Author Archives: Stéphane Bastianetto

1. Hallucinations

   6 février 2023 8 h 09 min Leave a Comment

   Hallucinations are signs of mental illness, but they don’t always mean that a person is sick. They are, in fact, quite common.

   A 2015 study done in Europe found that 7.3% of people said they had heard voices all their life. A study from South Africa on hallucinations in the general population estimated the higher rate at 12.7%

   Scientists don’t fully understand why some people have hallucinations and others don’t. They don’t know what causes them in people with mental disorders such as schizophrenia.

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   Types of Hallucinations

   Hallucinations are not always a sign of a mental health disorder. They can occur whenever there is a change in brain activity. 

   Some people are more vulnerable to hallucinations when they fall asleep or partially wake up.

   A 2019 study in mice that took a hallucinogenic drug found that the animals had less activity in brain regions that researchers have associated with processing incoming visual information.

   This observation suggests that a hallucination could be the brain’s way of compensating for a drop in sensory information.

   There are many types of hallucinations, including:

   • Auditory  : a person hears something that is not there, such as a voice or a radio.
   • Visual  : they cause someone to see something that is not real, such as a person or an animal.
   • Olfactory  : they can occur when a person smells something that is not there.
   • Gustatory : they transmit the taste to someone of something that he has not eaten.
   • Tactile  : they occur when a person has the impression that something or someone has touched them.
   • Somatic  : These hallucinations can affect the whole body, causing unreal sensations like that of insects crawling on the skin.

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   The causes

   Many medical conditions and other factors can cause hallucinations. 

   Drugs

   Medicines called hallucinogens can cause hallucinations. These drugs temporarily change the way the brain processes and sends information, causing unusual experiences and thoughts.

   LSD, dimethyltryptamine (DMT) and certain mushrooms are common hallucinogens.

   Schizophrenia

   Schizophrenia is a mental illness that changes the way a person thinks and behaves. It can also cause psychosis, which is a loss of contact with reality.

   People with psychosis may experience delusions and hallucinations and exhibit behaviors that are not typical. 

   Antipsychotic medications can help manage symptoms, and some people do better with treatment.

   Postpartum Mental Health Disorders

   Many new parents struggle with   postpartum  depression and anxiety.

   Some suffer from postpartum psychosis, but this is less common. For example, a mother thinks she hears her baby cry when the baby does not.

   Since postpartum psychosis can put the baby at risk and disrupt the parent-child relationship, prompt treatment is essential. Therapy, medication, and social support can help.

   Anxiety and depression

   People with anxiety and depression may experience periodic hallucinations. They are usually very brief and often relate to the specific emotions felt by the person. For example, a depressed person may hallucinate that someone tells them that they are worthless.

   Treatment of the underlying disorder can often eliminate these hallucinations.

   Alcohol withdrawal

   Alcohol withdrawal can cause hallucinations, especially in people who have a severe withdrawal syndrome called delirium tremens.

   A person with delirium tremens may also become very sick, vomit, or shake. Symptoms often disappear after several days.

   Dementia and other brain disorders

   Dementia progressively damages the brain, including areas involved in sensory processing. People with mid-to-late stage dementia may experience auditory and visual hallucinations.

   Occasionally they see dead people. In other cases, their hallucinations can be terrifying and can trigger feelings of paranoia and panic that prevent them from trusting caregivers.

   Medications can help relieve these symptoms.

   Epilepsy

   Sometimes hallucinations are a symptom of a seizure disorder. A person may experience hallucinations during or after a seizure which can be avoided by treating the seizures in most cases.

   Migraines

   Some people with migraines have hallucinations during or just before a migraine. These hallucinations are frequently visual. A person may see spots and colors that are not there, or other unusual images.

   Sleeping troubles

   Some people have hallucinations that doctors associate with  sleep disturbances. Hallucinations usually appear when a person falls asleep or wakes up.

   In some cases, the hallucination occurs with an episode of sleep paralysis, which occurs when a person wakes up and is temporarily unable to move.

   Treating sleep disorders can help relieve symptoms. In some cases, knowing that the hallucinations occur because of brain changes during the sleep cycle can make them less scary.

   Sensory disorders

   People who are hard of hearing or visually impaired can experience hallucinations. This may be due to brain changes in the regions responsible for processing sensory, visual or auditory information.

   Other causes

   In some cases, hallucinations may not be related to disease or medication. For example, in some religious traditions, a person may report an auditory hallucination. A person sleeping in a house they believe is haunted may hear noises or see ghostly figures due to increased anxiety.

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   Hallucinations are not delusions

   A hallucination is not a delusion, although the two are closely related. A delusion is a false belief, while a hallucination is a false perception.

   Many people may have fallen in love with optical illusions and other mental tricks. However, a hallucination is more than an error of perception.

   People with hallucinations see or hear things that aren’t actually there and don’t match the experiences of others around them.

   They may also believe in the reality of their hallucinations or attach specific meaning and false beliefs to them. These attached false beliefs are illusions.

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   Other symptoms associated with hallucinations

   Hallucinations often signal an underlying problem with how the brain processes information, such as when someone with dementia develops hallucinations or depression triggers psychosis.

   Some other symptoms accompanying hallucinations include:

   • changes in brain function as a person ages
   • unusual beliefs
   • depression or anxiety
   • visual or hearing problems
   • paranoid or aggressive behavior
   • a belief in the existence of a conspiracy
   • an epileptic seizure
   • headaches

2. Fibromyalgia

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   Fibromyalgia is a disorder that causes chronic pain, fatigue and other symptoms throughout the body. It’s estimated to affect up to 10 million Americans, but many don’t realize they have it because its symptoms can be mistaken for other conditions. This article explores its types, diagnosis, treatments and more.

   What is Fibromyalgia?

   Fibromyalgia is a chronic condition characterized by widespread pain and fatigue. It is often associated with mood disorders, such as depression and anxiety, sleep disturbances and digestive problems.

   Symptoms may vary in intensity throughout the day but are generally aggravated by physical activity or stress. Diagnosis typically involves an extensive medical examination as well as ruling out other medical conditions that have similar symptoms.

   Types of Fibromyalgia

   This condition can be classified into three categories: localized, systemic, and mixed. Localized fibromyalgia typically affects a specific area such as the neck or back. Systemic fibromyalgia involves pain throughout the body. Mixed forms of the disorder occur when both localized and systemic symptoms are present.

   Additionally, some individuals may experience more severity in certain areas than others, leading to regional differences in pain levels.

   Common Symptoms

   Fibromyalgia is often associated with pain, but this disorder is associated with several other symptoms as well.

   These common symptoms include chronic fatigue, difficulty sleeping, cognitive impairment, headaches and nausea, depression and anxiety, painful trigger points on the body, joint stiffness, tingling or numbness in hands or feet, abdominal pain and tenderness around the neck and shoulders.

   Treatment Options

   While there is no cure for this condition, there are many treatments that can help to manage the condition. Talk therapy, physical therapy, and medication are common options for treating the disorder. Many patients find relief with a combination of lifestyle changes such as stress management and exercise, relaxation techniques, and dietary modifications.

   Medications used to treat fibromyalgia include painkillers, antidepressants, anticonvulsants to reduce nerve-related pain, muscle relaxants and topical creams for tender points.

   Managing the Symptoms of Fibromyalgia

   A balanced approach to symptom management is the best way to deal with fibromyalgia. This includes proper sleep habits, regular physical activity, relaxation techniques, and dietary modification.

   Pain medications such as non-steroidal anti-inflammatory drugs may help control pain and stiffness.

   Muscle relaxants, antidepressants, and anticonvulsants can also be helpful in relieving symptoms. In some cases, specific therapies like acupuncture or chiropractic treatments can provide relief from mild muscle spasms or joint stiffness caused by fibromyalgia.

3. Thérapie par la danse et le mouvement

   29 janvier 2023 20 h 08 min Leave a Comment

   La thérapie par la danse et le mouvement est une forme de psychothérapie qui utilise la danse et le mouvement pour améliorer la santé mentale et physique. Il est fondé sur l’idée que l’esprit et le corps sont interdépendants, donc quand l’un est affecté, l’autre le sera aussi. 

   Grâce à cette thérapie, les personnes peuvent améliorer leur bien-être en développant leur force, leur coordination, leur équilibre, leur flexibilité, leur expression personnelle et leurs aptitudes sociales.

   Afin d’améliorer son bien-être général, la thérapie par la danse et le mouvement peut être une forme expressive de thérapie qui encourage la santé physique et mentale.

   Les gens peuvent utiliser des mouvements de danse pour exprimer leurs sentiments et leurs émotions afin de faciliter l’expression de soi, la créativité et la connexion avec leur moi intérieur grâce à des séances avec un professionnel qualifié.

   Comment ça marche?

   Il semble que la danse-thérapie favorise la santé en unifiant et en coordonnant tous les aspects d’une personne, tels que :

   En danse, la communication non verbale est aussi importante que la communication verbale.

   En plus de servir de moyen de communication, le mouvement peut également être expressif, fonctionnel ou développemental.

   L’évaluation et l’intervention peuvent toutes deux être accomplies par le mouvement.

   Effets bénéfiques possibles de la thérapie par la danse et le mouvement

   Les recherches sur les bienfaits physiques, mentaux et émotionnels de la danse-thérapie ne sont pas concluantes. Bien que d’autres études soient nécessaires, certaines preuves suggèrent que cela pourrait être bénéfique dans les domaines suivants :

   Santé mentale

   Les résultats d’une méta-analyse de 2019 portant sur 41 essais cliniques et impliquant 2 374 participants ont indiqué que la danse-thérapie améliore :

   Il est également possible que ces avantages soient à long terme, notamment l’anxiété, la dépression, la qualité de vie et les capacités cognitives.

   Une dépression

   Contrairement à la méta-analyse ci-dessus, une revue de 2019 a évalué huit essais cliniques qui ont examiné les effets de la thérapie par la danse et le mouvement sur 351 adultes aux prises avec la dépression.

   Les auteurs ont qualifié les preuves de qualité modérée à élevée et ont conclu que l’intervention pourrait offrir un traitement efficace pour les adultes souffrant de dépression. Comme la plupart des études incluses excluaient les enfants, les adolescents et les personnes âgées, elles n’ont pas pu évaluer son efficacité pour ces populations.

   Prévenir les chutes

   En améliorant la démarche, l’équilibre et la force musculaire, les auteurs d’une revue de 2017 ont examiné si la danse, une activité populaire chez les personnes âgées, peut aider à prévenir les chutes. Les chutes étant l’une des principales causes de maladie et de décès, les auteurs ont passé en revue 10 essais cliniques qui ont exploré la possibilité que la danse prévienne les chutes. Le nombre total de participants était de 680.

   Les auteurs notent que la danse semble être sans danger et démontre des avantages pour le bien-être des personnes âgées, malgré la nature préliminaire de leurs résultats et le manque de données à long terme.

   la maladie de Parkinson

   Une revue de 2018 a examiné 40 études et cinq revues portant sur les effets de la danse et de la musique sur les symptômes de la maladie de Parkinson, qui altère la démarche, ce qui peut augmenter le risque de chutes. Les résultats ont indiqué que les interventions pourraient améliorer la marche.

   Soins aux patients atteints de cancer

   En plus d’affecter la santé physique, le cancer affecte souvent les émotions et la socialisation. Afin de résoudre ces problèmes, les soins actuels contre le cancer incluent de plus en plus des interventions psychosociales. Une étude de 2015 a examiné trois essais cliniques impliquant 207 personnes atteintes d’un cancer du sein afin d’examiner les avantages de la thérapie par la danse et le mouvement contre le cancer.

   Dans l’analyse des données, des résultats mitigés ont été trouvés, mais l’intervention pourrait aider en :

   Cependant, il n’a trouvé aucune preuve que la danse-thérapie puisse réduire la somatisation, qui est la présentation de multiples symptômes physiques causés par des facteurs psychologiques.

   Une revue de 2021 a révélé que la danse-thérapie pouvait améliorer la qualité de vie des personnes atteintes d’un cancer du sein, mais a noté que cette thérapie pourrait être plus efficace lorsqu’elle est associée à d’autres thérapies.

   Pression artérielle

   En 2020, une méta-analyse de cinq essais cliniques a examiné les effets de la danse-thérapie sur la tension artérielle. Malgré le petit nombre d’essais, les résultats ont indiqué que l’intervention pouvait réduire de manière significative la pression artérielle systolique et diastolique.

   Une lecture de la pression artérielle systolique indique la pression sur les parois artérielles pendant les battements de cœur, tandis qu’une lecture diastolique indique la pression entre les battements de cœur.

   Selon les résultats, les Africains semblent bénéficier davantage de la danse-thérapie que ceux d’Europe ou d’Amérique.

   Maladie cardiaque chronique

   Les personnes souffrant d’insuffisance cardiaque chronique ou en cours ont été comparées à un traitement conventionnel dans une étude plus ancienne de 2014. Il a évalué deux enquêtes impliquant 62 participants à la danse-thérapie, 60 participants à l’exercice et 61 participants témoins.

   Une comparaison de la danse-thérapie avec l’exercice et l’absence d’exercice a révélé que la danse-thérapie augmentait la capacité d’exercice et la qualité de vie. 

   Selon les auteurs, la thérapie par la danse et le mouvement ne différait pas significativement des groupes d’exercices conventionnels en termes de résultats. Par conséquent, elle devrait être incluse dans les programmes de réadaptation cardiaque.

4. Dance movement therapy

   19 h 39 min Leave a Comment

   Dance movement therapy is a form of psychotherapy that utilizes dance and movement to improve both mental and physical health. It’s based on the idea that the mind and body are interrelated, so when one is affected, the other will be too. Through this therapy, people can work towards improved wellness by developing strength, coordination, balance, flexibility, self-expression and social skills.

   In order to improve one’s overall wellbeing, dance movement therapy can be an expressive form of healing that encourages physical and mental health.

   People can use dance movements to express their feelings and emotions to facilitate self-expression, creativity, and connection with their inner selves through sessions with a trained professional.

   How does it work?

   It seems that dance therapy promotes health by unifying and coordinating all aspects of a person, such as:

   In dance, nonverbal communication is as important as verbal communication.

   Additionally to serving as a means of communication, movement can also be expressive, functional, or developmental.

   Assessment and intervention can both be accomplished through movement.

   Possible beneficial effects

   Research on the physical, mental, and emotional benefits of dance therapy is inconclusive. Although more studies are necessary, some evidence suggests it may be beneficial in the following areas:

   Mental Health

   The results of a 2019 meta-analysis that looked at 41 clinical trials and involved 2,374 participants indicated that dance therapy improves:

   There is also a possibility that these benefits might be long-term, including anxiety, depression, quality of life, and cognitive skills.

   Depression

   In contrast to the above meta-analysis, a 2019 review evaluated eight clinical trials that examined dance therapy’s effects on 351 adults struggling with depression.

   The authors characterized the evidence as moderate to high quality and concluded that the intervention might offer an effective treatment for adults with depression. As most of the included studies excluded children, teenagers, and older adults, they could not assess its effectiveness for these populations.

   Preventing falls

   By improving gait, balance, and muscle strength, the authors of a 2017 review examined whether dance, a popular pursuit among older adults, can help prevent falls. As falls are a leading cause of illness and death, the authors reviewed 10 clinical trials that explored the possibility of dance preventing falls. Total participant numbers were 680.

   The authors note that dance appears to be safe and demonstrates benefits for well-being among older adults, despite the preliminary nature of their results and the lack of long-term data.

   Parkinson’s disease

   A 2018 review examined 40 studies and five reviews investigating the effects of dance and music on the symptoms of Parkinson’s disease, which impairs gait, which can increase the risk of falls. The results indicated that the interventions might improve gait.

   Care for cancer patients

   As well as affecting physical health, cancer often affects emotions and socialization. In order to address these issues, current cancer care increasingly includes psychosocial interventions. A 2015 study examined three clinical trials involving 207 individuals with breast cancer in order to examine the benefits of dance therapy for cancer.

   In the data analysis, mixed results were found, but the intervention might help by:

   However, it found no evidence that dance therapy can reduce somatization, which is the presentation of multiple physical symptoms caused by psychological factors.

   A 2021 review found that dance therapy could improve quality of life for people with breast cancer, but noted that this therapy might be more effective when combined with other therapies.

   Blood pressure

   In 2020, a meta-analysis of five clinical trials examined the effects of dance therapy on blood pressure. Despite the small number of trials, the results indicated that the intervention could significantly lower systolic and diastolic blood pressure.

   A systolic blood pressure reading indicates pressure on the arterial walls during heartbeats, while a diastolic reading indicates pressure between heartbeats.

   People from Africa seem to benefit more from dance therapy than those from Europe or America, according to the results.

   Chronic heart condition

   Individuals with chronic, or ongoing, heart failure were compared with conventional therapy in an older 2014 study. It evaluated two investigations that involved 62 dance therapy participants, 60 exercise participants, and 61 control participants.

   A comparison of dance therapy with exercise and no exercise found that dance therapy increased exercise capacity and quality of life. According to the authors, dance therapy did not significantly differ from conventional exercise groups in terms of outcomes. Therefore, dance therapy should be included in cardiac rehabilitation programs.

5. Atrial fibrillation

   19 h 22 min Leave a Comment

   Atrial fibrillation, also known as AFib, is a common form of abnormal heart rhythm that occurs when the two upper chambers of the heart beat in an irregular fashion.

   Around 3.5% of people aged 65-74 years old are affected by this medical condition and it can be lifethreatening if left untreated.

   Common treatments for Atrial fibrillation include blood thinners to reduce the risk of stroke and other medications to control arrhythmias.

   Atrial fibrillation and stroke

   In addition to being diagnosed during a medical examination, atrial fibrillation can also be diagnosed as a result of a stroke, which makes it one of the most common causes of strokes.

   A stroke caused by AF is much more serious: one in three people die within 30 days, and one in two within one year. As a result of stagnation of blood in the atria, atrial fibrillation facilitates the formation of clots.

   Atrial fibrillation can cause strokes when these clots break off and travel to the brain’s arteries. The risk of stroke is multiplied by five in a patient with atrial fibrillation, depending on other risk factors, such as age, gender, high blood pressure and diabetes.

   A number of treatments are available to slow the heart rate and reduce AF, including anticoagulants (antivitamin K or oral anticoagulants). Stroke prevention with aspirin and platelet aggregation inhibitors is rarely prescribed for patients with AF. High blood pressure and other risk factors must be avoided or controlled by people at risk.

   The causes of atrial fibrillation

   Atrial fibrillation is a condition characterized by an irregular heartbeat caused by chaotic electrical impulses in the atria. It can be caused by high blood pressure, heart attack or valve disorders, thyroid disease, lung disease, diabetes, sleep apnea, alcohol use disorder, and other underlying conditions that can strain or damage the heart’s muscle tissue.

   Certain medications or substances can also trigger atrial fibrillation.

   Symptoms

   The main symptoms are: fatigue, shortness of breath, palpitations with irregular and rapid heartbeats, chest pain, unsteadiness, dizziness, sweating, and nausea. However, some patients are asymptomatic.

   The diagnosis

   If the patient has rapid, irregular heartbeats, the doctor asks about:

   • his medical history;
   • his health problems (does he have heart disease, thyroid problems?);
   • the frequency of symptoms experienced;

   Epidemiology

   The number of French people with AF is between 600,000 and 1 million. It is estimated at 350,000 in Canada. The annual incidence is 5/1000 around sixty and 20/1000 after 80 years.

   Blood thinners are recommended for people with atrial fibrillation

   An updated guide from the American Academy of Neurology recommends that individuals with atrial (or atrial) fibrillation take blood thinners to prevent the risk of stroke.

   This particularly concerns those who have already suffered a stroke or a transient brain attack.

   The danger of atrial fibrillation (irregular heartbeat) is explained by the fact that the blood stays longer in the atria, which favors the appearance of clots by coagulation phenomenon. The clots can then travel from the heart to the brain. One in 20 people with untreated atrial fibrillation is likely to have a stroke within the next year.

   Anticoagulants are medicines that help prevent clots from forming inside the heart and preventing them from traveling to the brain. The newer anticoagulants (dabigatran, rivaroxaban and apixaban) are as (if not more) effective than warfarin, the standard anticoagulant. In addition, the risk of bleeding with warfarin is greater. Source: American Academy of Neurology (AAN).

   Atrial fibrillation can accelerate memory problems

   Rapid, irregular heartbeats — signs of atrial fibrillation — are quite common in older people, which could trigger early problems with memory and reasoning.
   “This means that heart health is an important factor related to brain health. says lead study author E. Thacker (University of Alabama at Birmingham, USA).

   More than 5000 elderly people, with no history of atrial fibrillation or stroke, were followed for an average of 7 years. At the same time, they took cognitive tests every year. Of the 5,150 participants, 11% developed atrial fibrillation over the 7 years. The study showed that people with atrial fibrillation had lower scores on cognitive tests (memory, reasoning), compared to those without heart problems .

   If these results are confirmed, the next steps will have to determine the cause and the means to prevent this cognitive decline, adds Dr. Thacker.
   Source: American Academy of Neurology (AAN). Rapid, irregular heartbeat may be linked to problems with memory and thinking, 2013.

6. Méditation : peut-elle aider à ralentir l’apparition de la maladie d’Alzheimer ?

   18 h 00 min Leave a Comment

   Il existe de nombreux avantages pour la santé associés à la méditation, autant physiques que mentaux, et c’est une pratique croissante. 

   Des études soulignent qu’elle peut améliorer le bien-être et la santé mentale en vieillissant, et notamment réduire le risque de maladies neurodégénératives : un atout qui pourrait s’avérer crucial compte tenu de l’espoir croissant de vivre, signe d’une population vieillissante.

   La méditation est un excellent moyen de cultiver l’attention mentale et le bien-être émotionnel. Asseyez-vous simplement dans une chaise confortable, respirez profondément par le nez, maintenez-le pendant quelques secondes, puis expirez complètement par le nez. Continuez ce processus de respiration intentionnelle pendant 10 à 15 minutes, en comptant chaque inspiration à haute voix. Gardez votre attention sur le cycle inspiration/expiration, en revenant au comptage chaque fois que votre esprit vagabonde. Il s’agit d’une technique de méditation connue sous le nom de comptage de la respiration.

   De nombreux types de méditation, tels que la réduction du stress basée sur la pleine conscience (MBSR), la Méditation Transcendantale® et la pratique du Koan, existent avec peu de preuves que l’un est supérieur à l’autre. La pratique la plus appropriée pour un individu est probablement celle avec laquelle il est le plus facile de rester cohérent. 

   Des études ont suggéré que la méditation peut améliorer certaines capacités cognitives. Cependant, il n’y a pas suffisamment de données pour déterminer si elle diminue les risques de développer la maladie d’Alzheimer ou si elle profite aux personnes qui en souffrent déjà. Dans l’ensemble, la méditation peut contribuer au bien-être général.

   Des bienfaits possibles de la méditation pour les personnes âgées

   Il y a des questions précises sur la santé des personnes âgées. Près de 15 % des adultes de plus de 60 ans souffrent de pathologies liées au vieillissement. Le nombre de personnes atteintes de la maladie d’Alzheimer ou d’autres maladies neurodégénératives augmente parallèlement à l’allongement de la durée de vie.

   Maintenir la bonne santé mentale de ce public est donc un défi, et toute stratégie de prévention doit être envisagée. Cependant, les effets réels de la méditation n’ont jamais vraiment été étudiés dans cette perspective.

   Toute une série de facteurs de risque des maladies neurodégénératives ont été identifiés : tabagisme, pollution, mauvaise alimentation, sédentarité… Il existe plusieurs moyens de les contrer : exercice physique, entraînement cognitif, alimentation saine (de préférence méditerranéenne), éducation à la santé cardiovasculaire… Ces méthodes ont été évaluées dans plusieurs études.

   La recherche a cependant largement sous-estimé d’autres facteurs de risque, dont certains sont amplifiés avec l’âge : dépression, stress, anxiété, troubles du sommeil (affectant une personne sur deux de plus de 60 ans), solitude et exclusion de la société. De plus, ces facteurs de risque psychologiques (socio-) émotionnels n’ont pas de programmes d’intervention préventive scientifiquement justifiés.

   En ce qui concerne les maladies neurodégénératives chez les personnes âgées, les facteurs de risque psycho-(socio-)affectifs restent peu étudiés. Cependant, la dépression, le stress, l’anxiété, les problèmes de sommeil et la solitude ont un impact réel.

   Le projet européen H2020 Silver Health Study vise à combler cette lacune en étudiant les effets de la méditation.

   Le projet de recherche européen H2020

   Le projet de recherche européen H2020, qui mobilise onze équipes de recherche dans six pays, doit étudier l’impact sur de multiples facteurs associés au vieillissement et à la maladie d’Alzheimer par le biais d’essais cliniques. Trois groupes de 137 participants de plus de 65 ans ont été divisés en trois : un recevant une formation à la méditation (45 personnes), un suivant une activité cognitive (ici, l’apprentissage d’une langue étrangère ; 46 personnes), et le groupe contrôle (pas d’activité spécifique ; 46 personnes) .

   Une période d’observation typique dans ce type d’étude est de 2 à 6 mois, et le taux d’attrition (c’est-à-dire le pourcentage de participants quittant l’étude) est d’environ 15 %.

   Les résultats sont mitigés

   Les régions cérébrales qui devraient être principalement suivies ont été identifiées dans des recherches antérieures.

   En plus du cortex cingulaire antérieur, qui intègre des processus affectifs – sentiment émotionnel, rythme cardiaque – avec des processus cognitifs tels que l’anticipation de la récompense, la prise de décision et le contrôle cognitif, l’insula (impliquée dans les émotions, l’intéroception, la dépendance, la conscience…) a également joué un rôle.

   L’étude d’interventions établies sur le mode de vie telles que la méditation pose un défi lorsqu’il s’agit de définir un groupe placebo approprié. Par exemple, dans de nombreux essais de méditation, le groupe témoin inclut soit l’écoute d’une musique apaisante, soit des personnes inscrites sur une liste d’attente. D’autre part, les essais cliniques sur les médicaments impliquent généralement qu’une moitié des participants reçoivent le médicament et l’autre moitié un placebo, une réplique exacte qui ne contient aucun médicament actif (appelée pilule de sucre). Il est important d’avoir de bons groupes placebo car avoir des attentes concernant l’obtention d’un traitement peut souvent créer une amélioration de l’état. Même certains contrôles placebo, y compris la musique, peuvent avoir des effets positifs.

   Il n’est pas certain que la méditation ait un impact direct sur la diminution du risque de maladie d’Alzheimer. Cependant, il existe d’autres conditions qui peuvent être aidées par son utilisation. Les niveaux de stress et d’anxiété peuvent être réduits et le sommeil amélioré, comme le risque cardiovasculaire et la tension artérielle. En prime, il est économique et sans stress à mettre en œuvre dans son style de vie. Il existe de nombreuses ressources en ligne, dans des livres et des cours qui peuvent aider à apprendre différentes techniques. Et, si s’éloigner de la technologie aide, il existe de nombreuses applications téléphoniques proposant un soutien à la méditation.

7. Meditation : can it Help Slow the Onset of Alzheimer’s Disease ?

   17 h 17 min Leave a Comment

   There are many health benefits associated with meditation, both physical and mental, and it is a growing practice. Studies are pointing out that it may improve well-being and mental health in aging, and particularly reduce the risk of neurodegenerative disease: an asset that could prove crucial given the increasing hope of life, which is a sign of an aging population.

   Meditation is a great way to cultivate mental attention and emotional wellbeing. Simply sit in a comfortable chair, take a deep breath through the nose, hold it for a few seconds, and then exhale fully through the nose. Continue this process of intentional breathing for 10-15 minutes, counting each inhalation aloud. Keep your awareness on the inhaling/exhaling cycle, returning to the counting whenever your mind wanders. This is one technique of meditation known as breath counting.

   Many kinds of meditation, such as mindfulness-based stress reduction (MBSR), Transcendental Meditation®, and Koan practice, exist with little proof that one is superior to another. The most suitable practice for an individual is probably the easiest one for them to stay consistent with. Studies have suggested meditation can improve some cognitive abilities, yet there is insufficient data to determine if it diminishes the chances of Alzheimer’s or benefits individuals already suffering from it. All in all, meditation may contribute towards overall well-being.

   The possible benefits of meditation for the elderly

   There are specific questions about the health of seniors. Almost 15% of adults over 60 suffer from pathologies associated with aging. The number of people affected by Alzheimer’s disease or other neurodegenerative diseases is increasing along with the increase in lifespan.

   Keeping the good mental health of this public is therefore a challenge, and any preventative strategy should be considered. However, meditation’s real effects have never really been studied from this perspective.

   In this paper, we present the results, and perspectives of a study conducted as part of the Age-Well project (Silver Health Study program).

   A whole series of risk factors for neurodegenerative diseases have been identified: smoking, pollution, poor diet, physical inactivity, etc. There are several methods to counter them: exercise, cognitive training, a healthy diet (preferably Mediterranean), cardiovascular health education… These methods have been evaluated in several studies.

   The research, however, has largely underestimated other risk factors, some of which are amplified with age: depression, stress, anxiety, sleep problems (affecting one out of two people over 60), loneliness, and exclusion from society. Furthermore, these psychological-(socio-)emotional risk factors do not have scientifically substantiated preventive intervention programs.

   In terms of neurodegenerative diseases among the elderly, psycho-(socio-)affective risk factors remain understudied. However, depression, stress, anxiety, sleep problems, and loneliness have a real impact.

   The European project H2020 Silver Health Study aims to fill this deficiency by studying the effects of meditation.

   The European research project H2020

   The European research project H2020, which involves eleven research teams in six countries, is to study the impact on multiple factors associated with aging and Alzheimer’s disease through clinical trials.

   Three groups of 137 participants over 65 were divided into three: one receiving meditation training (45 people), one following a cognitive activity (here, learning a foreign language; 46 people), and the control group (no specific activity; 46 people).

   A typical observation period in this type of study is 2 to 6 months, and the attrition rate (i.e. the percentage of participants leaving the study) is about 15%.

   Results are mixed

   Brain regions that should be tracked primarily have been identified in previous research.

   As well as the anterior cingulate cortex, which integrates affective processes – emotional feeling, heartbeat – with cognitive processes such as reward anticipation, decision-making, and cognitive control, the insula (involved in emotions, interoception, dependence, consciousness…) also played a role.

   Studying interventions based on lifestyle such as meditation poses a challenge when it comes to defining an appropriate placebo group. For example, in many meditation trials the control group involves either calming music or people put on a waiting list. On the other hand, drug clinical trials commonly involve one half of the participants receiving the medication and another half being given a placebo—an exact replica which does not contain any active drugs (known as a sugar pill). It is important to have good placebo groups since having expectations about getting a treatment can often create an improvement in condition. Even certain placebo controls including music may have positive effects.

   It is not definitive whether meditation has a direct impact on decreasing the chance of Alzheimer’s disease. However, there are other conditions that can be helped through its use. Stress and anxiety levels may be reduced and sleep improved, as can cardiovascular risk and blood pressure. As an added bonus, it is economical and stress-free to implement into one’s lifestyle. There are many resources online, in books and classes that may help with learning different techniques. And if getting away from technology helps, there are plenty of phone apps offering support with meditation.

8. Dizziness

   10 h 17 min Leave a Comment

   Many older people experience dizziness that can be acute (coming on suddenly) or chronic (continuing). 

   Dizziness can be the result of a specific disorder or a combination of several problems. 

   Symptoms of dizziness that occur before fainting are called presyncope. 

   Dizziness can be caused by medications, blood pressure changes, heart problems, neurological disorders, or inner ear problems.

   The causes of dizziness

   Dizziness is a common symptom that can be caused by several health issues. One of these conditions is orthostatic or postural hypotension, a sudden drop in blood pressure due to a quick change in posture from sitting to standing.

   Dizziness may also be associated with anxiety disorders, especially during panic attacks and periods of hyperventilation.

   In addition, some individuals may experience presyncope — sudden lightheadedness without loss of consciousness — which is particularly prevalent among those with chronic diseases like heart disease or diabetes.

   Symptoms

   Dizziness can be caused by a variety of issues related to the inner ear. Benign paroxysmal positional vertigo (BPPV) is the most commoncause in the elderly, which occurs when calcium crystals become dislodged from their normal position and incorrect messages are sent to your brain about head movement.

   Labyrinthitis, or acute vestibular neuritis, is an inflammation of the inner ear often afflicting elderly people. It can cause intense dizziness lasting days or even longer. Meniere’s disease results in a build up of fluid in the inner ear, while vestibular migraine causes prolonged lightheadedness between episodes of migraine headaches.

   Vestibular schwannoma is a rarer form that usually has slowly progressive hearing loss as one of its symptoms. Vertigo can also be indicative of strokes or multiple sclerosis.

   Diagnosis and tests for dizziness

   The therapy required to relieve dizziness depends on the causes detected after assessment of medical history and overall health.

   Benign paroxysmal positional vertigo is eased with the highly effective Epley maneuver which simply involves slow head and body movements intended to realign any calcium crystals stuck in inner ear semicircular canals; it’s pain-free and non-invasive although multiple sessions might be needed for lasting results.

   For labyrinthitis, motion sickness medicine will help reduce acute feelings of dizziness alongside anti-inflammatory medication for inflammation relief if necessary plus antibiotics in some cases. For Meniere’s disease medication like meclinizine (Antivert) will prove useful for controlling persistent vertigo along with diuretics & saline restriction to reduce fluid buildup within inner ears – however it’s classed as chronic so symptoms need minimizeeing rather than curing completely.

   If low blood pressure leads to feeling faint then a glance at medications needs looking into before alternative treatments like eating specifically outlining your diet.

   Suggested over-the-knee stockings might help improve circulation together with exercising more care when undertaking physical activities outside during hot days.

   Drugs such as fludrocortisone increasing bodily fluids and Midodrine raising blood pressure when standing also are helpful.

   NSAIDs and caffeine despite their associated risks may be useful.

   Lifestyle and management

   Dizziness can be caused by a wide range of lifestyle and environmental factors, ranging from lack of rest or dehydration to inner ear issues.

   However, managing these factors is essential in minimizing or completely avoiding dizziness.

   This could include drinking more water and getting enough rest, avoiding strong smells or sudden movements that may induce vertigo, as well as following any medical instructions prescribed by your physician.

   Adjustments to your diet

   One thing you can do to reduce or manage the feeling of dizziness is to make adjustments to your diet.

   Eating small and regular meals, ensuring you get enough vitamins and minerals in your diet, avoiding substances such as alcohol and caffeine, getting enough sleep and staying hydrated are all important for helping to maintain a healthy balance of fluids in your body, which can help reduce feelings of dizziness.

   If you suddenly have low blood pressure (orthostatic hypotension), you should:

   • Drink plenty of fluids every day.
   • Avoid alcohol.
   • Consider increasing your salt intake to promote fluid retention (if you don’t have high blood pressure between episodes of low blood pressure). Check with your doctor if it is safe for you to raise your salt.

   Complications

   Dizziness is a feeling of lightheadedness or unsteadiness that can range from subtle to intense and may signal a medical problem.

   It can be caused by factors such as dehydration, medication side effects, sudden drops in blood pressure, inner ear disorders, or underlying health conditions like hypoglycemia, stroke and heart disease.

   Treating dizziness usually depends on the cause and may include lifestyle changes, medications or physical therapy.

9. Post-Traumatic Disorder (PTSD)

   10 h 03 min 1 Comment

   Post-traumatic stress disorder (PTSD) is a type of anxiety disorder that can develop in people who have experienced or witnessed a traumatic event. Knowing the signs of PTSD and finding effective, evidence-based treatments early are important for managing this disorder.

   What is PTSD?

   PTSD is an anxiety disorder that is caused by a traumatic event and can cause flashbacks, nightmares, physical sensations like heart palpitations, numbness and dissociation from emotions. It often leads to intense feelings of guilt and shame, heightened emotional reactions, lack of concentration and low self-esteem. People with PTSD can experience difficulty functioning in the world, leading to social isolation and impaired relationships.

   Symptoms

   Post-traumatic stress disorder can cause a wide range of symptoms, with the most common being intrusive memories, flashbacks and nightmares; avoidance behaviors such as refusing to talk about the trauma; negative thoughts or feelings related to the experience, such as guilt and shame; difficulty sleeping; increased irritability; hyper-vigilance and an exaggerated startle response. Other symptoms may include depression, fearfulness, reckless behavior, isolation from loved ones, refusal to leave home, mistrust of others and suicidal thoughts or ideation.

   Treatment Options

   Treatment for PTSD is typically tailored to the individual and their unique symptoms. Options include trauma-focused cognitive behavioral therapy (TF-CBT), medication management, exposure therapies, and eye movement desensitization and reprocessing (EMDR).

   In general, the goal is to identify triggers and create coping strategies, bolster support systems, provide valuable life skills and manage medications. It is important to remember that recovery from PTSD takes time, but with proper professional help it can be improved and even eliminated.

   Outcomes from Treatment for PTSD

   Treatment for PTSD can be successful and lead to numerous positive outcomes for those suffering from the disorder. Many people experience improved mental health, reduced suicidal thoughts and behaviors, an improved sense of control over their lives, strengthened relationships with family and friends, improved cognitive functioning, improved ability to manage stressful situations and triggers, improved physical well-being, decreased feelings of depression and anxiety, better coping skills in difficult times.

   Managing the Effects of PTSD on Your Life and Relationships

   PTSD can have wide-ranging effects on daily life and relationships, but the following strategies are beneficial for managing those effects. Counseling can help a person learn how to manage the symptoms of PTSD and develop better coping skills. Participating in activities that provide support, distraction, and relaxation can also be helpful in addressing the effects of PTSD.

   Additionally, developing good communication skills with close family members or friends is an important part of managing the disorder since it can help one better express their feelings, needs, and concerns. Finally, establishing healthy lifestyle habits like getting proper rest, exercising regularly, and eating nourishing foods will all contribute to improved mental health.

10. Lecanemab : un nouveau médicament contre la maladie d’Alzheimer ?

    9 h 14 min Leave a Comment

    L’agence américaine de santé américaine (Food and Drug Administration, FDA) a approuvé le médicament lecanemab, vendu sous le nom de marque Leqembi, dans le traitement de la maladie d’Alzheimer.

    Cette approbation a eu lieu début l2023, par le biais d’une « voie d’approbation accélérée ».

    Cette voie accélère les traitements cliniques prometteurs pour les maladies pour lesquelles il n’existe pas d’autres options actuellement efficaces.

    Le lecanemab est un anticorps monoclonal qui cible la bêta-amyloïde, une protéine naturelle qui devient toxique lorsqu’elle s’agglutine pour former les plaques caractéristiques qui s’accumulent dans le cerveau des personnes atteintes de la maladie d’Alzheimer.

    Le médicament est administré par perfusion intraveineuse toutes les deux semaines.

    Les anticorps sont des protéines circulant dans le sang et qui reconnaissent et neutralisent les substances présentes dans le corps qu’ils considèrent comme étrangères, telles que les bactéries et les virus.

    Un anticorps monoclonal est produit en clonant ou en faisant une copie d’un seul globule blanc de sorte que tous les anticorps dérivés soient dérivés de la même cellule et se lient à une cible spécifique. Dans ce cas, le lecanemab se lie uniquement aux protéines bêta-amyloïdes.

    Lecanemab se lie à une forme particulière de bêta-amyloïde lorsqu’elle s’agglutine, appelée protofibrille.

    Des études suggèrent que c’est l’espèce d’amyloïde qui est la plus susceptible de jouer un rôle dans le développement de la maladie d’Alzheimer.

    Des essais antérieurs impliquant d’autres anticorps monoclonaux n’ont pas réussi à démontrer un effet bénéfique, peut-être parce qu’ils ciblaient des formes plus précoces d’amyloïde.

    Le lecanemab : un traitement prometteur de la maladie d’Alzheimer ?

    Une étude, publiée début janvier 2023, a rapporté les résultats d’un essai clinique de phase 3 qui incluaient1 795 participants, dont la moitié recevait du lecanemab et l’autre moitié non.

    Le traitement par lecanemab a non seulement atteint tous ses objectifs cliniques, mais il a également réduit les quantités d’amyloïdes mesurées dans les tests d’imagerie et sanguins. Les chercheurs ont aussi constaté des réductions des niveaux de tau, la protéine responsable des enchevêtrements neurofibrillaires qui s’accumulent à l’intérieur des neurones chez les patients atteints de la maladie d’Alzheimer.

    Une autre étude publiée fin en décembre 2022 a rapporté les résultats d’une étude de phase 2 avec 856 participants. Le traitement par lecanemab a également entraîné des réductions significatives de plaques amyloïdes lors des tests d’imagerie cérébrale et sanguins.

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    Les résultats des études

    Après 18 mois de traitement dans l’étude de phase 3, le lecanemab a ralenti la progression de la maladie de 27 % par rapport au groupe témoin.

    Par rapport à ceux qui n’ont pas reçu le traitement, les participants traités par lecanemab ont également montré une amélioration de 26 % aux tests cognitifs et un déclin plus lent dans les activités quotidiennes.

    L’étude a aussi rapporté une réduction marquée de la quantité d’amyloïde dans le cerveau chezceux qui ont reçu le traitement.

    Ces résultats sont parmi les effets les plus importants jamais observés dans un essai clinique sur la maladie d’Alzheimer.

    Bien qu’ils ne guérissent pas, ils donnent l’espoir qu’en ralentissant considérablement le déclin physique, cognitif et fonctionnel tout en éliminant l’amyloïde, l’évolution de la maladie pourrait être modifiée pour donner aux patients une meilleure qualité de vie.

    Il est important de rappeler que l’essai n’a été réalisé que sur 18 mois. Par conséquent, les bénéfices à long terme du lecanemab ne sont pas connus.
    

    Bien que le lecanemab ait montré des avantages évidents, il s’accompagne également d’effets indésirables potentiels notables qui doivent être étudiés.

    Dans l’essai clinique de phase 3, sur les 1 795 participants, 12,6 % prenant du lécanemab ont présenté un gonflement du cerveau à l’IRM, contre 1,7 % de ceux qui ont reçu le placebo. Dans l’ensemble, seuls 2,8 % des participants ont présenté des symptômes, principalement des maux de tête.

    De plus, 17,3 % de ceux qui ont reçu du lecanemab ont eu de petites hémorragies du cerveau observés à l’IRM, contre 9 % dans le groupe placebo.

    Le lecanemab diffère-t-il d’autres traitements ?

    Les traitements de la maladie d’Alzheimer actuellement disponibles – qui comprennent le donépézil, la rivastigmine, la galantamine et la mémantine – traitent principalement les symptômes. Ils ne s’attaquent pas aux mécanismes sous-jacents et présentent des avantages cliniques modestes.

    Un médicament qui traite la maladie, l’aducanumab, vendu sous le nom de marque Aduhelm, a été approuvé par la FDA en 2021 selon le même processus accéléré que le lecanemab. Mais il n’est pas devenu largement utilisé en raison de la controverse sur son efficacité et son prix

    Le lecanemab n’a pas été étudié et n’a pas été approuvé pour les personnes atteintes de stades modérés ou sévères de la maladie d’Alzheimer.

    Bien que le lecanemab ait reçu l’approbation de la FDA, il faudra plusieurs mois – du moins aux États-Unis – avant qu’il ne soit disponible pour une utilisation clinique.