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Tournier BB, Sorce S, Marteyn A, Ghidoni R, Benussi L, Binetti G, Herrmann FR, Krause K, Zekry D. CCR5 deficiency: Decreased neuronal resilience to oxidative stress and increased risk of vascular dementia. Alzheimers Dement 2024; 20:124-135. [PMID: 37489764 PMCID: PMC10917026 DOI: 10.1002/alz.13392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 05/09/2023] [Accepted: 06/19/2023] [Indexed: 07/26/2023]
Abstract
INTRODUCTION As the chemokine receptor5 (CCR5) may play a role in ischemia, we studied the links between CCR5 deficiency, the sensitivity of neurons to oxidative stress, and the development of dementia. METHODS Logistic regression models with CCR5/apolipoprotein E (ApoE) polymorphisms were applied on a sample of 205 cognitively normal individuals and 189 dementia patients from Geneva. The impact of oxidative stress on Ccr5 expression and cell death was assessed in mice neurons. RESULTS CCR5-Δ32 allele synergized with ApoEε4 as risk factor for dementia and specifically for dementia with a vascular component. We confirmed these results in an independent cohort from Italy (157 cognitively normal and 620 dementia). Carriers of the ApoEε4/CCR5-Δ32 genotype aged ≥80 years have an 11-fold greater risk of vascular-and-mixed dementia. Oxidative stress-induced cell death in Ccr5-/- mice neurons. DISCUSSION We propose the vulnerability of CCR5-deficient neurons in response to oxidative stress as possible mechanisms contributing to dementia.
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Affiliation(s)
- Benjamin B. Tournier
- Department of PsychiatryGeneva University Hospitals and University of GenevaGenevaSwitzerland
| | - Silvia Sorce
- Department of Pathology and ImmunologyFaculty of MedicineUniversity of GenevaGenevaSwitzerland
| | - Antoine Marteyn
- Department of Pathology and ImmunologyFaculty of MedicineUniversity of GenevaGenevaSwitzerland
- Division of GeriatricsDepartment of Rehabilitation and GeriatricsGeneva University HospitalsThônexSwitzerland
- Division of Internal Medicine for the AgedDepartment of Rehabilitation and GeriatricsGeneva University HospitalsThônexSwitzerland
| | - Roberta Ghidoni
- Molecular Markers LaboratoryIRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Luisa Benussi
- Molecular Markers LaboratoryIRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Giuliano Binetti
- MAC Memory Clinic and Molecular Markers LaboratoryIRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - François R Herrmann
- Division of GeriatricsDepartment of Rehabilitation and GeriatricsGeneva University HospitalsThônexSwitzerland
| | - Karl‐Heinz Krause
- Department of Pathology and ImmunologyFaculty of MedicineUniversity of GenevaGenevaSwitzerland
| | - Dina Zekry
- Division of Internal Medicine for the AgedDepartment of Rehabilitation and GeriatricsGeneva University HospitalsThônexSwitzerland
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Zekry D, D'Amelio P, Graf C. Sommes-nous prêts à trouver le médicament qui guérit ? Rev Med Suisse 2023; 19:2031-2032. [PMID: 37910050 DOI: 10.53738/revmed.2023.19.848.2031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Affiliation(s)
- Dina Zekry
- Service de médecine interne de l'âgé, Hôpitaux universitaires de Genève
| | - Patrizia D'Amelio
- Service de gériatrie et réadaptation gériatrique, Département de médecine, Centre hospitalier universitaire vaudois, Lausanne
| | - Christophe Graf
- Service de gériatrie et de réadaptation, Département de réadaptation et gériatrie, Hôpitaux universitaires de Genève
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Srinivasan M, Duong S, Trombert V, Kalberer N, Zekry D, Herrmann FR, Delavy J, Gold G, Müller F. A novel prosthesis presentation test to screen for cognitive and functional decline. Gerodontology 2023. [PMID: 37584635 DOI: 10.1111/ger.12708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2023] [Indexed: 08/17/2023]
Abstract
OBJECTIVES AND BACKGROUND To validate a novel screening test for cognitive and functional decline in older patients rehabilitated with complete removable dental prostheses (CRDPs). MATERIALS AND METHODS Edentate old in-patients rehabilitated with CRDPs were included in this study. Participants were requested to remove their prostheses before their intraoral examinations. The prostheses were then presented in an inverted orientation. Participants had to correct the orientation of the prostheses and insert them in the appropriate jaws. The test was repeated after the intraoral exam. Appropriate statistical models were used (⍺ = .05) to associate the test results with the participants' mini-mental state examination (MMSE) score, functional independence measure (FIM), age and sex. RESULTS Among the 86 participants (mean-age: 85.4 ± 6.4 years; mean MMSE: 19.8 ± 5.5; mean FIM: 77.9 ± 20.8), 21 (24.4%) failed to correctly insert the prosthesis. The prosthesis presentation test (PPT) was associated with the FIM but not the MMSE. Regression models further confirmed an association with age (P = .043), but not sex. Additional analyses revealed the PPT test is associated with the FIM's cognitive sub-sets of memory, problem solving and social interaction. CONCLUSION The PPT is a novel, simple and quick screening tool that can help detect functional difficulties in older people. It can easily be performed during an oral examination. Future studies are needed to determine whether the PPT can be used to detect deficits in executive function, as a complement to the MMSE and also as a first assessment of a patient's ability to manage dentures independently.
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Affiliation(s)
- Murali Srinivasan
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Stephan Duong
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Veronique Trombert
- Division of Internal Medicine for the aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Thônex, Switzerland
| | - Nicole Kalberer
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Dina Zekry
- Division of Internal Medicine for the aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Thônex, Switzerland
| | - François R Herrmann
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Thônex, Switzerland
| | - Joris Delavy
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Gabriel Gold
- Department of Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Thônex, Switzerland
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Cuvelier C, Hars M, Zamorani-Bianchi MP, Herrmann FR, Wieczorkiewicz CD, Zekry D, Gold G, Trombetti A. Hypnosis to reduce fear of falling in hospitalized older adults: a feasibility randomized controlled trial. Pilot Feasibility Stud 2023; 9:139. [PMID: 37559112 PMCID: PMC10410891 DOI: 10.1186/s40814-023-01366-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 07/18/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Fear of falling is associated with numerous negative health outcomes in older adults and can limit the rehabilitation process. Hypnosis is now recognized as an effective treatment for a variety of conditions, especially anxiety and pain, which can be integrated safely with conventional medicine. The objective of this study was to assess the feasibility and acceptability of a hypnosis intervention in hospitalized older adults to reduce fear of falling. METHODS In this feasibility randomized controlled trial, 32 older patients, hospitalized in geriatric rehabilitation wards, were randomly allocated (1:1 ratio) to either an intervention group (hypnosis, 2 sessions, one per week, plus usual rehabilitation program) or a control group (usual rehabilitation program only). Clinical assessors and statistician were blinded to group allocation. Primary outcomes were recruitment rate, retention rate, and adherence to the intervention. Exploratory outcomes, analyzed according to the intention-to-treat principle, included impact of hypnosis on fear of falling (assessed by a new scale perform-FES), functional status, in-hospital falls, and length of hospital stay. RESULTS Recruitment rate was 1.3 patients per week. The recruitment of the population sample was achieved in 5.5 months. The retention rate did not differ significantly between groups and a good adherence to the hypnosis intervention was achieved (77% of patients received the full intervention). No adverse event related to the hypnosis intervention was observed. Regarding exploratory clinical outcomes, no differences were found between groups on any outcome. CONCLUSION Hypnosis is feasible and well accepted in a geriatric hospitalized population undergoing rehabilitation. Further pilot work should be conducted, with an increased number of hypnosis sessions, before conducting a full-scale trial to conclude whether, or not, hypnosis is effective to reduce fear of falling. TRIAL REGISTRATION NCT04726774.
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Affiliation(s)
- Clémence Cuvelier
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Mélany Hars
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Maria Pia Zamorani-Bianchi
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Catherine Ducharne Wieczorkiewicz
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Dina Zekry
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Gabriel Gold
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Andrea Trombetti
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland.
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
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Maillard J, Elia N, Ris F, Courvoisier DS, Zekry D, Labidi Galy I, Toso C, Mönig S, Zaccaria I, Walder B. Changes of health-related quality of life 6 months after high-risk oncological upper gastrointestinal and hepatobiliary surgery: a single-centre prospective observational study ( ChangeQol Study). BMJ Open 2023; 13:e065902. [PMID: 36813502 PMCID: PMC9950916 DOI: 10.1136/bmjopen-2022-065902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
INTRODUCTION Postoperative health-related quality of life (HRQoL) is an essential outcome in oncological surgery, particularly for elderly patients undergoing high-risk surgery. Previous studies have suggested that, on average, HRQoL returns to premorbid normal levels in the months following major surgery. However, the averaging of effect over a studied cohort may hide the variation of individual HRQoL changes. The proportions of patients who have a varied HRQoL response (stable, improvement, or a deterioration) after major oncological surgery is poorly understood. The study aims to describe the patterns of these HRQoL changes at 6 months after surgery, and to assess the patients and next-of-kin regret regarding the decision to undergo surgery. METHODS AND ANALYSIS This prospective observational cohort study is carried out at the University Hospitals of Geneva, Switzerland. We include patients over 18 years old undergoing gastrectomy, esophagectomy, pancreas resection or hepatectomy. The primary outcome is the proportion of patients in each group with changes in HRQoL (improvement, stability or deterioration) 6 months after surgery, using a validated minimal clinically important difference of 10 points in HRQoL. The secondary outcome is to assess whether patients and their next-of-kin may regret their decision to undergo surgery at 6 months. We measure the HRQoL using the EORTC QLQ-C30 questionnaire before and 6 months after surgery. We assess regret with the Decision Regret Scale (DRS) at 6 months after surgery. Key other perioperative data include preoperative and postoperative place of residence, preoperative anxiety and depression (HADS scale), preoperative disability (WHODAS V.2.0), preoperative frailty (Clinical Frailty Scale), preoperative cognitive function (Mini-Mental State Examination) and preoperative comorbidities. A follow-up at 12 months is planned. ETHICS AND DISSEMINATION The study was first approved by the Geneva Ethical Committee for Research (ID 2020-00536) on 28 April 2020. The results of this study will be presented at national and international scientific meetings, and publications will be submitted to an open-access peer-reviewed journal. TRIAL REGISTRATION NUMBER NCT04444544.
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Affiliation(s)
- Julien Maillard
- Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - Nadia Elia
- Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, University Hospitals of Geneva, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Frédéric Ris
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Digestive Surgery, Department of Surgery, University Hospitals of Geneva, Geneva, Switzerland
| | - Delphine S Courvoisier
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Quality of Care, University Hospitals of Geneva, Geneva, Switzerland
| | - Dina Zekry
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Internal Medicine for the Elderly, University Hospitals of Geneva, Geneva, Switzerland
| | - Intidhar Labidi Galy
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Oncology, University Hospitals of Geneva, Geneva, Switzerland
| | - Christian Toso
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Digestive Surgery, Department of Surgery, University Hospitals of Geneva, Geneva, Switzerland
| | - Stefan Mönig
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Digestive Surgery, Department of Surgery, University Hospitals of Geneva, Geneva, Switzerland
| | - Isabelle Zaccaria
- Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - Bernhard Walder
- Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, University Hospitals of Geneva, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
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6
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Mendes A, Serratrice C, Herrmann FR, Gold G, Graf CE, Zekry D, Genton L. Nutritional risk at hospital admission is associated with prolonged length of hospital stay in old patients with COVID-19. Clin Nutr 2022; 41:3085-3088. [PMID: 33933295 PMCID: PMC7985608 DOI: 10.1016/j.clnu.2021.03.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/08/2021] [Accepted: 03/15/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND & AIMS To investigate the association of nutritional risk at admission with the length of hospital stay (LOS) and mortality in older patients with COVID-19. METHODS Retrospective monocentric study in an acute geriatric hospital. Data were collected after an extensive review of medical records and the nutritional risk was assessed according to the Nutritional Risk Screening (NRS). Univariate and multivariate (adjusted for age, sex and comorbidity burden) Cox proportional-hazard and linear regression models were used to investigate the association with the above-mentioned outcomes. RESULTS Of a total of 245 patients (86.1 ± 6.4 yrs), 50.6% had a severe nutritional risk with an NRS≥5/7 at admission. Lower BMI, cognitive impairment and swallowing disorders were more prevalent in the patients with a higher NRS. A NRS≥5 was not associated with mortality but prolonged by more than 3 days the LOS among the 173 survivors (β 3.69; 0.71-6.67 95% CI; p = 0.016), with a discharge rate delayed by 1.8 times (HR 0.55; 0.37-0.83 95% CI; p = 0.101). CONCLUSION Among the survivors of COVID-19 in an acute geriatric hospital, a NRS ≥5 at admission was associated with a longer LOS, but not with mortality.
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Affiliation(s)
- Aline Mendes
- Division of Geriatrics, University Hospitals of Geneva and University of Geneva, Chemin du Pont-Bochet 3, Geneva, Switzerland,Corresponding author. Chemin du Pont-Bochet 3, Thônex, Geneva, Switzerland
| | - Christine Serratrice
- Division of Internal Medicine for the Aged, University Hospitals of Geneva and University of Geneva, Chemin du Pont-Bochet 3, Geneva, Switzerland
| | - François R. Herrmann
- Division of Geriatrics, University Hospitals of Geneva and University of Geneva, Chemin du Pont-Bochet 3, Geneva, Switzerland
| | - Gabriel Gold
- Division of Geriatrics, University Hospitals of Geneva and University of Geneva, Chemin du Pont-Bochet 3, Geneva, Switzerland
| | - Christophe E. Graf
- Division of Internal Medicine and Rehabilitation, University Hospitals of Geneva and University of Geneva, Chemin du Pont-Bochet 3, Geneva, Switzerland
| | - Dina Zekry
- Division of Internal Medicine for the Aged, University Hospitals of Geneva and University of Geneva, Chemin du Pont-Bochet 3, Geneva, Switzerland
| | - Laurence Genton
- Clinical Nutrition, University Hospitals of Geneva and University of Geneva, Chemin du Pont-Bochet 3, Geneva, Switzerland
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Prendki V, Clivaz F, Raulais R, Hsissou A, Kaiser L, Graf C, Zekry D. [An infectious diseases ward dedicated to elderly patients: why and how?]. Rev Med Suisse 2022; 18:2063-2066. [PMID: 36326224 DOI: 10.53738/revmed.2022.18.802.2063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The management of infections in the elderly requires medical and nursing expertise with a standardized global geriatric evaluation. We present here an original and pioneering unit in Switzerland, dedicated to polymorbid and complex elderly patients hospitalized for an acute infection and who will benefit from joint management by an interdisciplinary team including a geriatrician, an infectious diseases specialist and a pharmacogeriatrician. The Hôpital des Trois-Chêne, which has geriatric emergencies, intermediate care beds, SOMADEM (somatic dementia) and UGIMP (medico-psychiatric) programs adapted to this population, seems to be the ideal place to host this unit. The teams will benefit from theoretical and practical training associated with field coaching.
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Affiliation(s)
- Virginie Prendki
- Service de médecine interne de l'âgé, Hôpital des Trois-Chêne, Hôpitaux universitaires de Genève, 1211 Genève 14
- Service des maladies infectieuses, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Florence Clivaz
- Service de médecine interne de l'âgé, Hôpital des Trois-Chêne, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Ronan Raulais
- Service de médecine interne de l'âgé, Hôpital des Trois-Chêne, Hôpitaux universitaires de Genève, 1211 Genève 14
- Direction des soins, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Aurélie Hsissou
- Direction des soins, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Laurent Kaiser
- Service des maladies infectieuses, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Christophe Graf
- Service de gériatrie, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Dina Zekry
- Service de médecine interne de l'âgé, Hôpital des Trois-Chêne, Hôpitaux universitaires de Genève, 1211 Genève 14
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8
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Graf C, Zekry D, D'amelio P, Büla C. [Not Available]. Rev Med Suisse 2022; 18:2043-2044. [PMID: 36326220 DOI: 10.53738/revmed.2022.18.802.2043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Christophe Graf
- Service de gériatrie et de réadaptation, Département de réadaptation et gériatrie, Hôpitaux universitaires de Genève, Loëx/Genève
| | - Dina Zekry
- Service de gériatrie et de réadaptation, Département de réadaptation et gériatrie, Hôpitaux universitaires de Genève, Loëx/Genève
| | - Patrizia D'amelio
- Service de gériatrie et réadaptation gériatrique, Département de médecine, Centre hospitalier universitaire vaudois, Lausanne
| | - Christophe Büla
- Service de gériatrie et réadaptation gériatrique, Département de médecine, Centre hospitalier universitaire vaudois, Lausanne
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9
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Nehme M, Vieux L, Courvoisier DS, Braillard O, Spechbach H, Jacquerioz F, Salamun J, Assal F, Lador F, Coen M, Agoritsas T, Reny JL, Graf C, Benzakour L, Favale R, Soccal PM, Bondolfi G, Tardin A, Zekry D, Stringhini S, Baggio S, Genevay S, Lauper K, Meyer P, Kwabena Poku N, Landis BN, Grira M, Sandoval J, Ehrsam J, Regard S, Genecand C, Kopp G, Guerreiro I, Allali G, Vetter P, Kaiser L, Chappuis F, Chenaud C, Guessous I. The pandemic toll and post-acute sequelae of SARS-CoV-2 in healthcare workers at a Swiss University Hospital. Prev Med Rep 2022; 29:101899. [PMID: 35822203 PMCID: PMC9263685 DOI: 10.1016/j.pmedr.2022.101899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 11/10/2022] Open
Abstract
Healthcare workers have potentially been among the most exposed to SARS-CoV-2 infection as well as the deleterious toll of the pandemic. This study has the objective to differentiate the pandemic toll from post-acute sequelae of SARS-CoV-2 infection in healthcare workers compared to the general population. The study was conducted between April and July 2021 at the Geneva University Hospitals, Switzerland. Eligible participants were all tested staff, and outpatient individuals tested for SARS-CoV-2 at the same hospital. The primary outcome was the prevalence of symptoms in healthcare workers compared to the general population, with measures of COVID-related symptoms and functional impairment, using prevalence estimates and multivariable logistic regression models. Healthcare workers (n = 3083) suffered mostly from fatigue (25.5 %), headache (10.0 %), difficulty concentrating (7.9 %), exhaustion/burnout (7.1 %), insomnia (6.2 %), myalgia (6.7 %) and arthralgia (6.3 %). Regardless of SARS-CoV-2 infection, all symptoms were significantly higher in healthcare workers than the general population (n = 3556). SARS-CoV-2 infection in healthcare workers was associated with loss or change in smell, loss or change in taste, palpitations, dyspnea, difficulty concentrating, fatigue, and headache. Functional impairment was more significant in healthcare workers compared to the general population (aOR 2.28; 1.76–2.96), with a positive association with SARS-CoV-2 infection (aOR 3.81; 2.59–5.60). Symptoms and functional impairment in healthcare workers were increased compared to the general population, and potentially related to the pandemic toll as well as post-acute sequelae of SARS-CoV-2 infection. These findings are of concern, considering the essential role of healthcare workers in caring for all patients including and beyond COVID-19.
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Affiliation(s)
- Mayssam Nehme
- Division of Primary care Medicine of the Geneva University Hospitals, Geneva, Switzerland
| | - Laure Vieux
- Division of Occupational Medicine, Geneva University Hospital, Geneva, Switzerland
| | - Delphine S Courvoisier
- Quality of Care Division, Medical Directorate, Geneva University Hospitals, Geneva, Switzerland.,Cantonal Health Service, General Directorate for Health, Geneva, Switzerland
| | - Olivia Braillard
- Division of Primary care Medicine of the Geneva University Hospitals, Geneva, Switzerland
| | - Hervé Spechbach
- Division of Primary care Medicine of the Geneva University Hospitals, Geneva, Switzerland
| | - Frederique Jacquerioz
- Division of Primary care Medicine of the Geneva University Hospitals, Geneva, Switzerland.,Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland.,Geneva Center for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Julien Salamun
- Division of Primary care Medicine of the Geneva University Hospitals, Geneva, Switzerland
| | - Frederic Assal
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Frederic Lador
- Division of Pulmonary Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Matteo Coen
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Thomas Agoritsas
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Jean-Luc Reny
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Christophe Graf
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Lamyae Benzakour
- Division of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Riccardo Favale
- Division of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Paola M Soccal
- Division of Pulmonary Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Guido Bondolfi
- Division of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Aglaé Tardin
- Cantonal Health Service, General Directorate for Health, Geneva, Switzerland
| | - Dina Zekry
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Silvia Stringhini
- Division of Primary care Medicine of the Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Stéphanie Baggio
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.,Division of Prison Health, Geneva University Hospitals, Geneva, Switzerland
| | - Stéphane Genevay
- Division of Rheumatology, Geneva University Hospitals, Geneva, Switzerland
| | - Kim Lauper
- Division of Rheumatology, Geneva University Hospitals, Geneva, Switzerland
| | - Philippe Meyer
- Division of Cardiology, Geneva University Hospitals, Geneva, Switzerland
| | - Nana Kwabena Poku
- Division of Cardiology, Geneva University Hospitals, Geneva, Switzerland
| | - Basile N Landis
- Division of Otolaryngology, Geneva University Hospitals, Geneva, Switzerland
| | - Marwène Grira
- Division of Primary care Medicine of the Geneva University Hospitals, Geneva, Switzerland
| | - José Sandoval
- Department of Oncology, Geneva University Hospitals, Geneva, Switzerland
| | - Julien Ehrsam
- Division of Primary care Medicine of the Geneva University Hospitals, Geneva, Switzerland.,Department of Medical Information Sciences, Geneva University Hospitals, Geneva, Switzerland
| | - Simon Regard
- Cantonal Health Service, General Directorate for Health, Geneva, Switzerland.,Division of Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Camille Genecand
- Cantonal Health Service, General Directorate for Health, Geneva, Switzerland
| | - Garance Kopp
- Division of Pulmonary Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Ivan Guerreiro
- Division of Pulmonary Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Gilles Allali
- Division of Neurology, Geneva University Hospitals, Geneva, Switzerland.,Leenaards Memory Center, Lausanne University Hospital, Lausanne, Switzerland
| | - Pauline Vetter
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.,Geneva Center for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland.,Division of Laboratory Medicine, Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland
| | - Laurent Kaiser
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.,Geneva Center for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland.,Division of Laboratory Medicine, Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland
| | - François Chappuis
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Catherine Chenaud
- Division of Occupational Medicine, Geneva University Hospital, Geneva, Switzerland
| | - Idris Guessous
- Division of Primary care Medicine of the Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
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10
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Dürst AV, Graf CE, Ruggiero C, Zekry D, Boccardi V, Monney L, Joss I, Vuilloud K, Vespignani G, Bosshard W, Mecocci P, Bula CJ, D'Amelio P. Fighting social isolation in times of pandemic COVID-19: the role of video calls for older hospitalized patients. Aging Clin Exp Res 2022; 34:2245-2253. [PMID: 35794314 PMCID: PMC9261146 DOI: 10.1007/s40520-022-02188-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/16/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Loneliness and social isolation are associated with anxiety and psychological discomfort, especially amongst the oldest and fragile persons. AIMS SILVER evaluates the acceptance of video calls by old hospitalized patients and their relatives during the ban on visits due to the COVID-19. Moreover, SILVER evaluates if the use of different communication technology is associated with different outcomes in terms of anxiety, fear of self and of others' death and mood. METHODS SILVER is an observational multicentre study. Patients hospitalized in two geriatric units in Switzerland and in one orthogeriatric unit in Italy and their relatives were enrolled. Participants can freely choose to use phone or video calls and were evaluated over a week. We measured anxiety, fear of death and mood at baseline and at the end of the study with standard scales. The use of video or phone calls was associated to a change in these parameters by two-way ANOVA for repeated measures. RESULTS Sixty-four patients and relatives were enrolled, 26.5% used phone calls and 73.5% video calls. The use of video calls was associated with a reduction in anxiety and fear of death in patients and relatives as compared to participants using phone calls. DISCUSSION Old patients and their relatives accepted and appreciated the use of video calls during hospitalization; moreover, participant using video calls appears to be less anxious and less afraid of death. CONCLUSIONS Video calls may be a useful communication tool for hospitalized older patients to keep social relationships with relatives and reduce their anxiety and fear of death. TRIAL REGISTRATION Retrospectively registered on 1st September 2021 in ClinicalTrials.gov (NCT05000099).
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Affiliation(s)
- Anne-Véronique Dürst
- Service of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, University of Lausanne Hospital (CHUV), Mont-Paisible 16, 1011, Lausanne, Switzerland
| | - Christophe E Graf
- Service of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Carmelinda Ruggiero
- Geriatric and Orthogeriatric Units, Department of Medicine and Surgery, University Hospital of Perugia, University of Perugia, Perugia, Italy
| | - Dina Zekry
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Virginia Boccardi
- Geriatric and Orthogeriatric Units, Department of Medicine and Surgery, University Hospital of Perugia, University of Perugia, Perugia, Italy
| | - Lauretta Monney
- Service of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, University of Lausanne Hospital (CHUV), Mont-Paisible 16, 1011, Lausanne, Switzerland
| | - Isaline Joss
- Service of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, University of Lausanne Hospital (CHUV), Mont-Paisible 16, 1011, Lausanne, Switzerland
| | - Karine Vuilloud
- Service of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Giulia Vespignani
- Geriatric and Orthogeriatric Units, Department of Medicine and Surgery, University Hospital of Perugia, University of Perugia, Perugia, Italy
| | - Wanda Bosshard
- Service of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, University of Lausanne Hospital (CHUV), Mont-Paisible 16, 1011, Lausanne, Switzerland
| | - Patrizia Mecocci
- Geriatric and Orthogeriatric Units, Department of Medicine and Surgery, University Hospital of Perugia, University of Perugia, Perugia, Italy.,Division of Clinical Geriatrics, NVS Department, Karolinska Institutet, Stockholm, Sweden
| | - Christophe J Bula
- Service of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, University of Lausanne Hospital (CHUV), Mont-Paisible 16, 1011, Lausanne, Switzerland
| | - Patrizia D'Amelio
- Service of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, University of Lausanne Hospital (CHUV), Mont-Paisible 16, 1011, Lausanne, Switzerland.
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11
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Nehme M, Braillard O, Chappuis F, Courvoisier DS, Kaiser L, Soccal PM, Reny JL, Assal F, Bondolfi G, Tardin A, Graf C, Zekry D, Stringhini S, Spechbach H, Jacquerioz F, Salamun J, Lador F, Coen M, Agoritsas T, Benzakour L, Favale R, Genevay S, Lauper K, Meyer P, Poku NK, Landis BN, Baggio S, Grira M, Sandoval J, Ehrsam J, Regard S, Genecand C, Kopp G, Guerreiro I, Allali G, Vetter P, Guessous I, Genecand C, Kopp G, Guerreiro I, Allali G, Vetter P. One-year persistent symptoms and functional impairment in SARS-CoV-2 positive and negative individuals. J Intern Med 2022; 292:103-115. [PMID: 35555926 PMCID: PMC9115262 DOI: 10.1111/joim.13482] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Persistent symptoms of SARS-CoV-2 are prevalent weeks to months following the infection. To date, it is difficult to disentangle the direct from the indirect effects of SARS-CoV-2, including lockdown, social, and economic factors. OBJECTIVE The study aims to characterize the prevalence of symptoms, functional capacity, and quality of life at 12 months in outpatient symptomatic individuals tested positive for SARS-CoV-2 compared to individuals tested negative. METHODS From 23 April to 27 July 2021, outpatient symptomatic individuals tested for SARS-CoV-2 at the Geneva University Hospitals were followed up 12 months after their test date. RESULTS At 12 months, out of the 1447 participants (mean age 45.2 years, 61.2% women), 33.4% reported residual mild to moderate symptoms following SARS-CoV-2 infection compared to 6.5% in the control group. Symptoms included fatigue (16% vs. 3.1%), dyspnea (8.9% vs. 1.1%), headache (9.8% vs. 1.7%), insomnia (8.9% vs. 2.7%), and difficulty concentrating (7.4% vs. 2.5%). When compared to the control group, 30.5% of SARS-CoV-2 positive individuals reported functional impairment at 12 months versus 6.6%. SARS-CoV-2 infection was associated with the persistence of symptoms (adjusted odds ratio [aOR] 4.1; 2.60-6.83) and functional impairment (aOR 3.54; 2.16-5.80) overall, and in subgroups of women, men, individuals younger than 40 years, those between 40-59 years, and in individuals with no past medical or psychiatric history. CONCLUSION SARS-CoV-2 infection leads to persistent symptoms over several months, including in young healthy individuals, in addition to the pandemic effects, and potentially more than other common respiratory infections. Symptoms impact functional capacity up to 12 months post infection.
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Affiliation(s)
- Mayssam Nehme
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Olivia Braillard
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - François Chappuis
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland.,Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Delphine S Courvoisier
- Cantonal Health Service, General Directorate for Health, Geneva, Switzerland.,Quality of Care Division, Medical Directorate, Geneva University Hospitals, Geneva, Switzerland
| | - Laurent Kaiser
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.,Geneva Center for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland.,Division of Laboratory Medicine, Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland
| | - Paola M Soccal
- Division of Pulmonary Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Jean-Luc Reny
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Frederic Assal
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Guido Bondolfi
- Division of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Aglaé Tardin
- Cantonal Health Service, General Directorate for Health, Geneva, Switzerland
| | - Christophe Graf
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Dina Zekry
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Silvia Stringhini
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Hervé Spechbach
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Frederique Jacquerioz
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland.,Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland.,Geneva Center for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Julien Salamun
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Frederic Lador
- Division of Pulmonary Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Matteo Coen
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Thomas Agoritsas
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Lamyae Benzakour
- Division of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Riccardo Favale
- Division of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Stéphane Genevay
- Division of Rheumatology, Geneva University Hospitals, Geneva, Switzerland
| | - Kim Lauper
- Division of Rheumatology, Geneva University Hospitals, Geneva, Switzerland
| | - Philippe Meyer
- Division of Cardiology, Geneva University Hospitals, Geneva, Switzerland
| | - Nana K Poku
- Division of Cardiology, Geneva University Hospitals, Geneva, Switzerland
| | - Basile N Landis
- Division of Otolaryngology, Geneva University Hospitals, Geneva, Switzerland
| | - Stéphanie Baggio
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland.,Division of Prison Health, Geneva University Hospitals, Geneva, Switzerland
| | - Marwène Grira
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - José Sandoval
- Department of Oncology, Geneva University Hospitals, Geneva, Switzerland
| | - Julien Ehrsam
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland.,Department of Medical Information Sciences, Geneva University Hospitals, Geneva, Switzerland
| | - Simon Regard
- Cantonal Health Service, General Directorate for Health, Geneva, Switzerland.,Division of Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Camille Genecand
- Cantonal Health Service, General Directorate for Health, Geneva, Switzerland
| | - Garance Kopp
- Division of Pulmonary Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Ivan Guerreiro
- Division of Pulmonary Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Gilles Allali
- Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Pauline Vetter
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.,Geneva Center for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland.,Division of Laboratory Medicine, Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland
| | - Idris Guessous
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | -
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Camille Genecand
- Cantonal Health Service General Directorate for Health Geneva Switzerland
| | - Garance Kopp
- Division of Pulmonary Medicine Geneva University Hospitals Geneva Switzerland
| | - Ivan Guerreiro
- Division of Pulmonary Medicine Geneva University Hospitals Geneva Switzerland
| | - Gilles Allali
- Division of Neurology Geneva University Hospitals Geneva Switzerland
| | - Pauline Vetter
- Division of Infectious diseases Geneva University Hospitals Geneva Switzerland
- Geneva Center for Emerging Viral Diseases Geneva University Hospitals Geneva Switzerland
- Division of Laboratory Medicine, Laboratory of Virology Geneva University Hospitals Geneva Switzerland
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12
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Malézieux-Picard A, Nascè A, Azurmendi L, Pagano S, Vuilleumier N, Sanchez JC, Reny JL, Zekry D, Roux X, Stirnemann J, Garin N, Prendki V. Kinetics of inflammatory biomarkers to predict one-year mortality in older patients hospitalized for pneumonia: a multivariable analysis. Int J Infect Dis 2022; 122:63-69. [PMID: 35550179 DOI: 10.1016/j.ijid.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/25/2022] [Accepted: 05/01/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Long-term mortality is increased in older patients with pneumonia. We aimed to test whether residual inflammation is predictive of one-year mortality after pneumonia. METHODS Inflammation biomarkers (C-reactive protein [CRP], interleukin [IL]-6 and IL-8, tumor necrosis factor-α, serum amyloid A, neopterin, myeloperoxidase, anti-apolipoprotein A-1, and anti-phosphorylcholine IgM) were measured at admission and discharge in older patients hospitalized for pneumonia in a prospective study. Univariate and multivariate analyses were conducted using absolute level at discharge and relative and absolute differences between admission and discharge for all biomarkers, along with usual prognostic factors. RESULTS In the 133 included patients (median age, 83 years [interquartile range: 78-89]), one-year mortality was 26%. In univariate analysis, the relative difference of CRP levels had the highest area under the receiver operating characteristic curve (0.70; 95% confidence interval [CI] 0.60-0.80). A decrease of CRP levels of more than 67% between admission and discharge had 68% sensitivity and 68% specificity to predict survival. In multivariate analysis, lower body mass index (hazard ratio=0.87 [CI 95% 0.79-0.96], P-value=0.01), higher IL-8 (hazard ratio=1.02 [CI 95% 1.00-1.04], P-value=0.02), and higher CRP (1.01 [95% CI 1.00-1.02], P=0.01) at discharge were independently associated with mortality. CONCLUSION Higher IL-8 and CRP levels at discharge were independently associated with one-year mortality. The relative CRP difference during hospitalization was the best individual biomarker for predicting one-year mortality.
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Affiliation(s)
- Astrid Malézieux-Picard
- Division of Internal Medicine for the Elderly, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Genève, Switzerland.
| | - Alberto Nascè
- Division of Internal Medicine for the Elderly, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Genève, Switzerland
| | - Leire Azurmendi
- Department of Internal Medicine, Medical Faculty, Geneva University Hospitals, Genève, Switzerland
| | - Sabrina Pagano
- Department of Internal Medicine, Medical Faculty, Geneva University Hospitals, Genève, Switzerland; Division of Laboratory Medicine, Diagnostic Department, Geneva University Hospitals, Genève, Switzerland
| | - Nicolas Vuilleumier
- Department of Internal Medicine, Medical Faculty, Geneva University Hospitals, Genève, Switzerland; Division of Laboratory Medicine, Diagnostic Department, Geneva University Hospitals, Genève, Switzerland; Medical Faculty, University of Geneva, Genève, Switzerland
| | - Jean-Charles Sanchez
- Department of Internal Medicine, Medical Faculty, Geneva University Hospitals, Genève, Switzerland; Medical Faculty, University of Geneva, Genève, Switzerland
| | - Jean-Luc Reny
- Division of General Internal Medicine, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals, Genève, Switzerland; Medical Faculty, University of Geneva, Genève, Switzerland
| | - Dina Zekry
- Division of Internal Medicine for the Elderly, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Genève, Switzerland; Medical Faculty, University of Geneva, Genève, Switzerland
| | - Xavier Roux
- Division of Internal Medicine for the Elderly, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Genève, Switzerland; Intensive Care Division, Geneva University Hospitals, Genève, Switzerland
| | - Jérôme Stirnemann
- Division of General Internal Medicine, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals, Genève, Switzerland; Medical Faculty, University of Geneva, Genève, Switzerland
| | - Nicolas Garin
- Medical Faculty, University of Geneva, Genève, Switzerland; Department of General Internal Medicine, Riviera-Chablais Hospital, Rennaz, Switzerland
| | - Virginie Prendki
- Division of Internal Medicine for the Elderly, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Genève, Switzerland; Medical Faculty, University of Geneva, Genève, Switzerland; Division of Infectious Diseases, Geneva University Hospitals, Genève, Switzerland
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13
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Ing Lorenzini K, Wainstein L, Curtin F, Trombert V, Zekry D, Gold G, Piguet V, Desmeules J. Adverse Drug Reactions Due to Opioid Use in Oldest-Old Patients Visiting the Emergency Unit of the Geneva Geriatric Hospital. J Frailty Aging 2022; 11:329-334. [DOI: 10.14283/jfa.2022.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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14
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Abbas M, Cori A, Cordey S, Laubscher F, Robalo Nunes T, Myall A, Salamun J, Huber P, Zekry D, Prendki V, Iten A, Vieux L, Sauvan V, Graf CE, Harbarth S. Reconstruction of transmission chains of SARS-CoV-2 amidst multiple outbreaks in a geriatric acute-care hospital: a combined retrospective epidemiological and genomic study. eLife 2022; 11:76854. [PMID: 35850933 PMCID: PMC9328768 DOI: 10.7554/elife.76854] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 07/03/2022] [Indexed: 12/02/2022] Open
Abstract
Background There is ongoing uncertainty regarding transmission chains and the respective roles of healthcare workers (HCWs) and elderly patients in nosocomial outbreaks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in geriatric settings. Methods We performed a retrospective cohort study including patients with nosocomial coronavirus disease 2019 (COVID-19) in four outbreak-affected wards, and all SARS-CoV-2 RT-PCR positive HCWs from a Swiss university-affiliated geriatric acute-care hospital that admitted both Covid-19 and non-Covid-19 patients during the first pandemic wave in Spring 2020. We combined epidemiological and genetic sequencing data using a Bayesian modelling framework, and reconstructed transmission dynamics of SARS-CoV-2 involving patients and HCWs, to determine who infected whom. We evaluated general transmission patterns according to case type (HCWs working in dedicated Covid-19 cohorting wards: HCWcovid; HCWs working in non-Covid-19 wards where outbreaks occurred: HCWoutbreak; patients with nosocomial Covid-19: patientnoso) by deriving the proportion of infections attributed to each case type across all posterior trees and comparing them to random expectations. Results During the study period (1 March to 7 May 2020), we included 180 SARS-CoV-2 positive cases: 127 HCWs (91 HCWcovid, 36 HCWoutbreak) and 53 patients. The attack rates ranged from 10% to 19% for patients, and 21% for HCWs. We estimated that 16 importation events occurred with high confidence (4 patients, 12 HCWs) that jointly led to up to 41 secondary cases; in six additional cases (5 HCWs, 1 patient), importation was possible with a posterior probability between 10% and 50%. Most patient-to-patient transmission events involved patients having shared a ward (95.2%, 95% credible interval [CrI] 84.2%-100%), in contrast to those having shared a room (19.7%, 95% CrI 6.7%-33.3%). Transmission events tended to cluster by case type: patientnoso were almost twice as likely to be infected by other patientnoso than expected (observed:expected ratio 2.16, 95% CrI 1.17-4.20, p=0.006); similarly, HCWoutbreak were more than twice as likely to be infected by other HCWoutbreak than expected (2.72, 95% CrI 0.87-9.00, p=0.06). The proportion of infectors being HCWcovid was as expected as random. We found a trend towards a greater proportion of high transmitters (≥2 secondary cases) among HCWoutbreak than patientnoso in the late phases (28.6% vs. 11.8%) of the outbreak, although this was not statistically significant. Conclusions Most importation events were linked to HCW. Unexpectedly, transmission between HCWcovid was more limited than transmission between patients and HCWoutbreak. This finding highlights gaps in infection control and suggests the possible areas of improvements to limit the extent of nosocomial transmission. Funding This study was supported by a grant from the Swiss National Science Foundation under the NRP78 funding scheme (Grant no. 4078P0_198363).
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Affiliation(s)
- Mohamed Abbas
- Infection Control Programme & WHO Collaborating Centre on Patient Safety, Geneva University HospitalsGenevaSwitzerland,MRC Centre for Global Infectious Disease Analysis, Imperial College LondonLondonUnited Kingdom,Faculty of Medicine, University of GenevaGenevaSwitzerland
| | - Anne Cori
- MRC Centre for Global Infectious Disease Analysis, Imperial College LondonLondonUnited Kingdom,Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College LondonLondonUnited Kingdom
| | - Samuel Cordey
- Faculty of Medicine, University of GenevaGenevaSwitzerland,Laboratory of Virology, Department of Diagnostics, Geneva University HospitalsGenevaSwitzerland
| | - Florian Laubscher
- Laboratory of Virology, Department of Diagnostics, Geneva University HospitalsGenevaSwitzerland
| | - Tomás Robalo Nunes
- Infection Control Programme & WHO Collaborating Centre on Patient Safety, Geneva University HospitalsGenevaSwitzerland,Serviço de Infecciologia, Hospital Garcia de Orta, EPEAlmadaPortugal
| | - Ashleigh Myall
- Department of Infectious Diseases, Imperial College LondonLondonUnited Kingdom,Department of Mathematics, Imperial College LondonLondonUnited Kingdom
| | - Julien Salamun
- Department of Primary Care, Geneva University HospitalsGenevaSwitzerland
| | - Philippe Huber
- Department of Rehabilitation and Geriatrics, Geneva University HospitalsGenevaSwitzerland
| | - Dina Zekry
- Department of Rehabilitation and Geriatrics, Geneva University HospitalsGenevaSwitzerland
| | - Virginie Prendki
- Department of Rehabilitation and Geriatrics, Geneva University HospitalsGenevaSwitzerland,Division of Infectious Diseases, Geneva University HospitalsGenevaSwitzerland
| | - Anne Iten
- Infection Control Programme & WHO Collaborating Centre on Patient Safety, Geneva University HospitalsGenevaSwitzerland
| | - Laure Vieux
- Occupational Health Service, Geneva University HospitalsGenevaSwitzerland
| | - Valérie Sauvan
- Infection Control Programme & WHO Collaborating Centre on Patient Safety, Geneva University HospitalsGenevaSwitzerland
| | - Christophe E Graf
- Department of Rehabilitation and Geriatrics, Geneva University HospitalsGenevaSwitzerland
| | - Stephan Harbarth
- Infection Control Programme & WHO Collaborating Centre on Patient Safety, Geneva University HospitalsGenevaSwitzerland,Faculty of Medicine, University of GenevaGenevaSwitzerland,Division of Infectious Diseases, Geneva University HospitalsGenevaSwitzerland
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15
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Scheffler M, Genton L, Graf CE, Remuinan J, Gold G, Zekry D, Serratrice C, Herrmann FR, Mendes A. Prognostic Role of Subcutaneous and Visceral Adiposity in Hospitalized Octogenarians with COVID-19. J Clin Med 2021; 10:jcm10235500. [PMID: 34884199 PMCID: PMC8658645 DOI: 10.3390/jcm10235500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/20/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND We investigated the prognostic significance of visceral and subcutaneous adiposity in octogenarians with COVID-19. METHODS This paper presents a monocentric retrospective study that was conducted in acute geriatric wards with 64 hospitalized patients aged 80+ who had a diagnosis of COVID-19 and who underwent a chest CT scan. A quantification of the subcutaneous, visceral, and total fat areas was performed after segmentations on the first abdominal slice caudal to the deepest pleural recess on a soft-tissue window setting. Logistic regression models were applied to investigate the association with in-hospital mortality and the extent of COVID-19 pneumonia. RESULTS The patients had a mean age of 86.4 ± 6.0 years, and 46.9% were male, with a mean BMI of 24.1 ± 4.4Kg/m2 and mortality rate of 32.8%. A higher subcutaneous fat area had a protective effect against mortality (OR 0.416; 0.183-0.944 95% CI; p = 0.036), which remained significant after adjustments for age, sex, and BMI (OR 0.231; 0.071-0.751 95% CI; p = 0.015). Inversely, higher abdominal circumference, total fat area, subcutaneous fat area, and visceral fat were associated with worse COVID-19 pneumonia, with the latter presenting the strongest association after adjustments for age, sex, and BMI (OR 2.862; 1.523-5.379 95% CI; p = 0.001). CONCLUSION Subcutaneous and visceral fat areas measured on chest CT scans were associated with prognosis in octogenarians with COVID-19.
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Affiliation(s)
- Max Scheffler
- Division of Radiology, Diagnostic Department, University Hospitals of Geneva, 1205 Geneva, Switzerland; (M.S.); (J.R.)
| | - Laurence Genton
- Unit of Clinical Nutrition, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland;
| | - Christophe E. Graf
- Division of Internal Medicine and Rehabilitation, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland;
| | - Jorge Remuinan
- Division of Radiology, Diagnostic Department, University Hospitals of Geneva, 1205 Geneva, Switzerland; (M.S.); (J.R.)
| | - Gabriel Gold
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland; (G.G.); (F.R.H.)
| | - Dina Zekry
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland; (D.Z.); (C.S.)
| | - Christine Serratrice
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland; (D.Z.); (C.S.)
| | - François R. Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland; (G.G.); (F.R.H.)
| | - Aline Mendes
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland; (G.G.); (F.R.H.)
- Correspondence: ; Tel.: +41-079-553-83-65
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16
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Cuvelier C, Lacroix O, Zekry D, Fassier T, Roux X. [Use of the non-invasive respiratory support in the geriatric intermediate care unit : The Geneva experience]. Rev Med Suisse 2021; 17:1866-1870. [PMID: 34738760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Non-invasive respiratory therapy makes it possible to limit the use of invasive ventilation in certain situations. It can be applied to elderly patients and is effective, including outside intensive care units. The geriatric intermediate care structure at Trois-Chêne Hospital in Geneva is a certified intermediate care unit with a special focus on the care of older patients. This article describes the specificities and challenges of such a unit through its experience with the use of non-invasive respiratory therapy during the Covid-19 pandemic.
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Affiliation(s)
- Clémence Cuvelier
- Service de médecine interne de l'âgé, Département de réhabilitation et gériatrie, Hôpital des Trois-Chêne, HUG, 1226 Thônex
| | - Océana Lacroix
- Service de médecine interne de l'âgé, Département de réhabilitation et gériatrie, Hôpital des Trois-Chêne, HUG, 1226 Thônex
| | - Dina Zekry
- Service de médecine interne de l'âgé, Département de réhabilitation et gériatrie, Hôpital des Trois-Chêne, HUG, 1226 Thônex
| | - Thomas Fassier
- Service de médecine interne de l'âgé, Département de réhabilitation et gériatrie, Hôpital des Trois-Chêne, HUG, 1226 Thônex
- Centre interprofessionnel de simulation, Faculté de médecine, Université de Genève, 1211 Genève 4
| | - Xavier Roux
- Service de médecine interne de l'âgé, Département de réhabilitation et gériatrie, Hôpital des Trois-Chêne, HUG, 1226 Thônex
- Service des soins intensifs adultes, Département de médecine aiguë, HUG, 1211 Genève 14
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Alves C, Zekry D, Ponte B. [Hypertension and dementia : A complex link]. Rev Med Suisse 2021; 17:1567-1570. [PMID: 34528420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
High blood pressure and dementia are both frequent age-related diseases. The purpose of this article is to review the treatment of hypertension and his effects on cognition, and to propose key points to improve hypertension's treatment in dementia suffering patients. The management of hypertension in middle-life patients seems to be very important to avoid or decrease the progression of cognitive impairment or dementia. Nevertheless, there is no guidelines regarding blood pressure in patients concerned by dementia. To personalize the treatment, to take other comorbidities into account, and the frequent reevaluation of the medication are keys of an optimal management of hypertension in general and becomes crucial more specific in this population.
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Affiliation(s)
- Cyrielle Alves
- Service de néphrologie et hypertension, Département des spécialités de médecine, HUG, 1211 Genève 14
| | - Dina Zekry
- Service de médecine interne de l'âgé, Département de réadaptation et gériatrie, HUG, 1211 Genève 14
| | - Belén Ponte
- Service de néphrologie et hypertension, Département des spécialités de médecine, HUG, 1211 Genève 14
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18
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Mendes A, Herrmann FR, Périvier S, Gold G, Graf CE, Zekry D. Delirium in Older Patients With COVID-19: Prevalence, Risk Factors, and Clinical Relevance. J Gerontol A Biol Sci Med Sci 2021; 76:e142-e146. [PMID: 33539505 PMCID: PMC7929187 DOI: 10.1093/gerona/glab039] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Indexed: 12/19/2022] Open
Abstract
Background Delirium prevalence increases with age and is associated with poor outcomes. We aimed to investigate the prevalence and risk factors for delirium in older patients hospitalized with COVID-19, as well as its association with length of stay and mortality. Method This was a retrospective study of patients aged 65 years and older hospitalized with COVID-19. Data were collected from computerized medical records and all patients had delirium assessment at admission. Risk factors for delirium as well as the outcomes mentioned above were studied by 2-group comparison, logistic regression, and Cox proportional hazard models. Results Of a total of 235 Caucasian patients, 48 (20.4%) presented with delirium, which was hypoactive in 41.6% of cases, and hyperactive and mixed in 35.4% and 23.0%, respectively. Patients with cognitive impairment had a nearly 4 times higher risk of developing delirium compared to patients who were cognitively normal before SARS-CoV-2 infection (odds ratio 3.7; 95% CI: 1.7–7.9, p = .001). The presence of delirium did not modify the time from symptoms’ onset to hospitalization or the length of stay in acute care, but it was associated with an increased risk of dying (hazard ratio 2.1; 95% CI: 1.2–3.7, p = .0113). Conclusion Delirium was a prevalent condition in older people admitted with COVID-19 and preexisting cognitive impairment was its main risk factor. Delirium was associated with higher in-hospital mortality. These results highlight the importance of early recognition of delirium especially when premorbid cognitive comorbidities are present.
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Affiliation(s)
- Aline Mendes
- Division of Geriatrics, University Hospitals of Geneva, Switzerland
| | | | - Samuel Périvier
- Division of Geriatrics, University Hospitals of Geneva, Switzerland
| | - Gabriel Gold
- Division of Geriatrics, University Hospitals of Geneva, Switzerland
| | - Christophe E Graf
- Division of Internal Medicine and Rehabilitation, University Hospitals of Geneva, Switzerland
| | - Dina Zekry
- Division of Internal Medicine for the Aged, University Hospitals of Geneva, Switzerland
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Gagesch M, Edler K, Chocano-Bedoya PO, Abderhalden LA, Seematter-Bagnoud L, Meyer T, Bertschi D, Zekry D, Büla CJ, Gold G, Kressig RW, Stuck AE, Bischoff-Ferrari HA. Swiss Frailty Network and Repository: protocol of a Swiss Personalized Health Network's driver project observational study. BMJ Open 2021; 11:e047429. [PMID: 34261684 PMCID: PMC8280893 DOI: 10.1136/bmjopen-2020-047429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Early identification of frailty by clinical instruments or accumulation of deficit indexes can contribute to improve healthcare for older adults, including the prevention of negative outcomes in acute care. However, conflicting evidence exists on how to best capture frailty in this setting. Simultaneously, the increasing utilisation of electronic health records (EHRs) opens up new possibilities for research and patient care, including frailty. METHODS AND ANALYSIS The Swiss Frailty Network and Repository (SFNR) primarily aims to develop an electronic Frailty Index (eFI) from routinely available EHR data in order to investigate its predictive value against length of stay and in-hospital mortality as two important clinical outcomes in a study sample of 1000-1500 hospital patients aged 65 years and older. In addition, we will examine the correlation between the eFI and a test-based clinical Frailty Instrument to compare both concepts in Swiss older adults in acute care settings. As a Swiss Personalized Health Network (SPHN) driver project, our study will report on the characteristics and usability of the first nationwide eFI in Switzerland connecting all five Swiss University Hospitals' Geriatric Departments with a representative sample of patients aged 65 years and older admitted to acute care. ETHICS AND DISSEMINATION The study protocol was approved by the competent ethics committee of the Canton of Zurich (BASEC-ID 2019-00445). All acquired data will be handled according to SPHN's ethical framework for responsible data processing in personalised health research. Analyses will be performed within the secure BioMedIT environment, a national infrastructure to enable secure biomedical data processing, an integral part of SPHN. TRIAL REGISTRATION NUMBER NCT04516642.
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Affiliation(s)
- Michael Gagesch
- Department of Geriatrics, University Hospital Zurich, Zurich, Switzerland
- Centre on Aging and Mobility, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Karin Edler
- Research Data Service Center, Clinical Trails Center, University Hospital Zurich, Zurich, Switzerland
| | - Patricia O Chocano-Bedoya
- Centre on Aging and Mobility, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Lauren A Abderhalden
- Centre on Aging and Mobility, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Laurence Seematter-Bagnoud
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health, Lausanne, Switzerland
- Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital, Lausanne, Switzerland
| | - Tobias Meyer
- Universitäre Altersmedizin FELIX PLATTER, Basel, Switzerland
| | - Dominic Bertschi
- Department of Geriatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Dina Zekry
- Division of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Christophe J Büla
- Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital, Lausanne, Switzerland
| | - Gabriel Gold
- Department of Rehabilitation and Geriatrics, University Hospitals Geneva, Geneva, Switzerland
| | - Reto W Kressig
- Universitäre Altersmedizin FELIX PLATTER, Basel, Switzerland
- Universität Basel, Basel, Switzerland
| | - Andreas E Stuck
- Department of Geriatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Heike A Bischoff-Ferrari
- Department of Geriatrics, University Hospital Zurich, Zurich, Switzerland
- Centre on Aging and Mobility, University Hospital Zurich and University of Zurich, Zurich, Switzerland
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20
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Karege G, Zekry D, Allali G, Adler D, Marti C. Gait speed is associated with death or readmission among patients surviving acute hypercapnic respiratory failure. BMJ Open Respir Res 2021; 7:7/1/e000542. [PMID: 32561512 PMCID: PMC7304813 DOI: 10.1136/bmjresp-2019-000542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 05/19/2020] [Accepted: 05/29/2020] [Indexed: 12/15/2022] Open
Abstract
Objectives Death or hospital readmission are frequent among patients surviving acute hypercapnic respiratory failure (AHRF). Severity scores are not valid to predict death or readmission after AHRF. Gait speed, a simple functional parameter, has been associated with hospital admission and death in the general population. The purpose of this study is to highlight an association between gait speed at hospital discharge and death or readmission among AHRF survivors. Design Secondary analysis of a prospective cohort study. Settings Single Swiss tertiary hospital, pulmonary division. Participants Patients were prospectively recruited to form a cohort of patients surviving AHRF in the intensive care unit between January 2012 and May 2015. Outcome measure Gait speed was derived from a 6 min walking test (6MWT) before hospital discharge. All predictive variables were prospectively collected. Death or hospital readmission were recorded for 6 months. Univariate and multivariate analyses were performed to evaluate the association between predictive variables and death or hospital readmission. Results 71 patients performed a 6MWT. 34/71 (48%) patients died or were readmitted to the hospital during the observation period. Median gait speed was 0.7 (IQR 0.3–1.0) m/s. At 6 months, 66% (25/38) of slow walkers (gait speed <0.7 m/s) and 27% (9/33) of non-slow walkers died or were readmitted to the hospital (p=0.002). In univariate analysis, gait speed was associated with death or readmission (HR 0.41; 95% CI 0.19 to 0.90, p=0.025). In a multivariate model adjusted for age, gender, body mass index, forced expired volume, heart failure and home mechanical ventilation, gait speed remained the only variable associated with death or readmission (multivariate HR: 0.35; 95% CI 0.14 to 0.88, p=0.025). Conclusion This study suggests that a simple functional parameter such as gait speed is associated with death or hospital readmission in patients surviving AHRF. Trial registration number NCT02111876.
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Affiliation(s)
- Gatete Karege
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Dina Zekry
- Division of Internal Medicine for the Aged, Geneva University Hospitals, Geneva, Switzerland
| | - Gilles Allali
- Division of Neurology, Geneva University Hospitals, Geneve, Switzerland.,Division of Neurology, Yeshiva University, New York, New York, USA
| | - Dan Adler
- Division of Pulmonary Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Christophe Marti
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
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21
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Malézieux-Picard A, Ferrer Soler C, De Macedo Ferreira D, Gaud-Luethi E, Serratrice C, Mendes A, Zekry D, Gold G, Lobrinus JA, Arnoux G, Serra F, Prendki V. Undetected Causes of Death in Hospitalized Elderly with COVID-19: Lessons from Autopsy. J Clin Med 2021; 10:jcm10071337. [PMID: 33804890 PMCID: PMC8037274 DOI: 10.3390/jcm10071337] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/17/2021] [Accepted: 03/20/2021] [Indexed: 12/20/2022] Open
Abstract
Background: Mechanisms and causes of death in older patients with SARS-CoV-2 infection are still poorly understood. Methods: We conducted in a retrospective monocentric study, a clinical chart review and post-mortem examination of patients aged 75 years and older hospitalized in acute care and positive for SARS-CoV-2. Full body autopsy and correlation with clinical findings and suspected causes of death were done. Results: Autopsies were performed in 12 patients (median age 85 years; median of 4 comorbidities, mainly hypertension and cardiovascular disease). All cases showed exudative or proliferative phases of alveolar damage and/or a pattern of organizing pneumonia. Causes of death were concordant in 6 cases (50%), and undetected diagnoses were found in 6. Five patients died from hypoxemic respiratory failure due to coronavirus disease 2019 (COVID-19), five had another associated diagnosis and two died from alternative causes. Deaths that occurred in the second week were related to SARS-CoV-2 pneumonia whereas those occurring earlier were related mainly to heart failure and those occurring later to complications. Conclusions: Although COVID-19 hypoxemic respiratory failure was the most common cause of death, post-mortem pathological examination revealed that acute decompensation from chronic comorbidities during the first week of COVID-19 and complications in the third week contributed to mortality.
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Affiliation(s)
- Astrid Malézieux-Picard
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Hôpital des Trois-Chêne, 1226 Thônex-Genève, Switzerland; (D.D.M.F.); (C.S.); (D.Z.); (V.P.)
- Correspondence:
| | - Cecilia Ferrer Soler
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Hôpital des Trois-Chêne, 1226 Thônex-Genève, Switzerland; (C.F.S.); (E.G.-L.); (A.M.); (G.G.)
| | - David De Macedo Ferreira
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Hôpital des Trois-Chêne, 1226 Thônex-Genève, Switzerland; (D.D.M.F.); (C.S.); (D.Z.); (V.P.)
| | - Emilie Gaud-Luethi
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Hôpital des Trois-Chêne, 1226 Thônex-Genève, Switzerland; (C.F.S.); (E.G.-L.); (A.M.); (G.G.)
| | - Christine Serratrice
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Hôpital des Trois-Chêne, 1226 Thônex-Genève, Switzerland; (D.D.M.F.); (C.S.); (D.Z.); (V.P.)
| | - Aline Mendes
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Hôpital des Trois-Chêne, 1226 Thônex-Genève, Switzerland; (C.F.S.); (E.G.-L.); (A.M.); (G.G.)
| | - Dina Zekry
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Hôpital des Trois-Chêne, 1226 Thônex-Genève, Switzerland; (D.D.M.F.); (C.S.); (D.Z.); (V.P.)
| | - Gabriel Gold
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Hôpital des Trois-Chêne, 1226 Thônex-Genève, Switzerland; (C.F.S.); (E.G.-L.); (A.M.); (G.G.)
| | | | - Grégoire Arnoux
- Division of Pathology, University Hospitals of Geneva, 1205 Geneva, Switzerland; (J.A.L.); (G.A.); (F.S.)
| | - Fulvia Serra
- Division of Pathology, University Hospitals of Geneva, 1205 Geneva, Switzerland; (J.A.L.); (G.A.); (F.S.)
| | - Virginie Prendki
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Hôpital des Trois-Chêne, 1226 Thônex-Genève, Switzerland; (D.D.M.F.); (C.S.); (D.Z.); (V.P.)
- Division of Infectious Disease, University Hospitals of Geneva, 1205 Geneva, Switzerland
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22
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Dalex M, Malezieux A, Parent T, Zekry D, Serratrice C. Phrenic nerve stimulation, a rare complication of pacemaker: A case report. Medicine (Baltimore) 2021; 100:e25060. [PMID: 33725981 PMCID: PMC7982205 DOI: 10.1097/md.0000000000025060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 02/15/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE The phrenic nerve stimulation (PNS) is a rare complication after pacemaker setting. We report a case report that describes this complication and how it can be resolved. PATIENT CONCERNS An 88-year-old man presented himself to the emergency geriatric unit with intermittent painless abdominal contraction due to phrenic nerve stimulation. He has a history of transcatheter aortic valve implantation with cardiac resynchronization therapy pacemaker due to persistent left bundle branch block. DIAGNOSES All the usual causes for abdominal spasms were eliminated and the possibility of a link with the pacemaker was considered. The phrenic nerve stimulation is a rare complication of a pacemaker implantation. It can be clinically nonrelevant but challenging to diagnose for those not familiar with cardiac devices technology. INTERVENTIONS Initial setting was an axis of stimulation between distal left ventricular (LV) and right ventricular. It was changed to LV and D1-M2. OUTCOMES This noninvasive procedure managed to eradicate the involuntary abdominal spasms. LESSONS PNS could be challenging to diagnose for those not familiar with cardiac devices technology but easy to manage with noninvasive methods.
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Affiliation(s)
| | | | | | - Dina Zekry
- Division of Internal Medicine for the Aged
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Christine Serratrice
- Division of Internal Medicine for the Aged
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
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23
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Nehme M, Bron A, Châtelain D, Zekry D, Perrier-Gros-Claude O, Goldstein J, Courvoisier S, Vandeplas P, Di Pollina L, Balavoine JF, Guessous I, Tahar Chaouche A. [COGERIA: coordination of care for the frail elderly]. Rev Med Suisse 2021; 17:136-139. [PMID: 33470570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
COGERIA, a cantonal program is the fruit of a close collaboration between the Geneva General Directorate of Health and the major health and social partners in the canton. The program aims to improve inter-professional care for the frail elderly and to adapt their care pathways in close collaboration with their primary care physicians and home healthcare providers. Launched in May 2019, the program includes more than 283 beneficiaries and 152 primary care physicians in collaboration with the home healthcare providers in the Servette and Meyrin areas. Preliminary results show a possible trend towards a decrease in hospitalizations, as well as major satisfaction from beneficiaries and the COGERIA partners.
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Affiliation(s)
- Mayssam Nehme
- Service de médecine de premiers recours, HUG, 1211 Genève 14
| | - Adrien Bron
- Direction générale de la santé, Département de l'emploi, des affaires sociales et de la santé, État de Genève, 1207 Genève
| | - Didier Châtelain
- Association genevoise des médecins de famille internistes généralistes (AGeMIG), AMGe, 1205 Genève
| | - Dina Zekry
- Service de médecine interne de l'âgé, HUG, 1211 Genève 14
| | | | | | | | | | | | | | - Idris Guessous
- Service de médecine de premiers recours, HUG, 1211 Genève 14
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24
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Mendes A, Herrmann FR, Genton L, Serratrice C, Carrera E, Vargas MI, Gold G, Graf CE, Zekry D, Scheffler M. Incidence, characteristics and clinical relevance of acute stroke in old patients hospitalized with COVID-19. BMC Geriatr 2021; 21:52. [PMID: 33446113 PMCID: PMC7807227 DOI: 10.1186/s12877-021-02006-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 12/30/2020] [Indexed: 12/28/2022] Open
Abstract
Background Stroke in the course of coronavirus disease (COVID-19) has been shown to be associated with more severe respiratory symptoms and higher mortality, but little knowledge in this regard exists on older populations. We aimed to investigate the incidence, characteristics, and prognosis of acute stroke in geriatric patients hospitalized with COVID-19. Methods A monocentric cross-sectional retrospective study of 265 older patients hospitalized with COVID-19 on acute geriatric wards. 11/265 presented a stroke episode during hospitalization. Mortality rates and two-group comparisons (stroke vs non-stroke patients) were calculated and significant variables added in logistic regression models to investigate stroke risk factors. Results Combined ischemic and hemorrhagic stroke incidence was 4.15%. 72.7% of events occurred during acute care. Strokes presented with altered state of consciousness and/or delirium in 81.8%, followed by a focal neurological deficit in 45.5%. Ischemic stroke was more frequently unilateral (88.8%) and localized in the middle cerebral artery territory (55.5%). Smoking and a history of previous stroke increased by more than seven (OR 7.44; 95% CI 1.75–31.64; p = 0.007) and five times (OR 5.19; 95% CI 1.50–17.92; p = 0.009), respectively, the risk of stroke. Each additional point in body mass index (BMI) reduced the risk of stroke by 14% (OR 0.86; 95% CI 0.74–0.98; p = 0.03). In-hospital mortality (32.1% vs. 27.3%; p > 0.999) and institutionalization at discharge (36.4% vs. 21.1%; p = 0.258) were similar between patients with and without stroke. Conclusion Incident stroke complicating COVID-19 in old patients was associated with active smoking, previous history of stroke, and low BMI. Acute stroke did not influence early mortality or institutionalization rate at discharge. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02006-2.
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Affiliation(s)
- Aline Mendes
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva and Faculty of Medicine, Chemin du Pont-Bochet 3, 1226 Thônex, Geneva, Switzerland.
| | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva and Faculty of Medicine, Chemin du Pont-Bochet 3, 1226 Thônex, Geneva, Switzerland
| | - Laurence Genton
- Unit of Clinical Nutrition, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Christine Serratrice
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Emmanuel Carrera
- Division of Neurology, Department of Neurosciences, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Maria Isabel Vargas
- Division of Neuroradiology, Diagnostic Department, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Gabriel Gold
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva and Faculty of Medicine, Chemin du Pont-Bochet 3, 1226 Thônex, Geneva, Switzerland
| | - Christophe E Graf
- Division of Internal Medicine and Rehabilitation, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Dina Zekry
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Max Scheffler
- Division of Radiology, Diagnostic Department, University Hospitals of Geneva, Geneva, Switzerland
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25
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Ferrer Soler C, Cuvelier C, Hars M, Herrmann FR, Charpiot A, Ducharne Wieczorkiewicz C, Bruyère O, Beaudart C, Zekry D, Gold G, Trombetti A. Validation of the Perform-FES: a new fear of falling scale for hospitalized geriatric patients. Aging Clin Exp Res 2021; 33:67-76. [PMID: 33063292 PMCID: PMC7897618 DOI: 10.1007/s40520-020-01726-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 09/26/2020] [Indexed: 11/28/2022]
Abstract
Background Fear of falling is highly prevalent in older adults and associated with numerous negative health events. The main objective of this study was to validate a scale to assess fear of falling, based on performance in real situation (Perform-FES), in a hospitalized geriatric population. Methods In this cross-sectional study, 55 patients (mean age: 85.3 years; 58% women) hospitalized in a geriatric hospital in Geneva (Switzerland) were enrolled. The Perform-FES scale was administered to all patients in conjunction with four other fear of falling scales. We determined the floor and ceiling effects, internal consistency, reliability, construct validity, and discriminative power of the Perform-FES scale. Results The Perform-FES scale did not demonstrate any significant floor or ceiling effect. It had a good internal consistency (Cronbach’s alpha = 0.78) and an excellent reliability (intraclass correlation coefficient = 0.94). Regarding convergent validity, good correlations were shown between the score obtained on the Perform-FES scale and those obtained on other fear of falling scales. Also, the Perform-FES scale was able to discriminate patients with severe functional impairments (area under the ROC curve = 0.81) and had significantly better discriminating performance than other fear of falling scales. Conclusion Findings suggest that the Perform-FES scale has good psychometric properties and may be a relevant tool to assess fear of falling in a geriatric hospitalized population. Future research should focus in particular on assessing the sensitivity to change and the predictive value of this scale in longitudinal studies, and its validity in other populations.
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Affiliation(s)
- Cecilia Ferrer Soler
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Clémence Cuvelier
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Mélany Hars
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Adrienne Charpiot
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
| | - Catherine Ducharne Wieczorkiewicz
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
| | - Charlotte Beaudart
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
| | - Dina Zekry
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Gabriel Gold
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Andrea Trombetti
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland.
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
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Vernaz N, Agoritsas T, Calmy A, Gayet-Ageron A, Gold G, Perrier A, Picard F, Prendki V, Reny JL, Samer C, Stirnemann J, Vetter P, Zanella MC, Zekry D, Baggio S. Early experimental COVID-19 therapies: associations with length of hospital stay, mortality and related costs. Swiss Med Wkly 2020; 150:w20446. [PMID: 33382449 DOI: 10.4414/smw.2020.20446] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
AIMS OF THE STUDY Hydroxychloroquine and lopinavir/ritonavir have been used as experimental therapies to treat COVID-19 during the first wave of the pandemic. Randomised controlled trials have recently shown that there are no meaningful benefits of these two therapies in hospitalised patients. Uncertainty remains regarding the potential harmful impact of these therapies as very early treatments and their burden to the health care system. The present study investigated the length of hospital stay (LOS), mortality, and costs of hydroxychloroquine, lopinavir/ritonavir or their combination in comparison with standard of care among patients hospitalised for coronavirus disease 2019 (COVID-19). METHODS This retrospective observational cohort study took place in the Geneva University Hospitals, Geneva, Switzerland (n = 840) between 26 February and 31 May 2020. Demographics, treatment regimens, comorbidities, the modified National Early Warning Score (mNEWS) on admission, and contraindications to COVID-19 treatment options were assessed. Outcomes included LOS, in-hospital mortality, and drug and LOS costs. RESULTS After successful propensity score matching, patients treated with (1) hydroxychloroquine, (2) lopinavir/ritonavir or (3) their combination had on average 3.75 additional hospitalisation days (95% confidence interval [CI] 1.37–6.12, p = 0.002), 1.23 additional hospitalisation days (95% CI −1.24 – 3.51, p = 0.319), and 4.19 additional hospitalisation days (95% CI 1.52–5.31, p <0.001), respectively, compared with patients treated with the standard of care. Neither experimental therapy was significantly associated with mortality. These additional hospital days amounted to 1010.77 additional days for hydroxychloroquine and hydroxychloroquine combined with lopinavir/ritonavir, resulting in an additional cost of US$ 2,492,214 (95%CI US$ 916,839–3,450,619). CONCLUSIONS Prescribing experimental therapies for COVID-19 was not associated with a reduced LOS and might have increased the pressure put on healthcare systems.
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Affiliation(s)
- Nathalie Vernaz
- Medical Directorate, Finance Directorate, Geneva University Hospitals, Geneva University, Switzerland
| | - Thomas Agoritsas
- Division of General Internal Medicine and Division of Clinical Epidemiology, University Hospitals of Geneva, Switzerland / Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Alexandra Calmy
- Division of Infectious Diseases, HIV/AIDS Unit, Geneva University Hospitals, Switzerland
| | - Angèle Gayet-Ageron
- CRC and Division of Clinical Epidemiology, Department of Health and Community Medicine, University of Geneva and University Hospitals of Geneva, Switzerland
| | - Gabriel Gold
- Service of Geriatrics, Department of Internal Medicine Rehabilitation and Geriatrics, University Hospitals and University of Geneva, Switzerland
| | - Arnaud Perrier
- Medical Directorate, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland / Department of General Internal Medicine, Geneva University Hospitals, Switzerland
| | - Fabienne Picard
- Division of Neurology, Department of Clinical Neurosciences, University of Geneva and University Hospitals of Geneva, Switzerland
| | - Virginie Prendki
- Division of Internal Medicine for the Aged, University of Geneva and University Hospitals of Geneva, Thônex, Switzerland
| | - Jean-Luc Reny
- Department of General Internal Medicine, Geneva University Hospitals, Switzerland
| | - Caroline Samer
- Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals, Switzerland
| | - Jérôme Stirnemann
- Department of General Internal Medicine, Geneva University Hospitals, Switzerland
| | - Pauline Vetter
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Switzerland
| | | | - Dina Zekry
- Division of Internal Medicine for the Aged, University of Geneva and University Hospitals of Geneva, Thônex, Switzerland
| | - Stéphanie Baggio
- Division of Prison Health, University of Geneva and University Hospitals of Geneva, Thônex, Switzerland / Office of Corrections, Department of Justice and Home Affairs of the Canton of Zurich, Zurich, Switzerland
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Hars M, Mendes A, Serratrice C, Herrmann FR, Gold G, Graf C, Zekry D, Trombetti A. Sex-specific association between vitamin D deficiency and COVID-19 mortality in older patients. Osteoporos Int 2020; 31:2495-2496. [PMID: 33048168 PMCID: PMC7552596 DOI: 10.1007/s00198-020-05677-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 10/07/2020] [Indexed: 01/28/2023]
Affiliation(s)
- M Hars
- Department of Medicine, Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, CH-1205, Geneva, Switzerland
- Department of Rehabilitation and Geriatrics, Division of Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - A Mendes
- Department of Rehabilitation and Geriatrics, Division of Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - C Serratrice
- Department of Rehabilitation and Geriatrics, Division of Internal Medicine for the Aged, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - F R Herrmann
- Department of Rehabilitation and Geriatrics, Division of Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - G Gold
- Department of Rehabilitation and Geriatrics, Division of Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - C Graf
- Department of Rehabilitation and Geriatrics, Division of Rehabilitation and Internal Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - D Zekry
- Department of Rehabilitation and Geriatrics, Division of Internal Medicine for the Aged, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - A Trombetti
- Department of Medicine, Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, CH-1205, Geneva, Switzerland.
- Department of Rehabilitation and Geriatrics, Division of Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
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28
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Serratrice C, Mendes A, Herrmann F, Périvier S, Genton L, Fassier T, Di Silvestro K, Trombert V, Roux X, Cuvelier C, Huber P, Jacques MC, Prendki V, Harbarth S, Scheffler M, Graf C, Zekry D. [Issues and challenges related to COVID-19 in acute geriatric care: lessons learned from the Geneva experience]. Rev Med Suisse 2020; 16:2153-2155. [PMID: 33174695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The older patients have been the most affected by the SARS-CoV-2 pandemic. In addition, this infection has been responsible for high mortality rate in this population. In this article we wanted to describe the clinical findings we encountered in older people with COVID-19 and share some of the issues and challenges we faced during the COVID-19 pandemic.
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Affiliation(s)
- Christine Serratrice
- Service de médecine interne de l'âgé, Département de réadaptation et gériatrie, HUG, 1211 Genève 14
| | - Aline Mendes
- Service de gériatrie, Département de réadaptation et gériatrie, HUG, 1211 Genève 14
| | - François Herrmann
- Service de gériatrie, Département de réadaptation et gériatrie, HUG, 1211 Genève 14
| | - Samuel Périvier
- Service de gériatrie, Département de réadaptation et gériatrie, HUG, 1211 Genève 14
| | - Laurence Genton
- Unité de nutrition clinique, Service d'endocrinologie, diabétologie, nutrition et éducation thérapeutique, HUG, 1211 Genève 14
| | - Thomas Fassier
- Service de médecine interne de l'âgé, Département de réadaptation et gériatrie, HUG, 1211 Genève 14
| | - Katharine Di Silvestro
- Service de médecine interne de l'âgé, Département de réadaptation et gériatrie, HUG, 1211 Genève 14
| | - Véronique Trombert
- Service de médecine interne de l'âgé, Département de réadaptation et gériatrie, HUG, 1211 Genève 14
| | - Xavier Roux
- Service de médecine interne de l'âgé, Département de réadaptation et gériatrie, HUG, 1211 Genève 14
| | - Clémence Cuvelier
- Service de médecine interne de l'âgé, Département de réadaptation et gériatrie, HUG, 1211 Genève 14
| | - Philippe Huber
- Service de gériatrie, Département de réadaptation et gériatrie, HUG, 1211 Genève 14
| | - Marie-Claire Jacques
- Service de gériatrie, Département de réadaptation et gériatrie, HUG, 1211 Genève 14
| | - Virginie Prendki
- Service de médecine interne de l'âgé, Département de réadaptation et gériatrie, HUG, 1211 Genève 14
| | - Stephan Harbarth
- Service des maladies infectieuses et de prévention et contrôle des infections, HUG, 1211 Genève 14
| | - Max Scheffler
- Service de radiologie, Département diagnostique, HUG, 1211 Genève 14
| | - Christophe Graf
- Service de médecine interne et réadaptation, Département de réadaptation et gériatrie, HUG, 1211 Genève 14
| | - Dina Zekry
- Service de médecine interne de l'âgé, Département de réadaptation et gériatrie, HUG, 1211 Genève 14
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Mendes A, Serratrice C, Herrmann FR, Genton L, Périvier S, Scheffler M, Fassier T, Huber P, Jacques MC, Prendki V, Roux X, Di Silvestro K, Trombert V, Harbarth S, Gold G, Graf CE, Zekry D. Predictors of In-Hospital Mortality in Older Patients With COVID-19: The COVIDAge Study. J Am Med Dir Assoc 2020; 21:1546-1554.e3. [PMID: 33138936 PMCID: PMC7491997 DOI: 10.1016/j.jamda.2020.09.014] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To determine predictors of in-hospital mortality related to COVID-19 in older patients. DESIGN Retrospective cohort study. SETTING AND PARTICIPANTS Patients aged 65 years and older hospitalized for a diagnosis of COVID-19. METHODS Data from hospital admission were collected from the electronic medical records. Logistic regression and Cox proportional hazard models were used to predict mortality, our primary outcome. Variables at hospital admission were categorized according to the following domains: demographics, clinical history, comorbidities, previous treatment, clinical status, vital signs, clinical scales and scores, routine laboratory analysis, and imaging results. RESULTS Of a total of 235 Caucasian patients, 43% were male, with a mean age of 86 ± 6.5 years. Seventy-six patients (32%) died. Nonsurvivors had a shorter number of days from initial symptoms to hospitalization (P = .007) and the length of stay in acute wards than survivors (P < .001). Similarly, they had a higher prevalence of heart failure (P = .044), peripheral artery disease (P = .009), crackles at clinical status (P < .001), respiratory rate (P = .005), oxygen support needs (P < .001), C-reactive protein (P < .001), bilateral and peripheral infiltrates on chest radiographs (P = .001), and a lower prevalence of headache (P = .009). Furthermore, nonsurvivors were more often frail (P < .001), with worse functional status (P < .001), higher comorbidity burden (P < .001), and delirium at admission (P = .007). A multivariable Cox model showed that male sex (HR 4.00, 95% CI 2.08-7.71, P < .001), increased fraction of inspired oxygen (HR 1.06, 95% CI 1.03-1.09, P < .001), and crackles (HR 2.42, 95% CI 1.15-6.06, P = .019) were the best predictors of mortality, while better functional status was protective (HR 0.98, 95% CI 0.97-0.99, P = .001). CONCLUSIONS AND IMPLICATIONS In older patients hospitalized for COVID-19, male sex, crackles, a higher fraction of inspired oxygen, and functionality were independent risk factors of mortality. These routine parameters, and not differences in age, should be used to evaluate prognosis in older patients.
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Affiliation(s)
- Aline Mendes
- Division of Geriatrics, University Hospitals of Geneva, Geneva, Switzerland.
| | - Christine Serratrice
- Divison of Internal Medicine for the aged, University Hospitals of Geneva, Geneva, Switzerland
| | | | - Laurence Genton
- Clinical Nutrition, University Hospitals of Geneva, Geneva, Switzerland
| | - Samuel Périvier
- Division of Geriatrics, University Hospitals of Geneva, Geneva, Switzerland
| | - Max Scheffler
- Division of Radiology, University Hospitals of Geneva, Geneva, Switzerland
| | - Thomas Fassier
- Divison of Internal Medicine for the aged, University Hospitals of Geneva, Geneva, Switzerland
| | - Philippe Huber
- Division of Geriatrics, University Hospitals of Geneva, Geneva, Switzerland
| | | | - Virginie Prendki
- Divison of Internal Medicine for the aged, University Hospitals of Geneva, Geneva, Switzerland
| | - Xavier Roux
- Divison of Internal Medicine for the aged, University Hospitals of Geneva, Geneva, Switzerland
| | - Katharine Di Silvestro
- Divison of Internal Medicine for the aged, University Hospitals of Geneva, Geneva, Switzerland
| | - Véronique Trombert
- Divison of Internal Medicine for the aged, University Hospitals of Geneva, Geneva, Switzerland
| | - Stephan Harbarth
- Division of Infectious Diseases and Infection Control Program, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Gabriel Gold
- Division of Geriatrics, University Hospitals of Geneva, Geneva, Switzerland
| | - Christophe E Graf
- Division of Internal Medicine and Rehabilitation, University Hospitals of Geneva, Geneva, Switzerland
| | - Dina Zekry
- Divison of Internal Medicine for the aged, University Hospitals of Geneva, Geneva, Switzerland
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30
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Prendki V, Malézieux-Picard A, Azurmendi L, Sanchez JC, Vuilleumier N, Carballo S, Roux X, Reny JL, Zekry D, Stirnemann J, Garin N. Accuracy of C-reactive protein, procalcitonin, serum amyloid A and neopterin for low-dose CT-scan confirmed pneumonia in elderly patients: A prospective cohort study. PLoS One 2020; 15:e0239606. [PMID: 32997689 PMCID: PMC7526885 DOI: 10.1371/journal.pone.0239606] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 09/09/2020] [Indexed: 01/16/2023] Open
Abstract
Objective The diagnosis of pneumonia based on semiology and chest X-rays is frequently inaccurate, particularly in elderly patients. Older (C-reactive protein (CRP); procalcitonin (PCT)) or newer (Serum amyloid A (SAA); neopterin (NP)) biomarkers may increase the accuracy of pneumonia diagnosis, but data are scarce and conflicting. We assessed the accuracy of CRP, PCT, SAA, NP and the ratios CRP/NP and SAA/NP in a prospective observational cohort of elderly patients with suspected pneumonia. Methods We included consecutive patients more than 65 years old, with at least one respiratory symptom and one symptom or laboratory finding suggestive of infection, and a working diagnosis of pneumonia. Low-dose CT scan and comprehensive microbiological testing were done in all patients. The index tests, CRP, PCT, SAA and NP, were obtained within 24 hours. The reference diagnosis was assessed a posteriori by a panel of experts considering all available data, including patients’ outcome. We used area under the curve (AUROC) and Youden index to assess the accuracy and obtain optimal cut-off of the index tests. Results 200 patients (median age 84 years) were included; 133 (67%) had pneumonia. AUROCs for the diagnosis of pneumonia was 0.64 (95% CI: 0.56–0.72) for CRP; 0.59 (95% CI: 0.51–0.68) for PCT; 0.60 (95% CI: 0.52–0.69) for SAA; 0.41 (95% CI: 0.32–0.49) for NP; 0.63 (95% CI: 0.55–0.71) for CRP/NP; and 0.61 (95% CI: 0.53–0.70) for SAA/NP. No cut-off resulted in satisfactory sensitivity or specificity. Conclusions Accuracy of traditional (CRP, PCT) and newly proposed biomarkers (SAA, NP) and ratios of CRP/NP and SAA/NP was too low to help diagnosing pneumonia in the elderly. CRP had the highest AUROC. Clinical Trial Registration NCT 02467092
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Affiliation(s)
- Virginie Prendki
- Department of Rehabilitation and Geriatrics, Division of Internal Medicine for the Aged, Geneva University Hospitals, Thônex, Switzerland
- Medical Faculty, Geneva, Switzerland
| | - Astrid Malézieux-Picard
- Department of Rehabilitation and Geriatrics, Division of Internal Medicine for the Aged, Geneva University Hospitals, Thônex, Switzerland
- * E-mail:
| | - Leire Azurmendi
- Department of Internal Medicine Specialties, Medical Faculty, Geneva University Hospitals, Geneva, Switzerland
| | - Jean-Charles Sanchez
- Medical Faculty, Geneva, Switzerland
- Department of Internal Medicine Specialties, Medical Faculty, Geneva University Hospitals, Geneva, Switzerland
| | - Nicolas Vuilleumier
- Medical Faculty, Geneva, Switzerland
- Department of Internal Medicine Specialties, Medical Faculty, Geneva University Hospitals, Geneva, Switzerland
- Diagnostic Department, Division of Laboratory Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Sebastian Carballo
- Medical Faculty, Geneva, Switzerland
- Department of Internal Medicine, Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Xavier Roux
- Department of Rehabilitation and Geriatrics, Division of Internal Medicine for the Aged, Geneva University Hospitals, Thônex, Switzerland
- Department of Intensive Care Unit, Geneva University Hospitals, Geneva, Switzerland
| | - Jean-Luc Reny
- Medical Faculty, Geneva, Switzerland
- Department of Internal Medicine, Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Dina Zekry
- Department of Rehabilitation and Geriatrics, Division of Internal Medicine for the Aged, Geneva University Hospitals, Thônex, Switzerland
- Medical Faculty, Geneva, Switzerland
| | - Jérôme Stirnemann
- Medical Faculty, Geneva, Switzerland
- Department of Internal Medicine, Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Nicolas Garin
- Medical Faculty, Geneva, Switzerland
- Department of Internal Medicine, Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of General Internal Medicine, Division of General Internal Medicine, Riviera Chablais Hospitals, Rennaz, Switzerland
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31
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Mendes A, Herrmann FR, Scheffler M, Gabriel G, Sveikata L, Rakotomiaramanana B, Frisoni GB, Zekry D, Gold G. Cortical Superficial Siderosis: A Descriptive Analysis in a Memory Clinic Population. J Alzheimers Dis 2020; 73:1467-1479. [PMID: 31929155 DOI: 10.3233/jad-190619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cortical superficial siderosis (cSS) is a hemorrhagic marker of blood-brain barrier disruption detected in brain MRI. Together with cerebral microbleeds (CMB), they are recognized as a small vessel disease marker associated with cerebral amyloid angiopathy. OBJECTIVE This study aims to determine the prevalence and the characteristics of cSS in a memory clinic population. METHODS Cross-sectional retrospective analysis of 613 patients from Geneva University Hospitals memory clinic. All patients underwent standardized brain MRI and neuropsychological assessment with diagnosis confirmed by an expert. The presence of cSS was visually assessed and classified as focal (restricted to 3 sulci) or disseminated within the correspondent topography. CMB were classified according to the Microbleed Anatomical Rating Scale. RESULTS cSS was detected in 26/613 patients (4.2%), classified as disseminated in 5/26 cases (19%). Alzheimer's disease (AD) and AD associated with a significant vascular component were the diagnoses more frequently related to cSS (18/26; 69%). Patients with cSS had an increased prevalence of both hypertension (81% versus 57%; p = 0.015) and WMH burden (p = 0.012). The overall prevalence of cerebral microbleeds (69% versus 32%; p < 0.01), as well as their mean number (0.69±0.47 versus 0.32±0.46; p < 0.01) were both increased in patients with cSS. In the logistic regression model, the presence of 5 or more CMB (OR 11.35; 95% CI 4.68-27.55; p < 0.01) and hypertension (OR 3.31; 95% CI 1.19-9.15; p = 0.021) were significantly associated with cSS. CONCLUSIONS cSS is observed in patients diagnosed with AD and AD with a vascular component, being independently associated with multiple CMB and hypertension.
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Affiliation(s)
- Aline Mendes
- Memory Center, Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - François R Herrmann
- Memory Center, Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Max Scheffler
- Department of Radiology, Geneva University Hospitals, Geneva, Switzerland
| | - Gemma Gabriel
- Memory Center, Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Lukas Sveikata
- Division of Neurology, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Barinjaka Rakotomiaramanana
- Memory Center, Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Giovanni B Frisoni
- Memory Center, Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Dina Zekry
- Memory Center, Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.,Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Gabriel Gold
- Memory Center, Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
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Herrmann FR, Zekry D, Kressig RW, Graf CE. The Presence of a Geriatrician in a Nursing Home Could Prevent Hospitalization. J Am Med Dir Assoc 2020; 21:139-140. [PMID: 31590921 DOI: 10.1016/j.jamda.2019.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 08/19/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Francois R Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Bernex, Switzerland; University of Geneva, Geneva, Switzerland
| | - Dina Zekry
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Bernex, Switzerland; University of Geneva, Geneva, Switzerland
| | - Reto W Kressig
- Felix Platter Hospital, University Center for Medicine of Aging, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Christophe E Graf
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Bernex, Switzerland; University of Geneva, Geneva, Switzerland
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Mendes A, Herrmann F, Scheffler M, Gabriel G, Carruzzo F, Rakotomiaramanana B, Frisoni GB, Gold G, Zekry D. P1-329: RELATION OF CLINICAL BLEEDING RISK SCORES WITH CEREBRAL MICROBLEEDS AND CORTICAL SUPERFICIAL SIDEROSIS IN A MEMORY CLINIC POPULATION. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | - François Herrmann
- Geriatrics Division, Internal Medicine, Rehabilitation and Geriatrics Department; Geneva University Hospitals; Geneva Switzerland
| | | | - Gemma Gabriel
- Geriatrics Division, Internal Medicine, Rehabilitation and Geriatrics Department; Geneva University Hospitals; Geneva Switzerland
| | - Fabien Carruzzo
- Geriatrics Division, Internal Medicine, Rehabilitation and Geriatrics Department; Geneva University Hospitals; Geneva Switzerland
| | - Barinjaka Rakotomiaramanana
- Memory Center, Geriatrics Division, Internal Medicine, Rehabilitation and Geriatrics Department; Geneva University Hospitals; Geneva Switzerland
| | - Giovanni B. Frisoni
- Memory Clinic; University Hospital; Geneva Switzerland
- LANVIE - Laboratory of Neuroimaging of Aging; University of Geneva; Geneva Switzerland
| | - Gabriel Gold
- Memory Center, Geriatrics Division, Internal Medicine, Rehabilitation and Geriatrics Department; Geneva University Hospitals; Geneva Switzerland
- Division of Geriatrics; University Hospital of Geneva; Geneva Switzerland
| | - Dina Zekry
- Geneva University Hospitals; Geneva Switzerland
- Memory Center, Geriatrics Division, Internal Medicine, Rehabilitation and Geriatrics Department; Geneva University Hospitals; Geneva Switzerland
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Ribaldi F, Festari C, Andryszak P, Assal F, Mendes A, Zekry D, Chicherio C, Scheffler M, Lovblad KO, Dodich A, Marizzoni M, Garibotto V, Frisoni GB. O4-04-03: THE BIOLOGICAL BASIS OF COGNITIVE IMPAIRMENT DUE TO SUSPECTED NON-ALZHEIMER'S PATHOLOGY (SNAP): STUDY DESIGN AND BASELINE COHORT FEATURES. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Federica Ribaldi
- University of Geneva; Geneva Switzerland
- University of Brescia; Brescia Italy
- IRCCS Centro San Giovanni di Dio Fatebenefratelli; Brescia Italy
| | - Cristina Festari
- University of Brescia; Brescia Italy
- IRCCS Centro San Giovanni di Dio Fatebenefratelli; Brescia Italy
| | | | | | | | - Dina Zekry
- Geneva University Hospitals; Geneva Switzerland
| | | | | | | | | | - Moira Marizzoni
- IRCCS Centro San Giovanni di Dio Fatebenefratelli; Brescia Italy
| | | | - Giovanni B. Frisoni
- University of Geneva; Geneva Switzerland
- Geneva University Hospitals; Geneva Switzerland
- Lab Alzheimer's Neuroimaging & Epidemiology; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli; Brescia Italy
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35
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Srinivasan M, Delavy J, Schimmel M, Duong S, Zekry D, Trombert V, Gold G, Müller F. Prevalence of oral hygiene tools amongst hospitalised elders: A cross‐sectional survey. Gerodontology 2019; 36:125-133. [DOI: 10.1111/ger.12388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 12/10/2018] [Accepted: 12/13/2018] [Indexed: 12/24/2022]
Affiliation(s)
- Murali Srinivasan
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
| | - Joris Delavy
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
| | - Martin Schimmel
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
- Division of Gerodontology University of Bern Bern Switzerland
| | - Stephan Duong
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
| | - Dina Zekry
- Service of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics Geneva University Hospitals Thônex Switzerland
| | - Veronique Trombert
- Department of Internal Medicine and Rehabilitation (Trois‐Chêne) Geneva University Hospitals Geneva Switzerland
| | - Gabriel Gold
- Service of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics Geneva University Hospitals Thônex Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
- Service of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics Geneva University Hospitals Thônex Switzerland
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Zekry D, Le Breton J. [Video games and smartphones : what impacts on cognitive capacities ?]. Rev Med Suisse 2018; 14:2003-2006. [PMID: 30422419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Age-related changes in mental health are an important concern in today's world. Researchers have investigated the effects of video games on mental health for the past 30 years but research on the cognitive impact of smartphones is just beginning. Studies have shown contradictory results and need to be interpreted with caution. Users should be made aware of current knowledge on their potential risks and benefits, without demonizing these relatively new technologies. They should learn how to take advantage of the great potential of these modern devices (they can for example enhance curiosity, sense of purpose and creativity) without becoming enslaved by them.
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Affiliation(s)
- Dina Zekry
- Service de médecine interne et de réhabilitation des Trois-Chêne (SMI-R 3C), Département de médecine interne, de réhabilitation et de gériatrie (DMIRG), HUG, Chemin du Pont-Bochet 3, 1226 Thônex
| | - Julien Le Breton
- Service de médecine interne et de réhabilitation des Trois-Chêne (SMI-R 3C), Département de médecine interne, de réhabilitation et de gériatrie (DMIRG), HUG, Chemin du Pont-Bochet 3, 1226 Thônex
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Herr M, Jeune B, Fors S, Andersen-Ranberg K, Ankri J, Arai Y, Cubaynes S, Santos-Eggimann B, Zekry D, Parker M, Saito Y, Herrmann F, Robine JM. Frailty and Associated Factors among Centenarians in the 5-COOP Countries. Gerontology 2018; 64:521-531. [PMID: 30032145 DOI: 10.1159/000489955] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 05/11/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The global number of centenarians is still strongly growing and information about the health and healthcare needs of this segment of the population is needed. This study aimed to estimate the prevalence of frailty among centenarians included in a multinational study and to investigate associated factors. METHODS The 5-COOP study is a cross-sectional survey including 1,253 centenarians in 5 countries (Japan, France, Switzerland, Denmark, and Sweden). Data were collected using a standardized questionnaire during a face-to-face interview (73.3%), telephone interview (14.5%), or by postal questionnaire (12.2%). The 5 dimensions of the frailty phenotype (weight loss, fatigue, weakness, slow walking speed, and low level of physical activity) were assessed by using self-reported data. Factors associated with frailty criteria were investigated by using multivariate regression models. RESULTS Almost 95% of the participants had at least 1 frailty criterion. The overall prevalence of frailty (3 criteria or more) was 64.7% (from 51.5% in Sweden to 77.6% in Switzerland), and 32.2% of the participants had 4 or 5 criteria. The most frequent criteria were weakness (84.2%), slow walking speed (77.6%), and low level of physical activity (72.5%), followed by fatigue (43.8%) and weight loss (23.8%). Factors associated with frailty included data collection modes, country of residence, gender, living in institution, depression, dementia, disability, falls, and sensory impairments. CONCLUSIONS This study shows that reaching 100 years of age rarely goes without frailty and sheds light on factors associated with frailty at a very old age.
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Affiliation(s)
- Marie Herr
- INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France.,Université de Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France.,Département Hospitalier d'Epidémiologie et Santé Publique, Hôpitaux Universitaires Paris Ile-de-France Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Bernard Jeune
- Epidemiology and Biostatistics, Institute of Public Health, and Danish Aging Research Centre, University of Southern Denmark, Odense, Denmark
| | - Stefan Fors
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Karen Andersen-Ranberg
- Epidemiology and Biostatistics, Institute of Public Health, and Danish Aging Research Centre, University of Southern Denmark, Odense, Denmark
| | - Joël Ankri
- INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France.,Université de Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France.,Département Hospitalier d'Epidémiologie et Santé Publique, Hôpitaux Universitaires Paris Ile-de-France Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Yasu Arai
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Sarah Cubaynes
- MMDN, Université de Montpellier, EPHE, INSERM, U1198, PSL Research University, Montpellier, France
| | - Brigitte Santos-Eggimann
- Lausanne University Hospital, Institute of Social and Preventive Medicine, Lausanne, Switzerland
| | - Dina Zekry
- Division of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Marti Parker
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Yasuhiko Saito
- University Research Center, Nihon University, Tokyo, Japan
| | - François Herrmann
- Division of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Jean-Marie Robine
- MMDN, Université de Montpellier, EPHE, INSERM, U1198, PSL Research University, Montpellier, France
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Zekry D, Mendes A, Herrmann F, Gold G. ACUTE CARE UNITS FOR ALZHEIMER’S PATIENTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D. Zekry
- Internal Medicine, Rehabilitation and Geriatrics of Geneva University Hospitals, Geneva, Switzerland
| | - A. Mendes
- Internal Medicine, Rehabilitation and Geriatrics of Geneva University Hospitals, Geneva, Switzerland
| | - F.R. Herrmann
- Internal Medicine, Rehabilitation and Geriatrics of Geneva University Hospitals, Geneva, Switzerland
| | - G. Gold
- Internal Medicine, Rehabilitation and Geriatrics of Geneva University Hospitals, Geneva, Switzerland
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Gondo Y, Fors S, Jeune B, Andersen-Ranberg K, Zekry D, Robine J. LIVING CONDITIONS AND HEALTH CHARACTERISTICS AMONG CENTENARIANS IN THE FIVE COUNTRIES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Y. Gondo
- Osaka University Graduate School of Human Sciences, Clinical Thanatology and Geriatric Behavioral Science, Suita, Osaka, Japan
| | - S. Fors
- Aging Research Center, Karolinska institutet and Stockholm university, Stockholm, Sweden,
| | - B. Jeune
- Danish Aging Research Center, Institute of Public Health, University of Southern Denmark, Odense, Denmark,
| | | | - D. Zekry
- Internal medicine, rehabilitation and geriatrics, Geneva University Hospitals, THONEX, Switzerland,
| | - J. Robine
- Ecole Pratique des Hautes Etudes (EPHE), Paris, France,
- Université de Montpellier, Inserm, U1198, Montpellier, France,
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Zekry D, Mendes A, Mieiro L, Maringue A, Layat-Jacquier P, Herrmann F, Gold G. FREEDOM OF MOVEMENT: A MULTILEVEL INTERVENTION TO REDUCE PHYSICAL RESTRAINTS USE IN ACUTE CARE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D. Zekry
- Internal Medicine, Rehabilitation and Geriatrics of Geneva University Hospitals, Geneva, Switzerland
| | - A. Mendes
- Internal Medicine, Rehabilitation and Geriatrics of Geneva University Hospitals, Geneva, Switzerland
| | - L. Mieiro
- Internal Medicine, Rehabilitation and Geriatrics of Geneva University Hospitals, Geneva, Switzerland
| | - A. Maringue
- Internal Medicine, Rehabilitation and Geriatrics of Geneva University Hospitals, Geneva, Switzerland
| | - P. Layat-Jacquier
- Internal Medicine, Rehabilitation and Geriatrics of Geneva University Hospitals, Geneva, Switzerland
| | - F.R. Herrmann
- Internal Medicine, Rehabilitation and Geriatrics of Geneva University Hospitals, Geneva, Switzerland
| | - G. Gold
- Internal Medicine, Rehabilitation and Geriatrics of Geneva University Hospitals, Geneva, Switzerland
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Zekry D, Gondo Y, Herr M, Parker M, Herrmann F, Andersen-Ranberg K. COMORBIDITY, COGNITIVE, FUNCTIONAL, AND FRAILTY STATUS: SIMILARITIES OF THEIR LEVELS AND OVERLAPS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D. Zekry
- Internal medicine, rehabilitation and geriatrics, Geneva University Hospitals, Geneva, Switzerland,
| | - Y. Gondo
- Osaka University Graduate School of Human Sciences, Clinical Thanatology and Geriatric Behavioral Science, Suita, Osaka, Japan,
- for the “Japanese 5-COOP team”: Yasu Arai; Yasuhiko Saito; Hirose Nobuyoshi; Yasu Arai; Donald Craig Willcox; Marina Kozono; Yukie Masui; Hiroki Inagaki, Various cities, Japan
| | - M. Herr
- INSERM UMR 1168, Université Versailles St Quentin en Yvelines, Versailles, France,
| | - M.G. Parker
- Aging Research Center, Karolinska Institute, Stockholm, Sweden,
| | - F.R. Herrmann
- Internal medicine, rehabilitation and geriatrics, Geneva University Hospitals, Geneva, Switzerland,
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Herrmann F, Zekry D. COMPARISON OF CENTENARIANS’ CHARACTERISTICS AMONG 5 COUNTRIES, THE OLDEST OLD PROJECT (5-COOP). Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- F.R. Herrmann
- Geneva University Hospitals, THONEX, Geneva, Switzerland
| | - D. Zekry
- Internal Medicine, Rehabilitation and Geriatrics of Geneva University Hospitals
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Herrmann F, Zekry D, Lachat V, Rizzoli R. IMPACT OF DIABETES ON THE PREVALENCE OF MALNUTRITION AND SARCOPENIA IN AGED HOSPITALIZED PATIENTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- F.R. Herrmann
- Division of Geriatrics, Internal Medicine, Rehabilitation and Geriatrics,Geneva University Hospitals and University of Geneva,Geneva, Switzerland
| | - D. Zekry
- Division of Geriatrics, Internal Medicine, Rehabilitation and Geriatrics,Geneva University Hospitals and University of Geneva,Geneva, Switzerland
| | - V. Lachat
- Division of Geriatrics, Internal Medicine, Rehabilitation and Geriatrics,Geneva University Hospitals and University of Geneva,Geneva, Switzerland
| | - R. Rizzoli
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and University of Geneva, Geneva, Switzerland,
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Mistridis P, Mata J, Neuner-Jehle S, Annoni JM, Biedermann A, Bopp-Kistler I, Brand D, Brioschi Guevara A, Decrey-Wick H, Démonet JF, Hemmeter U, Kressig RW, Martin B, Rampa L, Savaskan E, Stuck A, Tschopp P, Zekry D, Monsch A. Use it or lose it! Cognitive activity as a protec-tive factor for cognitive decline associated with Alzheimer's disease. Swiss Med Wkly 2017; 147:w14407. [PMID: 28322422 DOI: 10.4414/smw.2017.14407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Because of the worldwide aging of populations, Alzheimer's disease and other dementias constitute a devastating experience for patients and families as well as a major social and economic burden for both healthcare systems and society. Multiple potentially modifiable cardiovascular and lifestyle risk factors have been associated with this disease. Thus, modifying these risk factors and identifying protective factors represent important strategies to prevent and delay disease onset and to decrease the social burden. Based on the cognitive reserve hypothesis, evidence from epidemiological studies shows that low education and cognitive inactivity constitute major risk factors for dementia. This indicates that a cognitively active lifestyle may protect against cognitive decline or delay the onset of dementia. We describe a newly developed preventive programme, based on this evidence, to stimulate and increase cognitive activity in older adults at risk for cognitive decline. This programme, called "BrainCoach", includes the technique of "motivational interviewing" to foster behaviour change. If the planned feasibility study is successful, we propose to add BrainCoach as a module to the already existing "Health Coaching" programme, a Swiss preventive programme to address multiple risk factors in primary care.
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Affiliation(s)
- Panagiota Mistridis
- Memory Clinic, University Centre for Medicine of Aging, Felix Platter Hospital, Basel, Switzerland
| | - Jutta Mata
- Health Psychology, Department of Social Sciences, University of Mannheim, Germany
| | - Stefan Neuner-Jehle
- Institute of Primary Care, University of Zurich and University Hospital Zurich, Switzerland; Swiss College of Primary Care Medicine, Fribourg, Switzerland Swiss College of Primary Care Medicine, Fribourg, Switzerland
| | - Jean-Marie Annoni
- Neurology Unit, Department of Medicine, Faculty of Science, University of Fribourg, Switzerland
| | | | - Irene Bopp-Kistler
- Memory Clinic, University Clinic of Geriatrics, Stadtspital Waid, Zurich, Switzerland
| | - Dominique Brand
- General Practitioner, Internal Medicine and Geriatrics, Courtelary, Switzerland
| | | | | | | | - Ulrich Hemmeter
- Psychiatric Services St Gallen-North, Centre of Education and Research (COEUR), St Gallen, Switzerland
| | - Reto W Kressig
- University of Basel, Switzerland; University Centre for Medicine of Aging, Felix Platter Hospital, Basel, Switzerland
| | - Brian Martin
- Chief Medical Officer of the Canton of Basel-Country, Liestal, Switzerland; Institute of Epidemiology, Biostatistics and Prevention EBPI, University of Zurich, Switzerland
| | - Luca Rampa
- University Hospital of Old Age Psychiatry, University of Bern, Switzerland
| | - Egemen Savaskan
- University Hospital of Psychiatry Zurich, Department of Geriatric Psychiatry, Zurich, Switzerland
| | - Andreas Stuck
- Department of Geriatrics, Inselspital, Berne University Hospital, University of Berne, Switzerland
| | | | - Dina Zekry
- Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Switzerland
| | - Andreas Monsch
- Memory Clinic, University Centre for Medicine of Aging, Felix Platter Hospital, Basel, Switzerland; University of Basel, Switzerland
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Bosco P, Redolfi A, Bocchetta M, Ferrari C, Mega A, Galluzzi S, Austin M, Chincarini A, Collins DL, Duchesne S, Maréchal B, Roche A, Sensi F, Wolz R, Alegret M, Assal F, Balasa M, Bastin C, Bougea A, Emek-Savaş DD, Engelborghs S, Grimmer T, Grosu G, Kramberger MG, Lawlor B, Mandic Stojmenovic G, Marinescu M, Mecocci P, Molinuevo JL, Morais R, Niemantsverdriet E, Nobili F, Ntovas K, O'Dwyer S, Paraskevas GP, Pelini L, Picco A, Salmon E, Santana I, Sotolongo-Grau O, Spiru L, Stefanova E, Popovic KS, Tsolaki M, Yener GG, Zekry D, Frisoni GB. The impact of automated hippocampal volumetry on diagnostic confidence in patients with suspected Alzheimer's disease: A European Alzheimer's Disease Consortium study. Alzheimers Dement 2017; 13:1013-1023. [PMID: 28263741 DOI: 10.1016/j.jalz.2017.01.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 10/25/2016] [Accepted: 01/23/2017] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Hippocampal volume is a core biomarker of Alzheimer's disease (AD). However, its contribution over the standard diagnostic workup is unclear. METHODS Three hundred fifty-six patients, under clinical evaluation for cognitive impairment, with suspected AD and Mini-Mental State Examination ≥20, were recruited across 17 European memory clinics. After the traditional diagnostic workup, diagnostic confidence of AD pathology (DCAD) was estimated by the physicians in charge. The latter were provided with the results of automated hippocampal volumetry in standardized format and DCAD was reassessed. RESULTS An increment of one interquartile range in hippocampal volume was associated with a mean change of DCAD of -8.0% (95% credible interval: [-11.5, -5.0]). Automated hippocampal volumetry showed a statistically significant impact on DCAD beyond the contributions of neuropsychology, 18F-fluorodeoxyglucose positron emission tomography/single-photon emission computed tomography, and cerebrospinal fluid markers (-8.5, CrI: [-11.5, -5.6]; -14.1, CrI: [-19.3, -8.8]; -10.6, CrI: [-14.6, -6.1], respectively). DISCUSSION There is a measurable effect of hippocampal volume on DCAD even when used on top of the traditional diagnostic workup.
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Affiliation(s)
- Paolo Bosco
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Alberto Redolfi
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Martina Bocchetta
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Clarissa Ferrari
- IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Anna Mega
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Samantha Galluzzi
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | | | - D Louis Collins
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada; True Positive Medical Devices Inc., Quebec City, Quebec, Canada
| | - Simon Duchesne
- True Positive Medical Devices Inc., Quebec City, Quebec, Canada
| | - Bénédicte Maréchal
- Advanced Clinical Imaging Technology (HC CMEA SUI DI BM PI), Siemens Healthcare AG, Lausanne, Switzerland; Department of Radiology, University Hospital (CHUV), Lausanne, Switzerland; LTS5, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Alexis Roche
- Advanced Clinical Imaging Technology (HC CMEA SUI DI BM PI), Siemens Healthcare AG, Lausanne, Switzerland; Department of Radiology, University Hospital (CHUV), Lausanne, Switzerland; LTS5, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | | | | | - Montserrat Alegret
- Alzheimer Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Frederic Assal
- University Hospitals and University of Geneva, Geneva, Switzerland
| | - Mircea Balasa
- Alzheimer's and Other Cognitive Disorder Unit, Hospital Clinic, Barcelona, Spain
| | - Christine Bastin
- GIGA-CRC In vivo Imaging and Memory Clinic, University of Liège, Liège, Belgium
| | - Anastasia Bougea
- First Department of Neurology, Eginition Hospital Kapodistrian University, Medical School of Athens, Athens, Greece
| | - Derya Durusu Emek-Savaş
- Department of Psychology, Dokuz Eylül University, Izmir, Turkey; Izmir International Biomedicine and Genome Center, Dokuz Eylul University, Izmir, Turkey
| | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium; Memory Clinic and Department of Neurology, Hospital Network Antwerp (ZNA) Hoge Beuken and Middelheim, Antwerp, Belgium
| | - Timo Grimmer
- Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Galina Grosu
- Radiology and Medical Imagery, Elias University Clinical Hospital, Bucharest, Romania
| | - Milica G Kramberger
- Department of Neurology, Centre for Cognitive Impairments, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Brian Lawlor
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
| | | | - Mihaela Marinescu
- Department of Geriatrics-Gerontology and Old Age Psychiatry, Elias University Clinic, Bucharest, Romania
| | - Patrizia Mecocci
- Istituto di Gerontologia e Geriatria, Università degli Studi di Perugia, Perugia, Italy
| | - José Luis Molinuevo
- Alzheimer's and Other Cognitive Disorder Unit, Hospital Clinic, Barcelona, Spain
| | - Ricardo Morais
- Medical Imaging Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Ellis Niemantsverdriet
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
| | - Flavio Nobili
- Clinical Neurology (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Konstantinos Ntovas
- 3rd Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sarah O'Dwyer
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
| | - George P Paraskevas
- First Department of Neurology, Eginition Hospital Kapodistrian University, Medical School of Athens, Athens, Greece
| | - Luca Pelini
- Istituto di Gerontologia e Geriatria, Università degli Studi di Perugia, Perugia, Italy
| | - Agnese Picco
- Clinical Neurology (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Eric Salmon
- GIGA-CRC In vivo Imaging and Memory Clinic, University of Liège, Liège, Belgium
| | - Isabel Santana
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Oscar Sotolongo-Grau
- Alzheimer Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Luiza Spiru
- Carol Davila University of Medicine, Bucharest, Romania; Ana Aslan Intl Foundation-Memory Clinic, Bucharest, Romania
| | - Elka Stefanova
- Institute of Neurology, CCS, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Magda Tsolaki
- 3rd Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Görsev G Yener
- Izmir International Biomedicine and Genome Center, Dokuz Eylul University, Izmir, Turkey; Department of Neurology, Dokuz Eylül University, Izmir, Turkey; Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, Izmir, Turkey
| | - Dina Zekry
- Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Giovanni B Frisoni
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland.
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Zekry D, Mendes A. [Management of co-morbidities in demented patients]. Rev Med Suisse 2016; 12:1904-1906. [PMID: 28696594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The interaction between co-morbidities and dementia is complex. Are co-morbidities dementia or age-related ? Does one die of dementia or with dementia ? Presentation of illness is atypical in older populations but particularly so in individuals with dementia. How should one then detect and measure the co-morbidity burden, what is the best management and the most ethically correct approach to decision making ? We will discuss basic principles that can be applied to ensure optimal care of co-morbidities in people with dementia with some practical examples.
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Affiliation(s)
- Dina Zekry
- Service de gériatrie, Département de médecine interne, de réhabilitation et de gériatrie, HUG, Chemin du Pont-Bochet 3, 1226 Thônex
| | - Aline Mendes
- Service de gériatrie, Département de médecine interne, de réhabilitation et de gériatrie, HUG, Chemin du Pont-Bochet 3, 1226 Thônex
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Graf CE, Pichard C, Herrmann FR, Sieber CC, Zekry D, Genton L. Prevalence of low muscle mass according to body mass index in older adults. Nutrition 2016; 34:124-129. [PMID: 28063507 DOI: 10.1016/j.nut.2016.10.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 09/24/2016] [Accepted: 10/01/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Low muscle mass has been associated with increased morbi-mortality and should be identified for optimizing preventive and therapeutic strategies. This study evaluates the prevalence of bioelectrical impedance analysis (BIA)-derived low muscle mass in older persons using definitions found through a systematic literature search and determines the link between body mass index (BMI) and low muscle mass. METHODS We performed a systematic search of trials involving ≥100 persons that derived low muscle mass from BIA and reported cut-offs for low muscle mass normalized for body height or weight. These cut-offs were applied to all adults ≥65 y who underwent a BIA measurement at Geneva University Hospital between 1990 and 2011 (N = 3181). The association between BMI and low muscle mass was evaluated through multivariate logistic regressions. RESULTS We identified 15 cut-offs based on the fat-free mass index (FFMI), skeletal muscle index (SMI), or skeletal muscle percentage (SMP). Depending on the definition, the prevalence of low muscle mass was 17% to 68% in women and 17% to 85% in men. The risk of low muscle mass increased with a BMI <18.5 kg/m2 when using cut-offs based on FFMI (odds ratio [OR] ♀ 14.28-24.04/♂ 25.42-50.64) or SMI (OR ♀ 3.56-4.56/♂ 7.07-8.87) and decreased with a BMI ≥25 kg/m2 (FFMI: OR ♀ 0.03-0.04/♂ 0.01-0.04; SMI: OR ♀ 0.18-0.25/♂ 0.14-0.18). The opposite association appeared between BMI and cut-offs based on SMP. CONCLUSION The prevalence of low muscle mass varies widely depending on the definition, especially in persons with BMI <18.5 or ≥25 kg/m2.
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Affiliation(s)
- Christophe E Graf
- Medical Rehabilitation, Department of Rehabilitation and Palliative Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Claude Pichard
- Clinical Nutrition, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - François R Herrmann
- Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Cornel C Sieber
- Friedrich-Alexander-University Erlangen-Nürnberg, Nürnberg, Germany
| | - Dina Zekry
- Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Laurence Genton
- Clinical Nutrition, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
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Bosco P, Redolfi A, Bocchetta M, Ferrari C, Mega A, Galluzzi S, Assal F, Balasa M, Bastin C, Bougea A, Emek-Savas DD, Engelborghs S, Giannakopoulos P, Gold G, Grimmer T, Grosu G, Kramberger MG, Lawlor B, Stojmenovic GM, Marinescu M, Mecocci P, Molinuevo JL, Morais R, Niemantsverdriet E, Nobili F, Ntovas K, O'Dwyer S, Paraskevas G, Pelini L, Picco A, Salmon E, Santana I, Sotolongo-Grau O, Spiru L, Stefanova E, Popovic KS, Tsolaki M, Yener G, Zekry D, Frisoni GB. P3‐209: Impact of Biomarkers On Diagnostic Confidence in Clinical Assessment of Patients with Suspected Alzheimer's Disease and High Diagnostic Uncertainty: An EADC Study. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | - Martina Bocchetta
- IRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
- University College LondonLondonUnited Kingdom
| | | | | | - Samantha Galluzzi
- IRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Frederic Assal
- University Hospitals and University of GenevaGenevaSwitzerland
| | | | | | - Anastasia Bougea
- Eginition Hospital Kapodistrian University, Medical School of AthensAthensGreece
| | | | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, University of AntwerpAntwerpBelgium
- Department of Neurology and Memory Clinic Hospital Network Antwerp (ZNA) Middelheim and Hoge BeukenAntwerpBelgium
| | | | - Gabriel Gold
- Division of Geriatrics University Hospital of GenevaGenevaSwitzerland
| | - Timo Grimmer
- Klinikum Rechts der Isar, Technische Universitaet MuenchenMunichGermany
| | - Galina Grosu
- Elias University Clinical HospitalBucharestRomania
| | | | - Brian Lawlor
- Mercer's Institute for Successful Ageing, St. James's HospitalDublinIreland
| | | | | | | | - Jose Luis Molinuevo
- ICN Hospital Clinic Universitari and Pasqual Maragall FoundationBarcelonaSpain
| | - Ricardo Morais
- Centro Hospitalar e Universitário de CoimbraCoimbraPortugal
| | - Ellis Niemantsverdriet
- Reference Center for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, University of AntwerpAntwerpBelgium
| | | | | | - Sarah O'Dwyer
- Mercer's Institute for Successful Ageing, St. James's HospitalDublinIreland
| | - George Paraskevas
- Eginition Hospital Kapodistrian University, Medical School of AthensAthensGreece
| | - Luca Pelini
- Istituto di Gerontologia e Geriatria, Università degli Studi di PerugiaPerugiaItaly
| | - Agnese Picco
- Neurology Unit, IRCCS AOU San Martino University of GenoaGenoaItaly
| | | | | | | | - Luiza Spiru
- Carol Davila University of MedicineBucharestRomania
- Ana Aslan Intl Foundation-Memory ClinicBucharestRomania
| | | | | | - Magda Tsolaki
- Aristotle University of ThessalonikiThessalonikiGreece
| | | | - Dina Zekry
- University Hospitals and University of GenevaGenevaSwitzerland
| | - Giovanni B. Frisoni
- IRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
- Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of GenevaGenevaSwitzerland
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49
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Trombella S, Assal F, Zekry D, Gold G, Giannakopoulos P, Garibotto V, Démonet JF, Frisoni GB. [Brain imaging of Alzheimer' disease: state of the art and perspectives for clinicians]. Rev Med Suisse 2016; 12:795-798. [PMID: 27276723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
To improve the clinical detection of Alzheimer's disease (AD) new diagnostic criteria have been proposed, based on biomarkers of synaptic dysfunction, AD-related neurodegeneration, and Aβ cerebral amyloidosis. Magnetic resonance imaging (MRI) and position emission tomography (PET) neuroimaging can be configured as powerful means for the detection of medial-temporal atrophy, reduced uptake of 18F-FDG PET or and increased retention of Aβ amyloid protein by amyloïd-PET. In this review, we will discuss these promising techniques that allow assessing in vivo AD pathology and help clinicians to better diagnose and follow-up patients, particularly in clinical trials using disease-modifying treatments.
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50
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Cesari M, Abellan Van Kan G, Ariogul S, Baeyens JP, Bauer J, Cankurtaran M, Cederholm T, Cherubini A, Cruz-Jentoft AJ, Curgunlu A, Landi F, Sayer AA, Strandberg T, Topinkova E, Van Asselt D, Vellas B, Zekry D, Michel JP. The European Union Geriatric Medicine Society (EUGMS) Working Group on «Frailty in Older Persons». J Frailty Aging 2016; 2:118-20. [PMID: 27070810 DOI: 10.14283/jfa.2013.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The concept of frailty was introduced in literature to help atclinically depicting the transition of a robust older individualinto a different clinical phenotype of risk (1-5). Frailty isgenerally described as a multisystemic impairment responsiblefor a state of increased vulnerability to endogenous andexogenous stressors (6, 7). This syndrome may represent thefirst step towards the evident and clinically relevant functionaldisability (a cornerstone outcome for geriatric medicine)8, andhas shown to be predictive of major negative health-relatedevents, including
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Affiliation(s)
- M Cesari
- Matteo Cesari, MD, PhD, Institut du Vieillissement, Gérontopôle, INSERM UMR 1027, Université Toulouse III - Paul Sabatier, 37 Allées Jules Guesde, 31000 Toulouse France, Phone: +33 (0)5 61145628, Fax: +33 (0)5 61145640,
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