'Selected' Exosomes from Sera of Elderly Severe Obstructive Sleep Apnea Patients and Their Impact on Blood-Brain Barrier Function: A Preliminary Report.

Obstructive sleep apnea syndrome (OSAS) affects a large part of the aging population. It is characterized by chronic intermittent hypoxia and associated with neurocognitive dysfunction. One hypothesis is that the blood-brain barrier (BBB) functions could be altered by exosomes. Exosomes are nanovesicles found in biological fluids. Through the study of exosomes and their content in tau and amyloid beta (Aß), the aim of this study was to show how exosomes could be used as biomarkers of OSAS and of their cognitive disorders. Two groups of 15 volunteers from the PROOF cohort were selected: severe apnea (AHI > 30) and control (AHI < 5). After exosome isolation from blood serum, we characterized and quantified them (CD81, CD9, CD63) by western blot and ELISAs and put them 5 h in contact with an in vitro BBB model. The apparent permeability of the BBB was measured using sodium-fluorescein and TEER. Cell ELISAs were performed on tight junctions (ZO-1, claudin-5, occludin). The amount of tau and Aß proteins found in the exosomes was quantified using ELISAs. Compared to controls, OSAS patients had a greater quantity of exosomes, tau, and Aß proteins in their blood sera, which induced an increase in BBB permeability in the model and was reflected by a loss of tight junction' expression. Elderly patients suffering severe OSAS released more exosomes in serum from the brain compartment than controls. Such exosomes increased BBB permeability. The impact of such alterations on the risk of developing cognitive dysfunction and/or neurodegenerative diseases is questioned.

Decreasing hospitalizations through geriatric hotlines: a prospective French multicenter study of people aged 75 and above.

BACKGROUND: The Emergency unit of the hospital (Department) (ED) is the fastest and most common way for most French general practitioners (GPs) to respond to the complexity of managing older adults patients with multiple chronic diseases. In 2013, French regional health authorities proposed to set up telephone hotlines to promote interactions between GP clinics and hospitals. The main objective of our study was to analyze whether the hotlines and solutions proposed by the responding geriatrician reduced the number of hospital admissions, and more specifically the number of emergency room admissions. METHODS: We conducted a multicenter observational study from April 2018 to April 2020 at seven French investigative sites. A questionnaire was completed by all hotline physicians after each call. RESULTS: The study population consisted of 4,137 individuals who met the inclusion and exclusion criteria. Of the 4,137 phone calls received by the participants, 64.2% (n = 2 657) were requests for advice, and 35.8% (n = 1,480) were requests for emergency hospitalization. Of the 1,480 phone calls for emergency hospitalization, 285 calls resulted in hospital admission in the emergency room (19.3%), and 658 calls in the geriatric short stay (44.5%). Of the 2,657 calls for advice/consultation/delayed hospitalization, 9.7% were also duplicated by emergency hospital admission. CONCLUSION: This study revealed the value of hotlines in guiding the care of older adults. The results showed the potential effectiveness of hotlines in preventing unnecessary hospital admissions or in identifying cases requiring hospital admission in the emergency room. Hotlines can help improve the care pathway for older adults and pave the way for future progress. TRIAL REGISTRATION: Registered under Clinical Trial Number NCT03959475. This study was approved and peer-reviewed by the Ethics Committee for the Protection of Persons of Sud Est V of Grenoble University Hospital Center (registered under 18-CETA-01 No.ID RCB 2018-A00609-46).

Musculoskeletal pains among amateur and professional athletes of five disciplines in Senegal: a preliminary study.

BACKGROUND: Musculoskeletal pains (MSPs) in sport are cause of poor performances and loss of competition in athletes. The present study aimed at determining the prevalence of MSPs with regard to sport disciplines and athletic status. METHODS: A cross-sectional study was conducted among 320 Senegalese professional and amateur athletes practicing football, basketball, rugby, tennis, athletics, and wrestling. Rates of MSPs in the past year (MSPs-12) and week (MSPs-7d) were assessed using standard questionnaires. RESULTS: Overall proportions of MSPs-12 and MSPs-7d were 70 and 74.2%, respectively. MSPs-12 were more frequently reported on shoulders (40.6%), neck (37.1%) and hips/thigh (34.4%), while MSPs-7d were predominant on hips/thigh (29.5%), shoulders (25.7%), and upper back (17.2%). Proportions of MSPs-12 and MSPs-7d varied significantly by sport disciplines, with highest values among basketball players. Again, highest MSPs-12 proportions on shoulders (29.7%, P = 0.02), wrists/hands (34.6%, P = 0.001), (40.2%, P = 0.0002), and knees (38.8%, P = 0.002) were seen among basketball players. High proportions of MSPs-7d were seen on shoulders (29.6%, P = 0.04) for tennis players, wrists/hands (29.4%, P = 0.03) for basketball and football players, and hips/thigh (38.8%, P < 0.00001) for basketball players. Football players had reduced risk of MSPs-12 by 75% on lower back (OR = 0.25; 95% CI. 0.10-0.63; P = 0.003) and by 72% on knees (OR = 0.28; 95% CI. 0.08-0. 95; P = 0.04). In contrast, tennis players were more at risk of MSPs-12 on shoulders (OR = 3.14; 95% CI. 1.14-8.68; P = 0.02), wrists/hands (OR = 5.18; 95% CI.1.40-11.13; P = 0.01), and hips/thigh (OR = 2.90; 95% CI. 1.1-8.38; P = 0.04). Professionals were protected from MSPs-12 on neck pain with a significant reduction of risk by 61% (OR = 0.39, 95% CI. 0.21-0.75, P = 0.03). CONCLUSION: MSPs are a reality among athletes and their risk is modulated by sport disciplines, athletic status and gender.

Prospective associations between subjective age and fear of falling in older adults.

OBJECTIVE: Subjective age has been implicated in a range of health outcomes but its associations with Fear of Falling (FoF) are unknown. The present study examined the relation between subjective age and FoF in large national sample. METHODS: Participants were drawn from the National Health and Aging Trends Study (NHATS, 2011-2017). 1,679 participants provided data on FoF, subjective age, demographic factors, depressive symptoms, prior falls, self-rated health and measures of the Short Physical Performance Battery. FoF was assessed again 7 years later. RESULTS: Regression analyses revealed that an older subjective age was related to a 24% higher likelihood to develop FoF 7 years later. This association was independent of age, sex, educational attainment, race and prior falls. In addition, depressive symptoms, self-rated health, and physical inactivity mediated the associations between subjective age and FoF. CONCLUSIONS: The present study showed that an older subjective age is related to the development of FoF over time, and further identified psychological and functional pathways that may explain this association. These results confirm the role of subjective age on one of the markers of frailty in the aging population.

[Compliance with recommendations during a stay in follow-up and rehabilitation care in the elderly, comparison of three intervention strategies]. / SSR, observance des recommandations : trois stratégies d'intervention.

The objective of this study was to compare three hierarchical intervention strategies of an educational program for the prevention of falls in elderly people in a follow-up and rehabilitation care facility, and to evaluate the compliance with the recommendations related to extrinsic risk factors for falls, behavioral and environmental.

Social marketing interventions to promote physical activity among 60 years and older: a systematic review of the literature.

BACKGROUND: Falls are a significant source of morbidity in people aged 65 and over, affecting one in three people in this age group. The scientific evidence indicates that physical activity is the most effective method for preventing falls among seniors. Although public health professionals often use social marketing to design and plan successful interventions, its use to promote physical activity and prevent falls among older people remains low. This article aims to provide a new systematic literature review of social marketing interventions promoting physical activity and targeting people aged 60 and over. METHODS: Following CRD's guidance and PRISMA guidelines, we searched between January 2008 and July 2019 for relevant articles in five primary databases using predefined search and inclusion criteria. Two independent reviewers analysed the selected articles to identify evidence of the seven social marketing benchmark criteria, defined by experts in the field as the common elements that contribute to social marketing success. RESULTS: The final review included nine studies. Of the studies selected, three specifically targeted over 60-year-olds, whereas the others segmented the population into several age-based subcategories, including over 60-year-olds. Eight studies highlighted positive results for the participants with an increase in participation or an increase in physical activity level. None of the nine studies selected for this systematic review implemented the entire social marketing approach. CONCLUSION: Few published interventions use the seven social marketing criteria. Further research is required to encourage uptake and inclusion in successful social marketing interventions to increase program effectiveness in this target population.

Correction to: Social marketing interventions to promote physical activity among 60 years and older: a systematic review of the literature.

An amendment to this paper has been published and can be accessed via the original article.

[How to get involved into physical activity, to learn how to manage with one's disease: example of two patients' experiences]. / S'engager dans une activité physique pour apprendre à gérer sa maladie : l'exemple de deux expériences de patients.

In both cases, although progressive co-construction of a new relationship to the body and "others" was observed as a result of physical activity, the interactions between all partners in the "trajectory" demonstrate a time aspect to involvement in "the physical activity career", that is specific to each patient..

The desire of autonomy: A lever for vaccination of the elderly? Results of a qualitative study.

The COVID-19 pandemic has highlighted the challenges of vaccination and the infectious risks among the elderlies. However, immunization rates for recommended vaccines in this population are insufficient in France. We aimed in this study to identify the levers and obstacles to vaccination among seniors, and to establish the arguments that could lead to some new vaccination behaviors. A qualitative survey based on 14 semi-structured interviews was conducted with people aged 65 and over, living at home in the Auvergne Rhône-Alpes region (France) from March to May 2022. The interviews were recorded, entirely transcribed, then subjected to a thematic content analysis. The results show that participants are keen to preserve their health by maintaining their physical capacity, taking regular exercise and eating a balanced diet. However, vaccination was not mentioned as a mean of preventing infectious diseases. Infections were not perceived as a cause for concern. Furthermore, the physical and cognitive consequences of infectious diseases, which could result in a loss of autonomy, were not known. These elements could be a good lever to bring hesitant elderly people to reconsider their position toward vaccination. Vaccines were not seen as a strategy to prevent loss of autonomy among elderlies. Since vaccines against influenza, COVID-19, shingles, pneumococcus have proved to be effective in protecting against cardiovascular events, this argument might be the starting point for a prevention campaign for the elderly.

The shifts in intergenerational relations in Cameroon and their potential impact on the health of older adults.

INTRODUCTION: Africa is experiencing a gradual demographic shift due to rising life expectancy and increasing urbanisation. In sub-Saharan Africa, elderly individuals typically reside with their children. The rise in life expectancy by almost a decade and the prevalence of precarious living conditions raise concerns about the sustainability of the healthcare system, which has traditionally relied on intergenerational solidarity. METHODS: The research aims to analyse the evolving role of older adults in Cameroonian society and to examine the potential impact of this change on intergenerational relationships and the health of older adults. A qualitative methodology was employed, using intergenerational focus groups in Cameroon. RESULTS: Traditionally, older adults held a central role in knowledge transmission through discourse. However, the modernisation of society is challenging this position.The emergence of new technologies, particularly communication tools, is leading to a questioning of older adults' experiential knowledge. Societal changes are contributing to a decline in respect for older adults in discourse. Older adults deplore these societal changes and fear for their place in society while young people are questioning the central role of older people in society. DISCUSSION: These changes could reduce the sense of usefulness of older people, with negative consequences for their health. Several studies have highlighted the impacts of ageism on the health of older adults in industrialised countries. However, there are little data on the impact of the marginalisation of older adults on their health in industrialising societies. Further research is needed to study the impact on the health of older adults.

Poor quality of sleep and musculoskeletal pains among highly trained and elite athletes in Senegal.

BACKGROUND: Previous studies reported that poor sleep quality (PSQ) was associated with musculoskeletal pains (MSP) and poor physical performance in athletes. OBJECTIVE: The current study aimed at determining PSQ and its associations with MSP in some sub-Saharan athletes. METHODS: A cross sectional study was conducted among 205 highly trained and 115 elite athletes (aged: 25 ± 2 years, Body mass index: 22.8 ± 0.9 kg/m2) in Dakar, Senegal, during a competitive season in a variety of sport disciplines including athletics, basketball, football, rugby, wrestling, tennis. Quality of sleep and MSP were assessed using the French version Pittsburgh Sleep Quality Index (PSQI) and French version of Nordic questionnaire respectively. Pain on body joints during a week was defined as seven-day MSP (MSP-7d) and PSQ for a PSQI > 5. RESULTS: 27.8% (95%CI: 23.2-32.9) of the overall sample suffered PSQ, with 33.7% (95%CI: 24.7-44.0) in basketball and 24.7% (95%CI: 16.9-34.6) in football. According to athletic status and gender, PSQ was more prevalent among highly trained (66.3; 95%CI: 55.9-75.3) and men (69.7%; 95%CI: 59.5-78.7). Among athletes with PSQ 43.8% (95%CI: 33.9-54.2) suffered MSP-7d, with 36.6%; highly trained (95%CI: 23.7-42.9) and 28.1% female. Considering body region, hips/thigh (14.6%; 95% CI: 8.74-23.4) and upper back (13.5%; 95%CI: 7.88 -21, 1) were more affected. Basketball players were more affected from MSP (MSP-7d = 38.5%; 95%CI: 24. 9-54.1) on high on wrists/hands (MSP-7d = 44.4%; 95%CI: 18.9 -73.3; P = 0.04). Based on athletic status, MSP-7d were higher on highly trained necks (100%; 95%CI: 56.1-100; p = 0.04). PSQ was associated with basketball (OR: 3.062, 95%CI: 1.130-8.300, p = 0.02) compared to Athletic. PSQ and MSP-7d were associated on Wrist/hands (OR: 3.352, 95%CI: 1.235-9.099, p = 0.01), and at the upper back (OR: 5.820, 95%CI: 2.096-16.161, p = 0.0007). CONCLUSION: These results indicate that PSQ is considerable among Senegalese athletes and is associated with MSP during a week. Hence, we recommend to look for strategies optimizing good quality of sleep in order to reduce pains, to improve health.

[Effect of a fall prevention program on subjective age in older people]. / Effet d'un programme de prévention des chutes sur l'âge subjectif des personnes âgées.

OBJECTIVE: This study tested whether the subjective age tends to decrease after following a fall preventive program. This study also examines whether physical abilities and psychological resources at baseline are associated with this decrease in subjective age. Finally, this study tested to what extent the evolution of subjective age is concomitant with the evolution of these physical abilities and psychological resources between the beginning and the end of the program. METHOD: A sample of 42 individuals over 65 years (M = 71) took part in a program comprising 12 balance sessions. These people answered a questionnaire to assess subjective age and fear of falling, at the beginning and at the end of the program. Participants also completed Time Up and Go test, before and after the program. In addition, demographic factors, chronic diseases, subjective health, as well as depressive symptoms were assessed at baseline, and included as covariates in the analyses. RESULTS: Wilcoxon signed rank analyzes showed that participants felt younger after the intervention than before (W = 334; p < 0.05). Concretely, participants feeling younger from 6.43% at baseline to 9.63% at the end of the program. The multiple linear regression analyzes reveal that a more favorable perceived health as well as a better mobility function at baseline are associated with an increase of feeling younger at the end of the program. Finally, an improvement in functional mobility between the start and the end of the program is also associated with an increase of feeling younger. DISCUSSION: This study highlights the benefits of a fall prevention program on feeling younger for old people. In view of the benefits generated by feeling younger than one's chronological age, this study increases the interest of preventive actions to reduce the loss of functional independence in aging.

Impact of influenza, herpes zoster, and pneumococcal vaccinations on the incidence of cardiovascular events in subjects aged over 65 years: a systematic review.

This systematic review aims to summarize the impact of vaccination against influenza, shingles, and pneumococcus on the incidence on the risk of cardiovascular events in the elderly. This protocol was developed in accordance with PRISMA guidelines. We conducted a literature search and identified all relevant articles published regarding the matter up to September 2022. We retrieved 38 studies (influenza vaccine = 33, pneumococcal vaccine = 5, and zoster vaccine = 2). A total of 28 and 2 studies have shown that influenza and pneumococcal vaccines significantly lower the risk of cardiovascular disease in the elderly. Also, repeated influenza vaccination shows a consistent and dose-dependent protective effect against acute coronary syndromes and stroke. Moreover, dual influenza and pneumococcal vaccination was associated with lower risks of some cardiovascular events (stroke, congestive heart failure, ischemic heart disease, and myocardial infarction). However, the impact of PCV13 on cardiovascular events has not been studied, nor has the currently recommended vaccination schedule (PCV13 + PPV23). As for herpes zoster vaccination, only the protective effect against stroke has been studied with the live attenuated herpes zoster vaccine, but no studies have been conducted with the recombinant subunit herpes zoster vaccine. This review outlines the benefits of the vaccines mentioned above beyond their preventive action on infectious diseases. It is intended for health professionals who wish to inform and advise their elderly patients.

The Acti-Pair program helps men with prostate cancer increase physical activity with peer support: a mixed method pilot study.

Background: Although the health benefits of physical activity (PA) are recognized, prostate cancer patients do not follow PA recommendations. Barriers to PA, whether physical, environmental or organizational, are known. Furthermore, even when these barriers are overcome, this achievement is not systematically accompanied by lifestyle change. Many strategies have shown to be effective in increasing patient adherence to PA. This study aims to assess the feasibility and the viability of the Acti-Pair program which combines three strategies: peer support, a personalized and realistic PA project, and support from health and adapted physical activity professionals in a local context. Methods and analysis: We conducted a pilot study utilizing a mixed qualitative and quantitative methodology, employing feasibility and viability assessments. Quantitative assessments included recruitment, retention adherence rates, process and potential effectiveness (PA and motivation) indicators; while qualitative methods were used to evaluate the program's practicality, suitability and usefulness. Indicators of potential effectiveness were assessed before and after the intervention using a Wilcoxon test for matched data. Qualitative data were collected through semistructured interviews conducted by two researchers with various program stakeholders. The study lasted for 3 years. Results: Twenty-four patients were recruited over a 25-month period. Forty-two percent of patients completed the program 3 months after the beginning. We recruited 14 peers and trained nine peers over a 10-month period. The program was coordinated extensively by adapted PA professionals, while health professionals were involved in recruiting patients and peers. Self-reporting of moderate to vigorous PA was increased after the Acti-Pair program initiation [42.86 (30.76) at baseline to 53.29 (50.73)]. Intrinsic motivation significantly increased after participation in the Acti-Pair program [1.76 (1.32) before the intervention vs. 2.91 (1.13) after the intervention]. The key player to support the Acti-Pair program in the field has been the PA support system. The main challenge has been the difficulty of health professionals in promoting PA. Discussion: This pilot study has shown that the Acti-Pair program is feasible and viable. It will allow us to extend the peer support intervention to other contexts and assess the effectiveness of this intervention and its generalization.

Relationship between moderate-to-vigorous, light intensity physical activity and sedentary behavior in a prospective cohort of older French adults: a 18-year follow-up of mortality and cardiovascular events ─ the PROOF cohort study.

Background: It is well documented that moderate-to-vigorous intensity physical activity (MVPA) is effective in the prevention of major chronic diseases. Even though the current international physical activity (PA) guidelines still mainly focus on MVPA, the topic of the most recent epidemiological studies has shifted from MVPA to light intensity physical activity (LPA), owing to the necessity of promoting all activities vs. sedentary behavior (SB). However, the evidence remains currently limited. Thus, the clarification of the effects of LPA and the close relationship with SB is crucial to promote public health. Method: PA and SB were assessed by a validated self-administered questionnaire (POPAQ) investigating 5 different types of PA during the 7 previous days. PA was measured in metabolic equivalent of task (MET)-h, which refers to the amount of energy (calories) expended per hour of PA. SB was measured in hour/day. Medical histories and examinations were taken during each clinical visit to determine clinical events. All-cause mortality was established using the same procedure and by checking local death registries. The relationships between the intensity of PA (light, moderate to vigorous) and mortality and between the periods of SB and mortality or CV events were analyzed by splines and COX models, adjusted for sex and year of birth. Results: From the 1011 65-year-old subjects initially included in 2001 (60% women), the last 18-year follow-up has been currently completed since 2019. A total of 197 deaths (19.2%, including 77 CV deaths) and 195 CV events (19.3%) were reported. Averages (standard deviation) of MVPA, LPA and SB were, respectively, 1.2 h/d (0.3), 5.8 h/d (1.1), and 6.6 h/d (2.3). For all-cause deaths, as well as CV deaths, the splines were significant for LPA (p = 0.04 and p = 0.01), and MVPA (p < 0.001 and p < 0.001), but not for SB (p = 0.24 and p = 0.90). There was a significant reduction in CV events when SB was decreasing from 10.9 to 3.3 h/d. Conclusion: The PROOF cohort study shows a clear dose-response between the dose of LPA, MVPA, SB and risk of mortality. These findings provide additional evidence to support the inclusion of LPA in future PA guidelines.

Prevalence of metabolic syndrome and components in rural, semi-urban and urban areas in the littoral region in Cameroon: impact of physical activity.

BACKGROUND: Living areas in developing countries impact seriously lifestyle by modifying energy consumption and energy expenditure. Thus, urbanization is associated with less practice of physical activity (PA), a leading cause of metabolic syndrome (MetS) which prevalence vary in African countries. The present study aimed to assess the effect of PA on MetS according to urbanization level in the littoral region, Cameroon. METHODS: A cross-sectional study was conducted in three geographical settings (urban, semi-urban, and rural) in the littoral region in Cameroon. A total of 879 participants were included (urban: 372, semi-urban: 195 and rural: 312). MetS was defined according to the International Federation of Diabetes 2009. The level of PA was assessed using the Global Physical Activity questionnaire. RESULTS: Low level of PA was (P < 0.0001) reported in urban (54.5%), semi-urban (28.7%) and rural (16.9%) and high level in rural area (77.9%). The prevalence of MetS was higher in urban areas (37.2%), then rural (36.8%) and finally semi-urban (25.9%). Hyperglycemia (p = 0.0110), low HDL-c (p < 0.0001) and high triglyceridemia (p = 0.0068) were most prevalent in urban residents. Participants with low level of PA were at risk of MetS (OR: 1.751, 95% CI 1.335-2.731, p = 0.001), hyperglycemia (OR: 1.909, 95% CI 1.335-2.731, p = 0.0004) abdominal obesity(OR: 2.007, 95% CI 1.389-2.900, p = 0.0002), low HDL-c (OR: 1.539, 95% CI 1.088-2.179, p = 0.014) and those with moderate level of PA were protected against high blood pressure(OR: 0.452, 95% CI 0.298-0.686, p = 0.0002) and compared to those with high level of PA. Urban dwellers were at the risk of MetS compared to rural residents (OR: 1.708, 95% CI. 1.277-2.285, p = 0.003) and protected against high blood pressure (OR:0.314, 95% CI 0.212-0.466, p < 0.0001), abdominal obesity (OR: 0.570, 95% CI 0.409-0.794, p = 0.0009), and low HDL-c (OR: 0.725, 95% CI 0.534-0.983, p = 0.038) compared to rural residents. CONCLUSIONS: MetS was more prevalent in urban dwellers and was associated with a low level of PA.

What obstacles to nursing home for Dependent older adults' entry? Analysis of 186 situations resulting from an Inter-Establishment Resident Orientation Commission / Quels freins à l'entrée en Établissement d'hébergement pour personnes âgées dépendantes ? Analyse de 186 situations issues d'une Commission d'orientation des résidents inter-établissement

The decision to admit an older adult with loss of autonomy to an institution is complex. There are many obstacles to the decision to be referred to an institution and it partly explain long hospital stays and inadequate health care spending. Several of these obstacles have been identified in the literature (medical complexity, psycho-behavioural disorders, social vulnerability, etc.). This work is based on an experiment that aimed at coordinating the players during an "inter-hospital consultation meeting" dedicated to the decision to admit older patients who cannot find a solution immediately. This work aim to identify the obstacles to the referral of patients to HITH services. This is a single-centre descriptive study. It analyses prospective data collected between January 2017 and the end of June 2019. The average length of hospitalisation before leaving the institution is relatively homogeneous according to the different complexity criteria defined, except for heavy dependence and obesity, where in these situations there are longer average lengths of hospitalisation. The absence of complexity criteria is not necessarily associated with a shorter hospital stay. The commission makes it possible to create synergies between players in the same gerontological basin and facilitates the admission of complex cases to hospital.

La décision d'entrée en établissement d'un sujet âgé en perte d'autonomie est complexe. Les freins à la décision d'orientation en établissement expliquent en partie des durées d'hospitalisation longues et à l'origine de dépense de santé inadéquates. Plusieurs de ces freins ont été identifiés dans la littérature (complexité médicale, troubles psycho-comportementaux, vulnérabilité sociale…). À partir d'une expérimentation qui vise la coordination des acteurs lors d'une « réunion de concertation inter-établissement ¼ dédiée à la décision d'entrée de patients âgés ne trouvant pas de solution dans l'immédiat, l'objectif de ce travail est d'identifier les freins à l'orientation des patients en Ehpad. Il s'agit d'une étude descriptive mono-centrique analysant des données prospectives recueillies entre janvier 2017 et fin juin 2019. Les durées moyennes d'hospitalisation avant le départ en institution sont relativement homogènes en fonction des différents critères de complexité définis sauf pour la dépendance lourde et l'obésité où dans ces situations il existe des durées moyennes d'hospitalisation plus longues. L'absence de critère de complexité n'est pas obligatoirement associée à un raccourcissement du séjour hospitalier. La CORIE permet de créer des synergies entre les acteurs d'un même bassin gérontologique et facilite l'entrée en établissement des cas complexes.

Subjective Age and Falls in Older Age: Evidence From Two Longitudinal Cohorts.

OBJECTIVES: Falls are a common and serious health problem. The present study examined the association between subjective age (i.e., feeling younger or older than one's chronological age) and falls in 2 large national samples. METHOD: Participants aged 65-105 years old were drawn from the National Health and Aging Trends Study (NHATS) and the Health and Retirement Study (HRS). Data on falls, subjective age, and demographic factors were available from 2,382 participants in HRS and 3,449 in NHATS. Falls were tracked for up to 8 (HRS) and 7 (NHATS) years. RESULTS: Cox regression analyses that included demographic covariates indicated that older subjective age increased the risk of falling in HRS (hazard ratio [HR] = 1.17, 95% confidence interval [CI] = 1.08-1.27) and in NHATS (HR = 1.06, 95% CI = 1.00-1.13). When compared to people who felt younger, people who reported an older subjective age had a higher risk of fall (HRS: HR = 1.65, 95% CI = 1.33-2.04; NHATS: HR = 1.44, 95% CI = 1.15-1.79). The associations remained significant after accounting for depressive symptoms, handgrip strength, chronic diseases, and cognitive impairment in HRS only. DISCUSSION: These results confirm the role of subjective age as an important health marker in the aging population. Subjective age assessment can help identify individuals at greater risk of falls.

Therapeutic Fasting: Are Patients Aged 65 and Over Ready?

While being the main potential beneficiaries of therapeutic fasting's health benefits, the elderly are frequently thought of as being too fragile to fast. The main objective of our survey was to review the knowledge, practices, and acceptability of therapeutic fasting in subjects aged 65 years and over. From September 2020 to March 2021, an online questionnaire was sent to subjects aged 65 and over, using the mailing list of local organizations working in the field of aging. The mean age of the 290 respondents was 73.8 ± 6.5 years, 75.2% were women and 54.1% had higher education. Among the respondents, 51.7% had already fasted and 80.7% deemed therapeutic fasting interesting, 83.1% would be willing to fast if it was proven beneficial for their health, and 77.2% if it was proven to decrease the burden of chronic diseases. Subjects aged 65 to 74 years considered themselves as having the greatest physical and motivational abilities to perform therapeutic fasting. People aged 65 years, or more, are interested in therapeutic fasting and a large majority would be ready to fast if such practice was proven beneficial. These results pave the way for future clinical trials evaluating therapeutic fasting in elderly subjects.

COVID-19 Health Crisis Workloads and Screening for Psychological Impact in Nursing Home Staff: A Qualitative and Quantitative Survey.

Background: Nursing homes were particularly affected by the COVID-19 pandemic. The purpose of this study was to evaluate qualitatively and quantitatively with the use of a self-reported questionnaire as a tool for screening for mental disorders in nursing home staff. Methods: A multicenter epidemiological study was conducted in 12 nursing homes in France with 1117 nursing home staff eligible. Socio-demographic, occupational, and medical data were collected by anonymous self-reported questionnaire using validated scales to assess anxiety/depressive symptoms (HAD scale) and post-traumatic stress disorder (PCL-5). A total of 12 semi-structured interviews were conducted to assess acceptance and expectations for the use of the questionnaire. Results: The participation rate was 34.5%. Data from 373 questionnaires were included in the analysis. The questionnaire was well accepted by the participants and met their wishes for prevention action. The sample was 82% female. More than half reported a feeling of powerlessness and lack of time or staffing. The prevalence of anxiety symptoms was 22%, depressive symptoms 10%, and post-traumatic stress 7%. Conclusions: This study underlines the interest in screening for mental disorders by self-reported questionnaire and deploying preventive actions in the workplace to reduce stress and facilitate the reconciliation of family and working life in this context of the pandemic.