Alzheimer’s disease (AD) is the most common neurodegenerative disease causing an alteration of life quality in the terminal stage. The purpose was to report 14 years of experience about the early impact on the qualit...Alzheimer’s disease (AD) is the most common neurodegenerative disease causing an alteration of life quality in the terminal stage. The purpose was to report 14 years of experience about the early impact on the quality of life of patients with AD. Methodology: Descriptive retrospective study over 14 years in the geriatric department of Pitié Salpêtrière Hospital, using the activity of daily living, Instrumental activity of daily living, neuropsychological inventory and Hoen Yahr scale evaluated at the time of diagnosis of AD according to the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer Disease’s and Related Disorders Association diagnostic criteria. Results: A total of 214 exploitable files had been listed. At the moment of diagnosis, the mean age was 82.1 years with extremes 68 to 95 with sex ratio 1.6 in women’s favor. The mean socio-cultural level was 4.9 with extremes about 0 to 7. There was poly pathology with a mean Cumulative Illness Rate Scale = 4.6 with extremes 0 to 16. the mean cognitive status was moderate = 22.5 with extremes 0 to 30. Quality life showed moderate impairment of IADL = 9.2 with extreme 3 to 11 compared to activity of daily living. The activity of daily living was more affected in 68 - 80-year-olds, while poly pathology impacted more on IADL in men. The cognitive impairment was more deficient in IADL when the MMSE test was low. The common disorders at the NPI were psychological, behavioral and psychotic. Conclusion: At the early diagnosis of Alzheimer’s Disease cognitive deficiencies were predominant and influenced on global Instrumental activity and psychological, behavioral disorders.展开更多
Background: Lewy body disease (LBD) is a neurodegenerative affection responsible for impaired quality of life. The objective was to share the data experience of 14 years concerning the functional, neuropsychological a...Background: Lewy body disease (LBD) is a neurodegenerative affection responsible for impaired quality of life. The objective was to share the data experience of 14 years concerning the functional, neuropsychological and behaviors effects on geriatrics patients. Methodology: Descriptive retrospective study over 14 years (2005 to 2019) in the geriatrics department of Pitié Salpétrière Hospital, using the instrumentals activity of daily living (IADL) sheets and the neuropsychological inventory (NPI) assessed at the moment diagnosis according to the diagnostic criteria of 2017 and 1996. Results: A total of 70 patients including 55 exploitable files had been listed with a mean age 82.6 years [70 - 91], a sex ratio 1.2 in men favor, a mean socio-cultural level 5.2 [1 - 7], a mean Cumulating Illness Scale (CIRS52) = 10 [1 - 22]. The mean IADL and NPI were respectively 9.3 [3 - 11] and 25.1 [0 - 79]. We found an early global impairment of IADL activities frequent in transport (65%), medication management (49%), and displacement (42%) for basic activities without significant statistical difference between the age and sex groups but statistically significant early involvement with polypathology after adjustment for displacement (45%) and transport (65%). The IADL impairment is significant as soon as the MMS-BREF decreases. Hoen Yahr (HY) scale increase could influences shopping (22%), displacement (27%) after adjustment. NPI disorders frequently found were apathy-depression (31.8% - 25%), anxiety (28%), irritability (25.6%) and sleep disturbance (22.9%) after 80 years old independently of gender and poly-pathology. Also, the best mental status was associated of less disturbance of NPI items. Conclusion: Polypathology, motor disorders and cognitive decline seem to influence IADL while with advanced age, cognitive decline appears to be worsened early in LBD.展开更多
Background: Rhupus is the rare association of two autoimmune diseases, systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) diagnosed according to validated ACR criteria. We present the first series of rhu...Background: Rhupus is the rare association of two autoimmune diseases, systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) diagnosed according to validated ACR criteria. We present the first series of rhupus in Niger. Observation 1: This is a patient suffering from chronic polyarthritis in whom the diagnosis of active seropositive, erosive and deforming RA had been made according to the 1987 ACR criteria and SLE on the presence of 4 criteria according to the 1997 ARA criteria and putting under conventional synthetic DMARDs. The outcome was favorable with a remission achieved after 8 weeks with a disease activity score (DAS) 28 at 2.2. Observation 2: 58-year-old patient with known diabetes type 2 in whom the diagnosis of rhupus was made according to the ACR/EULAR 2010 criteria for RA with a DAS28 of 3.6 and the 2019 LES criteria at 18 points with a SLEDAI score of 6. The evolution was marked by the occurrence of a myocardial infarction with a favorable outcome under medical management. Conclusion: Rhupus is a rare entity that can be complicated by cardiovascular events with the presence of an independent cardiovascular risk factor.展开更多
文摘Alzheimer’s disease (AD) is the most common neurodegenerative disease causing an alteration of life quality in the terminal stage. The purpose was to report 14 years of experience about the early impact on the quality of life of patients with AD. Methodology: Descriptive retrospective study over 14 years in the geriatric department of Pitié Salpêtrière Hospital, using the activity of daily living, Instrumental activity of daily living, neuropsychological inventory and Hoen Yahr scale evaluated at the time of diagnosis of AD according to the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer Disease’s and Related Disorders Association diagnostic criteria. Results: A total of 214 exploitable files had been listed. At the moment of diagnosis, the mean age was 82.1 years with extremes 68 to 95 with sex ratio 1.6 in women’s favor. The mean socio-cultural level was 4.9 with extremes about 0 to 7. There was poly pathology with a mean Cumulative Illness Rate Scale = 4.6 with extremes 0 to 16. the mean cognitive status was moderate = 22.5 with extremes 0 to 30. Quality life showed moderate impairment of IADL = 9.2 with extreme 3 to 11 compared to activity of daily living. The activity of daily living was more affected in 68 - 80-year-olds, while poly pathology impacted more on IADL in men. The cognitive impairment was more deficient in IADL when the MMSE test was low. The common disorders at the NPI were psychological, behavioral and psychotic. Conclusion: At the early diagnosis of Alzheimer’s Disease cognitive deficiencies were predominant and influenced on global Instrumental activity and psychological, behavioral disorders.
文摘Background: Lewy body disease (LBD) is a neurodegenerative affection responsible for impaired quality of life. The objective was to share the data experience of 14 years concerning the functional, neuropsychological and behaviors effects on geriatrics patients. Methodology: Descriptive retrospective study over 14 years (2005 to 2019) in the geriatrics department of Pitié Salpétrière Hospital, using the instrumentals activity of daily living (IADL) sheets and the neuropsychological inventory (NPI) assessed at the moment diagnosis according to the diagnostic criteria of 2017 and 1996. Results: A total of 70 patients including 55 exploitable files had been listed with a mean age 82.6 years [70 - 91], a sex ratio 1.2 in men favor, a mean socio-cultural level 5.2 [1 - 7], a mean Cumulating Illness Scale (CIRS52) = 10 [1 - 22]. The mean IADL and NPI were respectively 9.3 [3 - 11] and 25.1 [0 - 79]. We found an early global impairment of IADL activities frequent in transport (65%), medication management (49%), and displacement (42%) for basic activities without significant statistical difference between the age and sex groups but statistically significant early involvement with polypathology after adjustment for displacement (45%) and transport (65%). The IADL impairment is significant as soon as the MMS-BREF decreases. Hoen Yahr (HY) scale increase could influences shopping (22%), displacement (27%) after adjustment. NPI disorders frequently found were apathy-depression (31.8% - 25%), anxiety (28%), irritability (25.6%) and sleep disturbance (22.9%) after 80 years old independently of gender and poly-pathology. Also, the best mental status was associated of less disturbance of NPI items. Conclusion: Polypathology, motor disorders and cognitive decline seem to influence IADL while with advanced age, cognitive decline appears to be worsened early in LBD.
文摘Background: Rhupus is the rare association of two autoimmune diseases, systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) diagnosed according to validated ACR criteria. We present the first series of rhupus in Niger. Observation 1: This is a patient suffering from chronic polyarthritis in whom the diagnosis of active seropositive, erosive and deforming RA had been made according to the 1987 ACR criteria and SLE on the presence of 4 criteria according to the 1997 ARA criteria and putting under conventional synthetic DMARDs. The outcome was favorable with a remission achieved after 8 weeks with a disease activity score (DAS) 28 at 2.2. Observation 2: 58-year-old patient with known diabetes type 2 in whom the diagnosis of rhupus was made according to the ACR/EULAR 2010 criteria for RA with a DAS28 of 3.6 and the 2019 LES criteria at 18 points with a SLEDAI score of 6. The evolution was marked by the occurrence of a myocardial infarction with a favorable outcome under medical management. Conclusion: Rhupus is a rare entity that can be complicated by cardiovascular events with the presence of an independent cardiovascular risk factor.
