were living at home, and assessed in a memory clinic with a caregiver-relative. Caregiver-relatives took part in a semi-structured interview in which they completed a French version of the Safety Assessment Scale (Poulin de Courval et al., 2006). The results show that all people with dementia were exposed to risks at home. Patients living alone were perceived to be more at risk at home than those living with someone. The most commonly reported risks concerned fire, nutrition and polymedication. The assessment gathers interesting information, addressing a wide range of risks at home. The Safety Assessment Scale is a useful tool to detect the risks at home and to focus the interview with the caregivers towards their prevention, since improvements are likely to enhance safety.</p>","PeriodicalId":54537,"journal":{"name":"Psychologie & Neuropsychiatrie Du Vieillissement","volume":"7 3","pages":"213-24"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/pnv.2009.0174","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28447346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}