COVID-19 as an Independent Risk Factor for Weight Loss in Older Adults Living in Nursing Homes.

INTRODUCTION: In nursing homes, where residents are at elevated risk for malnutrition, the specific additive effect of the coronavirus disease 2019 (COVID-19) on weight loss has not yet been adequately evaluated. This study aimed to determine the factors independently associated with weight loss in nursing home residents who survived the first wave of the COVID-19 pandemic, whether they have contracted COVID-19 or not. METHODS: This research was a retrospective study conducted in three nursing homes. Residents who survived the first French COVID-19 lockdown (March to May 2020) were included, provided their weight records were available. Baseline data included the body mass index (BMI), capacity to self-feed, need for texture-modified food, disability, and legal guardianship status. The diagnosis of COVID-19 was based on the results of a positive reverse transcriptase-polymerase chain reaction test. Univariate and multivariate logistic regression analyses were used to investigate associations between resident characteristics, COVID-19 status, and at least 5% weight loss. RESULTS: Of the 316 included residents (72% female, mean age of 88 years, 48% severely disabled, and 38% under legal guardianship), 111 (35%) contracted COVID-19 and 102 (32%) lost at least 5% of their body weight. No difference was observed between the baseline characteristics of residents subsequently affected or unaffected by COVID-19. In the univariate analysis, old age, severe disability, texture-modified food, the need for close mealtime supervision, and COVID-19 were significantly associated with at least 5% weight loss. In the multivariate logistic regression analysis, COVID-19 (p = 0.02) and the need for close mealtime supervision (p = 0.02) were associated with weight loss in a model that also included age, BMI, texture-modified food, disability, and nursing home. CONCLUSION: For nursing home residents, COVID-19 was an independent risk factor for weight loss. Weight loss was most common in residents needing close mealtime supervision, suggesting that organizational issues may have affected the quality of the nutritional care provided during the lockdown.

Tinetti balance performance is associated with mortality in older adults with late-onset Parkinson's disease: a longitudinal study.

BACKGROUND: Parkinson's disease (PD) is associated with a 3-fold mortality risk, which is closely related to advancing age. Evidence is lacking regarding the factors associated with the risks of mortality or nursing-home (NH) admission, in elderly patients with PD. We aimed at identifying the clinical characteristics associated with these outcomes, in older community-dwelling patients with late-onset PD. METHODS: Retrospective, observational analysis of data from geriatric day hospital patients. Motor assessment included Unified Parkinson Disease Rating Scale (UPDRS) part III score, Tinetti Performance Oriented Mobility Assessment (POMA) balance and gait tests, and gait speed. Levodopa equivalent dose, comorbidity, cognitive performance, Activities of Daily Living performance were examined. Cox proportional hazards models were performed to identify the factors associated with mortality and NH admission rate (maximum follow-up time = 5 years). RESULTS: We included 98 patients, mean age 79.4 (SD = 5.3) of whom 18 (18.3%) died and 19 (19.4%) were admitted into NH, over a median follow-up of 4 years. In multivariate Cox models, poor balance on the Tinetti POMA scale (HR = 0.82 95%CI (0.66-0.96), p = .023) and older age (HR = 1.12 95%CI (1.01-1.25), p = .044) were the only variables significantly associated with increased mortality risk. A Tinetti balance score below 11/16 was associated with a 6.7 hazard for mortality (p = .006). No specific factor was associated with NH admissions. CONCLUSIONS: Age and the Tinetti POMA score were the only factors independently associated with mortality. The Tinetti POMA scale should be considered for balance assessment and as a screening tool for the most at-risk individuals, in this population.

Impact of a public open-access community-based physical activity and fall prevention program on physical performance in older adults.

BACKGROUND: In older adults, physical activity (PA) is important in maintaining physical performance. Data on the effectiveness of public open-access community-based programs on physical performance and fall prevention are scarce. METHODS: Prospective observational controlled study in community centers providing an open-access public prevention program. Retirees aged ≥60 years who chose to participate in weekly PA workshops for 3 months were compared to those who chose the cognitive stimulation (CS) workshops. Collected data: handgrip strength, five times sit-to-stand, single-leg stance, Timed Up and Go tests, gait speed, short physical performance battery (SPPB) and frailty status at baseline (M0) and at 3 months (M3). The proportion of participants reporting a history of falls was assessed at baseline and using follow-up telephone interviews (F-Up). RESULTS: Two hundred eighty-eight participants (age 73.8 years, 87% women) were included. The sit-to-stand test, single-leg stance and SPPB scores improved significantly between M0 and M3 in both groups. A greater SPPB increase was observed in the PA than in the CS group (+0.39 vs. +0.32 points, P = 0.02) after adjustment for age, sex, number of sessions attended, fall history and SPPB at baseline. During F-Up (median 22 months), the proportion of participants reporting at least one fall decreased from 55% to 31% (P = 0.01) in the PA group and from 27% to 19% (P = 0.12) in the CS group. CONCLUSION: In a public open-access community-based program participants improved physical performance and reduced fall incidence when participating in the PA or the CS workshops. Older adults may benefit most from multifaceted prevention programs.

[Assessment and impairment of cognitive functions]. / Évaluation et atteintes des fonctions cognitives.

Cognitive functions enable us to receive, select, store, transform, process and retrieve the information we receive from the outside world. These functions are controlled by different brain structures that interact with each other, enabling us to interact with and understand the world around us. In the course of aging or the onset of neurocognitive diseases, these functions may be impaired to a greater or lesser extent, giving rise to a considerable variety of neurocognitive impairment profiles. When a patient appears to be suffering from neurocognitive disorders, a thorough neuropsychological evaluation can help to characterize this impairment precisely, before guiding therapeutic management. It also contributes significantly to the etiological diagnosis of the disorder.

Older medical outliers on surgical wards: impact on 6-month outcomes.

BACKGROUND: Medical patients are on occasion admitted transiently to surgical wards when more appropriate wards are at capacity, potentially leading to suboptimal care. The aim of this study was to compare 6-month outcomes in older adults diagnosed with medical conditions in the ED then admitted inappropriately to surgical wards (defined as outliers), with outcomes in comparable patients admitted to medical wards (controls). METHODS: In a matched cohort study, 100 consecutive medical outliers from the ED aged 75 years and over were matched according to age, sex and diagnosis to 200 controls. Collected data included number of diagnoses reported in acute care, level of patient illness severity, length of stay, mortality and destination of patients discharged from acute care units (home, rehabilitation facility, nursing home or palliative care facility). An assessment was made of patient vital status and living environment (home, nursing home or hospital) at 6 months post-ED admission. RESULTS: Mean age was 85.6 years. The most common ED diagnoses were gait disorders/falls (18%), neurological disorders (17%) and exhaustion (16%). Outliers displayed lower illness severity levels (0.001) and shorter lengths of stay from ED admission to acute care discharge (p=0.040). Subsequent to acute care, outliers were less commonly discharged home (45% vs 59%) and more commonly discharged to rehabilitation facilities (42% vs 28%). At 6 months post-ED admission, multivariable regression analysis showed that outlier status (OR=0.44 (0.25-0.83); p=0.011) and numbers of diagnoses reported in acute care (OR=0.87 (0.76-0.98); p=0.028) were independently associated with lower probability of living at home. CONCLUSION: Outlying of older patients to surgical wards negatively affects their prospects of living at home at 6 months after hospital admission. Older patients hospitalised via the ED are entitled to appropriate medical care.

[Lipid pneumonitis, a serious iatrogenic event with lubricating laxatives]. / La pneumopathie lipidique, un accident iatrogène grave aux laxatifs lubrifiants.

The prescription of lubricating laxatives (paraffin oil) is widespread in geriatrics because of the frequency of constipation. These molecules can cause serious adverse effects such as lipoid pneumonia, especially in subjects with swallowing disorders.

A curable pseudo-dementia related to an atypical presentation of giant cell arteritis.

A 70-year-old patient was admitted with rapidly progressive cognitive decline associated with limitations in activities of daily living, weight loss and cerebellar ataxia. The diagnosis of giant cell arteritis (GCA) with vascular involvement was made, based on the presence of a metabolically active vasculitis of the brachiocephalic trunk on 18FDG-PET imaging. Temporal artery biopsy also revealed pan-arteritis. A progressive regression of cognitive disorders occurred under corticosteroid treatment and immunosuppressive therapy. Previously published case reports concerning this atypical presentation of GCA are scarce. They suggest that numerous cognitive symptoms, such as impairment of short-term memory, disorientation, delirium, impaired attention or visual hallucinations might be related to GCA. Thus, this diagnosis should be considered as a curable cause of unexplained cognitive impairment associated with weight loss and systemic inflammation.

[What is the place of a geriatric follow-up ambulatory care unit in the structures developed by the 2008/2012 Alzheimer Plan?]. / Quelle est la place d’un hôpital de jour de suivi gériatrique au sein des structures développées par le Plan Alzheimer 2008/2012'.

UNLABELLED: The French 2008/2012 Alzheimer Plan is designed to improve the support given to elderly patients and their families. Objective: To describe the typology of the patients managed in a Geriatric multidimensional rehabilitation ambulatory care unit between 2008 and 2012. METHODS: Programme de médicalisation des systèmes d'information database concerning the number of concomitant diseases and several specific indicators. RESULTS: The number of patients increased between 2008 (109) and 2009 (293) but then remained stable (about 300). The differences between 2008 and subsequent years were statically significant for the number of concomitant diseases (p < 0.001) and the number of days/patients (p < 0.01), but not for 2009-2012. CONCLUSION: The variations seem to be related to implementation of the Alzheimer Plan and a change in the organization of French gerontology health networks.

Citrulline Supplementation Induces Changes in Body Composition and Limits Age-Related Metabolic Changes in Healthy Male Rats.

BACKGROUND: Aging is associated with profound metabolic disturbances, and citrulline may be of use to limit them. OBJECTIVE: The aim of this work was to evaluate the long-term effect of citrulline supplementation on metabolism in healthy aged rats. METHODS: Twenty-month-old male rats were randomly assigned to be fed (ad libitum) for 12 wk with either a citrulline-enriched diet (1 g ⋅ kg(-1) ⋅ d(-1)) or a standard diet [rendered isonitrogenous by addition of nonessential amino acids (NEAAs)]. Motor activity and muscle strength were measured, body composition was assessed, and muscle metabolism (protein structure, mitochondrial exploration, and transductional factors) and lipid metabolism (lipoprotein composition and sensitivity to oxidative stress) were explored. RESULTS: Compared with the NEAA-treated group, citrulline supplementation was associated with lower mortality (0% vs. 20%; P = 0.05), 9% higher lean body mass (P < 0.05), and 13% lower fat mass (P < 0.05). Compared with the NEAA-treated group, citrulline-treated rats had greater muscle mass (+14-48% depending on type of muscle; P < 0.05 for tibialis, gastrocnemius, and plantaris). Susceptibility to oxidation of lipoproteins, as measured by the maximal concentration of 7-ketocholesterol after copper-induced VLDL and LDL oxidation, was lower in citrulline-treated rats than in NEAA-treated rats (187 ± 8 µmol/L vs. 243 ± 7 µmol/L; P = 0.0005). CONCLUSIONS: Citrulline treatment in male aged rats favorably modulates body composition and protects against lipid oxidation and, thus, emerges as an interesting candidate to help prevent the aging process.

[The mobile geriatric team of Bretonneau Hospital and nursing home professionals]. / Évaluation du dispositif d'équipe mobile de gériatrie et Ehpad.

In the wake of an experimental project, external mobile geriatric teams have been working in nursing homes in order to train the nursing teams in caring for geriatric pathologies. The mobile teams also give diagnostic and therapeutic recommendations in order to direct where necessary these dependent elderly people, often with multiple pathologies, towards geriatric care.

Geriatric assessment and quality of life for 2 years in older patients with head and neck cancer.

Due to the location and toxicity of treatments, head and neck cancer (HNC) has a major impact on quality of life (QoL). Objective: to assess the effects of geriatric-assessment (GA)-driven interventions on QoL over 2 years in older adults with HNC.EGeSOR was a randomized study of HNC patients aged ≥65, receiving a pretreatment GA, a geriatric intervention and follow-up (intervention) or standard of care (control). The primary endpoint was QoL score using the European Organisation for Research and Treatment of Cancer's (EORTC QLQ-C30) and HNC (QLQ-HN35) QoL questionnaires over 24 months.In total, 475 patients were included (median age: 75.3; women: 31%; oral cancer: 44%). QoL scores improved over 24 months with various trajectories, without significant differences between the groups. A total of 74% of patients (interventional group) did not receive the complete intervention. Cancer characteristics, functional status, and risk of frailty were associated with change in the Global Health Status QoL score.There is a need to develop an alternative model of implementation such as patient-centered health-care pathways. TRIAL REGISTRATION: NCT02025062.

Clinical characteristics and outcomes of respiratory syncytial virus-associated ARF in immunocompetent patients: A seven-year experience at a tertiary hospital in France.

BACKGROUND: Respiratory syncytial virus (RSV) is widely recognized as a cause of acute respiratory failure in infants and immunocompromised patients. However, RSV can also contribute to acute respiratory failure in adults, particularly among the elderly population. The objective of this study was to analyze the clinical characteristics and outcomes of immunocompetent adults hospitalized for RSV infection. METHODS: This retrospective study included all immunocompetent adult patients consecutively admitted to a tertiary care hospital with RSV-related acute respiratory failure over a seven-year period (2016-2023). Diagnosis of RSV infection was made through nasal swabs or pulmonary samples, with multiplex reverse transcription polymerase chain reaction (RT-PCR). Patients were eligible for inclusion if they required supplemental oxygen therapy for at least 48 h. RESULTS: One hundred and four patients met the inclusion criteria. Median age [IQR] was 77 years [67-85]. Ninety-seven patients had at least one comorbidity (97/104, 93%). At the time of RSV diagnosis, 67 patients (67/104, 64%) experienced acute decompensation of a pre-existing chronic comorbidity. Antibiotics were started in 80% (77/104) of patients; however, only 16 patients had a confirmed diagnosis of bacterial superinfection. Twenty-six patients needed ventilatory support (26/104, 25%) and 21 were admitted to the intensive care unit (21/104, 20%). The median duration of oxygen therapy [IQR] was 6 days [3-9], while the median hospital length of stay [IQR] was 11 days [6-15]. The overall mortality rate within 1 month of hospital admission was 13% (14/104). The sole variables associated with one-month mortality were age and maximum oxygen flow during hospitalization. CONCLUSION: RSV-associated acute respiratory failure affected elderly individuals with multiple comorbidities and was associated with prolonged hospitalization and a high mortality rate.

[Evaluation of the perspectives and experiences regarding lumbar puncture in cognitively impaired older adults over 70, their relatives and the care teams]. / Évaluation des représentations et du vécu liés à la ponction lombaire chez des patients âgés de plus de 70 ans atteints de troubles cognitifs, leurs accompagnants et les équipes soignantes.

INTRODUCTION: Lumbar puncture (LP) is an essential diagnostic procedure, which raises major concerns in older adults. Some patients may be denied LP because of the fear of complications in healthcare teams which are not familiar with the procedure. The objectives of our work were to analyze the perspectives and the experiences regarding scheduled LP in cognitively impaired older adults, as well as in their relatives, and the healthcare teams from geriatric day hospitals. METHODS: We conducted a qualitative, observational and multicentric study, based on semi-directive interviews of patients aged over 70 years with cognitive complaints undergoing a scheduled LP in a day hospital. Patients were interviewed before and after LP. Their relatives and the involved healthcare teams were also interviewed to analyze their expectations and perspectives regarding the procedure. The full interviews were transcribed and analyzed using interpretative phenomenological analysis. RESULTS: Ten patients (mean age 80.2 ± 7.2), five relatives and four healthcare teams were included. The goals and operating procedure of LP were poorly understood by several patients. Some individuals feared irreversible neurological consequences or LP-related pain, which was often overestimated with regards to the post-LP interviews. The patients' major expectation was to establish an accurate and early diagnosis of their cognitive disorder to provide optimal care plan. Relatives reported similar fears of major adverse events. They also expected an accurate diagnosis with biomarkers. The perspectives and experiences of the healthcare teams were heterogeneous, according to their level of practice of LP, but seemed in line with current scientific guidelines. CONCLUSION: This study highlighted the existence of false beliefs and poor knowledge regarding the LP procedure and its associated risks. The post-LP patients' feedbacks were better than their expectations, especially in day hospitals with solid experience in LP. Better patient information may be a key to improve our practice.

Four-week administration of an energy and protein dense oral nutritional supplement improves micronutrient concentrations but does not completely correct deficiencies in institutionalized malnourished older adults.

Introduction: Poor food intake is common among elderly living in nursing homes, leading to micronutrient deficiency (MD). There are no recommendations for the management of MD in malnourished older adults. Methods: We conducted a single arm, open-label, multicenter interventional study in institutionalized malnourished older adults to describe the effect of a 4-week daily energy and protein dense oral nutritional supplementation (ONS, 600 kcal, 30 g protein per unit) containing 50% of the recommended daily micronutrient intake on micronutrient status. Plasma concentrations of vitamins (A, B9, B12, C, E), magnesium (Mg), selenium (Se) and zinc (Zn), and erythrocyte vitamin B9 were measured at baseline and after 4 weeks. Results: Forty-six participants completed the study (age 87.4 ± 6.6). At baseline, the most frequent MD were Se (48%), Zn (35%), Mg (24%) and vitamin C (24%). Plasma concentrations of vitamins B9, B12, C and E, Mg, Se and Zn significantly increased and the proportion of subjects with at least one MD decreased (p = 0.006). However, after 4 weeks, 40% of subjects still had at least one MD. Discussion: ONS consumption improved micronutrient status but did not correct MD in all participants. Our data suggest that the prescription of vitamin, mineral and trace element supplementation should be considered in institutionalized malnourished older adults in addition to high energy and high protein ONS.

Fruit and vegetable intake in older hospitalized patients.

PURPOSE OF REVIEW: Regular intake of fruit and vegetables (F&Vs) has been widely recommended to improve the health of the population. Observational studies show a preventive effect of long-term consumption of adequate nutrients on cancer, diabetes, dementia and other age-related diseases. However, the short-term impact of F&V intake in more specific populations has been under-researched. In the hospital setting, economic choices and logistic problems result in poor quality of food in general, and particularly in fresh F&Vs. As hospital geriatricians, we set out to address the issue of F&V intake in elderly hospitalized patients, for whom we felt F&Vs might be beneficial in association with a protein and energy-dense diet. RECENT FINDINGS: In the community and in nursing homes, F&V consumption is associated with better overall food intake and improved quality of life in older patients. SUMMARY: General inspection of the literature suggests that F&Vs may be beneficial to elderly hospitalized patients, but no clinical studies have been conducted. There is a need to address the question of the impact of improved quality and quantity of F&Vs on quality of life, total food intake and constipation, particularly in hospitalized elderly patients who often stay in hospital for long periods. Positive results might help to promote F&V consumption in diverse populations, with the objective of improving eating pleasure for better health.

Leucine and citrulline modulate muscle function in malnourished aged rats.

Protein energy malnutrition in the elderly causes preferential loss of muscle mass which is associated with poor functional states. Leucine and citrulline are able to stimulate muscle protein synthesis in aged rats but no study has been undertaken to evaluate their effect on muscle function. Sprague-Dawley male rats aged 23 months were used in the experiment. Part of them were subjected to a dietary restriction for 12 weeks and then assigned to four groups: a group was euthanized (restricted group), and the others were refed for 1 week with either a leucine-, a citrulline-supplemented diet, or a standard diet. The other rats were fed ad libitum. Muscle mass and motor activity significantly increased during the refeeding with either leucine or citrulline (respectively, +51 and +37% for muscle mass, P < 0.05). The improvement of muscle mass and of motor activity induced by leucine and citrulline was highly associated with that of maximal tetanic isometric force (r = 0.769, P < 0.0001; r = 0.389, P < 0.05, respectively) but only leucine improved maximal tetanic isometric force (+101%, P < 0.05). In conclusion, this is the first study to demonstrate the ability of two amino acids (leucine and citrulline) to modulate muscle function.

[Screening and diagnosis of undernutrition in adults in daily practice]. / Dépistage et diagnostic de la dénutrition chez l'adulte en pratique quotidienne.

SCREENING AND DIAGNOSIS OF UNDERNUTRITION IN ADULTS IN DAILY PRACTICE Following an international expert consensus, the French National Authority for Health has revised the diagnostic criteria for undernutrition for adults -70 years (2019) and for adults 70 years (2021). The diagnosis of undernutrition is based on the combination of a phenotypic criterion and an etiological criterion. The phenotypic criteria as follows: weight loss, Body Mass Index (BMI) and criteria concerning muscle strength, muscle mass and physical performance. The aetiological criteria are three: decreased food intake, disturbed digestive absorption and acute or chronic pathologies leading to hypercatabolism. Hypoalbuminemia is no longer a diagnostic criterion for undernutrition, but it reflects its severity. Apart from BMI, these criteria also apply to obese people.

DÉPISTAGE ET DIAGNOSTIC DE LA DÉNUTRITION CHEZ L'ADULTE EN PRATIQUE QUOTIDIENNE À la suite d'un consensus international d'experts, la Haute Autorité de santé a révisé les critères diagnostiques de dénutrition pour les adultes de moins de 70 ans (2019) et pour les adultes à partir de 70 ans (2021). Le diagnostic de dénutrition repose sur l'association d'un critère phénotypique et d'un critère étiologique. Les critères phénotypiques sont les suivants : perte de poids, indice de masse corporelle (IMC) et critères concernant la force musculaire, la masse musculaire et les performances physiques. Les critères étiologiques sont au nombre de trois : baisse des apports alimentaires, troubles de l'absorption digestive et pathologies aiguës ou chroniques entraînant un hypercatabolisme. L'hypoalbuminémie ne représente plus un critère diagnostique de dénutrition mais elle reflète sa sévérité. Hormis l'IMC, ces critères s'appliquent également aux personnes en situation d'obésité.

Serum Leptin Levels, Nutritional Status, and the Risk of Healthcare-Associated Infections in Hospitalized Older Adults.

We aimed to determine whether serum leptin levels are predictive of the occurrence of healthcare-associated infections (HAIs) in hospitalized older patients. In a prospective cohort, 232 patients had available data for leptin and were monitored for HAIs for 3 months. Admission data included comorbidities, invasive procedures, the Mini Nutritional Assessment (MNA), BMI, leptin, albumin and C-reactive protein levels, and CD4 and CD8 T-cell counts. Multivariate logistic regression modelling was used to identify predictors of HAIs. Of the 232 patients (median age: 84.8; females: 72.4%), 89 (38.4%) experienced HAIs. The leptin level was associated with the BMI (p < 0.0001) and MNA (p < 0.0001) categories. Women who experienced HAIs had significantly lower leptin levels than those who did not (5.9 µg/L (2.6-17.7) and 11.8 (4.6-26.3), respectively; p = 0.01; odds ratio (OR) (95% confidence interval): 0.67 (0.49-0.90)); no such association was observed for men. In a multivariate analysis of the women, a lower leptin level was significantly associated with HAIs (OR = 0.70 (0.49-0.97)), independently of comorbidities, invasive medical procedures, and immune status. However, leptin was not significantly associated with HAIs after adjustments for malnutrition (p = 0.26) or albuminemia (p = 0.15)-suggesting that in older women, the association between serum leptin levels and subsequent HAIs is mediated by nutritional status.

Hypnosis for pain and anxiety management in cognitively impaired older adults undergoing scheduled lumbar punctures: a randomized controlled pilot study.

BACKGROUND: Core cerebrospinal fluid (CSF) amyloid and tau biomarker assessment has been recommended to refine the diagnostic accuracy of Alzheimer's disease. Lumbar punctures (LP) are invasive procedures that might induce anxiety and pain. The use of non-pharmacological techniques must be considered to reduce the patient's discomfort, in this setting. The objective of this study was to examine the efficacy of hypnosis on anxiety and pain associated with LP. METHODS: A monocentric interventional randomized-controlled pilot study is conducted in a university geriatric day hospital. Cognitively impaired patients aged over 70 were referred for scheduled LP for the diagnostic purpose (CSF biomarkers). The participants were randomly assigned either to a hypnosis intervention group or usual care. Pain and anxiety were both self-assessed by the patient and hetero-evaluated by the operator. RESULTS: We included 50 cognitively impaired elderly outpatients (women 54%, mean age 77.2 ± 5.0, mean Mini-Mental State Examination score 23.2 ± 3.5). Hypnosis was significantly associated with reduced self-assessed (p < 0.05) and hetero-assessed anxiety (p < 0.01). Hetero-evaluated pain was significantly lower in the hypnosis group (p < 0.05). The overall perception of hypnosis was safe, well-accepted, and feasible in all the participants of the intervention group with 68% perceiving the procedure as better or much better than expected. CONCLUSIONS: This pilot study suggested that hypnosis was feasible and may be used to reduce the symptoms of discomfort due to invasive procedures in older cognitively impaired patients. Our results also confirmed the overall good acceptance of LP in this population, despite the usual negative perception. TRIAL REGISTRATION: ClinicalTrials.gov NCT04368572. Registered on April 30, 2020.

Quality of life and sarcopenic patients.

Sarcopenia is defined as a progressive and generalised loss of muscle strength, muscle mass and physical performance with advancing age. Among the multiple consequences of sarcopenia, the reduction in the quality of life associated with it can undeniably be considered as a major consequence. Quality of life is measured via generic or specific questionnaires. Current research, mainly using so-called "generic" questionnaires, has identified a reduced quality of life in patients with primary age-related sarcopenia, mainly in areas related to functional status and physical performance. A specific quality of life questionnaire could, in combination with a generic questionnaire, provide more precise data on the impact that sarcopenia has on patient's quality of life. The first quality of life questionnaire specific to sarcopenia, the SarQoL®, was developed in 2015. Psychometric validation of the SarQoL® has been carried out in several international patient populations indicating excellent internal consistency, reliability and convergent validity and sensitivity to change, as well as an absence of floor and ceiling effects. In combination with a generic questionnaire, this specific questionnaire is therefore suitable for measuring the quality of life of populations suffering from sarcopenia, both in research and in clinical practice and in the context of both observational or interventional evaluations.