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1. Healthy Ageing Through Internet Counselling in the Elderly: the HATICE randomised controlled trial for the prevention of cardiovascular disease and cognitive impairment.

Author

Richard E, Jongstra S, Soininen H, Brayne C, Moll van Charante EP, Meiller Y, van der Groep B, Beishuizen CR, Mangialasche F, Barbera M, Ngandu T, Coley N, Guillemont J, Savy S, Dijkgraaf MG, Peters RJ, van Gool WA, Kivipelto M, and Andrieu S

Subjects
Aged, Aged, 80 and over, Cost-Benefit Analysis, Female, Finland, France, Humans, Internet statistics & numerical data, Life Style, Male, Netherlands, Prospective Studies, Research Design, Risk Factors, Self-Management, Cardiovascular Diseases prevention & control, Cognitive Dysfunction prevention & control, Counseling methods, Healthy Aging
Abstract

Introduction: Cardiovascular disease and dementia share a number of risk factors including hypertension, hypercholesterolaemia, smoking, obesity, diabetes and physical inactivity. The rise of eHealth has led to increasing opportunities for large-scale delivery of prevention programmes encouraging self-management. The aim of this study is to investigate whether a multidomain intervention to optimise self-management of cardiovascular risk factors in older individuals, delivered through an coach-supported interactive internet platform, can improve the cardiovascular risk profile and reduce the risk of cardiovascular disease and cognitive decline., Methods and Analysis: HATICE is a multinational, multicentre, prospective, randomised, open-label blinded end point (PROBE) trial with 18 months intervention. Recruitment of 2600 older people (≥65 years) at increased risk of cardiovascular disease will take place in the Netherlands, Finland and France. Participants randomised to the intervention condition will have access to an interactive internet platform, stimulating self-management of vascular risk factors, with remote support by a coach. Participants in the control group will have access to a static internet platform with basic health information.The primary outcome is a composite score based on the average z-score of the difference between baseline and 18 months follow-up values of systolic blood pressure, low-density-lipoprotein and body mass index. Main secondary outcomes include the effect on the individual components of the primary outcome, the effect on lifestyle-related risk factors, incident cardiovascular disease, mortality, cognitive functioning, mood and cost-effectiveness., Ethics and Dissemination: The study was approved by the medical ethics committee of the Academic Medical Center in Amsterdam, the Comité de Protection des Personnes Sud Ouest et Outre Mer in France and the Northern Savo Hospital District Research Ethics Committee in Finland.We expect that data from this study will result in a manuscript published in a peer-reviewed clinical open access journal., Trial Registration Number: ISRCTN48151589., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Published
2016
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2. Duration of preclinical, prodromal, and dementia stages of Alzheimer's disease in relation to age, sex, and APOE genotype

Author

Vermunt, L., Sikkes, S. A. M., van den Hout, A., Handels, R., Bos, I., van der Flier, W. M., Kern, S., Ousset, P. -J., Maruff, P., Skoog, I., Verhey, F. R. J., Freund-Levi, Y., Tsolaki, M., Wallin, A. K., Olde Rikkert, M., Soininen, H., Spiru, L., Zetterberg, H., Blennow, K., Scheltens, P., Muniz-Terrera, G., Visser, P. J., Vellas, B., Reynish, E., Ousset, P. J., Andrieu, S., Burns, A., Pasquier, F., Frisoni, G., Salmon, E., Michel, J. P., Zekry, D. S., Boada, M., Dartigues, J. F., Olde-Rikkert, M. G. M., Rigaud, A. S., Winblad, B., Malick, A., Sinclair, A., Frolich, L., Ribera, C., Touchon, J., Robert, P., Salva, A., Waldemar, G., Bullock, R., Rodriguez, G., Jones, R. W., Stiens, G., Stoppe, G., Eriksdotter Jonhagen, M., Cherubini, A., Lage, P. M., Gomez-Isla, T., Camus, V., Aguera-Morales, E., Lopez, F., Savy, S., Cantet, C., Coley, N., Psychiatrie & Neuropsychologie, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, MUMC+: MA Med Staf Spec Psychiatrie (9), Neurology, Amsterdam Neuroscience - Neurodegeneration, NCA - neurodegeneration, APH - Personalized Medicine, APH - Methodology, Epidemiology and Data Science, Clinical Neuropsychology, and Zekry Berger, Dina Selma

Subjects
0301 basic medicine, Apolipoprotein E, Oncology, Male, NATIONAL INSTITUTE, MILD COGNITIVE IMPAIRMENT, Neurology, Alzheimer`s disease Donders Center for Medical Neuroscience [Radboudumc 1], Time Factors, Epidemiology, Apolipoprotein E4, Disease, RECOMMENDATIONS, 0302 clinical medicine, Cerebrospinal fluid, Genotype, Longitudinal Studies, Apolipoprotein E4/genetics, Stage (cooking), Progression, Health Policy, Cognitive Dysfunction/pathology, NEURODEGENERATION, Alzheimer's disease, Preclinical, 3. Good health, PREVALENCE, Psychiatry and Mental health, Disease Progression, lipids (amino acids, peptides, and proteins), Female, ASSOCIATION WORKGROUPS, APOE, medicine.medical_specialty, Amyloid, Multistate model, BETA-AMYLOID 1-42, Prodromal Symptoms, tau Proteins, 03 medical and health sciences, Cellular and Molecular Neuroscience, Sex Factors, Developmental Neuroscience, SDG 3 - Good Health and Well-being, Alzheimer Disease, Internal medicine, mental disorders, medicine, Dementia, Humans, Biomarkers/cerebrospinal fluid, Cognitive Dysfunction, Alleles, Aged, Disease duration, DECLINE, business.industry, tau Proteins/cerebrospinal fluid, Alzheimer Disease/genetics/pathology, medicine.disease, Institutional repository, Clinical setting, 030104 developmental biology, Prodromal, Positron-Emission Tomography, ddc:618.97, RISK-FACTORS, DIAGNOSTIC GUIDELINES, Neurology (clinical), Geriatrics and Gerontology, business, 030217 neurology & neurosurgery, Biomarkers
Abstract

Introduction: We estimated the age-specific duration of the preclinical, prodromal, and dementia stages of Alzheimer's disease (AD) and the influence of sex, setting, apolipoprotein E (APOE) genotype, and cerebrospinal fluid tau on disease duration.Methods: We performed multistate modeling in a combined sample of 6 cohorts (n = 3268) with death as the end stage and estimated the preclinical, prodromal, and dementia stage duration.Results: The overall AD duration varied between 24 years (age 60) and 15 years (age 80). For individuals presenting with preclinical AD, age 70, the estimated preclinical AD duration was 10 years, prodromal AD 4 years, and dementia 6 years. Male sex, clinical setting, APOE epsilon 4 allele carriership, and abnormal cerebrospinal fluid tau were associated with a shorter duration, and these effects depended on disease stage.Discussion: Estimates of AD disease duration become more accurate if age, sex, setting, APOE, and cerebrospinal fluid tau are taken into account. This will be relevant for clinical practice and trial design. (C) 2019 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Published
2019

3. Predicting the Rate of Cognitive Decline in Alzheimer Disease

Author

Canevelli, Marco, Kelaiditi, Eirini, Del Campo, Natalia, Bruno, Giuseppe, Vellas, Bruno, Cesari, Matteo, Vellas, B., Reynish, E., Ousset, P. J., Andrieu, S., Burns, A., Pasquier, F., Frisoni, G., Salmon, E., Michel, J. P., Zekry, D. S., Boada, M., Dartigues, J. F., Olde Rikkert, M. G. M., Rigaud, A. S., Winblad, B., Malick, A., Sinclair, A., Frölich, L., Scheltens, P., Ribera, C., Touchon, J., Robert, P., Salva, A., Waldmar, G., Bullock, R., Costa Tsolaki, M., Rodriguez, G., Spiru, L., Jones, R. W., Stiens, G., Stoppe, G., Eriksdotter Jönhagen, M., Cherubini, A., Lage, P. M., Gomez Isla, T., Camus, V., Agüera Morales, E., Lopez, F., Savy, S., Cantet, C., Coley, N., Neurology, and Amsterdam Neuroscience - Neurodegeneration

Subjects
Male, Aging, medicine.medical_specialty, Cognitive decline, Neuropsychological Tests, Prediction models, Alzheimer disease, Longitudinal studies, Clinical Psychology, Gerontology, Geriatrics and Gerontology, Psychiatry and Mental Health, 03 medical and health sciences, 0302 clinical medicine, Alzheimer Disease, Negatively associated, Internal medicine, medicine, Humans, Cognitive Dysfunction, Prospective Studies, Cognitive impairment, Prospective cohort study, Aged, Mini–Mental State Examination, 030214 geriatrics, medicine.diagnostic_test, business.industry, Cognition, medicine.disease, Multinomial logistic regression analysis, Psychiatry and Mental health, Disease Progression, Female, Alzheimer's disease, business, 030217 neurology & neurosurgery
Abstract

Background: Different rates of cognitive progression have been observed among Alzheimer disease (AD) patients. The present study aimed at evaluating whether the rate of cognitive worsening in AD may be predicted by widely available and easy-to-assess factors. Methods: Mild to moderate AD patients were recruited in the ICTUS study. Multinomial logistic regression analysis was performed to measure the association between several sociodemographic and clinical variables and 3 different rates of cognitive decline defined by modifications (after 1 year of follow-up) of the Mini Mental State Examination (MMSE) score: (1) "slow" progression, as indicated by a decrease in the MMSE score ≤1 point; (2) "intermediate" progression, decrease in the MMSE score between 2 and 5 points; and (3) "rapid" progression, decrease in the MMSE score ≥6 points. Results: A total of 1005 patients were considered for the present analyses. Overall, most of the study participants (52%) exhibited a slow cognitive course. Higher ADAS-Cog scores at baseline were significantly associated with both "intermediate" and "rapid" decline. Conversely, increasing age was negatively associated with "rapid" cognitive worsening. Conclusions: A slow progression of cognitive decline is common among AD patients. The influence of age and baseline cognitive impairment should always be carefully considered when designing AD trials and defining study populations.

Published
2016

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