Fragility and quality of life, the benefits of physical activity for the elderly / Fragilité et qualité de vie, les apports de l'activité physique chez la personne âgée

Frailty and quality of life are concepts that emerged in the second half of the 20th century. Frailty can be defined as a clinical syndrome of decreased physiological reserves and resistance against stressful events conferring high risk for adverse health outcomes, including loss of independence, falls, hospitalization, institutionalization and mortality. However, it is considered that frailty can potentially be prevented or treated with specific modalities. Quality of life has various definitions because of its subjective nature. The World Health Organisation defined quality of life as "an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns". The aim of this study is to review information regarding the potential association between frailty and quality of life in the elderly, and the effects of physical activity among different parameters of these phenomena. There are few studies that investigate links between frailty, quality of life and physical activity. However, results tend to show that physical aspects of frailty syndrome are inversely proportional to the quality of life in several of its dimensions. Furthermore, community-based exercise programs involving the elderly seem to improve the quality of life. Considering that physical activity can potentially have an impact on the quality of life among frail elderly and promote healthy aging, further research will be necessary to corroborate these results.

La fragilité et la qualité de vie sont des concepts qui font leur apparition dans la deuxième moitié du XXe siècle. La fragilité se situe entre le vieillissement usuel et pathologique. Il reflète une diminution de la faculté de l'organisme à résister à un stress, favorisant la survenue d'évènements péjoratifs de santé. Il s'agit d'un syndrome clinique multifactoriel potentiellement réversible via des actions de prévention. La qualité de vie est un concept très large et multifactoriel correspondant à la perception qu'un individu a de sa place dans la vie. Ce travail a pour double objectif d'étudier l'existence d'un lien potentiel entre fragilité et qualité de vie, et d'évaluer les bénéfices de la pratique d'une activité physique sur ces phénomènes. Les recherches dans ce domaine tendent à montrer que la présence d'une fragilité chez la personne âgée induit une altération des différents domaines de la qualité de vie, notamment en termes d'état de santé perçu. Les résultats d'études interventionnelles incluant des programmes d'activité physique indiquent un bénéfice à la fois sur les paramètres physiques de la fragilité, mais également sur la qualité de vie. Toutefois, le niveau de preuve reste faible et de futures recherches seront nécessaires.

Frailty and quality of life, the benefits of physical activity for the elderly.

Frailty and quality of life are concepts that emerged in the second half of the 20th century. Frailty can be defined as a clinical syndrome involving decreased physiological reserves and resistance against stressful events conferring a high risk of adverse health outcomes, including loss of independence, falls, hospitalisation, institutionalisation and mortality. However, it is considered that frailty can potentially be prevented or treated in specific ways. There are various definitions of "quality of life" due to its subjective nature. The World Health Organization defines quality of life as "an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns". The aim of this study is to review information regarding the potential association between frailty and quality of life in the elderly, and the effects of physical activity among the various parameters of these phenomena. Few studies investigate the links between frailty, quality of life and physical activity. However, results tend to show that the physical aspects of frailty syndrome are inversely proportional to several aspects of quality of life. Furthermore, community-based exercise programmes involving the elderly seem to improve their quality of life. Considering that physical activity can potentially have an impact on quality of life among frail elderly people and can promote healthy ageing, further research will be necessary to corroborate these results.

[Fragility and quality of life, the benefits of physical activity for the elderly]. / Fragilité et qualité de vie, les apports de l'activité physique chez la personne âgée.

Frailty and quality of life are concepts that emerged in the second half of the 20th century. Frailty can be defined as a clinical syndrome of decreased physiological reserves and resistance against stressful events conferring high risk for adverse health outcomes, including loss of independence, falls, hospitalization, institutionalization and mortality. However, it is considered that frailty can potentially be prevented or treated with specific modalities. Quality of life has various definitions because of its subjective nature. The World Health Organisation defined quality of life as "an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns". The aim of this study is to review information regarding the potential association between frailty and quality of life in the elderly, and the effects of physical activity among different parameters of these phenomena. There are few studies that investigate links between frailty, quality of life and physical activity. However, results tend to show that physical aspects of frailty syndrome are inversely proportional to the quality of life in several of its dimensions. Furthermore, community-based exercise programs involving the elderly seem to improve the quality of life. Considering that physical activity can potentially have an impact on the quality of life among frail elderly and promote healthy aging, further research will be necessary to corroborate these results.

[Screening risk and protective factors of nursing home admission]. / Repérage des facteurs influençant le risque d'admission en établissement médico-social.

Many aged adults want to stay as long as possible in their own homes. Hence, it is important to identify factors that can predict nursing home admission, in order to prevent this admission and maintain people at home. Several studies have investigated the risk factors of nursing home admission but syntheses are still rare. The present study aimed to identify risk and protective factors for nursing home admission for aged adults. A literature review was conducted using the PubMed search engine. Of 177 relevant reports, 27 were analyzed. We have included studies, literature reviews and meta-analyses that have highlights 59 potential factors. Falls, especially when fall causes serious injuries, cognitive impairment, activities daily living dependencies and stroke were identified as the highest risk factors. In contrast, living with spouse, having adult children, receiving a home care program based on case management or being homeowner were identified as protectives factors. This knowledge of risk and protective factors can help our prevention strategies to delay or find alternatives to nursing home admission.

[Evaluation tools of drug adherence for elderly subjects: towards a new pattern of scale]. / Outils d'évaluation de l'observance de la personne âgée : vers la construction d'une nouvelle échelle.

INTRODUCTION: Medication non-adherence can be defined as a non-compliance with prescribed drugs. The characteristics of elderly people constitute major risk factors for non-adherence to medication. The aim of this study was to study the relevance of medication adherence scales that are identified in a previous work. METHODS: The current study was based on a previous work in which several adherence scales were identified. We reviewed articles that validated these scales to assess their performances and to measure their adaptation for elderly people. RESULTS: Eight scales were studied, of whom five were validated in high blood pressure therapy. Intrinsic performance as well as construction and validation of scales were weak. Furthermore, none of these validation studies were conducted in elderly population aged 75 years and over. Four aspects appeared to be necessary for scale development: knowledge of the disease and its treatment, perception of the efficacy and tolerance of the treatment, getting the therapy, and drug administration. The use of an evaluation scale in elderly population should consider the living location, the ability of the subject to respond, and the presence of informal or formal caregivers. CONCLUSIONS: Existing scales seem to be weak and elderly characteristics are not considered. Validated adherence medication scales adapted for elderly people are thus needed.