Cognitive Screening Tool for Geriatrics: A Retrospective Observational Study on the Correlation of the Scores in 30-Point Clock Face Test and MMSE.

BACKGROUND: Over the past 30 years, the clock drawing test (CDT) has generated considerable interest due to its usefulness in the early detection of cognitive impairments, particularly those seen in neurodegenerative dementias (including Alzheimer's disease), vascular dementia, and mixed dementia. The present study aimed to determine whether the results of the "30-Point Clock Face Test" (CFT-30), a standardized version of the CDT that uses a 30-point scale, correlate with those of the Mini-Mental State Examination (MMSE). METHODS: This is a retrospective, observational study. All patients hospitalized in a Hospital-University Clinic Geriatrics Unit (Grenoble Alpes University Hospital, Grenoble, France), from January 1, 2017, to December 31, 2018, were included. Patient data and scores were retrieved from hospital archives, and the results of the two tests of interest, MMSE and the CFT-30, were analyzed. RESULTS: We included 214 patients aged ≥75 years. The mean ± SD age was 86.4 ± 5.6 years, and 68.7% were female. A strongly positive, significant correlation was seen between the CFT-30 and MMSE (r = 0.73, P < 0.001) scores. The total scores obtained by these two tests were identical (t = 1.22, P = 0.22). CONCLUSION: CFT-30 is a good complement to the tools usually used in the investigation of cognitive impairments in older people. In addition to its metrological qualities, the standardized and normalized CFT-30 is extremely simple and very fast to use.

[Understanding lower gynaecological cancer consultation delay and help-seeking behavior in patients over 65]. / Compréhension du délai de consultation pour les cancers gynécologiques bas chez les patientes âgées de plus de 65 ans.

INTRODUCTION: Delays for consultation of more than six months exist for uterine cancer. Delays in diagnosis of more than five years exist for vulvar cancer. The peak incidence of these neoplasms appear after the age of 65 years. Patient's symptoms are characteristically swelling, vaginal bleeding or itching. This study aims to understand what is happening during this period for women over 65 years old. It also tries to identify triggers during the help-seeking period. METHODS: Qualitative studies using semi-structured interviews with dual analyses (semio-pragmatic and psychodynamic) have been conducted on a population of older (65+) gynaecologic cancer patients, recruited from a French oncology centre. RESULTS: Twelve patients were interviewed. Patients' courses of action were determined by the characteristics of their symptoms, their feelings and their emotions. Representations, subjective beliefs and past experiences were employed to make sense of their symptoms. The patient's friend and family circle had an important role in incentivizing the patient to seek consultation. Multiple factors affected the path towards consulting the doctor. The initial medical contact included several challenges. The patient would consult a doctor earlier if he had more information about his illness and if his relationship with the doctor was better. CONCLUSION: Our findings are similar to those of other cancers. The peculiarity for this population appears to be the different representations of age-related changes in the reproductive system, and the taboo associated with this issue when facing friends and family.

Representations of their own sexuality and aging body by old people: phenomenological and psychodynamic approach.

The sexuality of the elderly is rarely mentioned in general medicine although it holds an important place in many old people's life, and sexual well-being is a part of the global well-being according to the World Health Organization. To explore the representations of their own sexuality and aging body by the elderly. Qualitative study using semi-structured interviews in 15 healthy elderly people over 65 years of age, living at home. In-depth interviews were transcribed and submitted to qualitative content using a phenomenological and a psychodynamic analysis. The phenomenological approach allows to explore the meaning and significance of the sexuality of older people (their representations and individual experience). The psychodynamic approach allows an analysis of defense mechanisms in verbal and nonverbal behavior. Some elderly maintain a view of their sexuality in accordance with the societal standards existing before the sexual liberalization following the events of May 68 in France. For these people, sexuality is tabooed and only linked to procreation, no longer part of the aging body, and perceived as degraded, then difficult to be approached by general practitioners in relation with defense mechanisms. Other elderly people have managed to free themselves from those previous societal standards. The notion of pleasure is still present in these people and their aging body is perceived as an altered body, difficult to be accepted on account of the pressure for conformity due to actual societal standards. These standards reserve sexuality to young people and convey a picture of a sexuality that would be improper for the elderly. Understanding the representations of their sexuality by the elderly allows GPs a better approach for helping older patients to improve their sexual well-being.

[Exhaustion of family caregivers: a masked domestic crisis? A psychodynamic and systemic approach]. / L'épuisement des aidants familiaux : une crise intrafamiliale masquée ? Approche psychodynamique et systémique.

We try, from our clinical practice in a geriatric medicine department, to identify the processes involved in family crisis, especially in the relationship carer/cared. Psychodynamic and systemic determinants are highlighted to understand how family caregivers may suffer burn out, and suggest preventive measures.

[The aged and the test of folding a rhombus Psychometric and chronopsychological aspects]. / Le « vieillard ¼ et le Test du pliage d'un losange Aspects psychométriques et chronopsychologiques.

This study highlights the incongruence of geriatric institutions to set up activities for elderly people without taking into account the circadian fluctuations of cognitive processes related to circadian rhythms. By example, rehabilitation for falls is based on the indication given by the therapist (instruction), its integration and assimilation by the patient (comprehension), and the resulting action (execution). However, the recorded information and the execution may present a shift of phase and even an opposition of phase. The Test of Folding a Rhombus (TFR) was conceived to assess the fluctuation and articulation of these processes. It was proposed to 60 elderly individuals divided into 2 groups (30 subjects with cognitive disorders - case group - and 30 subjects without cognitive disturbance - control group -), and was applied at different time schedules of the day (8:00, 11:00, 15:00 and 18:00 h) once a week during 4 weeks. Its purpose was to quantify the relationship between automatic and controlled processes. Statistical analysis indicates significant circadian differences during the evolution of the two processes between the case and control groups. Simple, fast and easy to use, the TFR can also help professionals to choose the best automatic or controlled processes activity according to the need of patients.