Translation and validation of the Dutch SarQoL®, a quality of life questionnaire specific to sarcopenia.

OBJECTIVES: To translate the Sarcopenia Quality of Life (SarQoL®) questionnaire into Dutch and to evaluate the psychometric properties of the Dutch version of this questionnaire. METHODS: The translation was carried out using a 5-step process, with 2 initial translations, a merging of these 2 translations, 2 backwards translations, an expert committee review and a pretest of the questionnaire. Sarcopenia was diagnosed with the EWGSOP algorithm. The validation consisted of an examination of the discriminative power, internal consistency, construct validity, test-retest reliability and floor and ceiling effects. RESULTS: No significant problems were encountered during the translation process. A total of 92 subjects were included in the validation part of this study, 30 of which were sarcopenic. Discriminative power between sarcopenic and non-sarcopenic subjects was found for all domains and the Overall score (median overall QoL score: 67.15 vs 79.72; p=0.003). High internal consistency was found (Cronbach's alpha=0.883), as well as good construct validity with 75% of hypotheses confirmed. Test-retest reliability was excellent (ICC=0.976; 95% CI=0.947-0.989) and no floor or ceiling effects were observed. CONCLUSION: The Dutch version of the SarQoL® questionnaire is ready for use in clinical and research applications.

A comprehensive grid to evaluate case management's expected effectiveness for community-dwelling frail older people: results from a multiple, embedded case study.

BACKGROUND: Case management is a type of intervention expected to improve the quality of care and therefore the quality of life of frail, community-dwelling older people while delaying institutionalisation in nursing homes. However, the heterogeneity, multidimensionality and complexity of these interventions make their evaluation by the means of classical approaches inadequate. Our objective was twofold: (i) to propose a tool allowing for the identification of the key components that explain the success of case management for this population and (ii) to propose a typology based on the results of this tool. METHODS: The process started with a multiple embedded case study design in order to identify the key components of case management. Based on the results of this first step, data were collected among 22 case management interventions, in order to evaluate their expected effectiveness. Finally, multiple correspondence analyses was conducted to propose a typology of case management. The overall approach was informed by Wagner's Chronic Care Model and the theory of complexity. RESULTS: The study identified a total of 23 interacting key components. Based on the clustering of response patterns of the 22 case management projects included in our study, three types of case management programmes were evidenced, situated on a continuum from a more "socially-oriented" type towards a more "clinically-oriented" type of case management. The type of feedback provided to the general practitioner about both the global geriatric assessment and the result of the intervention turned out to be the most discriminant component between the types. CONCLUSION: The study design allowed to produce a tool that can be used to distinguish between different types of case management interventions and further evaluate their effect on frail older people in terms of the delaying institutionalisation, functional and cognitive status, quality of life and societal costs.

[Role of "light therapy" among older adults with dementia: an overview and future perspectives]. / Place des « thérapies lumière ¼ auprès des personnes âgées souffrant de pathologie démentielle : état des lieux et perspectives futures.

Given the relatively modest therapeutic benefits of drug treatments (and their associated costs) in dementia, there is a growing interest in non pharmacological approaches, including light therapy (light based therapy, LBT). Although various literature reviews exist, little attention has been given to the effects of these therapies (according to their modalities of application) on parameters related to both circadian rhythm and clinical parameters associated with dementia. AIMS: To provide an overview of available studies using LBT as non-pharmacological approach for managing persons with dementia and to make recommendations for its use. METHOD: Systematic searches in Medline and PsycINFO were carried out, from their inception to February 2017, by means of the combination of key words including dementia and light therapy. RESULTS: Forty-two articles were reviewed with particular attention to the subjects' characteristics and the modalities of the therapy. The effect of LBT has been considered as a mean of intervention to entrain the circadian rhythm as well as in a clinical approach to reduce behavioral disorders, to reduce cognitive decline or loss of independence, and so on. Depending on the parameters and modalities, the effect of LBT is partially or non-significant. CONCLUSIONS: Based on this literature review, some recommendations were formulated: prioritizing 'naturalistic' devices, setting a minimum threshold of 2,000 lux light intensity peak, testing the modulation of the light intensity during the day and finally, assessing the adequacy between the type of light (color) and the desired therapeutic objective (relaxing or stimulating effect).

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.

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.