[Behavioral and psychological symptoms in dementia: description and management]. / Les symptômes psychologiques et comportementaux de la démence: description et prise en charge.

Behavioral and Psychological Symptoms in Dementia (BPSD) are, beside cognitive disorders, major features of Alzheimer's disease and related disorders. Diagnosis is important to enhance our knowledge of the pathophysiology of dementia and of their functional consequences for patients and caregivers. Pharmacological and non-pharmacological management of dementia depends to a large extent on the presence of BPSD. A committee of geriatricians, neurologists and psychiatrists specialized in dementia (THEMA 2) has promoted an epidemiological, diagnostic and therapeutic update in this field. This work was based on the BPSD Consensus Conference Report edited in 2000 by the International Psychogeriatric Association. This report was updated with the most recent literature reports, and was adapted to the French environment. This paper is a synthesis of this meeting, validated and corrected by the entire Thema 2 group.

Growth hormone therapy in elderly people: an age-delaying drug?

The aims of this review are to present a brief overview of growth hormone (GH) physiology and to summarize the studies of GH treatment in adults. Special attention has been paid to randomized controlled trials. Studies have revealed a partial deficiency of GH secretion in the elderly. GH secretion on the average declines by 14% with each decade in normal adults after 20 years of age. Aging has a central effect on the GH secretion and peripheric effect on insulin-like growth factor 1 (IGF-1) through changes in the body composition. GH administration may attenuate several important decrements in body composition and in function associated with aging. GH may also have very potent anabolic effects in surgical situations. Short-term side-effects of GH therapy include edema, carpal tunnel syndrome and arthralgia. A number of agents such as oral GH-releasing peptides (GHRPs) increase GH secretion; they may be an alternative to GH treatment in the future. Further studies of GH replacement are needed, examining issues such as dosage, tolerance and efficacy before the widespread use of GH in the elderly is advocated.

[Growth hormone in adults. An elixir of youth?]. / L'hormone de croissance chez l'adulte. Un élixir de jouvence?

Studies have revealed a partial deficiency of growth hormone (GH) secretion in the elderly. Aging has a central effect on the GH secretion and probably a peripheral effect on insulin-like growth factor 1 (IGF-1) or somatomedin C through changes in body composition. Simultaneously therapeutic efficiency of recombinant GH was confirmed in adults with GH deficiency. These notions have led to some controlled trials of GH treatment in elderly. Further studies of GH replacement are needed, examining issues such as dosage, tolerance (still inadequate) and efficacy before the widespread use of GH or IGH-F 1 in the elderly is advocated.