Marie-Jeanne Kergoat

• M.D., CCFP, FCFP, CSPQ, FRCPC
• Full professor at Université de Montréal & Institut universitaire de gériatrie de Montréal

Background This quality assurance study was conducted during the COVID-19 pandemic to describe the profile of patients aged 65 years and older admitted to a transition unit in a long-term care (LTC) facility and to evaluate the impact of admission modalities, compliance with screening and hand hygiene practices, risk of COVID-19, and time to access...

Objective To ascertain the effect of curative‐intent surgery on loss of independence (LOI) in patients with oral cavity squamous cell carcinoma (OCSCC). Study Design Retrospective observational study of patients diagnosed from 2014 to 2021. Setting Single tertiary care academic center. Patients having undergone curative‐intent surgical treatment...

Sarcopenia is an increasingly recognized biomarker associated with poorer outcomes. The objective of this study was to ascertain the effect of sarcopenia on treatment tolerance and short‐term toxicity in head and neck cancer (HNC). A systematic review was performed using multiple databases. An inverse‐variation, random‐effects model was used to per...

Most older adults want to age in place even if changes in their health results in home safety concerns. A consistent approach to assessing both the physical and psychological risks associated with the decision to remain at home is lacking. The Living with Risk: Decision Support Approach (LwR:DSA) is a recently validated innovative clinical tool tha...

Introduction: Cardiovascular disease risk factors (CVRFs) contribute to the development of cognitive impairment and dementia. Methods: This study examined the associations between circulating CVRF biomarkers and cognition in 386 cognitively healthy older adults (mean age = 78 ± 4 years, 53% females) selected from the Quebec Longitudinal Study on N...

Background When there are safety concerns, healthcare professionals (HCPs) may disregard older adults’ wishes to return or remain at home. A paradigm shift is needed for HCPs to move from labelling older adults as living at risk to helping them live with risk. The Living with Risk: Decision Support Tool (LwR:DST) was developed to support older adul...

Senior adults (>age 65) represent almost 20% of the population but account for 48% of hospital bed occupancy. In older adults, hospitalization often results in functional decline (i.e., iatrogenic disability) and, consequently, the loss of autonomy. Physical activity (PA) has been shown to counteract these declines effectively. Nevertheless, PA is...

Purpose To understand the relationship between ambient air pollution and the onset of balance problems. Design Population-based prospective cohort study. Methods Baseline and 3-year follow-up data were used from the Canadian Longitudinal Study on Aging. The Comprehensive Cohort included adults aged 45–85 years old recruited from 11 sites across 7...

With age, older adults experience a decrease in muscle function and changes in body composition, which raise the risk of functional incapacity and loss of autonomy. These declines are more pronounced in older adults living in long-term care (LTC) facilities than those living in the community (ie, sarcopenia prevalence: ∼41% vs ∼10%; obesity prevale...

Background When there are safety concerns, healthcare professionals (HCPs) tend to overprotect older adults and may disregard their wishes to return or remain at home. A paradigm shift is needed for HCPs to move from labelling older adults as living at risk to helping them live with risk. The Living with Risk: Decision Support Tool (LwR:DST) was de...

The vast majority of people living in long-term care facilities (LTCFs) are octogenarians (i.e., in Québec, 57.4% of the residents are age 85 or older, 26.2% are between age 75 and 84, 10.7% are between age 65 and 74, and 5.7% are below age 65 (1)), who are affected by a great loss of physical or cognitive autonomy due to illnesses and are unable t...

Contexte En temps de pandémie, l'admission aux soins post-aigus et de réadaptation gériatrique a été faite en adoptant des mesures de confinement à la chambre, dans des unités transitoires désignées zones tampons. Dans notre établissement, gestionnaires et cliniciens se sont interrogés sur le mode d'admission optimal de tels patients en provenance...

Background We ascertain the role of a low cervical paraspinal skeletal muscle index (CPSMI) as a biomarker for poor treatment tolerance in patients with operable mucosal head and neck squamous cell carcinoma (HNSCC). Methods A prospective cohort of patients with operable HNSCC requiring microvascular reconstruction was evaluated. Low CPSMI was cal...

Objective Sarcopenia is increasingly being recognized as a negative prognostic factor in patients with head and neck cancer (HNC). We associate a sarcopenia biomarker measured radiographically from computed tomography (CT) of the neck to postoperative adverse events in patients with operable HNC. Patients and methods A prospective cohort of treatm...

Purpose To examine the longitudinal association between vision-related variables and the 3-year change in cognitive test scores in a community-dwelling sample of adults and to explore whether sex, education, or hearing loss act as effect modifiers. Methods Data came from two waves of a 3-year population-based prospective cohort study (Canadian Lon...

Introduction Assessment of decision-making capacity (DMC) is essential in daily life as well as for defining a person-centred care plan. Nevertheless, in ageing, especially if signs of dementia appear, it becomes difficult to assess decision-making ability and raises ethical questions. Currently, the assessment of DMC is based on the clinician’s ev...

Objective Major postoperative adverse events (MPAEs) following head and neck surgery are not infrequent and lead to significant morbidity. The objective of this study was to ascertain which factors are most predictive of MPAEs in patients undergoing head and neck surgery. Methods A cohort study was carried out based on data from patients registere...

Purpose: To determine the relationship between fine particulate matter (PM2.5) and ocular outcomes such as visual impairment and age-related eye disease. Methods: Baseline data were used from the Canadian Longitudinal Study on Aging. The Comprehensive Cohort consisted of 30,097 adults ages 45 to 85 years. Annual mean PM2.5 levels (µg/m3) for eac...

Purpose: To understand the relationship between visual impairment, self-reported eye disease, and the onset of balance problems. Design: Population-based prospective cohort study METHODS: : Baseline and 3-year follow-up data were used from the Canadian Longitudinal Study on Aging. The Comprehensive Cohort included 30,097 adults ages 45-85 years...

Objective Determine the 3-year incidence of visual impairment (VI) in Canada and its risk factors. Design Prospective 3-year cohort study Participants Data from 23 973 adults taking part in the Canadian Longitudinal Study on Aging Comprehensive Cohort baseline and 3-year follow-up exams were included. Methods Inclusion criteria were 45 to 85 yea...

Background Older adults hospitalized following a fall often encounter preventable adverse events when transitioning from hospital to home. Discharge planning interventions developed to prevent these events do not all produce the expected effects to the same extent. This realist synthesis aimed to better understand when, where, for whom, why and how...

Introduction: Brain activation is hypothesized to form an inverse U-shape in prodromal Alzheimer’s disease (AD), with hyperactivation in the early phase, followed by hypoac- tivation. Methods: Using task-related functional magnetic resonance imaging (fMRI), we tested the inverse U-shape hypothesis with polynomial regressions and between-group compa...

Background Fried’s Phenotype Model of Frailty (PMF) postulates that frailty is a syndrome. Features of a syndrome are a heterogeneous population that can be split into at least two classes, those presenting and those not presenting the syndrome. Syndromes are characterized by a specific mixture of signs and symptoms which increase in prevalence, fr...

Objectives This study examined the effect of dietary patterns and engagement in cognitive stimulating lifestyle (CSL) behaviors on the trajectory of global cognition, executive function (EF), and verbal episodic memory (VEM). Methods Western and prudent dietary patterns were empirically derived using food frequency questionnaire responses from 350...

Objectives Immobilization contribute to iatrogenic decline in hospitalized older adult. Implementing physical activity (PA) seems to be one of the best and easy solution. However, PA interventions are poorly integrated into usual care and those available are either non-specific, need supervision or requested human/material resources. Thus, we aimed...

Purpose: Our goal was to explore the longitudinal association between vision-related variables and incident depressive symptoms in a community-dwelling sample of older adults and to examine whether sex, education, or hearing loss act as effect modifiers. Methods: A 3-year prospective cohort study was performed using data from the Canadian Longit...

Objectives The main objective was to determine the trajectory of instrumental activities of daily living (iADL) decline in persons with mild cognitive impairment (MCI) who progressed towards dementia relative to persons with MCI who remained stable. Methods/Design At study entry, 121 participants met criteria for MCI. Based on the follow‐up, 47 pa...

Background: Consumption of a prudent dietary pattern rich in healthy nutrients is associated with enhanced cognitive performance in older adulthood, while a Western dietary pattern low in healthy nutrients is associated with poor age-related cognitive function. Sex differences exist in dietary intake among older adults; however, there is a paucity...

Background: Consumption of a prudent dietary pattern rich in healthy nutrients is associated with enhanced cognitive performance in older adulthood, while a Western dietary pattern low in healthy nutrients is associated with poor age-related cognitive function. Sex differences exist in dietary intake among older adults; however, there is a paucity...

Background Consumption of a prudent dietary pattern rich in healthy nutrients is associated with enhanced cognitive performance in older adulthood, while a Western dietary pattern low in healthy nutrients is associated with poor age-related cognitive function. Sex differences exist in dietary intake among older adults; however, there is a paucity o...

Introduction: The Consortium for the early identification of Alzheimer's disease-Quebec (CIMA-Q) created a research infrastructure to recruit, characterize, and track disease progression in individuals at risk of dementia. Methods: CIMA-Q established standardized clinical, neuropsychological, neuroimaging, blood (plasma, serum, RNA, genomic DNA)...

Purpose Age-related eye disease may be associated with cognitive decline, but the scientific literature has not been consistent. Furthermore, no studies have been able to explain the relationship. Our objective was to assess whether older adults with age-related macular degeneration (AMD) or glaucoma performed worse on 6 cognitive tests compared wi...

Objective: The aim of this study is to test the effects of a customized intervention on distress among caregivers of persons with dementia (PWD) using a quasi-experimental design. Method: Fifty-one spouse caregivers in the experimental group and 51 in the control group participated in the study. The effects of the intervention were examined by comp...

Background: Older patients experience increased loss of mobility after hospitalization, largely because of physical disabilities and inactivity. There are, however, no current recommendations for prescribing physical activity (PA) at hospital discharge. Objectives: Develop a decisional tree for the systematic prescription of an individualized, a...

Alzheimer’s disease (AD) occurs as either an autosomal dominant inherited disease or sporadically. While familial mutant genes can be expressed in cells or in animal models to assess dysregulated functions, sporadic AD cannot be replicated in models given our lack of understanding of causality. Furthermore, the study of sporadic forms of AD is diff...

Mobility decline leads to increased risk of falls, fractures and loss of autonomy. Around 21% of Canadians aged 65 and over report mobility limitations and 30–60% experience functional decline after hospitalisation. Even if improving mobility is a healthcare priority, there is no current recommendation for implementing physical activity(PA) prescri...

Background: Interactions between vision and chronic conditions affecting other balance control systems have rarely been investigated. We hypothesized that visual acuity would be more strongly related to balance in older adults with peripheral vascular disease (PVD) or diabetes. Methods: Cross-sectional data of the Canadian Longitudinal Study of Agi...

Background: Cross-sectional and longitudinal studies show conflicting results regarding the association between cognition and life-space mobility, and little is known regarding the mediators and moderators of the association. The aim of this study was to investigate the association between cognition and life-space mobility in older adults, as well...

Background An exercise program involving patients, caregivers, and professionals, entitled SPecific Retraining in INTerdisciplinarity (SPRINT), has been developed to prevent functional decline during hospitalization of older patients. Goal Assess the feasibility of implementing SPRINT in the context of a Geriatric Assessment Unit (GAU). Methods G...

Objectives To determine whether visual acuity is related to balance in older adults with peripheral vascular disease (PVD) or diabetes mellitus. Design Cross‐sectional analysis. Setting Canada. Participants Community‐dwelling adults aged 45 to 85 from the Canadian Longitudinal Study on Aging (N=30,097). Measurements Visual acuity was measured w...

Background: Spontaneous walking speed (SWS) is one of the most important indicators of health in older adults. Studies have shown benefits of physical trainings on SWS in older adults but the impact of cognitive training and multidomain interventions remains understudied. Aims: This original study aimed at comparing the impact of aerobic/resista...

Background Early assessment of cognitive symptoms is an issue in geriatrics. This study investigated the delay from the onset of cognitive symptoms to initial clinical assessment and its associations with patients’ sociodemographic and clinical characteristics. Methods This is a cross-sectional retrospective study using medical chart review of 316...

Objective: Semantic memory impairment has been documented in individuals with amnestic Mild cognitive impairment (aMCI), who are at risk of developing Alzheimer’s disease (AD), yet little is known about the neural basis of this breakdown. The aim of this study was to investigate the brain mechanisms associated with semantic performance in aMCI pati...

Introduction: The Confusion Assessment Method (CAM) is a validated key tool in clinical practice and research programs to diagnose delirium and assess its severity. There is no validated French version of the CAM training manual and coding guide (Inouye SK). The aim of this study was to establish a consensual French version of the CAM and its manu...

Studies have found a benefit to living a cognitively active life in older age. Our goal was to quantify participation in cognitively stimulating activities in adults with and without age-related eye disease. We conducted a cross-sectional hospital-based study in Montreal, Canada of older adults (n = 303) having either age-related macular degenerati...

Combined strength and aerobic (S+A) and gross motor skills programs (GMS) have shown promise in selectively improving executive functions (EF) of older adults. However, interruptions in training may occur resulting in losses of training-induced physiological benefits. So far, little is known about the effects of physical training cessation on EF. T...

Objective: Famous people knowledge has been shown to be impaired early in Alzheimer’s disease (AD) and amnestic mild cognitive impairment (aMCI). However, the question of whether recently acquired knowledge is more impaired than remotely acquired knowledge remains a matter of debate. The aim of this study was to investigate the patterns of semantic...

Objectives: To investigate the characteristics of the caregiving experience according to age at onset of dementia to adapt support programs. Method: Fifty-seven spouse caregivers of persons with early-onset dementia (PEOD) and 93 spouse caregivers of persons with late-onset dementia (PLOD) participated. The characteristics of the caregiving experie...

Background: Individuals with Parkinson's disease (PD) often present with visual symptoms (e.g., difficulty in reading, double vision) that can also be found in convergence insufficiency (CI). Our objective was to estimate the prevalence of CI-type visual symptomatology in individuals with PD, in comparison with controls. Methods: Participants ≥5...

Calibrated fMRI based on arterial spin-labeling (ASL) and blood oxygen-dependent contrast (BOLD), combined with periods of hypercapnia and hyperoxia, can provide information on cerebrovascular reactivity (CVR), resting blood flow (CBF), oxygen extraction fraction (OEF), and resting oxidative metabolism (CMRO2). Vascular and metabolic integrity are...

Introduction: This study reports a case series of orthoptic treatment (OT) for convergence insufficiency (CI) in individuals with Parkinson’s disease (PD). Method: We are reporting two cases of individuals with PD who completed OT for CI. Both had a confirmed diagnosis of CI, accompanied by CI-type symptomatology. They each underwent an OT program...

Methods: The visual acuity (VA) screening test was developed on an iPad retina display. Three optotypes were used (letters, numbers, and tumbling E's) to determine whether one works best with dementia. The screening VA results and algorithm decision were validated against those obtained by an optometrist performing a complete eye examination. Res...

Purpose: To estimate the prevalence of visual impairment (VI) in a sub-population of Canadian long-term care facilities, i.e. residents affected by dementia. Methods: This study was conducted in the long-term care facility units at the Institut universitaire de gériatrie de Montréal. All residents ≥65 years old (y.o.), having a clinical diagnosi...

Introduction: Prodromal markers of Alzheimer's disease (AD) have been derived from wakefulness. However, brain perfusion during rapid-eye movement (REM) sleep could be a sensitive marker of amnestic mild cognitive impairment (aMCI), as activation of REM sleep relies more on the cholinergic system. Methods: Eight subjects with aMCI, and 16 contro...

Background: Patients with Parkinson’s disease (PD) and/or Parkinsonism are affected by a complex burden of comorbidity. Many ultimately require institutional care, where they may be subject to the application of physical restraints or the prescription of antipsychotic medications, making them more vulnerable to adverse outcomes. Objectives: The obj...

Purpose: Gait speed is associated with survival in older adults and it was suggested that an elevated energy cost of walking (Cw) is an important determinant of gait speed reduction. Thus far, little is known about the factors that contribute to a lower Cw but it was shown that lower body strength training could reduce the Cw. Therefore, the objec...

Objectives To explore the experiences and adjustment modes of couples during the period between the initial signs of the Alzheimer's disease (AD) and the years following diagnosis, particularly in the case of early-onset AD.DesignA dyadic interpretative phenomenological analysis was conducted with married couples in which one member of each couple...

Aim: The aim of this study was to explore the needs of spouse caregivers of persons with dementia (PWD) and then to compare them based on the PWD's age at disease onset. This data could be used to adapt support programmes to address differences between the two groups. Method: Thirty-eight spouse caregivers of persons with late-onset dementia and...

Background: The progressive mobilization of spouse caregivers who take care of a person with dementia (PWD) can lead to situations of distress. Objective: The current study sought to investigate the influence of the characteristics of the caregiving context on spousal caregiver distress. Methods: 125 spousal caregivers participated in this study. T...

Background We recently reported that convergence insufficiency (CI)‐type visual symptomatology was more prevalent in participants with Parkinson's disease (PD), compared to controls. The objective of this work was to determine the prevalence of a confirmed clinical diagnosis of CI in PD, compared to controls. Methods Participants with (n = 80) and...

Purpose Physical exercise and cognitive training have been shown to enhance cognition among older adults. However, few studies have looked at the potential synergetic effects of combining physical and cognitive training in a single study. Prior trials on combined training have led to interesting yet equivocal results. The aim of this study was to e...

Objective: The growing interest in early-onset dementia has attracted attention to the situation and experiences of the caregiver, most often the spouse. Several qualitative studies on caregiving spouses have underlined the importance of the feeling of loss, the change of role reported by the caregiving spouses, and the strategies used to protect...

Prevalent face recognition difficulties in Alzheimer's disease (AD) have typically been attributed to the underlying episodic and semantic memory impairment. The aim of the current study was to determine if AD patients are also impaired at the perceptual level for faces, more specifically at extracting a visual representation of an individual face....

Characteristics of early- and late-onset dementia family caregivers were described and compared. Based on a theoretical model of role transition, data were collected through structured interviews from 48 caregivers of adults with Alzheimer's disease or a related dementia older than the age of 70 and 48 caregivers of similarly diagnosed adults young...

A 6-month dietary intervention program was designed for community-dwelling older adults with Alzheimer’s disease. Sixty-seven persons aged 70 years and above were recruited with their caregivers from six hospital memory and geriatric outpatient clinics, and allocated to intervention (n = 34 dyads) or control group (n = 33 dyads). Usual diet was ass...

The literature indicates that the prevalence of oculovisual problems increases with age and that it is higher in older individuals residing in long-term care facilities (LTCF) compared to those living in the community. It further indicates that eye care services in LTCF are sub-optimal. The objective of this article is to describe the university-ba...

Objective: Use of gastric acid inhibitors has emerged as a risk factor of vitamin B12 deficiency, especially in older adults. Calcium supplements could be an effect modifier of this relationship by its role in the absorption process of vitamin B12. The aim of this study is to examine whether the use of calcium supplements could be an effect modifi...

Only a limited number of studies have investigated the decline of discrete cognitive domains as individuals progress from mild cognitive impairment (MCI) to dementia. Thus, the goal of this longitudinal study was to evaluate the cognitive changes underway during the years preceding a diagnosis of probable Alzheimer’s disease (AD), and to compare th...

PurposeIn view of our interest in helping older institutionalised adults with co-existing visual and cognitive deficits, our objective was to review vision-related quality of life (VRQoL) questionnaires developed for people with dementia.MethodsA systematic literature search was performed in seven relevant databases, limited to peer-reviewed journa...

Purpose: Eye care services in long-term care facilities are not optimal and should be improved. In Canada, optometrists are the major providers of primary oculovisual examinations. Our objective was to evaluate the eye care services optometrists offer to older adults, in particular to frail older adults. Materials and methods: A questionnaire regar...

Purpose: To determine whether people with age-related eye disease have lower cognitive scores than people with normal vision. Methods: A hospital-based cross-sectional study was performed in which 420 people ages 65 and older from the ophthalmology clinics at Maisonneuve-Rosemont Hospital (Montreal, Canada) were recruited who had either age-related...

Though advances in knowledge and diagnostics make it possible today to identify persons with early-onset dementia or a related cognitive disorder much sooner, little is known about the support needs of the family caregivers of these persons. The aim of this study was to document the unmet support needs of this specific group of caregivers. This kno...

The effects of physical activity on cognition in older adults have been extensively investigated in the last decade. Different interventions such as aerobic, strength, and gross motor training programs have resulted in improvements in cognitive functions. However, the mechanisms underlying the relationship between physical activity and cognition ar...

Background The objective was to evaluate the eye care services offered to older residents living in long-term care facilities (LTCFs). Methods A questionnaire targeting residents aged ≥65 years was sent to all LTCFs in Quebec. Questions related to the institution’s characteristics, demographic data related to residents, oculovisual health of resid...