Geriatrie et Psychologie Neuropsychiatrie De Vieillissement最新文献

The 2007 French Haute Autorité de santé recommendation on the diagnosis of malnutrition in the elderly was revised in 2021. The main objective was to compare the prevalence of malnutrition according to the recommendations. The secondary objectives were to compare 3-month mortality and assess the prevalence of sarcopenia and sarcopenic obesity. The 2021 criteria were applied retrospectively to a cohort. Concordance analysis was carried out using Cohen's kappa coefficient and statistical analysis of mortality using Fisher's exact test. There were 135 patients, 60% malnourished with 35% severely malnourished according to HAS 2007, 49% malnourished with 62% severely malnourished according to HAS 2021 with moderate agreement. There were 25 cases of confirmed sarcopenia and one case of sarcopenic obesity. Moderately to severely malnourished people had an increased risk of death at 3 months (HAS 2021).

Odors are known to entertain a special link with memory: once the meaning of an odor has been learned, it naturally acts as a retrieval cue of the learning context, along with the emotions and behaviors associated with it. The existence of this link has for several years inspired the study of olfactory function in Alzheimer's disease (AD), known for the memory disorders it causes. The aim of this review is to summarize the current scientific knowledge on the almost paradoxical dual role played by odors in the management of AD, as both screening and therapeutic tools. In fact, while the existence of a specific olfactory deficit is confirmed in AD - as is its ability to screen for the disease - its properties do not prevent from taking advantage of the link between odors and memory to stimulate cognition and behavior in these patients. Current scientific data, albeit limited and with sometimes inconsistent results, suggest that this idea seems relevant. However, interventions based on impaired processing in AD, such as the recognition and naming of olfactory stimuli, must be avoided.

A quarter of nursing home residents dies in hospital. Few data are available about early in-hospital deaths of nursing home residents. The aim of the study was to describe the characteristics of early in-hospital deaths of nursing home residents after an admission in emergency department and to identify factors associated with a decision of limitation of care in emergency department. This retrospective monocentric descriptive study included all nursing home residents hospitalized and who died early (less than 3 days) after being admitted to the emergency department between 2017 and 2019. Patients' characteristics were collected in the medical record. These characteristics were compared by a logistic regression according to the existence or not of a limitation of care. 12,440 admissions of nursing home residents were identified and 332 patients died early in hospital. Half of them died in the emergency department. The first reason for admission was dyspnea (57.4%) and the main cause of death was pneumonia (41.7%). A limitation of care at emergency department was reported in 66.7% of cases. The factors independently associated with a limitation of care were the existence of active cancer (OR=5.34 [1.35-39.2], p=0.041) and severe dependence (OR=16.1 [1.60-415], p=0.034). Early in-hospital deaths of nursing home residents are common and most often related to pneumonia, dyspnea motivating the transfer. The anticipation of the care project and especially of end of life is mandatory in these patients.

Homicides-suicides within couples are rare situations but can be considered preventable deaths. Various studies have identified risk factors for these couples, regardless of their age, such as a history of domestic violence, psychiatric disorders, addictions, or substance abuse. However, it appears that homicides-suicides among elderly couples have specific characteristics unique to this population. The objective of this study is to draw on recent scientific literature and concrete cases to raise awareness and consider preventive measures for these fatal acts among older individuals. It appears that particular attention should be given in cases where the man is the primary caregiver, when there is a recent deterioration in one partner's health, when hospitalization or institutionalization is being discussed, or when a firearm is present in the household.

The risk of herpes zoster (HZ) and postherpetic neuralgia (PHN) increases rapidly after the age of 50 years old. The incidence of herpes zoster and PHN appears to be correctly measured albeit irregularly and the immediate and long-term complications are so poorly measured that the perception of a benign disease remains entrenched among professionals and in the general population. Because acute-phase treatments are only marginally effective in reducing the severity and duration of complications, zoster vaccines have been developed over the last twenty years. The first available vaccine was a live attenuated vaccine recommended in France in 2013 in very specific age groups, and in the absence of an implementation campaign, vaccine coverage has remained less than 1%. A second vaccine that can reduce the incidence of shingles by 90%, even in the oldest age groups and that can also be used in immunosuppressed members of the population, has been recommended since March 2024 by the French Haute Autorité de santé (HAS). However, it requires two injections, two and six months apart, and side effects are frequent, although mostly local. The implementation strategy for this new vaccine will need to be complemented by awareness campaigns among both health care professionals and users if we want to reduce the incidence of shingles as we should hope.

Older patients are at risk of falling, making fall prevention a critical component of training for future health professionals. To understand the expectations of health students regarding falls in the elderly, four consecutive focus groups were organized at the Angers hospital. The aim was to assess students' views on the effectiveness of using an educational or serious game to complement their traditional training. From the discussions, six key themes emerged: the definition of a fall, participants' emotional responses to falls, lessons learned to enhance their knowledge, the benefits and techniques of simulation games and board games, and the role of games in everyday life. Among the game formats discussed, simulation games, including escape rooms, were the most popular.

This article comes from an academic research, conducted with old persons living in French nursing homes and doing esports workshops, led by young volunteers. With the case of a 93-year-old resident, recently introduced to technological tools, we show how the stakes of videogames competition were at first met with her fear not to be good enough. However, her involvement in the competition mustered, through afterwardness, some elements from her childhood and adolescent psychic life. More precisely, by questioning her place in esports competition, this resident mobilized both the depressiveness necessary to aging, related to the confrontation to the limits inherent to the aging process, and tried to resolve a childhood trauma reactived after 80 years. This analysis also enabled to understand how these esports workshops, beyond the opportunity for entertainment and activity in order to take the mind off a monotonous life, could become devices supporting a potential therapeutic project.

The objective of our work was to study the impact of a mobile health unit of geriatric psychiatry (EMGP) on the number of consultations to the emergency medical service and on the rate of readmissions. This was an observational, retrospective, single-center cohort study, which aimed to identify the number of visits to the Troyes SAU for psychiatric reasons. This in patients who have previously benefited from hospitalization in the Aube geriatric-psychiatry department called Ellipses. The "patients exposed" group was exposed by the existence of EMGP during hospitalization between January 1, 2018 and December 31, 2019. The group not exposed by the non-existence of the system between January 1, 2014 and December 31, 2015. Our results suggest that the actions implemented by the EMGP tend to reduce the frequency of visits to the emergency room after hospitalization, among people aged 65 and over (p<0.001) as well as their duration of hospitalization (p=0.003).