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Romani S, Jacquet B, Cohen D, Curiale V, Laurent I, Louchart De La Chapelle S. Esketamine for resistant depression in older people with cognitive impairment: A case report. Encephale 2023; 49:651-653. [PMID: 37604711 DOI: 10.1016/j.encep.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/16/2023] [Accepted: 06/08/2023] [Indexed: 08/23/2023]
Affiliation(s)
- Serena Romani
- Centre de gérontologie clinique RAINIER III, centre hospitalier Princesse-Grace, 1, avenue Pasteur, 98000 Monaco, Monaco.
| | - Benjamin Jacquet
- Centre de gérontologie clinique RAINIER III, centre hospitalier Princesse-Grace, 1, avenue Pasteur, 98000 Monaco, Monaco
| | - Déborah Cohen
- Centre de gérontologie clinique RAINIER III, centre hospitalier Princesse-Grace, 1, avenue Pasteur, 98000 Monaco, Monaco
| | - Vito Curiale
- Centre de gérontologie clinique RAINIER III, centre hospitalier Princesse-Grace, 1, avenue Pasteur, 98000 Monaco, Monaco
| | - Ingrid Laurent
- Centre de gérontologie clinique RAINIER III, centre hospitalier Princesse-Grace, 1, avenue Pasteur, 98000 Monaco, Monaco
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Latrille A, Rault A, Ghebriou D, Magallon C, Valle A, Facy O. [COSA 80: Oncologic surgery in the elderly patients]. Bull Cancer 2023:S0007-4551(23)00159-5. [PMID: 37055308 DOI: 10.1016/j.bulcan.2023.03.014] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/22/2023] [Accepted: 03/17/2023] [Indexed: 04/15/2023]
Abstract
INTRODUCTION Due to longer life expectancy, an increasing number of older people are at risk of developing cancer. Surgical resection of a non-metastatic and resectable digestive tumor remains the main therapeutic weapon. The objective of our study is to assess the possibility of curative oncological surgery in patients over 80years of age, to study its impact in terms of morbidity and mortality, and to look for risk factors for the occurrence of complications. PATIENTS AND METHODS The study-included patients aged 80 and over operated on for digestive cancer in a curative situation. This was a multicenter prospective cohort study. A total of 230 patients were included in the study. In addition to demographic and medical data, the patients all benefited from an onco-geriatric assessment with the performance of various tests: WHO score, G8 score, IADL score, ADL score, mobility score, nutritional assessment, clock, thymic evaluation (Mini-GDS). Data collection of geriatric scores was repeated 3months postoperatively. RESULTS Of a total of 230 patients, 51% were male and 49% female. The average age was 84.7years. Tumor localization was mainly colorectal (65.81%). Age had no influence on the mortality rate, with a mean age with no significant difference in the event of an unfavorable outcome or not (84.6 vs. 85years). The results at the different scores were then analyzed in search of a significant difference between preoperative and at 3months. The only significant difference found was in the number of patients with a WHO status of 0 (P=0.021). CONCLUSION Our study shows that curative oncological surgery is possible in elderly patients without any adverse effect on their quality of life and level of postoperative autonomy. The multidisciplinary geriatric approach to the patient must make it possible to distinguish the patients who will benefit from a curative treatment and those in whom the benefit-risk balance is unfavorable.
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Affiliation(s)
- Antoine Latrille
- CHU Dijon, département de chirurgie digestive et cancérologique, Dijon, France.
| | - Alexandre Rault
- Hôpital Foch, département de chirurgie digestive, Suresnes, France
| | - Djamel Ghebriou
- AP-HP, hôpital Tenon, département d'oncologie médical, Paris, France
| | - Cloé Magallon
- Institut Paoli-Calmettes, département d'oncologie chirurgicale, Marseille, France
| | - Alexandre Valle
- Hôpital Foch, DRCI, département d'épidémiologie-data-biostatistique, Suresnes, France
| | - Olivier Facy
- CHU Dijon, département de chirurgie digestive et cancérologique, Dijon, France
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Boccara F. Never too old for lipid-lowering therapy. Arch Cardiovasc Dis 2021; 114:524-526. [PMID: 34257047 DOI: 10.1016/j.acvd.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Franck Boccara
- Department of Cardiology, Faculty of Medicine, Hôpital Saint-Antoine, Hôpitaux de l'Est Parisien, AP-HP, Sorbonne Université, 184, rue du Faubourg Saint-Antoine, 75012 Paris, France; Groupe de Recherché Clinique n(o) 22 (Complications cardiovasculaires au cours de l'infection par le VIH), Sorbonne Université, 75012 Paris, France; National Institute of Health and Medical Research, INSERM, UMR_S 938, Sorbonne Université, 75571 Paris, France.
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Arques S, Quennelle F, Roux E. Accuracy of peak mitral e-wave velocity in the diagnosis of heart failure with preserved ejection fraction in older patients with acute dyspnea. Ann Cardiol Angeiol (Paris) 2021; 70:281-285. [PMID: 34130805 DOI: 10.1016/j.ancard.2021.05.008] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/20/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The diagnosis of heart failure with preserved ejection fraction is characterized by its complexity, especially for physicians without great experience in comprehensive transthoracic Doppler echocardiography. Peak mitral E-wave (E) velocity has been successfully correlated to invasive left ventricular diastolic pressures in patients with structural heart disease. The aim of the study was to address the accuracy of E in the diagnosis of heart failure with preserved ejection fraction in elderly patients with acute dyspnea. METHODS This prospective study included 29 consecutive patients ≥70 years of age with heart failure with preserved ejection fraction and acute dyspnea and 29 controls ≥70 years of age. The final diagnosis was supported by the 2016 ASE/EACVI recommendations. RESULTS Mean age of the overall population was 85±7 years. E was strongly correlated with left atrial volume index (r=0.72, P<0.001) and with peak velocity of tricuspid regurgitation (r=0.77, P<0.001). E >85cm/s was 90% sensitive and 93% specific in the diagnosis of heart failure with preserved ejection fraction (AUC, 0.95). E/e' (0.95) and E/(e'xs') (0.92) did not perform better. CONCLUSION E/e' and E/(e'xs') provide essential diagnostic and prognostic information in heart failure with preserved ejection fraction and deserve to be included in every report of comprehensive transthoracic Doppler echocardiography. E velocity is a very simple and user-friendly parameter that can be used for the sole diagnostic purpose in elderly patients with acute dyspnea by operators without great deal of experience, such as cardiologists without formal training, emergency physicians, intensive care anesthetists, internists and geriatricians.
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Affiliation(s)
- S Arques
- Structure de cardiologie, centre hospitalier Edmond-Garcin, avenue des Soeurs Gastine, 13400 Aubagne, France.
| | - F Quennelle
- Structure de cardiologie, centre hospitalier Edmond-Garcin, avenue des Soeurs Gastine, 13400 Aubagne, France
| | - E Roux
- Structure de cardiologie, centre hospitalier Edmond-Garcin, avenue des Soeurs Gastine, 13400 Aubagne, France
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Gkotsi A, Bourdon C, Robert C, Schuind F. Normative values of the DASH questionnaire in healthy individuals over 50 years of age. Hand Surg Rehabil 2021; 40:258-262. [PMID: 33636383 DOI: 10.1016/j.hansur.2020.12.010] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/07/2020] [Accepted: 12/11/2020] [Indexed: 11/25/2022]
Abstract
This study aimed to define the normative values of the DASH score in healthy individuals over 50 years of age. One hundred and twenty subjects equally representing both genders and six age categories (50-54, 55-59, 60-64, 65-69, 70-74 and 75-80 years), with no past medical history affecting the upper limb, were asked to complete the DASH questionnaire. A visual analogue scale for pain and an HAQ-DI questionnaire were also completed to confirm the absence of symptomatic untreated upper limb pathologies. In this series of a priori normal subjects, most had a DASH score greater than 0. Moreover, the DASH score was found to rise with age, with a statistically significant difference between women and men. The DASH questionnaire is widely accepted in the everyday medical practice as a tool to evaluate upper limb function. However, age adjustment of the DASH questionnaire is necessary to correctly evaluate the clinical status and progression of individuals over the age of 50.
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Affiliation(s)
- A Gkotsi
- Department of Orthopaedics and Traumatology, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium.
| | - C Bourdon
- Physiotherapy and Rehabilitation Department, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - C Robert
- Physiotherapy and Rehabilitation Department, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - F Schuind
- Department of Orthopaedics and Traumatology, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
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Benhmida S, Sun R, Gherga E, Hammoud Y, Rouvier J, Mauvais O, Bockel S, Louvrier A, Lebbad A, Bontemps P, Ortholan C, Bourhis J, Lestrade L, Sun XS. Split-course hypofractionated radiotherapy for aged and frail patients with head and neck cancers. A retrospective study of 75 cases. Cancer Radiother 2020; 24:812-819. [PMID: 33144061 DOI: 10.1016/j.canrad.2020.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 03/07/2020] [Revised: 03/16/2020] [Accepted: 03/23/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To assess the efficacy and the tolerance of a split course hypofractionated (SCH) radiotherapy (RT) protocol in head and neck cancer (HNC) for eldery and/or unfit patients (pts). PATIENTS AND METHODS Pts with HNC treated by SCH-RT in two institutions were included retrospectively. The main SCH RT regimen was two courses of 30 grays (Gy)/10 fractions separated by 2-4 weeks, without any systemic therapy. RESULTS Between February 2012 and January 2019, 75 consecutive patients were analyzed. The median age was 80 years (range: 45.7-98.2) and 53 (70.7%) were men. Sixty-one (81.3%) pts had stage III/IV disease and 54 (72%) had at least two comorbidities. All of them were treated with intensity-modulated radiotherapy. Median follow-up was 10.6 months (range: 3.1-58.3). Local control at 12 and 24 months was 72.8% IC95%[62-85.5] and 51.7% IC95%[38.1-70.1] respectively. Progression free survival (PFS) at 12 and 24 months were 47.7% IC95%[37.4-60.8] and 41% IC95%[15-36.4] respectively, with a median of 11.5 months IC95%[8.9-17]. OS at 12 and 24 months were 60.4% IC95%[50-73.1] and 41% IC95%[30.6-54.9] respectively, with a median of 19.3 months IC95%[11.9-25.8]. Acute and late grade 3 or higher toxicities occurred for 6 (8%) and 3 (4%) pts. CONCLUSION The present SCH-RT regimen seems effective, well-tolerated and could represent an alternative to palliative strategies for pts deemed unfit for standard exclusive RT.
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Affiliation(s)
- S Benhmida
- Department of radiotherapy, CHU de Besancon, 2, boulevard Fleming, 25030 Besançon, France; Department of radiotherapy, Hopital Nord Franche-Comté de Montbéliard, site du Mittan, 1 rue Henri Becquerel, 25220 Montbéliard, France.
| | - R Sun
- Department of radiotherapy, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - E Gherga
- Department of radiotherapy, CHU de Besancon, 2, boulevard Fleming, 25030 Besançon, France; Department of radiotherapy, Hopital Nord Franche-Comté de Montbéliard, site du Mittan, 1 rue Henri Becquerel, 25220 Montbéliard, France
| | - Y Hammoud
- Department of radiotherapy, CHU de Besancon, 2, boulevard Fleming, 25030 Besançon, France; Department of radiotherapy, Hopital Nord Franche-Comté de Montbéliard, site du Mittan, 1 rue Henri Becquerel, 25220 Montbéliard, France
| | - J Rouvier
- Department of radiotherapy, Hopital Nord Franche-Comté de Montbéliard, site du Mittan, 1 rue Henri Becquerel, 25220 Montbéliard, France
| | - O Mauvais
- Department of head and neck surgery, CHU de Besançon, 2, boulevard Fleming, 25030 Besançon, France
| | - S Bockel
- Department of radiotherapy, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - A Louvrier
- Department of Maxillofacial Surgery and Stomatology, CHU de Besançon, 2, boulevard Fleming, 25030 Besançon, France
| | - A Lebbad
- Department of head and neck surgery, Hôpital Nord Franche-Comté, 100, route de Moval, Trevenans, France
| | - P Bontemps
- Department of radiotherapy, CHU de Besancon, 2, boulevard Fleming, 25030 Besançon, France; Department of radiotherapy, Hopital Nord Franche-Comté de Montbéliard, site du Mittan, 1 rue Henri Becquerel, 25220 Montbéliard, France
| | - C Ortholan
- Department of radiotherapy, Centre hospitalier Princesse-Grace, 98000 Monaco, Monaco
| | - J Bourhis
- Centre Hospitalier Universitaire Vaudois, Service de Radio-oncologie, 1005 Lausanne, Switzerland
| | - L Lestrade
- Department of radiotherapy, CHU de Besancon, 2, boulevard Fleming, 25030 Besançon, France; Department of radiotherapy, Hopital Nord Franche-Comté de Montbéliard, site du Mittan, 1 rue Henri Becquerel, 25220 Montbéliard, France
| | - X S Sun
- Department of radiotherapy, CHU de Besancon, 2, boulevard Fleming, 25030 Besançon, France; Department of radiotherapy, Hopital Nord Franche-Comté de Montbéliard, site du Mittan, 1 rue Henri Becquerel, 25220 Montbéliard, France
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Delrue N. Cognitive treatment of post-traumatic stress disorder in the elderly. A longitudinal study. Encephale 2021; 47:64-71. [PMID: 32928534 DOI: 10.1016/j.encep.2020.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 05/16/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE This article aims to verify whether a cognitive treatment of post-traumatic stress disorder (PTSD) by cognitive behavioural therapy (CBT) adapted to elderly subjects can lead to long-term improvement in symptomatology and quality of life. METHOD We present a longitudinal study of 32 subjects over the age of 65 years, with no cognitive impairment or mild impairment, residing in two nursing homes. We compare a target group (n=16) with PTSD treated with 20 CBT sessions and a control group (n=16) with PTSD without symptom treatment. The two groups are compared in four stages: (T1) before treatment of the target group's PTSD, (T2) after treatment of PTSD, (T3) after six months of follow-up and (T4) after 18 months of follow-up. The absence of cognitive impairment is verified with the MMSE. The evolution of PTSD is monitored with the CAPS. The evolution of the quality of life of the subjects in the target group is verified with the ADRQL. RESULTS If both groups show elevated PTSD symptoms at the beginning of the study (T1), the signs of PTSD disappear for the target group at the end of treatment (T2) at the same time as quality of life improves (scores more than doubled). These improvements continue for more than 18 months (T4). Conversely, the control group retains high PTSD symptoms, without significant decrease over time. CONCLUSION The treatment of PTSD by cognitive-behavioural therapy adapted to elderly people without cognitive impairment, or with mild cognitive or memory disorders, allows for a lasting disappearance of symptoms and an improvement in quality of life.
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Hekmat H, Sadat Mirzadeh F, Sharifi F, Raeesi S, Ashraf H. Comparison effectiveness of acute coronary syndrome treatments on geriatric function. Ann Cardiol Angeiol (Paris) 2020; 69:173-9. [PMID: 32800319 DOI: 10.1016/j.ancard.2020.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/21/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVES The study objectives were to compare short time complications, mortality, and effectiveness of primary Percutaneous Coronary Intervention (PCI) with optimal medical therapy in older adults with acute coronary syndromes (ACS). METHODS A prospective cohort study, which patients 60 years old and over with ACS were collecting by face to face interview and assessment of the electronic document, in two educational hospitals of Tehran medical university from May 2018 to Jan. 2019. Patients were evaluated in two groups (primary PCI and medical) in terms of complications, mortality and effectiveness, 24hours and 30 days after treatment. Initially, 312 patients were enrolled in the study that 192 were excluded for different reasons. In the final, 120 patients have met all inclusion criteria. RESULTS One hundred and twenty patients were collected with mean age 71.2±8.2 years old. In both groups every 1 point increase in Instrumental Activity Daily Living (IADL), the Major Adverse Cardiac Effect (MACE) was significantly reduced up to 88% (P=0.007). Short-term mortality was significantly higher in the optimal medical therapy group (P=0.006). In comparison complications 24hours between two groups, atrial fibrillation was significantly higher in the medical group which risk increased 11 times (OR=10.93, CI95%=1.38-87.04, P=0.02). CONCLUSIONS Notwithstanding, primary PCI reduced poor outcomes, and improve quality of life, but a lesser option for older adult patients. Primary PCI in older adult patients could maintain independence in functional daily living that results in reduced mortality and MACE considerably.
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Belmin J, Donadio C, Jarzebowski W, Genranmayeh K, Valembois L, Lafuente-Lafuente C. The value of B-type natriuretic peptide plasma concentrations in very old people with chronic peripheral oedema. Arch Cardiovasc Dis 2020; 113:332-340. [PMID: 32151555 DOI: 10.1016/j.acvd.2019.12.009] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 12/22/2019] [Accepted: 12/30/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Chronic peripheral oedema is frequent in old patients, and very often results from multiple causes. AIM To investigate whether determination of B-type natriuretic peptide plasma concentration helps with the diagnosis of chronic peripheral oedema aetiologies. METHODS This was a cross-sectional observational study conducted in geriatric hospital wards (intermediate and long-term care) on consecutive in-hospital patients aged>75 years with chronic peripheral oedema and no dyspnoea. From medical history, physical examination, routine biological tests and chest radiography, two investigators determined the aetiologies of oedema, with special attention paid to recognizing chronic heart failure. This reference diagnosis was compared with the clinical diagnosis mentioned in the medical chart. Brain natriuretic peptide plasma concentrations were measured soon after the investigators' visit. RESULTS Among the 141 patients (113 women and 28 men) aged 86±6 years, a single aetiology was identified in 53 (38%), and multiple aetiologies in 84 (60%). The main aetiologies were venous insufficiency (69%), chronic heart failure (43%), hypoproteinaemia (38%) and drug-induced oedema (26%). Chronic heart failure was frequently misdiagnosed by attending clinicians (missed in 18 cases and wrongly diagnosed in 14 cases). Brain natriuretic peptide concentration was significantly higher in patients with chronic heart failure than in those without: median (interquartile range) 490 (324-954) versus 137 (79-203) pg/mL, respectively (P<0.0001). The receiver operating characteristic curve showed that a concentration of 274pg/mL was appropriate for diagnosing chronic heart failure, with a specificity of 0.89 and a sensitivity of 0.82. Brain natriuretic peptide concentrations above this cut-off were significantly and independently associated with the diagnosis of chronic heart failure. CONCLUSIONS Chronic heart failure is frequently misdiagnosed in old patients with chronic peripheral oedema, and B-type natriuretic peptide plasma concentration helped to improve the diagnosis of this condition and identify chronic heart failure.
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Affiliation(s)
- Joël Belmin
- Service de Gériatrie, hôpital Charles-Foix, hôpitaux universitaires Pitié-Salpêtrière-Charles Foix, 7, avenue de la République, 94200 Ivry-sur-Seine, France; Sorbonne Université (UPMC), 75013 Paris, France.
| | - Cristiano Donadio
- Service de Gériatrie, hôpital Charles-Foix, hôpitaux universitaires Pitié-Salpêtrière-Charles Foix, 7, avenue de la République, 94200 Ivry-sur-Seine, France
| | - Witold Jarzebowski
- Service de Gériatrie, hôpital Charles-Foix, hôpitaux universitaires Pitié-Salpêtrière-Charles Foix, 7, avenue de la République, 94200 Ivry-sur-Seine, France
| | - Kamran Genranmayeh
- Service de Gériatrie, hôpital Charles-Foix, hôpitaux universitaires Pitié-Salpêtrière-Charles Foix, 7, avenue de la République, 94200 Ivry-sur-Seine, France
| | - Lucie Valembois
- Service de Gériatrie, hôpital Charles-Foix, hôpitaux universitaires Pitié-Salpêtrière-Charles Foix, 7, avenue de la République, 94200 Ivry-sur-Seine, France
| | - Carmelo Lafuente-Lafuente
- Service de Gériatrie, hôpital Charles-Foix, hôpitaux universitaires Pitié-Salpêtrière-Charles Foix, 7, avenue de la République, 94200 Ivry-sur-Seine, France; Sorbonne Université (UPMC), 75013 Paris, France
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El Osta N, Kanso F, Saad R, Khabbaz LR, Fakhouri J, El Osta L. Validation of the Arabic version of the SF-36, generic questionnaire of quality of life related to health among the elderly in Lebanon. East Mediterr Health J 2019; 25:706-714. [PMID: 31774136 DOI: 10.26719/emhj.19.041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 10/30/2018] [Indexed: 11/09/2022]
Abstract
Background Measuring health status of elderly is essential for the prediction of their health care needs. Health research usually considers objective outcome measure; however there is a need to increase self-reported measures of health. Aims The aim of this study was to assess the psychometric properties of the SF36 among a group of Lebanese elderly. Methods It was a cross-sectional observational study. A systematic sample of elderly people aged 60 years and more was selected from dispensary, private and governmental hospitals in Lebanon. Data were collected using face-to-face interview. The first part of the questionnaire consisted of sociodemographic characteristics. The second part consisted of the Arabic version of the SF-36. The third part consisted of Activity of Daily Living (ADL) scale, presence of health problems and number of medication consumed per day. Results A total of 250 elderly people were included. The mean age was 70.69±7.70 years. Cronbach alphas for all SF-36 scales exceeded 0.798. The intra-Class correlation coefficient varied between 0.675 (item 2) and 0.980 (items 14, 16 and 18) indicating good reliability. The quality of life (QoL) of women was poorer than men (p<0.001). It was significantly lesser when the number of health problems (p<0.001) and medications (p<0.001) increased, and the ADL score (p<0.05) decreased. Conclusion SF-36 is a valid and reliable instrument for measuring QoL among Lebanese elderly and could be used for monitoring the QoL of this population.
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Affiliation(s)
- Nada El Osta
- Département de Prothèse amovible, Faculté de Médecine dentaire, Université Saint-Joseph, Beyrouth (Liban) ; équipe d'accueil EA 4847, Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, Clermont-Ferrand (France); Laboratoire de Recherche Crâniofaciale, Unité de Santé Orale, Faculté de Médecine Dentaire, Université Saint-Joseph de Beyrouth, Liban
| | - Fatme Kanso
- Faculté de Médecine, Université Saint-Joseph, Beyrouth (Liban)
| | - Robert Saad
- Santé publique, Université Saint-Joseph, Beyrouth (Liban)
| | - Lydia Rabbaa Khabbaz
- Laboratoire de Pharmacologie, Pharmacie clinique et Contrôle de Qualité des Médicaments, Faculté de Pharmacie, Université Saint-Joseph, Beyrouth (Liban)
| | - Jihad Fakhouri
- Département de Prothèse amovible, Faculté de Médecine dentaire, Université Saint-Joseph, Beyrouth (Liban) ; équipe d'accueil EA 4847, Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, Clermont-Ferrand (France); Laboratoire de Recherche Crâniofaciale, Unité de Santé Orale, Faculté de Médecine Dentaire, Université Saint-Joseph de Beyrouth, Liban
| | - Lana El Osta
- Département de Santé publique, Faculté de Médecine, Université Saint-Joseph, Beyrouth (Liban)
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McGrath CE, Corrado AM. Adaptations to support occupational engagement with age-related vision loss: A metasynthesis study. Can J Occup Ther 2019; 86:377-387. [PMID: 31060363 DOI: 10.1177/0008417419834422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND. Age-related vision loss (ARVL) is a progressive process that adversely affects older adults' occupational engagement. As such, older adults often employ a variety of psychological adaptation strategies. PURPOSE. The purpose of this study was to identify those psychological adaptation strategies employed by older adults aging with ARVL. METHOD. This metasynthesis searched and identified 21 qualitative articles that described a link between psychological adaptation strategies and occupational engagement. FINDINGS. The psychological strategies identified were categorized into five themes. The strategies of persisting with hope, positivity, and acceptance and portraying a self-image consistent with independence, competence, and self-reliance were well established in the literature, while other themes were more emerging, such as using humour, relying on religious/spiritual beliefs, and comparing the self to others. IMPLICATIONS. By understanding the psychological adaptation strategies employed by older adults with ARVL, occupational therapists will be better positioned to guide their clients toward positive adaptive patterns.
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Gaultier De Saint Basile H, Poisson C, Arrondeau J, Boudou-Rouquette P, Goldwasser F, Tartour E, De Guillebon E. [Efficacy and toxicity of immune checkpoint inhibitors in elderly patients - 5th edition of the congress of pharmacology of anticancer drugs]. Bull Cancer 2018; 105:1202-8. [PMID: 30471959 DOI: 10.1016/j.bulcan.2018.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 08/24/2018] [Accepted: 10/02/2018] [Indexed: 11/23/2022]
Abstract
Physiological aging causes qualitative or quantitative immune system decline, also called immunosenescence. Older people with cancer are often ineligible for chemotherapy. The new immunotherapies (with PD1, PDL1 and CTLA4 checkpoint inhibitors) have proven their effectiveness in many tumor types regardless of age and are often better tolerated than chemotherapy. In the older population, the subgroup data from the different pivotal studies show fairly reassuring efficacy and safety data, despite the frequent lack of power given the small population included. There remains, however, some doubt that age may be a risk factor for hyperprogression. Studies focusing on older subjects and dedicated meta-analysis seem necessary to obtain more accurate data.
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Kopp-Bigault C, Walter M. [Prevention of suicide of the elderly in France. To a multimodal strategy against depression and isolation: CQFDi]. Encephale 2019; 45 Suppl 1:S35-7. [PMID: 30477900 DOI: 10.1016/j.encep.2018.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 09/17/2018] [Accepted: 09/26/2018] [Indexed: 10/27/2022]
Abstract
ISSUE Suicide is a major problem of public health around the world, and if suicidal mortality rates have declined in recent years, the elderly remain a category of the world's population at major risk of suicide. Seventeen percent of deaths by suicide across the world are individuals over the age of 65. The existence of suicidal ideas for an individual in this age group increases the risk of suicide attempt in the year by 34. In France, about a little less than a quarter of suicides belong to persons over 60-years-old. More risk factors found in the international literature are in the foreground of mental disorders and in particular the major depression episode, then secondarily addictions, neuro-degenerative disorders as well as pain and other diseases. Depression is found in 60% to 90% of suicides. We notice also that older people privileged the general practitioner as interlocutor to discuss their problems and worries much more than psychiatrists or psychologists. In fact, two-thirds of the elderly who committed suicide had consulted their general practioner in the month prior to suicide and half in the 10 last days. That raises the question of the identification of depression and the evaluation of suicidal risk. On the other side, there is an abundant literature about psychosocial risk factors especially on the influence of isolation and lack of social support as well as on conflicts and family losses. In France, more than 4 million of the elderly live alone. So, while the world population is increasing and life expectancy lengthens, it is important to already act for elderly suicide prevention. PERSPECTIVES Suicide prevention actions whose efficacity have been demonstrated around the world are designed as part of multimodal strategies combining several levers of action. The consensual recommendations for prevention of elderly suicide recommend the association of actions on the reduction of depression and combating social isolation in connection with the training of front-line actors such as general practitioners. As a result of these experiments and recommendations, the first francophone multimodal strategy was developed to act both on depression and social isolation: the Coopération Québec France sur la dépression et l'isolement (CQFDi) program which will be implemented in France and Quebec in 2019. CONCLUSION It has been proven that multimodal suicide prevention strategies allow a reduction in the number of suicides. The CQFDi program focuses on at risk of suicide population and aims to reduce the suicide rate of elderly people in France.
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Maggi P, de Almeida Mello J, Delye S, Cès S, Macq J, Gosset C, Declercq A. Fall determinants and home modifications by occupational therapists to prevent falls: Facteurs déterminants des chutes et modifications du domicile effectuées par les ergothérapeutes pour prévenir les chutes. Can J Occup Ther 2018; 85:79-87. [PMID: 29506411 DOI: 10.1177/0008417417714284] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Approximately one third of older people over 65 years fall each year. Home modifications may decrease occurrence of falls. PURPOSE This study aims to determine the risk factors of falls for frail older persons and to evaluate the impact of home modifications by an occupational therapist on the occurrence of falls. METHOD We conducted a longitudinal study using a quasiexperimental design to examine occurrence of falls. All participants 65 years of age and older and were assessed at baseline and 6 months after the intervention. Bivariate analysis and logistic regression models were used to study the risk factors of falls and the effect of home modifications on the incidence of falls. FINDINGS The main predictors of falls were vision problems, distress of informal caregiver, and insufficient informal support. Home modifications provided by an occupational therapist showed a significant reduction of falls. IMPLICATIONS Informal caregivers and their health status had an impact on the fall risk of frail older persons. Home modifications by an occupational therapist reduced the fall risk of frail older persons at 6-months follow-up.
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Kuntz L, Noel G, Antoni D. [Hypofractioned radiotherapy in elderly patient with glioblastoma]. Cancer Radiother 2018; 22:647-652. [PMID: 30197025 DOI: 10.1016/j.canrad.2018.07.135] [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: 07/10/2018] [Accepted: 07/17/2018] [Indexed: 11/19/2022]
Abstract
Glioblastoma is the most frequent primary brain tumor, with more than half of all patients being at least 65 years old. The treatment of the elderly in this pathology represents therefore a considerable challenge for oncologists and radiation therapists. However, in most clinical trials, age is a non-eligible criterial. In the last ten years, geriatric therapeutic trials have been multiplied. The treatment of glioblastoma consists of adjuvant chemoradiotherapy. In elderly patients, the evaluation of performans status and the molecular characteristics of the tumor are important factors in order to propose the appropriate treatment in terms of efficacy and toxicity.
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Affiliation(s)
- L Kuntz
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de-la-Porte de l'Hôpital, 67065 Strasbourg, France
| | - G Noel
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de-la-Porte de l'Hôpital, 67065 Strasbourg, France; CNRS, IPHC UMR 7178, centre Paul-Strauss, université de Strasbourg, Unicancer, 67000 Strasbourg, France
| | - D Antoni
- Département universitaire de radiothérapie, centre Paul-Strauss, Unicancer, 3, rue de-la-Porte de l'Hôpital, 67065 Strasbourg, France; CNRS, IPHC UMR 7178, centre Paul-Strauss, université de Strasbourg, Unicancer, 67000 Strasbourg, France.
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Lemoine L, Dupont C, Capron A, Cerf E, Yilmaz M, Verloop D, Blanckaert K, Senneville E, Alfandari S. Prospective evaluation of the management of urinary tract infections in 134 French nursing homes. Med Mal Infect 2018; 48:359-364. [PMID: 29747905 DOI: 10.1016/j.medmal.2018.04.387] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 01/15/2018] [Accepted: 04/06/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Prospective assessment of the management of urinary tract infections (UTI) in the nursing homes of the Hauts-de-France region. PATIENTS AND METHODS A 50-question form had to be filled in for up to five consecutive residents treated for UTI in each nursing home. If necessary, diagnoses were reclassified according to the 2014 French Infectious Diseases Society guidelines. Analyses were presented per supposed (reported) and reclassified diagnoses. RESULTS Of 397 contacted facilities, 134 participated and informed 444 UTI episodes. Reported diagnostic criteria were burning urination (32%), malodorous urine (29%), confusion (28%), and turbid urine (19%). Twenty-one percent of diagnoses were based on erroneous criteria. Less than 50% of residents had a urine dipstick test performed and 94% a urine culture. The main pathogen was Escherichia coli. Reported indications were uncomplicated cystitis (32%), unspecified UTI (26%), complicated cystitis (9%), while no reason was given in 25% of cases. Only 10% of diagnoses were consistent with the guidelines: complicated cystitis (49%), asymptomatic bacteriuria (21%), acute pyelonephritis (21%), male UTI (9%). Almost 85% of prescriptions were active on the isolated bacteria. The empirical antibiotic therapy was consistent with the diagnosis in 16% of cases (30% for reclassified diagnoses). The two most prescribed antibiotic classes were fluoroquinolones (22.1%) and oral third-generation cephalosporins (19.1%). Only two of 157 possible de-escalations were performed. Duration of treatment was adequate for 19% of UTIs (9.6% of reclassified cases). CONCLUSION Our study revealed multiple deficiencies in diagnosis, antibiotic choice, treatment duration, and reevaluation.
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Affiliation(s)
- L Lemoine
- Soins de suite polyvalents, centre hospitalier de Tourcoing, 59200 Tourcoing, France
| | - C Dupont
- ARS Hauts-de-France (anciennement Nord-Pas-de-Calais), 59000 Lille, France
| | - A Capron
- ARS Hauts-de-France (anciennement Nord-Pas-de-Calais), 59000 Lille, France
| | - E Cerf
- ARS Hauts-de-France (anciennement Nord-Pas-de-Calais), 59000 Lille, France
| | - M Yilmaz
- OMEDIT Hauts-de-France (anciennement OMEDIT Nord-Pas-de-Calais), 59000 Lille, France
| | - D Verloop
- ARS Hauts-de-France (anciennement Nord-Pas-de-Calais), 59000 Lille, France
| | - K Blanckaert
- CEPIAS Hauts-de-France (anciennement ARLIN Nord-Pas-de-Calais), 59000 Lille, France
| | - E Senneville
- Service universitaire des maladies infectieuses et du voyageur, centre hospitalier de Tourcoing, 59200 Tourcoing, France
| | - S Alfandari
- Service de réanimation et maladies infectieuses, centre hospitalier de Tourcoing, 59200 Tourcoing, France.
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Debove L, Bru N, Couderc M, Noé F, Paillard T. Physical activity limits the effects of age and Alzheimer's disease on postural control. Neurophysiol Clin 2017; 47:301-304. [PMID: 28479259 DOI: 10.1016/j.neucli.2017.03.005] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 03/23/2017] [Indexed: 10/19/2022] Open
Abstract
The aim was to study the possible influence of physical activity on the postural performance of subjects with Alzheimer's disease (AD). The postural performance (i.e. surface area of the center of foot pressure displacement) of 3 groups was compared: Alzheimer active group (AA), Alzheimer non-active group (ANA) and healthy non-active group (HNA). The AA group's postural performance was superior to that of the ANA and HNA groups. AD disturbed postural performance but participation in regular physical activity made it possible to limit the disturbing effects of AD to a surprising extent, since the postural performance of active AD subjects was also superior to that of healthy subjects.
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Affiliation(s)
- Lola Debove
- Laboratoire mouvement, équilibre, performance et santé, EA 4445, département STAPS, université de Pau et des Pays de l'Adour, ZA Bastillac sud, 11, rue Morane-Saulnier, 65000 Tarbes, France; Service gériatrique, centre hospitalier de Lourdes, rue Labastide, 65100 Lourdes, France
| | - Noelle Bru
- Laboratoire de mathématique et leurs applications, UMR CNRS 5142, université de Pau et des Pays de l'Adour, bâtiment IPRA, avenue de l'Université, BP 1155, 64013 Pau cedex, France
| | - Martine Couderc
- Service gériatrique, centre hospitalier de Lourdes, rue Labastide, 65100 Lourdes, France
| | - Frederic Noé
- Laboratoire mouvement, équilibre, performance et santé, EA 4445, département STAPS, université de Pau et des Pays de l'Adour, ZA Bastillac sud, 11, rue Morane-Saulnier, 65000 Tarbes, France
| | - Thierry Paillard
- Laboratoire mouvement, équilibre, performance et santé, EA 4445, département STAPS, université de Pau et des Pays de l'Adour, ZA Bastillac sud, 11, rue Morane-Saulnier, 65000 Tarbes, France.
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Retornaz F, Beliard S, Gremeaux E, Chiche L, Lagarde L, Andrianasolo M, Molines C, Oliver C. [Statin and cardiovascular diseases after 75 years]. Rev Med Interne 2016; 37:625-31. [PMID: 27389014 DOI: 10.1016/j.revmed.2016.06.001] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/15/2016] [Accepted: 06/02/2016] [Indexed: 11/16/2022]
Abstract
Statin prescription in persons older than 75 years or with frailty signs raises questions on the role of cholesterol in the genesis of atherosclerosis in this population, on the benefit of this treatment in primary or secondary prevention, and on their side effects in a context of multiple pathology and multiple medications. These questions are approached with the available literature data for this population. In secondary prevention, statin prescription is recommended whatever the age although intensive treatment should be avoided. In primary prevention, in the absence of consensus, their prescription depends on both geriatric and cardiovascular risk assessment.
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Affiliation(s)
- F Retornaz
- Centre gérontologique départemental, 176, avenue de Montolivet, 13012 Marseille, France; Institut Silvermed, 176, avenue de Montolivet, 13012 Marseille, France; Laboratoire de santé publique, évaluation des systèmes de soins et santé perçue, EA 3279 UFR médecine Aix-Marseille université, 27, boulevard Jean-Moulin, 13385 Marseille Cedex 05, France; Unité de recherche et de soins en médecine interne et maladies infectieuses, hôpital européen, 6, rue Desirée-Clary, 13003 Marseille, France.
| | - S Beliard
- Service d'endocrinologie, CHU de Conception, 47, boulevard Baille, 13005 Marseille, France; Faculté de médecine, boulevard Pierre-Dramard, 13005 Marseille, France
| | - E Gremeaux
- Centre gérontologique départemental, 176, avenue de Montolivet, 13012 Marseille, France
| | - L Chiche
- Unité de recherche et de soins en médecine interne et maladies infectieuses, hôpital européen, 6, rue Desirée-Clary, 13003 Marseille, France
| | - L Lagarde
- Centre gérontologique départemental, 176, avenue de Montolivet, 13012 Marseille, France
| | - M Andrianasolo
- Centre gérontologique départemental, 176, avenue de Montolivet, 13012 Marseille, France
| | - C Molines
- Centre gérontologique départemental, 176, avenue de Montolivet, 13012 Marseille, France; Institut Silvermed, 176, avenue de Montolivet, 13012 Marseille, France
| | - C Oliver
- Centre gérontologique départemental, 176, avenue de Montolivet, 13012 Marseille, France; Institut Silvermed, 176, avenue de Montolivet, 13012 Marseille, France; Faculté de médecine, boulevard Pierre-Dramard, 13005 Marseille, France
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Teixeira A, Arrigo M, Tolppanen H, Gayat E, Laribi S, Metra M, Seronde MF, Cohen-Solal A, Mebazaa A. Management of acute heart failure in elderly patients. Arch Cardiovasc Dis 2016; 109:422-30. [PMID: 27185193 DOI: 10.1016/j.acvd.2016.02.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 01/29/2016] [Accepted: 02/02/2016] [Indexed: 11/24/2022]
Abstract
Acute heart failure (AHF) is the most common cause of unplanned hospital admissions, and is associated with high mortality rates. Over the next few decades, the combination of improved cardiovascular disease survival and progressive ageing of the population will further increase the prevalence of AHF in developed countries. New recommendations on the management of AHF have been published recently, but as elderly patients are under-represented in clinical trials, and scientific evidence is often lacking, the diagnosis and management of AHF in this population is challenging. The clinical presentation of AHF, especially in patients aged>85years, differs substantially from that in younger patients, with unspecific symptoms, such as fatigue and confusion, often overriding dyspnoea. Older patients also have a different risk profile compared with younger patients: often heart failure with preserved ejection fraction, and infection as the most frequent precipitating factor of AHF. Moreover, co-morbidities, disability and frailty are common, and increase morbidity, recovery time, readmission rates and mortality; their presence should be detected during a geriatric assessment. Diagnostics and treatment for AHF should be tailored according to cardiopulmonary and geriatric status, giving special attention to the patient's preferences for care. Whereas many elderly AHF patients may be managed similarly to younger patients, different strategies should be applied in the presence of relevant co-morbidities, disability and frailty. The option of palliative care should be considered at an early stage, to avoid unnecessary and harmful diagnostics and treatments.
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Affiliation(s)
- Antonio Teixeira
- Geriatric Department, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France; INSERM UMR-S 942, Université Paris Diderot, PRES Sorbonne Paris Cité, Paris, France.
| | - Mattia Arrigo
- INSERM UMR-S 942, Université Paris Diderot, PRES Sorbonne Paris Cité, Paris, France
| | - Heli Tolppanen
- INSERM UMR-S 942, Université Paris Diderot, PRES Sorbonne Paris Cité, Paris, France
| | - Etienne Gayat
- INSERM UMR-S 942, Université Paris Diderot, PRES Sorbonne Paris Cité, Paris, France; Department of Anaesthesiology and Critical Care Medicine, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France
| | - Said Laribi
- INSERM UMR-S 942, Université Paris Diderot, PRES Sorbonne Paris Cité, Paris, France; Emergency Medicine Department, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France
| | - Marco Metra
- Division of Cardiology, Spedali Civili di Brescia and University of Brescia, Brescia, Italy
| | - Marie France Seronde
- INSERM UMR-S 942, Université Paris Diderot, PRES Sorbonne Paris Cité, Paris, France; Division of Cardiology, Besancon University Hospital, Besancon, France
| | - Alain Cohen-Solal
- INSERM UMR-S 942, Université Paris Diderot, PRES Sorbonne Paris Cité, Paris, France; Department of Cardiology, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France
| | - Alexandre Mebazaa
- INSERM UMR-S 942, Université Paris Diderot, PRES Sorbonne Paris Cité, Paris, France; Department of Anaesthesiology and Critical Care Medicine, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France
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Favier S, Izaute M, Teissèdre F. [How educating students in depression among older people can affect their motivation to work with this population]. Encephale 2016; 43:104-109. [PMID: 27156067 DOI: 10.1016/j.encep.2015.12.022] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 12/07/2015] [Accepted: 12/09/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Negative representations of ageing are conveyed in our society. We see that people frequently avoid working with older people, due to a lack of motivation. Depressive signs in older people are more frequently associated with normal ageing, rather than a pathology, giving health professionals the feeling that therapeutic efforts are likely to be unproductive. Yet, depression is a major public health problem, particularly among older people. It is a real pathology, affecting 20% of people aged 65 and older. In retirement homes the percentage can be as high as 45%. OBJECTIVE To study and evaluate how theoretical knowledge about older people and depression affects the motivation of 2nd year psychology students to work with this population. METHODS The study involves two groups. One of the groups (experimental group) followed an 8hour course on depression in older people, whereas the other (control group) followed an 8hour course on a different topic. The study was conducted in two parts. First, the two groups answered an initial questionnaire which measured how motivated they were to work with older people and what they knew about depression in older people. Then, after the experimental phase, all of the students answered the same questionnaire a second time. RESULTS The comparison shows a significant decline in knowledge between T1 and T2 for the control group (P<0.05), and a significant increase in the number of correct answers for the experimental group (P<0.001). Statistical results show that after receiving education in depression, students are more motivated to work with older people. Moreover, we observe that the more knowledge students have in this field, the more motivated they will be to work with older people. DISCUSSION Whereas there were no differences in knowledge before the course, we observed that the knowledge of the group who took part in the course about older people improved. Also, the evaluation showed that students who took the course were significantly more knowledgeable. Regarding motivation, our results vary according to the type of motivation. Overall, as regards intrinsic motivation, we observed an increase in motivation, insofar as the students who had followed the course were subsequently more likely to work with older people. Taking part in the course led to a systematic increase in the evaluation of extrinsic motivation. With respect to knowledge, half of the students interviewed think sadness or depression is a natural part of ageing. So, we observe that future health professionals often regard the signs observed in this population, such as sadness, apathy, and depression, as part of normal ageing. The people working with older people do not make the connection to actions and consequently in this action to wrongly thinking they are not in control of the situation. Depression is widely underestimated. Forty percent of cases of depression among older people go undetected. This study highlights the importance of making health professionals and future health professionals more aware of depression among older people. Knowing more about depression in this population can help guide recourse to psychology in gerontology.
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Affiliation(s)
- S Favier
- Université Blaise-Pascal, 34, avenue Carnot, 63037 Clermont-Ferrand cedex, France
| | - M Izaute
- Laboratoire de psychologie sociale et cognitive (lapsco - UMR - CNRS 6024), université Blaise-Pascal, 34, avenue Carnot, 63037 Clermont-Ferrand cedex, France
| | - F Teissèdre
- Laboratoire de psychologie sociale et cognitive (lapsco - UMR - CNRS 6024), université Blaise-Pascal, 34, avenue Carnot, 63037 Clermont-Ferrand cedex, France.
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Hien H, Berthé A, Drabo MK, Konaté B, Toé N, Tou F, Adiara M, Badini-Kinda F, Ouédraogo M, Meda N, Macq J. [Point of view of older adults on the potentially inappropriate medications prescribing in primary care facilities in Bobo-Dioulasso, Burkina Faso]. Rev Epidemiol Sante Publique 2016; 64:15-21. [PMID: 26745999 DOI: 10.1016/j.respe.2015.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 07/28/2015] [Accepted: 09/11/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Little is known about the organization of primary care facilities in sub-Saharan Africa that might lead to potentially inappropriate prescribing. The aim of this study was to analyze the factors that could lead to potentially inappropriate prescribing in primary care facilities in Bobo-Dioulasso (Burkina Faso), taking into consideration the patient's perspective. METHODS A cross-sectional qualitative study was conducted in primary care facilities from November 2013 to February 2014. People aged 60 years or more with at least one chronic disease were included. Individual interviews were conducted. An analysis of the thematic content of the interviews was conducted. RESULTS Our results showed that the patient referral system was insufficient. We also found many different prescribers for older people seeking care and poor communication between prescribers and patients. This caused some consequences such as the absence of review of drugs consumed before a new prescription, a lack of exchange on medication changes and repeated treatment change during hospitalization. Most of the persons who prescribed potentially inappropriate medications were nurses. CONCLUSION The poor communication between prescribers and patients is a challenge for the prevention of prescribing potentially inappropriate medications. Teamwork is an important feature of the organizational care system, strengthening it could be a way to improve rational prescription.
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Lang PO, Ferahta N. [Recommendations for treatment and prevention of herpes zoster and associated pain in aged adults]. Rev Med Interne 2016; 37:35-42. [PMID: 26383768 DOI: 10.1016/j.revmed.2015.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 07/25/2015] [Accepted: 08/17/2015] [Indexed: 12/23/2022]
Abstract
Initiated within the first 72 hours of the rash, prescribing antiviral drugs reduces both acute neuralgia (AN) and later complications and especially postherpetic neuralgia (PHN). But their analgesic as well as preventative effect on AN and PHN is modest. Combination with analgesic drugs is more often needed for pain management. However, the pharmacological management of pain, in the context of old patients' frailty, co-morbidities and often polypharmacy, must be carefully considered. Based on analyses of the evidences from the literature, this review presents the therapeutic options we have at one's disposal and proposes a stepwise management for both AN and PHN specifically designed for aged population.
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Obeid S, Kazour F, Kazour G. [Living environment and activation of early maladaptive schemas specific to the elderly: Comparative study among 80 individuals]. Encephale 2015; 41 Suppl 1:S29-36. [PMID: 25862313 DOI: 10.1016/j.encep.2015.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 01/09/2012] [Accepted: 07/29/2013] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Early maladaptive schemas described by Young may be identified in the elderly. They represent models and themes of emotions, memories, thoughts and bodily sensations experienced by the individual. This study aims to evaluate the activation of early maladaptive thoughts in the elderly depending on their living environment. METHODS The Young Schema Questionnaire--short form--was administered to 80 elderly individuals (40 living in a nursing home, and 40 in their own home with at least one person). The studied schemas that were most relevant to the elderly were the maladaptive schemas of abandonment, emotional deprivation, mistrust, exclusion, dependency, vulnerability and emotional overcontrol. The Mini-Mental State Examination (MMSE) and the Geriatric Depression Scale were administered to eliminate dementia or depression among individuals. RESULTS Individuals living in a nursing home, compared to their controls had increased activation of schemas of emotional deprivation (22.5% vs. 7.5%), abandonment (15% vs. 0%), mistrust (32.5% vs. 2.5%), exclusion (7.5% vs. 0%), and emotional overcontrol (25% vs. 2.5%). The activation of maladaptive schemas was significantly elevated in nursing homes for those 5 schemas, while there was no difference in activation between the 2 groups concerning the schemas of dependency and vulnerability. DISCUSSION The activation of early maladaptive schemas of emotional deprivation, abandonment, mistrust, exclusion, and emotional overcontrol is higher in individuals living in nursing homes compared to a control group of individuals living in their homes with at least one companion. This schema activation may be related to a lack of emotional and family support in the elderly.
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Affiliation(s)
- S Obeid
- Hôpital psychiatrique de la Croix, BP 60096, Jal-Eddib, Liban; Département de psychologie, faculté de philosophie et des sciences humaines, université Saint-Esprit de Kaslik, Jounieh, Liban
| | - F Kazour
- Hôpital psychiatrique de la Croix, BP 60096, Jal-Eddib, Liban; Département de psychiatrie, faculté de médecine, université Saint-Joseph, Beyrouth, Liban.
| | - G Kazour
- Hôpital psychiatrique de la Croix, BP 60096, Jal-Eddib, Liban; Département de psychologie, faculté des lettres-Section 2, université libanaise, Fanar, Liban
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Pin S, Spini D, Bodard J, Arwidson P. [Facilitators and barriers for older people to take part in fall prevention programs: A review of literature]. Rev Epidemiol Sante Publique 2015; 63:105-18. [PMID: 25840864 DOI: 10.1016/j.respe.2014.10.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 08/02/2014] [Accepted: 10/22/2014] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Falling is the leading cause of accidental death after 65. Fall prevention programs are effective, but they involve few seniors. This article reviewed the literature on facilitators and barriers to participate in such programs. METHODS A literature review was conducted to identify documents in English, German and French published between 1990 and May 2012. Medline database, PsychInfo, Psychological and behavioral sciences and Francis were systematically searched, as were the bibliographies and some journals of public health, gerontology and social sciences. Of 462 documents found, 19 were selected and analyzed. RESULTS Of the 19 articles selected, 12 were on qualitative studies and 7 on literature reviews. Among the barriers to participation in falls prevention programs, documents highlighted the perception of fall as an inevitable event, the inadequate timing of prevention intervention and material difficulties. Conversely, being referred to prevention intervention by a professional, being convinced by the social benefits of interventions and the adequacy of interventions to the needs of beneficiaries were factors facilitating the participation and compliance of the elderly. CONCLUSION This literature review identified three major issues to consider when implementing sustainable and acceptable fall prevention programs: choice of the referring agent, and social representations of falling.
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Samaké BM, Mangané SM, Togola M, Mangané M, Diani N, Diallo A. [Reasons for admission of elderly people in reanimation in the Gabriel Touré teaching hospital of Bamako]. Mali Med 2015; 30:25-27. [PMID: 29927154] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Reanimation consists of the taking care of patients of all ages presenting or likely to present one or more acute failures directly affecting their likelihood of survival. According to the Society of Reanimation of the French Languages in 2012, in the United States 50% of the patients admitted in reanimation have more than 65 years whereas in France, the patients older than 80 years represent more than 10% of the admissions of the intensive care units. OBJECTIVE To determine the reasons for admission of the elderly patients in reanimation of the Gabriel Touré teaching hospital. PATIENTS AND METHOD A cross-sectional study was conducted from October 2010 to September 2011 in the Gabriel Touré teaching hospital of Bamako. Patients aged 65 year old and up were included. All patients were the subject of a meticulous clinical examination. Data graphing was done using Excel. The analysis of the data was made on the SPSS 17.0 software. The statistical test used was Chi2 with a significance fixed to P = 0, 05. RESULTS During the period of study, the data of 95 elderly people was collected for 501 admissions (18.9%); the 65 to 74 years old age bracket represented 63.3% (figure 1). The sex-ratio was 1.4 in favour of men. Mental deterioration was the principal cause for admission in 65.3% of the cases. Cerebral vascular accidents were the most encountered pathology with 40.7% of cases. The most common noted prognosis was the likelihood of intervention complications. CONCLUSION The most common admission factors were mental deterioration, respiratory distress syndrome. The prognosis is conservative considering the patients' old age, medical pathology, and a Glasgow score inferior to 8 at the time of admission.
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Affiliation(s)
- B M Samaké
- Service anesthésie réanimation C.H.U. Gabriel Touré
| | - S M Mangané
- Service anesthésie réanimation C.H.U. Gabriel Touré
| | - M Togola
- Service anesthésie réanimation C.H.U. Gabriel Touré
| | - M Mangané
- Service anesthésie réanimation C.H.U. Gabriel Touré
| | - N Diani
- Service anesthésie réanimation Hôpital du Mali
| | - A Diallo
- Service anesthésie réanimation C.H.U. Gabriel Touré
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Melancon MO, Lorrain D, Dionne IJ. Exercise and sleep in aging: emphasis on serotonin. ACTA ACUST UNITED AC 2014; 62:276-83. [PMID: 25104243 DOI: 10.1016/j.patbio.2014.07.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 07/09/2014] [Indexed: 11/23/2022]
Abstract
Reductions in central serotonin activity with aging might be involved in sleep-related disorders in later life. Although the beneficial effects of aerobic exercise on sleep are not new, sleep represents a complex recurring state of unconsciousness involving many lines of transmitters which remains only partly clear despite intense ongoing research. It is known that serotonin released into diencephalon and cerebrum might play a key inhibitory role to help promote sleep, likely through an active inhibition of supraspinal neural networks. Several lines of evidence support the stimulatory effects of exercise on higher serotonergic pathways. Hence, exercise has proved to elicit acute elevations in forebrain serotonin concentrations, an effect that waned upon cessation of exercise. While adequate exercise training might lead to adaptations in higher serotonergic networks (desensitization of forebrain receptors), excessive training has been linked to serious brain serotonergic maladaptations accompanied by insomnia. Dietary supplementation of tryptophan (the only serotonin precursor) is known to stimulate serotonergic activity and promote sleep, whereas acute tryptophan depletion causes deleterious effects on sleep. Regarding sleep-wake regulation, exercise has proved to accelerate resynchronization of the biological clock to new light-dark cycles following imposition of phase shifts in laboratory animals. Noteworthy, the effect of increased serotonergic transmission on wake state appears to be biphasic, i.e. promote wake and thereafter drowsiness. Therefore, it might be possible that acute aerobic exercise would act on sleep by increasing activity of ascending brain serotonergic projections, though additional work is warranted to better understand the implication of serotonin in the exercise-sleep axis.
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Berthé A, Berthé-Sanou L, Konaté B, Hien H, Tou F, Somda S, Bamba I, Drabo M, Badini-Kinda F, Macq J. [The unmet needs of the elderly living with functional disabilities in Bobo-Dioulasso (Burkina Faso)]. Rev Epidemiol Sante Publique 2013; 61:531-7. [PMID: 24206905 DOI: 10.1016/j.respe.2013.07.682] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 01/30/2013] [Revised: 04/03/2013] [Accepted: 07/24/2013] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND In sub-Sahara Africa, the strong involvement of the family in multidimensional cares/supports of elderly is often presented like the family ensures almost everything to these people. Thus, few studies have focused on unmet needs of the elderly in their family or above. This study was conducted in Bobo-Dioulasso to identify those needs. METHODS This is a longitudinal study including 58 people or 15 elderly and 43 caregivers from 15 families in Bobo-Dioulasso. In addition to regular observations of these families during 1 year, we conducted in-depth individual interview with each participant at the beginning and at the end of the study. The data were analyzed using QSR NVivo 8 software. RESULTS A priori, respondents let believe that there is no unmet functional needs of the elderly in their family. However, the food, the first and main functional need of the elderly is not qualitatively satisfied by their family as well as other equipments or health needs. The quality of social cares/supports, biomedical cares and community supports are insufficient when these cares/supports are provided. The family demands many free or subsidized services to public or community structures then they are not currently available. DISCUSSION In a context of widespread poverty, it is difficult for each actor of the social system of maintaining elderly in functional autonomy to provide services/supports of optimal quality. A synergy of action will reduce the unmet needs of the elderly in Bobo-Dioulasso.
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Affiliation(s)
- A Berthé
- Centre Muraz, 01 BP 390, Bobo-Dioulasso 01, Burkina Faso; Institut de recherche santé et société, université catholique de Louvain (UCL), 30, clos Chapelle aux Champs (B-3013), 1200 Bruxelles, Belgique; Association Burkinabé de santé publique (ABSP), 01 BP 3718, Ouagadougou 01, Burkina Faso.
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