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Shatenstein B.,University of Montreal | Ferland G.,University of Montreal | Belleville S.,University of Montreal | Gray-Donald K.,McGill University | And 5 more authors.
Experimental Gerontology | Year: 2012

Background and objectives: A healthy diet may prevent cognitive decline either directly, or by decreasing risk of nutrition-related chronic diseases associated with cognitive decline. This study examined the relationships between diet quality (DQ) and cognition for over 3. years among 1488 older adults (52.6% female) from the NuAge study, aged 67 to 84. years at recruitment. Methods: Cognition was assessed at four annual visits using the modified mini-mental status examination (3MS); rate of cognitive decline was computed for each participant over the 3. years of follow-up using mixed model analyses and the individual-specific number of months between 3MS assessments. Dietary data were collected at recruitment using a validated 78-item, semi-quantitative food frequency questionnaire (FFQ). DQ was characterized as the Canadian Healthy Eating Index (C-HEI), a 9-component global DQ index (maximum score. =. 100) computed from the FFQ output. Other variables were collected by questionnaire or direct measurement. Multivariate analyses were carried out to assess the association of DQ controlled for confounders on cognition. Results: Total C-HEI was better in females (78.7. ±. 9.1 vs 75.7. ±. 9.4, p. <. .0001) as were C-HEI component subscores. Males, the less educated, smokers, those with poor social engagement, symptoms of depression, a higher waist:hip ratio and who reported financial insecurity had a poor quality diet that could contribute to chronic diseases associated with cognition. Along with functional autonomy, most of these variables emerged as covariates of baseline 3MS and predictors of cognitive decline. While certain C-HEI subscores and total C-HEI were positive univariate correlates of 3MS at recruitment, total DQ was not associated with cognition in multivariate analyses, either at baseline or over 3. years of follow-up. Conclusions: DQ was not independently associated with cognition. However, the study demonstrates relationships between diet quality and risk factors for chronic diseases associated with cognition. Consequently, older adults might benefit from a healthy diet to decrease risk of nutrition-related chronic diseases established as risk factors for cognitive decline. Further work in diverse older populations, use of dietary data collected earlier in life, finer cognitive measures and longer follow-up are necessary to better elucidate relationships between diet quality, chronic diseases and cognition. © 2012 Elsevier Inc.


Tomlinson G.,University of Toronto | Tomlinson G.,Toronto General Research Institute | Bremner K.E.,Toronto General Research Institute | Ritvo P.,University of Toronto | And 4 more authors.
Medical Decision Making | Year: 2012

Background. Previously, we developed a prostate cancer (PC)-specific health state classification system, the Patient Oriented Prostate Utility Scale (PORPUS). In this study, we developed a scoring system to allow indirect calculation of utilities from the PORPUS. Methods. We interviewed 234 PC outpatients, including those with newly diagnosed and metastatic disease, to obtain rating scale (RS) values on 4 to 6 levels of each of the 10 attributes of the PORPUS, and on 10 corner states (worst level on 1 attribute, best on 9). Patients also completed standard gamble (SG) and RS tasks on 4 multiattribute states (impotence and pain corner states, mild and severe PC symptoms). We used the RS and SG scores for multiattribute states to determine a risk aversion function for mapping values to utilities. We then tested 15 different strategies to estimate the multiattribute utility function (MAUF), using the single attribute disutilities for each level of the 10 PORPUS attributes, and the disutilities for the corner states. The root mean squared error (RMSE) of prediction of the SG on the 4 multiattribute states was used to identify the optimal strategy and scoring system. Results. The optimal strategy gave an RMSE of 0.06. Comparison of mean MAUF-predicted utilities to directly elicited SG utilities for the 2 multiattribute states from patients in 2 previously published studies (n = 248 and n = 141) supported the validity of the MAUF. Conclusions. The scoring system together with the PORPUS comprise an indirect utility instrument, the PORPUS-U, which can be used in clinical and research settings.


Mariani M.,Sudbury Regional Hospital | Shammi P.,Baycrest Center
Clinical Neuropsychologist | Year: 2010

We present a case study of an individual diagnosed with isolated neurosarcoidosis, a rare granulomatous condition of unknown aetiology. Although the extant medical literature on this disease is adequate, no study has focused on the neuropsychological sequelae involved with such an inflammatory disorder. The case described herein is of a 57-year-old woman who participated in a neuropsychological evaluation following complaints of recurring cognitive difficulties. Results of the assessment revealed moderate difficulties in effortful word retrieval and recall of unstructured verbal information, as well as some mild mental rigidity, slowing, and subtle difficulties with attention. Her neuropsychological profile is discussed in terms of neuroanatomic lesion localization and clinical diagnostic implications.


Fujioka T.,Rotman Research Institute | Ween J.E.,Baycrest Center | Ween J.E.,Rockwood Deaconess Medical Center | Jamali S.,University of Toronto | And 3 more authors.
Annals of the New York Academy of Sciences | Year: 2012

Precise timing of sound is crucial in music for both performing and listening. Indeed, listening to rhythmic sound sequences activates not only the auditory system but also the sensorimotor system. Previously, we showed the significance of neural beta-band oscillations (15-30 Hz) for the timing processing that involves such auditory-motor coordination. Thus, we hypothesized that motor rehabilitation training incorporating music playing will stimulate and enhance auditory-motor interaction in stroke patients. We examined three chronic patients who received Music-Supported Therapy following the protocols practiced by Schneider. Neuromagnetic beta-band activity was remarkably alike during passive listening to a metronome and during finger tapping, with or without the metronome, for either the paretic or nonparetic hand, suggesting a shared mechanism of the beta modulation. In the listening task, the magnitude of the beta decrease after the tone onset was more pronounced at the posttraining time point and was accompanied by improved arm and hand skills. The present case data give insight into the neural underpinnings of rehabilitation with music making and rhythmic auditory stimulation. © 2012 New York Academy of Sciences.


Winocur G.,Rotman Research Institute | Winocur G.,Trent University | Winocur G.,University of Toronto | Moscovitch M.,Rotman Research Institute | And 3 more authors.
Neurobiology of Learning and Memory | Year: 2013

This review evaluates three current theories - Standard Consolidation (Squire & Wixted, 2011), Overshadowing (Sutherland, Sparks, & Lehmann, 2010), and Multiple Trace-Transformation (Winocur, Moscovitch, & Bontempi, 2010) - in terms of their ability to account for the role of the hippocampus in recent and remote memory in animals. Evidence, based on consistent findings from tests of spatial memory and memory for acquired food preferences, favours the transformation account, but this conclusion is undermined by inconsistent results from studies that measured contextual fear memory, probably the most commonly used test of hippocampal involvement in anterograde and retrograde memory. Resolution of this issue may depend on exercising greater control over critical factors (e.g., contextual environment, amount of pre-exposure to the conditioning chamber, the number and distribution of foot-shocks) that can affect the representation of the memory shortly after learning and over the long-term. Research strategies aimed at characterizing the neural basis of long-term consolidation/transformation, as well as other outstanding issues are discussed. © 2013 Elsevier Inc.

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