Chewing efficiency seems stronger associated with cognitive impairment than the number of teeth. Hence, in a more holistic approach for the geriatric assessment, the dental examination may be complemented by a chewing efficiency test.

Is steatosis related to the spontaneous carbohydrate intake in patients with NAFLD? We performed dietary records for 24 patients with NAFLD, 3 months after their liver biopsy was performed and before the deliverance of a dietary advice. The food quotient, indicator of the proportion of calories from carbohydrates, was calculated as (1.00×%  calories from carbohydrates/100) + (0.70×%  calories from lipids/100) + (0.81×%  calories from proteins/100). The associations between diet variables and steatosis% on the hepatic biopsies were tested by regression analysis, and diet variables were compared according to the presence of fibrosis. The subjects displayed a large range of steatosis, 50.5% ± 25.5 [10–90], correlated with their energy intake (1993 ± 597 kcal/d, r = 0.41, P < 0.05) and food quotient (0.85 ± 0.02, r = 0.42, P < 0.05), which remained significant with both variables by a multivariate regression analysis (r = 0.51, P < 0.05). For the 17/24 patients with a hepatic fibrosis, the energy intake was lower (fibrosis: 1863 ± 503 versus others: 2382 ± 733 kcal/d, P < 0.05), and their food quotients did not differ from patients without fibrosis. Hepatic steatosis was related to the energy and carbohydrate intakes in our patients; the role of dietary carbohydrates was detectable in the range of usual carbohydrate intake: 32% to 58% calories.

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Les troubles cognitifs peuvent interférer avec l'aptitude à la conduite automobile. Une hausse des demandes d'évaluation ciblée sur cet aspect est observée au Centre Leenaards de la Mémoire. Les modifications de la loi pourraient être un facteur explicatif. Les avis formulés en 2019 sont majoritairement défavorables chez les patients présentant des troubles cognitifs dus à une maladie d'Alzheimer ou une pathologie apparentée, mais jamais en lien avec le vieillissement seul. Les avis défavorables sont fréquents avant l'âge de 75 ans. Chaque situation est donc unique et chaque décision prise se base non pas sur l'âge du patient, ni sur le diagnostic étiologique, mais sur le profil cognitif. Nous abordons dans cet article les raisons d'un avis défavorable et les discutons dans le contexte des missions de notre centre. Cognitive fitness to drive : feedback at Leenaards Memory CentreCognitive impairment can interfere with the fitness to drive. An increase in requests to assess this aspect is observed at Leenaards Memory Centre. Changes in the law could be an explanatory factor. The views formulated in 2019 are mainly unfavorable because all the patients present cognitive disorders, generally attributed to Alzheimer's disease or a related disorder, but never linked with aging only. Moreover, unfavorable views are frequently expressed before the age of 75. Therefore, each patient is unique, and each decision is based neither on the patient's age or his diagnosis, but rather on his cognitive profile. In this article we discuss the reasons for an unfavorable view and discuss them in the context of the tasks of our centre.