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Saint-Sauveur-en-Rue, France

Thomas-Anterion C.,CNRS Laboratory of Cognitive Mechanisms | Hugonot-Diener L.,Hopital Broca
Pratique Neurologique - FMC

Summary The MoCA was built as a screening test for detecting patients in the general population with light cognitive dysfunctions and at a higher risk for dementia. It is available in 20 languages (http://www.mocatest.org/), but it does not have normative data in French. This test assesses different cognitive functions in 10 tasks: executive functions, attention and concentration, memory, language, visuospatial skills, capacities of abstraction, calculation and orientation. The administration time ranges from 6 to 15 minutes. The pathological threshold of 26/30 appears to be relevant. The test was developed to screen for pre-Alzheimer MCI, but its executive component has been found to be more sensitive for patients with an executive function impairment, such as in Parkinson's or Huntington's disease, but not for patients with vascular disease. This test contribution to the screening procedure for executive function disorders, avoiding over-correlation with the sociocultural level. © 2013 Elsevier Masson SAS. All rights reserved. Source

Cocaine addiction has medical, psychological, cognitive, social, and legal consequences. For a while confined to a targeted audience, epidemiological data show that cocaine addiction considerably "increases" in Europe and reaches all social categories, including socialized people. The cognitive-behavioral approach provides a conceptual frame allowing a better understanding of the mechanisms involved in at the beginning and all along the cocaine addiction. Consumption and addiction to cocaine are then considered learned behaviors. Cognitive-behavioral therapies applied to the treatment of cocaine addiction include different therapeutic techniques that modify maladjusted behaviors, thoughts, and feelings leading to consumption. On a pharmacologic point of view, there is no drug treatment for this disorder, even though promising tracks emerged, especially the N-acétylcystéine. © 2010 Springer Verlag France. Source

Duron E.,University of Paris Descartes | Hanon O.,Hopital Broca
Journal of Alzheimer's Disease

Chronic hypertension is associated with an increased risk of both vascular dementia and Alzheimer's disease (AD). In this context, the role of anti-hypertensive therapy for the prevention and delay of cognitive decline and dementia is of central importance. Most longitudinal studies have shown a significant inverse association between anti-hypertensive therapies and dementia incidence and for some of these, particularly in AD. Seven randomized, double blind placebo-controlled trials have evaluated the benefit of antihypertensive treatments on cognition. Three of them found positive results in term of prevention of dementia (SYST-EUR) or cognitive decline (PROGRESS, HOPE). Others disclosed non-significant results (MRC, SHEP, SCOPE, HYVET-COG). This discrepancy emphasizes the difficulty to perform such trials: the follow-up has to be long enough to disclose a benefit, a large number of patients is needed for these studies, and because of ethical reasons some anti-hypertensive treatments are often prescribed in the placebo group. Results of the two more recent meta-analyses are inconsistent, possibly due to methodological issues. Antihypertensive treatments could be beneficial to cognitive function by lowering blood pressure and/or by specific neuroprotective effect. Three main antihypertensive subclasses have been associated with a beneficial effect on cognitive function beyond blood pressure reduction (calcium channel blockers, angiotensin converting enzyme inhibitor, angiotensin-AT1-receptor-blockers). Further long-term randomized trials, designed especially to assess a link between antihypertensive therapy and cognitive decline or dementia are therefore needed with cognition as the primary outcome. A low blood pressure threshold that could be deleterious for cognitive function should also be determined. © 2010 - IOS Press and the authors. Source

Wu Y.-H.,Hopital Broca | Wu Y.-H.,University of Paris Descartes | Wrobel J.,Hopital Broca | Wrobel J.,University of Paris Descartes | And 11 more authors.

Objective: The ROBADOM project was devoted to the design of a "robot butler", capable of providing verbal and non-verbal interactions and feedbacks for assisting older adults at home. In this article we focused on the following issues: (1) study the social context for designing social robot; define the robot appearance and investigate the perceptions and attitudes of older adults towards an assistive robot; (2) examine the perception of the expressivity of the robot, the social signals showing the end-user engagement level and the role of agent embodiment during the interaction between older adults and a robot. Method: The design of the studies involved both qualitative and experimental methods. Results & Discussion: Small robots with some traits between human/animal and machine were appreciated by the participants. As regards services, cognitive stimulation, reminder and object localization were positively rated. Although the participants considered an assistive robot as useful, they were not yet ready to adopt it. The expressions of the robot were perceived differently in older and young adults. Thus, a robotic system dedicated to older adults should be tailored to the specific characteristics of this population. We also identified social signals as indicators of the user's engagement level during interaction. Finally, the issue of the added valued of a robotic system in comparison to a laptop was raised by our participants. Therefore, various issues (technological development, human-robot interaction, social context...) are to be explored before testing the impact of the robot at home. © 2013 Published by Elsevier Masson SAS. Source

Pino M.,Hopital Broca | Pino M.,University of Paris Descartes | Benveniste S.,CEN STIMCO | Benveniste S.,MINES ParisTech | And 3 more authors.
Assistive Technology Research Series

Assistive technology (AT) products and services are increasingly used to support persons with dementia (PwD) and their caregivers, in terms of healthcare, safety, autonomy, leisure and social participation. Studies conducted in this area have tended to focus on usability engineering and AT acceptance, rather than on AT provision and follow-up plans. In other fields of disability, efforts have been made to integrate AT modeling frameworks into delivery practices, including the selection and assessment of AT over time. In the context of dementia, probably because of the relative novelty of the use of AT, only a few works have stressed the need for a comprehensive framework to guide users, practitioners and product developers in decision-making regarding the conception, evaluation and provision of AT. In this paper we provide preliminary guidance for the definition of such a framework. For doing so, first we review two existing AT models, chosen because of their applicability in the field of dementia: Hersh & Johnson's 'Comprehensive Assistive Technology' model and Scherer and colleagues' 'ICF core set for Matching Older Adult with Dementia and Technology'. Then we discuss some implications of the use of AT models and frameworks for clinical practice, specifically their incorporation within the integrated care systems increasingly adopted worldwide. Subsequently, we propose a set of key factors that should be considered for building tools to support AT design, provision and assessment in the context of dementia: the progressive nature of the disease, the clinical heterogeneity observed among PwD and the subsequent need for personalized care plans, the dynamics of function allocation between PwD, AT and caregivers, and the role of fluctuating symptoms and preserved abilities in this population. Finally, we suggest some directions for further research in this field. © 2013 The authors and IOS Press. All rights reserved. Source

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