Old age (\> 60 years) is at high risk to develop major depression disorders (MDD). MDD doubles the risk for subsequent cognitive disorders and dementia. Apathy (i.e. the lack of motivation) is a core problem in depression in older age and is frequently associated with cognitive decline in people who have mild cognitive disorders. The investigator propose here to combine actimetry (the measurement of motor activity using a simple device worn at the wrist) and brain imaging to show that it's possible to measure apathy using actimetry in a population of elders with MDD. Having shown that apathy can reliably be measured with actimetry and that it is associated with brain abnormalities, the investigator will be able to test whether actimetry can predict cognitive decline in elders with MDD and can be routinely used in a day-to-day medical practice.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
102
This scale was developed to assess the cognitive status of patients with neurodegenerative diseases. There are 37 items that are presented in a fixed order and grouped into five sub-scales: attention, initiation, construction, conceptualization and memory. Patients and healthy subjects with a score below 125 are not included because of major cognitive impairment.
This scale is used to rate the severity of extra-pyramidal symptoms (akinesia, rigidity and tremors). These symptoms may be the cause of reduction of motor activity apart from any reduction in motivation, they onstitute a confounding factor that it should be controlled.
This is a structured interview that allows rapid screening in about 20 minutes of troubles Psychiatric. It is based on short questions to which the patient must answer yes or no and on a decision tree. Patients must validate clinical diagnoses of depression.
This scale is composed of 10 items from 0 to 6 from a semi-structured interview, to obtain a total depression score of 0 to 60 (0 no depression, 60 maximum intensity of depression).
heterosexual assessment that rates the severity of symptoms suicidal and changes in suicidal symptoms. Any subject with a score greater than 4 is not included.
The clinical criteria make it possible to make a diagnosis of apathy with a functional repercussion. It is based on a lack of motivation felt by the patient, causing a functional or social impact that is not the consequence of a disturbance of consciousness or a disability engine. The cognitive, emotional and behavioral dimensions are affected.
The patient is timed to walk 10m. A speed \<1m / sec is a criterion exclusion because it shows severe sarcopenia and constitutes a bias.
accelerometer presentation and pose
withdrawal of the accelerometer and data acquisition from the accelerometer
clinician version and near-helping version. It's a hetero rating scale from an interview semi structured by a trained clinician. It assesses cognitive, emotional and behavioral apathy than three items of various apathy. The total score ranges from 18 (total absence of apathy) to 72.
To date, there is no valid fatigue scale in the depression of the elderly subject, a fortiori in French. The fatigue scale in adult depression includes has been validated with an EVA (Visual Analogue Scale) (38). We therefore propose to use this type of evaluation to control this aspect.
* Modified Card Sorting Test MCST(Modified Card Sorting Test) (Wisconsin Test): This test assesses conceptualization, attention and mental flexibility using a deck of cards. * Trail Making Test (TMT): This test is used to assess mental flexibility. * Fluences verbal: This test tests the capacities of setting up search strategies in memory semantics and oral language. * Stroop Paradigm: This test is used to evaluate the resistance to interference, ie the patient's ability to inhibit some over-learned and automated responses.
An MRI lasting 30 minutes is programmed
This is a self-questionnaire of 18 items, each side on a 5-level Likert scale (0: not everything at 4: very often). It differentiates between "behavioral" apathy and "social" apathy. "Emotional".
Centre Mémoire de Ressources et de Recherche (CMRR),
Nice, France
CHU Pontchaillou, Département de Radiologie et d'Imagerie Médicale
Rennes, France
Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte
Rennes, France
CHU Bretonneau, Consultations Intersectorielles de Gérontopsychiatrie
Tours, France
CHU Bretonneau,CIC
Tours, France
Service de Radiologie- Neuroradiologie,CHU bretonneau
Tours, France
Actimetry
Measure of actimetry: immobility, transfer, walking, movement given by the accelerometer
Time frame: 3 days
grey matter density
Magnetic Resonance Imaging brain metrics: grey matter density
Time frame: at Day 3 (+/- 2 days)
cortical thickness
Magnetic Resonance Imaging brain metrics: cortical thickness;
Time frame: at Day 3 (+/- 2 days)
diffusion tensor imaging,
Magnetic Resonance Imaging brain metrics: diffusion tensor imaging,
Time frame: at Day 3 (+/- 2 days)
Rest functional connectivity analysis
Magnetic Resonance Imaging brain metrics: regional cerebral blood flow
Time frame: at Day 3 (+/- 2 days)
pulsatility.
Magnetic Resonance Imaging brain metrics: pulsatility.
Time frame: at Day 3 (+/- 2 days)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.