Sébastien Grenier

• M.Ps., Ph.D.
• Researcher at Université de Montréal

The psychobiological response to stress is known to be a key factor affecting health at any age, but especially in older adults. It involves the hypothalamic-pituitary-adrenal (HPA) axis, a hormonal circuit whose product is the activation of cortisol. We sought to explore the relationships leading to resilience to stress, as exemplified by the mode...

Background Subjective cognitive decline (SCD) is linked to a more rapid progression to the development of mild cognitive impairment (MCI) or Alzheimer's disease (AD). SCD has been correlated with affective symptoms such as depression and anxiety. Recent research aimed to shed light on the relationship between these affective symptoms and how they m...

Objectives: Our objective was to assess the effect of cognitive-behavioral therapy for insomnia (CBTi) on subjective and objective sleep quality (including sleep spindles) and cognition during a sedative-hypnotics withdrawal program in older adults with insomnia disorder. Methods: We performed a two-arm randomised controlled trial (RCT) of a sedati...

Introduction As people age, chronic stress, resulting in prolonged or repeated activation of the hypothalamic–pituitary–adrenal (HPA) axis, has been associated with long-term adverse health outcomes. Coping strategies and social support have been recognized as contributing to resilience to stress in older adults. Few studies have evaluated stress m...

Background Anxiety disorders are prevalent amongst older adults and negatively impact their quality-of-life and health. Anxiety disorders often go undetected or are misattributed to age-related changes. The aim of this systematic review of reviews, was to synthesize existing evidence on risk factors associated with anxiety in older adults to improv...

This study examines the differential weight of a wide range of factors—sociodemographic factors, indicators of autonomy, social support, coping styles, vulnerability to emotional contagion, and empathy—in the presence of two profiles of psychological distress and in their absence. This cross-sectional study included 170 older adults. As assessed by...

INTRODUCTION In a 5‐year follow‐up study, we investigated the enduring effects of cognitive training on older adults with mild cognitive impairment (MCI). METHODS A randomized controlled single‐blind trial involved 145 older adults with MCI, assigned to cognitive training (MEMO+), an active control psychosocial intervention, or a no‐contact condit...

Objectives: To examine how change in benzodiazepine (BZD) use is linked to changes in depressive symptoms intensity, worry intensity, and sleep quality over 16 months. Method: Data come from a larger randomised controlled trial (RCT) named the 'Programme d'Aide du Succès au SEvrage (PASSE-60+)' study (NCT02281175). Seventy-three participants age...

Background A diagnosis of Alzheimer’s disease (AD) is a crucial moment in an individual’s existence and represents a major life change that often results in psychological distress, diminish of perceived quality of life, and loss of independence. It is important to better understand the emotional experience of people with dementia to intervene accor...

Background:Only a small proportion of older adults with generalized anxiety disorder (GAD) seek professional help. One reason is the lack of access to mental health professionals licensed to provide psychotherapy. One way to improve access to psychotherapy is through guided self- help (GSH). GSH based on the principles of cognitive-behavior therapy...

Background Scarce are the studies focusing on initiation of new mental health service use (MHSU) and distinguishing individuals who have sought services but have been unsuccessful in accessing these. Aims Assessing the factors associated with initiating new MHSU as compared to no MHSU due to self-reported no need, no MHSU due to health system and...

Low use of professional help for anxiety disorders in older adults may be due in part to limited access to mental health services. Self-help guided by lay providers (LPs) could help improve access to treatment. This study evaluated the efficacy and long-term outcomes of self-help guided by LPs for generalized anxiety disorder (GAD) in older adults....

Objectives Few are the longitudinal studies on the changes in moderate or severe symptoms of anxiety or depression (MSS-ANXDEP) from before to during the COVID-19 pandemic in Canada. The aim was to study the change in MSS-ANXDEP and associated sociodemographic, economic, psychosocial, health behaviour and lifestyle, and clinical factors. Methods T...

The COVID-19 pandemic provided a unique opportunity to examine the contributions of social interaction and other non-social factors to loneliness among older adults in the context of confinement measures constraining opportunities for in-person social interactions. This study aims to identify groups of individuals with heterogeneous trajectories of...

Objective: To identify sociodemographic, psychological, and health factors related to trajectories of insomnia symptoms in older adults during the COVID-19 pandemic. Methods: From May 2020 to May 2021, 644 older adults (mean age = 78.73, SD = 5.60) completed telephone-administered self-reported measures (ie, Insomnia Severity Index, consensus sl...

Objectives Using Andersen’s model of health care seeking behavior, we examined the predisposing, enabling, and need factors associated with mental health service use (MHSU) during the first wave of the COVID-19 pandemic across Canada. Methods The sample included n = 45,542 participants in the 5 established regional cohorts of the Canadian Partners...

Objective: The COVID-19 pandemic and its associated public health measures may increase the risk for psychological distress among vulnerable older adults. This longitudinal study aimed to identify predictors of psychological distress trajectories among community-dwelling older adults in Quebec, Canada. Methods: The study spanned four time points...

Intergenerational initiatives have the potential to bring generations together and can have a wide range of benefits for the health of older adults as well as for the development of young people. This paper presents a five-phase participatory action research protocol for the co-design and pilot implementation of a toolkit supporting intergeneration...

A growing body of research examines the COVID-19 pandemic’s effects on well-being. Only few studies focus on older adults or explore the predictors of COVID-19-related anxiety. Intolerance of uncertainty (IU) and some behaviors (e.g., avoidance, procrastination) are linked to anxiety among older adults and could both be relevant to consider in a pa...

Contexte La compréhension des déterminants et barrières à la vaccination contre la COVID-19 est un enjeu de santé publique. Méthodes Enquête transversale chez les aînés au Québec. Les données collectées par le biais d'entretiens téléphoniques au printemps 2021 (3e vague) auprès de 476 sujets ≥ 65 ans vivant à domicile comprenaient : le statut vacc...

Objectives: To identify profiles of aging by combining psychological distress, cognition and functional disability, and their associated factors. Methods: Data were drawn from the Étude sur la Santé des Aînés-Services study and included 1585 older adults. Sociodemographic, psychosocial, lifestyle and health factors were informed from structured...

Objective To assess the association between receipt of minimally adequate treatment (MAT) and mortality in a sample of community primary care older adults with depression and anxiety. Method The present study was conducted among a sample of 358 older adults ( ≥ 65 years old) with depression or an anxiety disorder recruited in primary care practice...

PurposeThe epidemiology of late-life psychosis (LLP) remains unclear comparatively to early-onset psychosis. The study aims to estimate the prevalence and incidence of LLP over a 3-year period and examine the correlates of LLP in community-living older adults aged ≥ 65 years recruited in primary care. Methods Study sample included N = 1481 primary...

Receipt of quality mental health (MH) care can influence mortality. Given the scarce literature on the topic, the aim was to assess the 3-year risk of mortality in older adults (OA) associated with receiving adequate MH treatment for depression/anxiety in an epidemiologic context. The study sample included 358 OA with depression/anxiety recruited i...

Background Cognitive training was found to have a positive effect on the memory of healthy older adults, including long‐term benefits (Rebok et al, 2014). This finding offers hope that cognitive training could contribute to prevention approaches. However, little is known regarding the long‐term benefits of cognitive training in older adults with mi...

Background. Half of the people with Fear of Falling (FoF) are non-fallers, and the reason why some people considered non-fallers are afraid of falling is unknown, but reduced mobility or cognition, or both concurrently must be considered as potential risk factors. Aim. The study aimed to determine if mobility and/or cognitive abilities could ident...

Objective To examine associations between chronic pain conditions, pain level, and subclinical/clinical anxiety in community-dwelling older adults. Design Cross-sectional associations were analyzed using multinomial logistic regression to compare the odds of having subclinical/clinical anxiety by painful condition and pain level, controlling for c...

Background Only a small proportion of older patients with generalized anxiety disorder (GAD) seek professional help. Difficulties in accessing treatment may contribute to this problem. Guided self-help based on the principles of cognitive-behavioral therapy (GSH-CBT) is one way of promoting access to psychological treatment. Moreover, because the t...

Historically, clinicians and researchers have focused on depression and dementia in older people, paying little attention to anxiety except as a complication of these disorders. However, increased research into late-life anxiety has seen a growth in scientific literature and clinical interest. This important book brings together international exper...

Epidemiological studies have revealed that behavioral and psychological (or non-cognitive) symptoms are risk factors for cognitive decline in older adults. This study aimed to systematically review the literature and determine which behavioral and psychological symptoms are most predictive of future cognitive decline among individuals with no pre-e...

Purpose of Review Anxiety disorders are the most prevalent mental disorders. Although prevalence estimates are lower in males than females, the disability associated with anxiety disorders has been increasing in males. This review focuses on recent research studying sex differences in anxiety disorders and associated symptoms in older adults. Rece...

Background Providing care to cancer patients is associated with a substantial psychological and emotional load on oncology workers. The purpose of this project is to co-construct, implement and assess multidimensional intervention continuums that contribute to developing the resilience of interdisciplinary cancer care teams and thereby reduce the b...

Background: Long-term benzodiazepine (BZD) use among seniors is mostly inappropriate and associated with adverse health outcomes. To prevent these consequences, withdrawal is crucial, yet knowledge is limited about what predicts BZD discontinuation. Until now, most studies have focused on sociodemographic and BZD intake factors as predictors while...

Introduction: It is generally accepted that physical activity promotes healthy aging. Recent studies suggest dance could also benefit cognition and physical health in seniors, but many styles and approaches of dance exist and rigorous designs for intervention studies are still scarce. The aim of this study was to compare the effects of Dance/Movem...

Objective: Benzodiazepines (BZD) are often prescribed to address sleep difficulties but many BZD users report a poor quality of sleep. Although social support was found to be associated with quality of sleep in a recent meta-analysis, this relationship was never studied in older BZD users. This study thus aims to examine how social support is assoc...

Objectives To estimate the 6‐month prevalence of Generalized Anxiety Disorder (GAD) in primary care patients aged 70 years and over and to describe their clinical profile, including types of worries. Methods/Design Participants (N=1193) came from the ESA‐services study conducted in Quebec, Canada. An in‐person structured interview was used to iden...

Objectives To provide an estimate of 12‐month and lifetime prevalence of DSM‐IV anxiety disorders in older adults based on published studies on this topic, and to identify the impact of gender and age. Methods/Design A systematic review and meta‐analysis was performed. Six databases were searched and manual searches through reference lists of sele...

Background: The effect of alcohol consumption on cognitive decline is not clear. We aimed to study the association between alcohol consumption and cognitive functioning controlling for functional heath status. Methods: A total of 1610 older adults with a score ≥26 on the Mini-Mental State Examination (MMSE) were followed to assess the change in...

Background Motoric cognitive risk (MCR) syndrome, a recently described pre-dementia syndrome, has been associated with cardiovascular disease and their risk factors (CVDRF). Objective To determine whether MCR syndrome was associated with CVDRF in French community-dwelling older adults, and to quantitatively evaluate, with a systematic review and m...

Fear of falling (FOF) is a major health problem for more than 50% of the older adults. The aim of this study was to determine if there is a link between cognition and/or mobility performances and falls in people with FOF. Twenty-six older adults with FOF participated in this study. Neuropsychological and mobility assessments were performed focusin...

We investigated the association between fear of falling (FoF) and motor imagery (MI) abilities in older people. Cross-sectional data from 3552 French older adults were used to conduct a multiple linear regression analysis looking at the association between FoF and MI abilities after controlling for several factors (e.g. gender, age, history of fall...

Background/objectives: There is no consensus on the efficacy of cognitive training in persons with mild cognitive impairment (MCI) because of the paucity of well-designed randomized controlled trials. The objective was to assess the effect of memory training on the cognitive functioning of persons with MCI and its durability and to evaluate whethe...

Background: Gait disorders, a highly prevalent condition in older adults, are associated with several adverse health consequences. Gait analysis allows qualitative and quantitative assessments of gait that improves the understanding of mechanisms of gait disorders and the choice of interventions. This manuscript aims (1) to give consensus guidance...

Falls are a consequence of gait instability. Cortical and subcortical abnormalities have been associated with gait instability but not yet with falls. This study aims to compare the global and regional brain subvolumes between healthy older fallers and non-fallers. A total of 77 healthy older individuals (23 fallers and 54 non-fallers, 69.8 ± 3.5 y...

Objective: A relationship between generalized anxiety disorder (GAD) and fear of falling (FOF) has long been proposed but never specifically studied. This study aimed at analyzing the relationship between FOF and GAD or anxiety symptoms, while controlling for major depressive episodes (MDE), depressive symptoms, fall risk, and sociodemographic vari...

Background Few studies have examined the effect of anti-dementia drugs (i.e., acetylcholinesterase inhibitors and N-methyl-d-aspartate receptor antagonists) on gait performance. Past studies have focused on the stride time (i.e., gait cycle duration) but not on the mental imagery of gait. Objectives To compare mental imagery of gait and spatiotempo...

Fear of falling and other fall-related psychological concerns (FRPCs), such as falls-efficacy and balance confidence, are highly prevalent among community-dwelling older adults. Anxiety and FRPCs have frequently, but inconsistently, been found to be associated in the literature. The purpose of this study is to clarify those inconsistencies with a s...

Anxiety scales. (DOCX)

Full search strategy. (DOCX)

Fear of falling scales. (DOCX)

Falls efficacy or balance confidence scale. (DOCX)

PRISMA 2009 Checklist. (DOC)

The term phobias derives from the name of Phobos, a Greek god who according to legend scared his enemies with his awesome face. It was not until the late 1940s that phobias became a distinct psychiatric diagnosis. In psychiatric manuals, phobias are usually divided into three categories: specific (simple) phobia, social phobia, and agoraphobia. Thi...

Le trouble d’anxiété généralisée (TAG) est un des troubles anxieux les plus répandus chez les personnes âgées et ses retombées négatives sont importantes. Malgré la disponibilité de traitements efficaces, le TAG est sous-traité dans cette population. Les raisons expliquant cette situation sont nombreuses et incluent les difficultés d’accès aux trai...

The main objective of this study was to examine the efficacy of a guided self-help treatment based on cognitive behavioral principles (CBT-GSH) for generalized anxiety disorder (GAD) in older adults. Three older adults aged from 66 to 70 and diagnosed with GAD were included in a single-case experimental multiple-baseline protocol. Data were collect...

Objectives: Our goal was to build a systemic model of chronic use among community-dwelling mature benzodiazepine (BZD) users. BZDs are commonly prescribed for symptoms of anxiety and/or insomnia despite their documented side effects over time. Method: We conducted in-depth interviews with 23 mature (50 years and over) users, 14 women and 9 men,...

Objective Sleep complaints are often associated with anxiety and depression, but the specific complaints related to each syndrome are poorly characterized, especially in older adults. The objective was to identify subjective sleep characteristics specific to anxiety and depression in this population.MethodsA random sample of 2393 individuals aged 6...

Cognitive-behavioral therapy (CBT) using traditional exposure techniques (i.e. imaginal and in vivo ) seems less effective to treat anxiety in older adults than in younger ones. This is particularly true when imaginal exposure is used to confront the older patient to inaccessible (e.g. fear of flying) or less tangible/controllable anxiety triggers...

To document the 6-month prevalence of posttraumatic stress syndrome (PTSS) in the older adult population and the validity of a PTSS Scale in an epidemiologic setting. Data came from the Enquête sur la santé des aînés et l'utilisation des services de santé (ESA Services Study) conducted during 2012-2013 using a probability sample of older adults see...

Background: Several studies have suggested that cognitive training is a potentially effective way to improve cognition and postpone cognitive decline in older adults with mild cognitive impairment (MCI). The MEMO+ study is a randomized, controlled, single-blind trial designed to test the efficacy, specificity, and long-term effect of a cognitive t...

ABSTRACT The present study was conducted to determine whether anxiety among community-dwelling elders is associated with cognitive decline over a period of one year as well as to verify whether there are sex differences in the association between anxiety and cognitive decline. Participants (n=1942) were community-dwelling adults aged 65-96 years as...

Background Falls and depression are two major public health problems that affect millions of older people each year. Several factors associated with falls are also related to depressive symptoms such as medical conditions, sleep quality, use of medications, cognitive functioning, and physical capacities. To date, studies that investigated the assoc...

Plusieurs personnes âgées présentent des symptômes anxieux qui varient en intensité ou en sévérité. Si l’anxiété gériatrique n’est pas traitée rapidement et efficacement, des conséquences sérieuses peuvent en découler, dont la perturbation du fonctionnement quotidien, la détérioration du bien-être général, la dépression, la surutilisation des servi...

RÉSUMÉ Les données de l’étude ESA ont été appariées aux données d’utilisation des services médicaux et pharmaceutiques de la Régie d’assurance maladie du Québec pour documenter la prescription potentiellement non appropriée de benzodiazépines chez les personnes âgées. Nos résultats indiquent que 32% des répondants ont pris une dose journalière moye...

To examine in cognitively intact older men and women the associations between subjective sleep quality and 1-yr incident cognitive impairment. Prospective cohort study. General community. 1,664 cognitively intact individuals age 65 to 96 years. Sleep quality at baseline was measured using the Pittsburgh Sleep Quality Index (PSQI). Cognitive functio...

Studies that examined the prevalence of anxiety in older adults with cardiovascular diseases (CVD) were mainly conducted in clinical settings limiting the generalizability of the results to community-based samples. Moreover, among older adults with CVD, little is known about the prevalence of subthreshold anxiety and about which characteristics dif...

Anxiety symptoms are highly prevalent in elders with mild cognitive disorders, but little is known about the associations of specific anxiety disorders to mild cognitive disorders. To identify the clinical and subclinical anxiety disorders associated with cognitive impairment no dementia (CIND) and to determine whether these associations differ dep...

Over the years, psychotropic drugs have been prescribed for symptoms of anxiety and/or insomnia. Elderly women are especially at risk of chronic use and ensuing side-effects. We examined psychosocial processes associated with long-term psychotropic drug use. We conducted in-depth interviews with 21 frail elderly women in a home care program and 14...

Background Sleep disturbances are frequently reported in the older adult population and benzodiazepines are the drugs most often prescribed to treat these problems. Nearly 25% of the older adult population uses these drugs and 83% of benzodiazepine users report sleep problems. Although the Collège des Médecins du Québec suggests a maximum length of...

To examine in men and women the independent associations between anxiety and depression and 1-year incident cognitive impairment and to examine the association of cognitive impairment, no dementia (CIND) and incident cognitive impairment with 1-year incident anxiety or depression. Prospective cohort study. General community. Population-based sample...

To assess the prevalence rate of mood disorders, anxiety disorders, benzodiazepine dependence, and insomnia in older men and women with probable cognitive impairment no dementia (CIND) and to examine the independent associations between each disorder and CIND. Participants were a random sample of community-dwelling individuals aged 65-96 (N = 2414)...

Specific phobias have received little attention among older adults. This study is aimed at determining the 12-month prevalence rates of fear subtypes in older adults with a full or subthreshold DSM diagnosis of specific phobia as well as to examine differences among these conditions according to health and health behavior characteristics potentiall...

Subthreshold anxiety refers to a condition where individuals do not meet the full symptom criteria (i.e., the number of symptoms required for a formal diagnosis is not reached) and/or do not report significant impairment or distress in functioning (i.e., the clinical significance criterion is not met). The purpose of this study was to examine how t...

Several neuropsychiatric symptoms observed in elders with cognitive impairment no dementia (CIND) can be part of a major depressive episode (MDE) or a "subthreshold" depressive episode. Certain neuropsychiatric symptoms of CIND are essential symptoms of MDE (e.g. dysphoria, anhedonia), while other are non-essential symptoms (NESD; e.g. fatigue, ins...

About 50% of the elderly population report being dissatisfied with their sleep. Although benzodiazepines are the most prescribed drugs to treat sleep complaints, the effectiveness of their use on the quality of sleep is not well documented. This study aimed to assess the association between benzodiazepine use and global sleep quality, as well as si...

To document the remission and persistence of psychiatric disorders in Quebec's older adult population. Data came from the Enquête sur la santé des aînés (ESA) study conducted in 2005-2008 using a representative sample (n = 2784) of community-dwelling older adults. The ESA study results indicate that 12% of respondents met the Diagnostic and Statist...

To examine the incidence of psychiatric disorders in the Quebec older adult population. Data from the Enquête sur la Santé des Aînés (ESA) study conducted in 2005 to 2008 using a representative sample (n = 2784) of community-dwelling adults aged 65 years and older were used. The ESA study's results indicate that 12.0% of the respondents met the Dia...

Despite the important role of doubt in understanding obsessive-compulsive disorder (OCD), current cognitive models of OCD usually do not separate this initial doubt from the anticipated consequence of not ritualizing. The current study evaluates belief in the obsessional doubt as a real probability as an additional cognitive dimension of obsessive-...

The purpose of this study was to determine OCD prevalence among older adults living in the community and to examine its correlates. Data were drawn from a large population survey using a representative sample of older adults aged 65 years and over (N=2798). The 12-month prevalence rate of OCD was 1.5%. Results showed that older adults with OCD were...

To document the prevalence of psychiatric disorders in Quebec's older adult population. Data came from the Enquête sur la santé des aînés study conducted in 2005--2006 using a representative sample (n = 2798) of community-dwelling older adults. Our results indicate that 12.7% of the respondents met the Diagnostic and Statistical Manual of Mental Di...

The current study reports a case series examining (1) the variation in strength of obsessional doubt and belief in consequences of the doubt; and (2) the interaction between these cognitive components and symptom measures of duration and severity of obsessive-compulsive disorder (OCD), over 24 weeks of cognitive behaviour therapy. Eight participant...

Cognitive-behavioural therapy (CBT) has proved effective in treating delusions, both in schizophrenia and delusional disorder (DD). Clinical trials of DD have mostly compared CBT with either treatment as usual, no treatment, or a wait-list control. This current study aimed to assess patients with DD who received CBT, compared with an attention plac...

To compare cognitive behaviour therapy (CBT) with CBT plus medication; medication alone; and placebo in the treatment of adult obsessive-compulsive disorder (OCD). Forty-eight participants (43 completers) were recruited into two protocols. In the first protocol, 21 people with OCD were randomly allocated to either a standard medication (fluvoxamine...

It is assumed that an individual suffers from obsessive-compulsive disorder (OCD) with poor insight when he or she does not recognize for most of the time that his or her obsessions/compulsions are unreasonable ( American Psychiatric Association, 2000). In this critical review of research concerning insight in obsessions, overvalued ideas and delus...

Some individuals suffering from obsessive-compulsive disorder (OCD) may over invest in their obsessional doubts while according little importance to anticipated consequences. The aim of the present study is to investigate whether sociodemographic and clinical characteristics of patients who over invest in their obsessional doubts differ from OCD pa...

In the model of Generalised Anxiety Disorder (GAD) proposed by Dugas, Gagnon, Ladouceur, and Freeston (1998), Intolerance of Uncertainty (IU) plays a central role in the acquisition and maintenance of worries. A similar concept, Intolerance of Ambiguity (IA) was introduced by Frenkel-Brunswik 50 years ago. For decades, IU has been confused with IA....

Résumé Cet article passe en revue les quatre conceptions du trouble obsessionnel-compulsif (TOC) : la première conception présuppose que le TOC est un trouble du mouvement, la deuxième soutient que cette maladie fait partie du spectre TOC incluant, à la fois, les troubles impulsifs et compulsifs, la troisième fait référence à la classification actu...