Ionized Calcium and Behavioural Disorders in Older Adults (CALICO Study)

Study Overview
=================
Brief Summary
-----------------
The primary objective of this study is to determine whether geriatric inpatients with severe behavioral disorders exhibit higher serum ionized calcium concentration than geriatric inpatients without behavioral disorders, but no difference in serum calcium or corrected calcium concentrations. The secondary objective of this study is to determine whether the serum ionized calcium concentration is associated with behavioral and cognitive performance among geriatric inpatients.

Detailed Description
-----------------
Growing attention is paid to the neurological effects of calcium. While calcium is necessary for neuronal physiology, it appears that high serum calcium concentrations may be toxic to neurons. An analysis of the Rotterdam Study showed that, among older adults, higher concentrations of calcium were associated with greater cognitive disorders and faster cognitive decline. Similarly, delirium and behavioural disorders are reported in older adults with hypercalcemia. In contrast, other studies failed to find any association. For example, in France, an analysis of the EPIDOS study found no association between calcium concentration and cognitive performance. Thus, further studies remain necessary to make firmer conclusions about this link. In particular, it is interesting to note that all previous studies have used the serum concentrations of calcium or corrected calcium, but not yet ionized calcium. This assay is yet more reproducible, more sensitive and more correlated with clinical events. We propose that the non-use of ionized calcium assay may explain, at least in part, the discrepancies between previous studies.

Official Title
-----------------
Ionized Calcium and Behavioural Disorders in Older Adults (CALICO Study)

Conditions
-----------------
Geriatric Disorders

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Age 75 years and over Cases : Inpatient with severe behavioural disorders Being hospitalized in the geriatric acute care unit of Angers University Hospital, France Controls : Inpatients without severe behavioural disorder and taking no antipsychotics Being hospitalized in the geriatric acute care unit of Angers University Hospital, France Paired on age (± 3 years) and gender Exclusion Criteria: Inability to understand and speak French Opposition to the use of information collected for this research

Ages Eligible for Study
-----------------
Minimum Age: 75 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Cases<br>Inpatient with severe behavioural disorders | |
| Controls<br>Inpatients without severe behavioural disorder and taking no antipsychotics | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Comparison of serum ionized calcium concentrations between cases and paired controls. | This measurement is assessed by a blood test. | This outcome is assessed at baseline. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Comparison of serum corrected calcium concentration between cases and paired controls. | This measurement is assessed by a blood test. | This outcome is assessed at baseline. | 
| Comparison of the severity of behavioural disorders between cases and paired controls. | The severity of behavioural disorders is assessed by a standardized scale (Frontotemporal Behavioural Rating Scale (FBRS), Lebert F. et Pasquier F., 1998) | This outcome is assessed at baseline. | 
| Comparison of cognitive performance between cases and paired controls. | Cognitive performance is assessed by the Mini-Mental State Examination (MMSE) score. | This outcome is assessed at baseline. |