Authors: Rouch, Isabelle | Padovan, Catherine | Pongan, Elodie | Boublay, Nawéle | Laurent, Bernard | Dorey, Jean-Michel | Krolak-Salmon, Pierre
Article Type: Research Article
Abstract: Background: A link between personality traits and cognitive performance has been shown in normal adults and elderly individuals. Very few studies have evaluated this link in Alzheimer’s disease (AD). Objective: To better understand cognitive performance as regards to personality traits, our study was aimed to evaluate the role of premorbid personality on cognitive functioning in a population of patients presenting prodromal or mild AD. Methods: 181 elderly with prodromal or mild AD participated in a cross-sectional, prospective cohort study. The participants completed a personality inventory and a neuropsychological battery exploring memory, attention, executive function, language, and praxis. Cognitive performance were …compared according to the level of each personality trait, using multivariate MANOVA models. Results: A higher level of neuroticism was associated with lower performance at similarities test (D = 9.49, p = 0.003), delayed Free and Cued Selective Reminding test (D = 5.22, p = 0.02), and digit span score (D = 7.99, p = 0.006). A higher level of openness was related to better performance at similarities (D = 4.33, p = 0.04), letter fluency (D = 11.45, p = 0.001), and category fluency test (D = 5.85, p = 0.02). Neuroticism interfered negatively with cognitive functioning at the prodromal stage; the association between openness and cognitive function was observed at both prodromal and mild AD stage. Conclusion: These results suggest that personality traits, in particular neuroticism and openness, modulate cognitive abilities in patients with early AD. These results encourage the development of stress management programs to prevent its negative effects on cognitive aging. Show more
Keywords: Alzheimer’s disease, cognitive function, neuroticism, openness, personality
DOI: 10.3233/JAD-190459
Citation: Journal of Alzheimer's Disease, vol. 71, no. 4, pp. 1153-1162, 2019
Authors: Pongan, Elodie | Dorey, Jean-Michel | Borg, Céline | Getenet, Jean Claude | Bachelet, Romain | Lourioux, Charles | Laurent, Bernard | COVCARE Group | Rey, Romain | Rouch, Isabelle
Article Type: Research Article
Abstract: Background: From March 2020, the support and care systems for caregivers and people with dementia (PWD) were suspended or dramatically changed due to the lockdown during the world pandemic of COVID-19. Thus, these changes in living conditions have had deleterious consequences on the behavior of PWD and subsequently on their caregivers’ mental health, the two being linked. Objective: Our study aimed to examine changes in behavior among PWD and to look for associations between the evolution of behavioral and psychological symptoms of dementia (BPSD) and caregivers’ mental health in the context of COVID-19. Methods: The study was conducted among caregivers …of PWD living at home in France. Caregivers were interviewed via an anonymous cross-sectional online survey during the first lockdown between April 15 and June 15, 2020. Results: Three hundred and eighty-nine caregivers accompanying a relative living at home participated in the study; 43.3%of the PWD presented a worsening of BPSD during the lockdown. With multivariate logistic regressions, a significant association was observed between ”more BPSD” and burden, anxiety and depression, between “BPSD equivalent” and anxiety and depression, and between “emerging BPSD” and only depression. Conclusion: The lockdown seems to have an impact on behavioral disorders in PWD and these disorders are associated with poorer mental health of caregivers. Our findings suggest attention should be given to caregivers of PWD who have BPSD before lockdown and the need for continued consultations and professional help in case of new lockdowns. Show more
Keywords: Behavioral disorder, caregivers, COVID-19, lockdown, mental health
DOI: 10.3233/JAD-201396
Citation: Journal of Alzheimer's Disease, vol. 80, no. 4, pp. 1713-1721, 2021
Authors: Dorey, Jean-Michel | Rouch, Isabelle | Padovan, Catherine | Boublay, Nawèle | Pongan, Elodie | Laurent, Bernard | PACO Group | von Gunten, Armin | Krolak-Salmon, Pierre
Article Type: Research Article
Abstract: Background: Neuroticism is recognized as the personality domain that is most strongly associated with behavioral and psychological symptoms (BPS) of Alzheimer’s disease (AD). Two sub-components of neuroticism have been recently isolated. Neuroticism-withdrawal (N-withdrawal) refers to the tendency to internalize negative emotion, whereas neuroticism-volatility (N-volatility) reflect the predisposition to externalize negative emotions. Objective: The objective of the current study was to investigate the specific influence of these two sub-components of neuroticism on BPS. Methods: One hundred eighty-seven patients with prodromal or mild AD were drawn from the PACO study (Personalité Alzheimer COmportement). Neuroticism and its facets were assessed at baseline using …the NEO-PI-R inventory. N-withdrawal and N-volatility were isolated using a principal component analysis led on the six facets composing neuroticism. BPS were measured with the short version of Neuropsychiatric Inventory (NPI-Q) and collected at baseline, then every 6 months over an 18-month follow-up. Linear mixed-effect analyses were conducted to investigate the association between N-withdrawal, N-volatility, and the severity of BPS over the follow-up. Results: Mean age of the participant was 79.2±6.5; 59% were female; mean MMSE was 24.5±2.5. Both N-volatility and N-withdrawal were related with the NPI-Q (p < 0.001; p = 0,004). N-withdrawal was positively associated with anxiety (p = 0.001) and depression (p = 0.002), while N-volatility was positively related to delusions (p = 0.004), agitation/aggression (p < 0.001), irritability/volatility (p = 0.037), and apathy (p = 0.021). Conclusion: The present study demonstrates that N-volatility and N-withdrawal influence the risk of developing BPS in a different way. These results highlight the relevance of considering sub-components of neuroticism when studying links between personality and BPS. Show more
Keywords: Alzheimer’s disease, behavior, dementia, neuroticism, personality
DOI: 10.3233/JAD-190884
Citation: Journal of Alzheimer's Disease, vol. 74, no. 1, pp. 79-89, 2020
Authors: Rouch, Isabelle | Pongan, Elodie | Leveque, Yohana | Tillmann, Barbara | Trombert, Béatrice | Getenet, Jean Claude | Auguste, Nicolas | Krolak-Salmon, Pierre | the LACMé group | Laurent, Bernard | Dorey, Jean-Michel
Article Type: Research Article
Abstract: Background: Alzheimer’s disease (AD) mainly occurs in elderly individuals. Comorbidities and chronic pain are frequent in this population. Previous studies revealed that personality modulates both chronic pain (CP) andADoccurrence and evolution. Moreover, as pain treatments can induce side-effects, non-drugs treatments, such as art interventions, are interesting alternative therapies for decreasing CP in these patients. Objective: Our aim was to assess the potential role of personality traits on art intervention efficacy for reducing CP in a population of patients with mild AD. Methods: Design: multicenter randomized controlled trial. Fifty mild AD patients underwent a 12-week art intervention including singing and painting …groups. Personality was assessed with the Big Five Inventory before the sessions. CP was measured with Numeric Rating Scale (NRS) [Usual pain (NRS-U) and most Intense pain (NRS-I)], Simple Visual Scale [Usual pain (SVS-U) and most Intense pain (SVS-I)] and Brief Pain Inventory (BPI) before and after the sessions. The influence of personality traits on CP evolution before and after art intervention was assessed with multiple linear regression models. Results: A positive association was observed between neuroticism and the evolution of three CP measures including NRS-U (B = 0.34, p = 0.01), SVS-U (B = 0.20, p = 0.04), and BPI-U (B = 0.46, p = 0.02) evolution. No significant relationship was observed between neuroticism and NRS-I, SVS-I and BPI-R evolution. Conclusions: Our findings suggest that neuroticism can decrease the efficacy of group art intervention on pain in patients with mild AD. Individual therapies could be more appropriate for these patients. These results emphasize the interest of taking into account patients’ personality before proposing them to participate to a group therapy. Show more
Keywords: Alzheimer’s disease, music, pain, personality
DOI: 10.3233/JAD-170990
Citation: Journal of Alzheimer's Disease, vol. 63, no. 2, pp. 617-624, 2018
Authors: Pongan, Elodie | Dorey, Jean-Michel | Krolak-Salmon, Pierre | Federico, Denis | Sellier, Claire | Auguste, Nicolas | Fabre, Florence | Laurent, Bernard | Trombert-Paviot, Béatrice | Rouch, Isabelle
Article Type: Research Article
Abstract: Background: Previous studies showed that a third of patients living at home entered an institution after hospitalization in Cognitive and Behavioral Units (CBUs). Objective: The main objective of this study was to identify predictors of discharge destination for these patients. The secondary objective was to estimate whether institutionalization can have an impact on a patient’s long-term prognosis. Methods: The study population was selected from the EVITAL study and included 140 participants living at home before hospitalization in CBUs. Factors favoring nursing-home admission were investigated and the impact of discharge destinations (i.e., home or nursing home) on patients’ prognosis was examined. …Results: Institutionalized patients were more likely to be women (F = 4.7; p = 0.03), with a higher dementia severity (F = 9.82; p = 0.007), often living alone (F = 19.69; p = 0.001), with a caregiver other than spouse (F = 8.93; p = 0.003), and with a higher patient quality of life (QoL) according to the caregiver (F = 11.73; p = 0.001). When using multivariate logistic linear regressions, we showed a relationship between marital status (OR = 0.19, 95% CI: 0.08–0.43, p < 0.001), dementia severity (OR = 0.15, 95% CI: 0.03–0.79, p = 0.03), QoL (OR = 0.88, 95% CI: 0.79–0.98, p = 0.017), and institutionalization. At three months, a higher overall rate of rehospitalization (F = 12.21; p < 0.001) and rehospitalization for behavioral and psychological symptoms of dementia (F = 6.76; p = 0.006) were observed for patients staying at home after CBU discharge. Conclusion: Our study allows for a better understanding of the institutionalization risk factors of the patients hospitalized in CBUs. Identification of these factors could help clinicians to better support patients and to help the transition to be smoother. Moreover, our results suggest that prognosis of institutionalized patients is not unfavorable when compared with patients staying at home. Show more
Keywords: Alzheimer’s disease and related disorders, behavioral and psychological symptoms of dementia, caregivers, institutionalized patients, nursing home placement, predictors
DOI: 10.3233/JAD-170419
Citation: Journal of Alzheimer's Disease, vol. 60, no. 4, pp. 1259-1266, 2017
Authors: Borg, Céline | Rouch, Isabelle | Pongan, Elodie | Getenet, Jean Claude | Bachelet, Romain | Herrmann, Mathieu | Bohec, Anne-Lise | Laurent, Bernard | COVCARE Group | Rey, Romain | Dorey, Jean-Michel
Article Type: Research Article
Abstract: Background: People with dementia (PWD) and their caregivers are populations highly vulnerable to COVID-19 pandemic and its consequences. A better knowledge of the living conditions during the first lockdown is necessary to prevent the risk of poor mental health (PMH) in this population. Objective: The present study aimed to compare the mental health of caregivers of PWD living at home or in nursing-homes and to identify specific factors influencing their mental health. Methods: We conducted an anonymous cross-sectional online survey in France from March 17 to May 11, 2020. Three hundred and eighty-nine caregivers accompanying a PWD living at home …(HC) and 159 accompanying a PWD living in a nursing home (NHC) participated in the study. Caregivers’ mental health including anxiety, depression, stress, and burden was assessed with self-reported standardized scales. Results: Half of the caregivers exhibited PMH, including depression, anxiety, or self-reported stress. Similar PMH rates were provided whatever the PWD place of residence. Regarding HC, our results also highlighted a number of risk factors for PMH, including the fact that caregiver live with PWD, to give increased support to PWD, and to feel more isolated for managing PWD since lockdown. Conclusion: PMH was observed for caregivers of PWD during lockdown, whatever PWD living place, suggesting that concern for PWD may explain more of caregiver distress than increased material tasks. In the future, it will be necessary to pay attention to caregivers after the crisis by estimating the longer-term impact on their mental health. Show more
Keywords: Alzheimer’s disease, caregivers, COVID-19, dementia, lockdown, mental health
DOI: 10.3233/JAD-210079
Citation: Journal of Alzheimer's Disease, vol. 82, no. 4, pp. 1531-1541, 2021
Authors: Pongan, Elodie | Tillmann, Barbara | Leveque, Yohana | Trombert, Béatrice | Getenet, Jean Claude | Auguste, Nicolas | Dauphinot, Virginie | El Haouari, Hanane | Navez, Malou | Dorey, Jean-Michel | Krolak-Salmon, Pierre | The LACMé Group | Laurent, Bernard | Rouch, Isabelle
Collaborators: Auguste, Nicolas | Bachelet, Romain | Brunon, Laurence | Dayot, Jenny | Dorey, Jean-Michel | El Haouari, Hanane | Fatisson, Marion | Ferrer, Marion | Gaillat, Charlotte | Gentil, Claire | Getenet, Jean Claude | Goldet, Karine | Krolak-Salmon, Pierre | Laurent, Bernard | Leroyer, Marie | Leveque, Yohana | Michon, Agnès | Mortreux, Angélique | Navez, Malou | Neagu, Anca | Perrot, Catherine | Pongan, Elodie | Rouch, Isabelle | Solimeo, Mathilde | Tillmann, Barbara | Touzet du Vigier, Anaïs | Vulliez, Elodie
Article Type: Research Article
Abstract: Background: Among non-pharmacological therapies, musical intervention is often used for patients with Alzheimer’s disease (AD) and patients presenting chronic pain. However, their efficacy is still under debate. Objective: Our aim was to determine the efficacy of choral singing versus painting sessions on chronic pain, mood, quality of life, and cognition in AD patients. Methods: In this multicenter randomized controlled trial, 59 mild AD patients were randomized to a 12-week singing (SG; n = 31) or painting group (PG; n = 28). Chronic pain, anxiety, depression, and quality of life were assessed before, after, and 1 month after the sessions. Cognitive abilities were …assessed before and after interventions. The evolution of these different measures was assessed with mixed linear models. The primary data analysis was by intention-to-treat, and completed by a ‘per protocol’ approach. Results: Both singing and painting interventions led to significant pain reduction (Time effect: F = 4.71; p = 0.01), reduced anxiety (Time effect: F = 10.74; p < 0.0001), improved Quality of Life (Time effect: F = 6.79; p = 0.002), improved digit span (F = 12.93; p = 0.001), and inhibitory processes (Time effect: F = 4.93; p = 0.03). Depression was reduced over time in PG only (Time x Group effect: F = 4.53; p = 0.01). Verbal Memory performance remained stable over time in SG, but decreased in PG (Time x group effect: F = 9.29; p = 0.004). Conclusion: Findings suggest that singing and painting interventions may reduce pain and improve mood, quality of life, and cognition in patients with mild AD, with differential effects of painting for depression and singing for memory performance. Show more
Keywords: Alzheimer’s disease, anxiety, cognitive impairment, depression, music, pain
DOI: 10.3233/JAD-170410
Citation: Journal of Alzheimer's Disease, vol. 60, no. 2, pp. 663-677, 2017
Authors: Rouch, Isabelle | Pongan, Elodie | Trombert, Béatrice | Fabre, Florence | Auguste, Nicolas | Sellier, Claire | Freulon, Magalie | Jacqueline, Sophie | Federico, Denis | Mouchoux, Christelle | Martin-Gaujard, Géraldine | Krolak-Salmon, Pierre | Laurent, Bernard | Dorey, Jean-Michel
Article Type: Research Article
Abstract: Background: The 2008–2012 French Alzheimer’s Plan has provided hospital Cognitive and Behavioral Units (CBU) to improve the management of patients with productive behavioral and psychological symptoms of dementia (BPSD). Little is known concerning the behavioral outcome of these patients after discharge. Objective: The present study investigated the long-term evolution of BPSD over one year after CBU discharge. Methods: The EVITAL cohort included 221 participants admitted to the CBUs of 3 French hospitals. BPSD were collected using the Neuropsychiatric Inventory (NPI) at admission and 3, 6, and 12 months after hospitalization. The global NPI score evolution was assessed using a linear …mixed-effect model. A four-factor model of the NPI including behavioral dyscontrol, psychosis, mood, and agitation subscores was also analyzed. Results: Our analysis focused on 148 patients followed up during 12 months and evaluated at each visit. The global NPI score was 48.5 (SD 21.7) at baseline, 28.8 (SD 18.7) at 3-month, 23.2 (SD 16.4) at 6-month and 20.9 (SD 15.9) at 12-month follow-up. The score significantly decreased from baseline to follow-up (F = 109.3 p < 0.0001). Moreover, the decrease was observed for each NPI subscores. The Clinical Dementia Rating (CDR) scale score was significantly linked to the baseline NPI score (t = 2.76, p = 0.009). Conversely, the NPI decline was observed whatever the CDR level. Conclusion: The present study showed a decrease in the global NPI score and all its subscores during the year following the CBU hospitalization, regardless of the initial CDR score. Show more
Keywords: Alzheimer’s disease, behavioral disorders, BPSD, dementia, longitudinal study
DOI: 10.3233/JAD-161023
Citation: Journal of Alzheimer's Disease, vol. 57, no. 1, pp. 147-155, 2017
