973 resultados para COGNITIVE DECLINE


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Cannabis use has been related to an elevated psychosis risk and attenuated cognitive functioning. Cannabis-related cognitive impairments are also observed in populations along the psychosis dimension. We here investigated whether a potential behavioural marker of the psychosis dimension (attenuated functional hemispheric asymmetry) is even further attenuated in individuals using cannabis (CU) versus those not using cannabis (nCU). We tested 29 patients with first episode psychosis (FEP; 11 CU) and 90 healthy controls (38 CU) on lateralized lexical decisions assessing left hemisphere language dominance. In patients, psychotic symptoms were assessed (PANSS). In controls, self-reported schizotypy was assessed (O-LIFE questionnaire). Results indicated that nCU FEP patients had a relative reduced hemispheric asymmetry, as did controls with increasing cognitive disorganisation scores, in particular when belonging to the group of nCU controls. Positive, disorganised and negative PANSS scores in patients and negative and positive schizotypy in controls were unrelated to hemispheric asymmetry. These findings suggest that cannabis use balances rather than exacerbates uncommon hemispheric laterality patterns. Moreover, in healthy populations, the potential stabilisation of typical hemispheric asymmetry in CU might be most relevant to individuals with elevated cognitive disorganisation. We discuss the potential beneficial and harmful effects of cannabis use along the psychosis dimension together with propositions for future studies that should account for the mediating role of additional substances (e.g. nicotine), cannabis composition (e.g. cannabidiol content), and individual differences (e.g. physical health, or absence of significant polysubstance use).

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PURPOSE: Huntington's disease is a rare condition. Patients are commonly treated with antipsychotics and tetrabenazine. The evidence of their effect on disease progression is limited and no comparative study between these drugs has been conducted. We therefore compared the effectiveness of antipsychotics on disease progression. METHODS: 956 patients from the Huntington French Speaking Group were followed for up to 8 years between 2002 and 2010. The effectiveness of treatments was assessed using Unified Huntington's Disease Rating Scale (UHDRS) scores and then compared using a mixed model adjusted on a multiple propensity score. RESULTS: 63% of patients were treated with antipsychotics during the survey period. The most commonly prescribed medications were dibenzodiazepines (38%), risperidone (13%), tetrabenazine (12%) and benzamides (12%). There was no difference between treatments on the motor and behavioural declines observed, after taking the patient profiles at the start of the drug prescription into account. In contrast, the functional decline was lower in the dibenzodiazepine group than the other antipsychotic groups (Total Functional Capacity: 0.41 ± 0.17 units per year vs. risperidone and 0.54 ± 0.19 vs. tetrabenazine, both p<0.05). Benzamides were less effective than other antipsychotics on cognitive evolution (Stroop interference, Stroop color and Literal fluency: p<0.05). CONCLUSIONS: Antipsychotics are widely used to treat patients with Huntington's disease. Although differences in motor or behavioural profiles between patients according to the antipsychotics used were small, there were differences in drug effectiveness on the evolution of functional and cognitive scores.

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Résumé : J'ai souvent vu des experts être d'avis contraires. Je n'en ai jamais vu aucun avoir tort. Auguste Detoeuf Propos d'O.L. Brenton, confiseur, Editions du Tambourinaire, 1948. En choisissant volontairement une problématique comptable typiquement empirique, ce travail s'est attelé à tenter de démontrer la possibilité de produire des enseignements purement comptables (ie à l'intérieur du schème de représentation de la Comptabilité) en s'interdisant l'emprunt systématique de theories clé-en-main à l'Économie -sauf quant cela s'avère réellement nécessaire et légitime, comme dans l'utilisation du CAPM au chapitre précédent. Encore une fois, rappelons que cette thèse n'est pas un réquisitoire contre l'approche économique en tant que telle, mais un plaidoyer visant à mitiger une telle approche en Comptabilité. En relation avec le positionnement épistémologique effectué au premier chapitre, il a été cherché à mettre en valeur l'apport et la place de la Comptabilité dans l'Économie par le positionnement de la Comptabilité en tant que discipline pourvoyeuse de mesures de représentation de l'activité économique. Il nous paraît clair que si l'activité économique, en tant que sémiosphère comptable directe, dicte les observations comptables, la mesure de ces dernières doit, tant que faire se peut, tenter de s'affranchir de toute dépendance à la discipline économique et aux théories-méthodes qui lui sont liées, en adoptant un mode opératoire orthogonal, rationnel et systématique dans le cadre d'axiomes lui appartenant en propre. Cette prise de position entraîne la définition d'un nouveau cadre épistémologique par rapport à l'approche positive de la Comptabilité. Cette dernière peut se décrire comme l'expression philosophique de l'investissement de la recherche comptable par une réflexion méthodique propre à la recherche économique. Afin d'être au moins partiellement validé, ce nouveau cadre -que nous voyons dérivé du constructivisme -devrait faire montre de sa capacité à traiter de manière satisfaisante une problématique classique de comptabilité empirico-positive. Cette problématique spécifique a été choisie sous la forme de traitement-validation du principe de continuité de l'exploitation. Le principe de continuité de l'exploitation postule (énonciation d'une hypothèse) et établit (vérification de l'hypothèse) que l'entreprise produit ses états financiers dans la perspective d'une poursuite normale de ses activités. Il y a rupture du principe de continuité de l'exploitation (qui devra alors être écartée au profit du principe de liquidation ou de cession) dans le cas de cessation d'activité, totale ou partielle, volontaire ou involontaire, ou la constatation de faits de nature à compromettre la continuité de l'exploitation. Ces faits concernent la situation financière, économique et sociale de l'entreprise et représentent l'ensemble des événements objectifs 33, survenus ou pouvant survenir, susceptibles d'affecter la poursuite de l'activité dans un avenir prévisible. A l'instar de tous les principes comptables, le principe de continuité de l'exploitation procède d'une considération purement théorique. Sa vérification requiert toutefois une analyse concrète, portant réellement et de manière mesurable à conséquence, raison pour laquelle il représente un thème de recherche fort apprécié en comptabilité positive, tant il peut (faussement) se confondre avec les études relatives à la banqueroute et la faillite des entreprises. Dans la pratique, certaines de ces études, basées sur des analyses multivariées discriminantes (VIDA), sont devenues pour l'auditeur de véritables outils de travail de par leur simplicité d'utilisation et d'interprétation. À travers la problématique de ce travail de thèse, il a été tenté de s'acquitter de nombreux objectifs pouvant être regroupés en deux ensembles : celui des objectifs liés à la démarche méthodologique et celui relevant de la mesure-calibration. Ces deux groupes-objectifs ont permis dans une dernière étape la construction d'un modèle se voulant une conséquence logique des choix et hypothèses retenus.

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Driving requires integrating multiple motor, sensory, and cognitive skills. As people age, cognition becomes increasingly vulnerable due to impairment and dementia. Older drivers suffering from dementia, even at an early stage, have been shown to be significantly more likely to develop unsafe driving. Primary care physicians have the difficult task to assess these persons' driving capacity. This paper briefly describes the consequences of altered cognition on driving capacity and proposes an algorithm to address this challenge.

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Immunotherapy against amyloid-β(Aβ) may improve rodent cognitive function by reducing amyloid neuropathology and is being validated in clinical trials with positive preliminary results. However, for a complete understanding of the direct and long-term immunization responses in the aged patient, and also to avoid significant side effects, several key aspects remain to be clarified. Thus, to investigate brain Aβ clearance and Th2 responses in the elderly, and the reverse inflammatory events not found in the immunized rodent, better Alzheimer"s disease (AD) models are required. In the aged familiar canine with a Cognitive Dysfunction Syndrome (CDS) we describe the rapid effectiveness and the full safety profile of a new active vaccine candidate for human AD prevention and treatment. In these aged animals, besidesa weak immune system, the antibody response activated a coordinated central and peripheral Aβ clearance, that rapidly improved their cognitive function in absence of any side effects. Our results also confirm the interest to use familiar dogs to develop innovative and reliable therapies for AD.

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BACKGROUND: Hodgkin lymphoma (HL) is a largely curable disease and its mortality had steadily declined in western Europe since the late 1960s. Only modest declines were, however, observed in central/eastern Europe. MATERIALS AND METHODS: We updated trends in mortality from HL in various European areas up to 2004 and analyzed patterns in incidence for selected European countries providing national data. RESULTS: In most western European countries, HL mortality continued to steadily decline up to the mid 2000s. More recent reductions were also observed in eastern European countries. Overall, mortality from HL declined from 1.17/100,000 (age-standardized, world population) in 1980-1989 to 1.42/100,000 in 2000-2004 in men from the 15 member states of the European Union (EU) from western and northern Europe. In the EU 10 accession countries of central and eastern Europe, male mortality from HL was 1.42/100,000 in 1980-1984, 1.32 in 1990-1994, and declined to 0.76 in 2000-2004. Similar trends were observed in women. No consistent patterns were found for HL incidence. CONCLUSIONS: The present work confirms the persistent declines in HL mortality in western European countries, and shows favorable patterns over more recent calendar years in central/eastern ones, where rates, however, are still at levels observed in western Europe in the early 1990s.

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Fundamentos: el aumento de la esperanza de vida en las personas con síndrome de Down plantea nuevos interrogantes sobre el proceso de su envejecimiento. La revisión bibliográfica sobre el tema muestra acuerdo sobre algunos aspectos diferenciales respecto a la población con discapacidad psíquica y la población general. Entre ellos, destacamos dos: a) la precocidad del inicio del proceso y b) el aumento de la probabilidad de desarrollar un envejecimiento patológico a causa de la demencia tipo Alzheimer. El objetivo del presente estudio se centra en la aportación de datos que ayuden a delimitar los posibles indicadores del declive cognitivo de las personas adultas con síndrome de Down relacionados con un posible deterioro propio de la demencia tipo Alzheimer. Método: el estudio se realiza en una muestra de 84 personas adultas con discapacidad psíquica, 42 de las cuales presentan el síndrome de Down. La media de edad se sitúa entorno a los 40 años y su nivel de retraso mental es medio. Se aplica de forma longitudinal en un período de dos años el test d’Aptituds Cognitives per a Deficiència del 65% (Castelló, Carrillo y Barnosell, 1996). Se utiliza un diseño factorial mixto de medidas repetidas controlando las variables etiología, edad cronológica, nivel de retraso mental y paso del tiempo. Resultados: se observa con el paso del tiempo, un declive cognitivo significativo de las personas con síndrome de Down de más de 38 años y nivel de retraso mental ligero respecto al grupo con discapacidad psíquica de referencia. Los indicadores cognitivos se sitúan preferentemente en las áreas de lenguaje y coordinación visomotora. Conclusiones: las personas con síndrome de Down de más de 38 años y nivel de retraso mental ligero manifiestan una probabilidad mayor de desarrollar un declive cognitivo relacionado con un probable deterioro propio de la demencia Alzheimer.

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Although usability evaluations have been focused on assessing different contexts of use, no proper specifications have been addressed towards the particular environment of academic websites in the Spanish-speaking context of use. Considering that this context involves hundreds of millions of potential users, the AIPO Association is running the UsabAIPO Project. The ultimate goal is to promote an adequate translation of international standards, methods and ideal values related to usability in order to adapt them to diverse Spanish-related contexts of use. This article presents the main statistical results coming from the Second and Third Stages of the UsabAIPO Project, where the UsabAIPO Heuristic method (based on Heuristic Evaluation techniques) and seven Cognitive Walkthroughs were performed over 69 university websites. The planning and execution of the UsabAIPO Heuristic method and the Cognitive Walkthroughs, the definition of two usability metrics, as well as the outline of the UsabAIPO Heuristic Management System prototype are also sketched.

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AIM: Longitudinal studies that have examined cognitive performance in children with intellectual disability more than twice over the course of their development are scarce. We assessed population and individual stability of cognitive performance in a clinical sample of children with borderline to mild non-syndromic intellectual disability. METHOD: Thirty-six children (28 males, eight females; age range 3-19y) with borderline to mild intellectual disability (Full-scale IQ [FSIQ] 50-85) of unknown origin were examined in a retrospective clinical case series using linear mixed models including at least three assessments with standardized intelligence tests. RESULTS: Average cognitive performance remained remarkably stable over time (high population stability, drop of only 0.38 IQ points per year, standard error=0.39, p=0.325) whereas individual stability was at best moderate (intraclass correlation of 0.58), indicating that about 60% of the residual variation in FSIQ scores can be attributed to between-child variability. Neither sex nor socio-economic status had a statistically significant impact on FSIQ. INTERPRETATION: Although intellectual disability during childhood is a relatively stable phenomenon, individual stability of IQ is only moderate, likely to be caused by test-to-test reliability (e.g. level of child's cooperation, motivation, and attention). Therefore, clinical decisions and predictions should not rely on single IQ assessments, but should also consider adaptive functioning and previous developmental history.