Publications by authors named "Anne Laure Couderc"
Effect of frailty on unplanned readmission in older adults: A systematic review.
J Epidemiol Popul Health
October 2024
Article Synopsis
- The study investigates the connection between frailty in older adults and their risk of unplanned hospital readmissions over varying time frames, emphasizing the importance of identifying high-risk individuals.
- Researchers conducted a systematic review of studies published from 2011 to 2021, focusing on adults aged 65 and older, and analyzed data from 44 eligible studies across 16 countries.
- Findings revealed that a significant percentage (up to 84.5%) of frail older adults experience unplanned readmissions, with specific assessment tools like the Hospital Frailty Risk Score and Clinical Frailty Scale being most effective for predicting this risk.
Article Synopsis
- The Chibanis are aging former immigrant workers in France who arrived in the 1970s and currently live in unsuitable immigrant hostels in Marseille.
- An anthropological study of 67 Chibanis aged 65 and over revealed high levels of chronic diseases and access to general practitioners but low adherence to follow-up medical care.
- The Chibanis face geographical and social isolation, poor socio-economic conditions, and challenges in managing their health, highlighting the need for improved care pathways and targeted prevention efforts.
Article Synopsis
- Older adults (75+) who are frail or dependent often face frequent hospitalizations through emergency departments and can be readmitted shortly after discharge.
- The 2012 social security financing act led to experiments aimed at improving care for the elderly, including the development of a risk assessment tool (TAGRAVPA) at Marseille University Hospital to identify risks of health deterioration and early re-hospitalization.
- A study indicated that TAGRAVPA effectively assesses re-hospitalization risk, demonstrating varying sensitivity and specificity depending on the department, making it a useful tool across hospital settings to tailor care for elderly patients.
Article Synopsis
- * Conducted in three French hospitals from February 2021 to February 2022, the research analyzed the outcomes of 235 hospitalized COVID-19 patients, matching them to reduce bias in treatment allocation.
- * Results indicated that both medications had similar effects on 28-day mortality rates, in-hospital mortality, oxygen requirements, ICU admissions, and secondary infection rates, suggesting comparable safety and efficacy.
Article Synopsis
- The study aimed to assess the quality of life (QoL) of lung cancer survivors five years post-diagnosis, comparing those aged 70 and over with younger survivors, while identifying factors linked to poorer QoL in both age groups.
- The research included 371 lung cancer patients from a national survey, revealing that issues like self-consciousness and suspected neuropathic pain primarily impacted older survivors' physical and mental QoL, while factors like gender and cancer severity affected younger patients.
- The findings suggest tailored psychological support and physical activities for improving QoL, emphasizing the need for pain management strategies for older patients experiencing neuropathic pain.
Article Synopsis
- This study investigates the prevalence of pre-therapeutic sarcopenia (PS) in adult cancer patients and its effects on cancer treatment outcomes.
- A meta-analysis was conducted, reviewing data from 65,936 cancer patients, revealing a PS prevalence of 38% and significant associations with poorer overall survival, progression-free survival, and increased complications.
- Using a consensus-based algorithm that included muscle mass and strength, the prevalence dropped to 22% and showed even stronger correlations with patient outcomes, indicating the importance of assessing PS in cancer care.
Article Synopsis
- This study investigates the effectiveness of antiresorptive treatment in preventing bone loss caused by aromatase inhibitors in early breast cancer patients.
- Patients not receiving the treatment faced a 20.8-fold increased risk of bone loss after 24 months.
- Results showed that those on antiresorptive treatment had significant increases in both femoral and lumbar bone mineral density after the same period, highlighting its protective benefits.
-negative myeloproliferative neoplasms (MPNs) include three major subgroups-polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF)-which are characterized by aberrant hematopoietic proliferation with an increased risk of leukemic transformation. Besides the driver mutations, which are , more than twenty additional mutations have been identified through the use of next-generation sequencing (NGS), which can be involved with pathways that regulate epigenetic modifications, RNA splicing, or DNA repair. The aim of this short review is to highlight the impact of molecular biology on the diagnosis, prognosis, and therapeutic management of patients with PV, ET, and PMF.
View Article and Find Full Text PDFThe Chibanis represent the population of aging former immigrant workers who arrived in France in the 1970s in order to take up employment. Most of them still live in immigrant hostels, which are not appropriate for an older population. This anthropological study was conducted on Chibanis living in an immigrant hostel in the 15th arrondissement of Marseille.
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- Data on treating octogenarian patients with newly diagnosed multiple myeloma (NDMM) is limited, and this study examines a retrospective cohort of 74 such patients treated with bortezomib and dexamethasone.
- The treatment involved initial induction therapy, followed by dose escalation with other drugs if patients didn't respond, leading to an overall response rate of 73%.
- Despite the good response rate, median progression-free survival was 13.2 months, and overall survival was 26.9 months, with worse outcomes for patients with poor ECOG performance status, and there were significant early mortality rates during treatment.
Geriatric syndromes in a centenarians population.
Aging Clin Exp Res
December 2022
Background: Centenarians develop diseases later than younger populations.
Aims: Assessment of geriatric syndromes in centenarians living in Marseille in 2020.
Methods: Observational preliminary study describing centenarians living in the Marseille area, being part of the patients base of the general practitioners (GPs).
Article Synopsis
- The study focused on assessing the acceptance of COVID-19 vaccinations among older cancer patients at a geriatric oncology center in France, starting from January 2021.
- Out of 150 patients aged 70 and older, a high vaccination acceptance rate of 82.6% was found, with 75.3% completing the two-dose regimen.
- The results demonstrated good vaccine tolerability and a reduced incidence of COVID-19 among vaccinated patients compared to those who were unvaccinated.
Article Synopsis
- * A French multidisciplinary task force reviewed studies from 2010 to 2021 and focused on three key considerations for older patients regarding TKI treatment options.
- * Recommendations include using osimertinib for patients with EGFR mutations, considering full-dose first-generation TKIs, and emphasizing the need to evaluate a patient's overall health, including malnutrition and comorbidities, before starting treatment.
Article Synopsis
- Sarcopenia, marked by muscle strength and mass loss, is influenced by aging and treatments like androgen deprivation therapy (ADT) in prostate cancer patients.
- This study aims to assess the prevalence of sarcopenia and muscle disorders in patients over 70 years old before and after ADT and radiotherapy for prostate cancer.
- By enrolling 200 patients, the study seeks to examine risk factors, the impact of ADT on muscle health, and how socio-behavioral aspects affect sarcopenia, potentially leading to improved care guidelines.
Article Synopsis
- The study evaluates how functional status, measured by Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL), impacts the mortality rates and unplanned hospitalizations in older lung cancer patients over three and six months.
- Conducted between September 2015 and January 2019, the research analyzed 227 outpatients aged 70 and older at Marseille University Hospital, highlighting the prevalence of functional impairments among these patients.
- Findings indicate that impairments in ADL and IADL significantly increase the risk of unplanned hospitalizations and six-month mortality, suggesting these assessments should be integrated into treatment planning for lung cancer patients.
Article Synopsis
- The study aimed to evaluate the prognostic value of the B12/CRP index (BCI) in older cancer patients undergoing treatment and its relationship with pre-existing frailty.
- Conducted at Marseille University Hospital, this observational study involved 863 patients aged 70 and over, revealing that those with a low BCI had significantly better survival rates compared to those with mid to high BCI values.
- The findings suggest that a BCI over 10,000 is a strong indicator of poorer survival and existing frailty in older cancer patients prior to starting systemic therapy.
Older people living in nursing homes (NH) are at a higher risk of preventable drug-related adverse events because of age-related physiological changes, polypathology, and polypharmacy. NH residents are particularly exposed to potentially inappropriate medications (PIMs). Many strategies have been developed to improve the quality and the safety of drug prescription in NH, including medication reviews (MRs).
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- A study was conducted to evaluate the prevalence and risk factors of cachexia (a condition involving significant weight loss) in older cancer patients, as well as its impact on 6-month mortality rates.
- The research surveyed 1,030 patients aged 70 and older across 55 geriatric oncology clinics in France, revealing that over half of the participants (52%) met the criteria for cachexia.
- Factors linked to higher rates of cachexia included specific cancer types (like colorectal cancer), prior surgeries, presence of metastases, poor performance status, low food intake, cognitive issues, and potential depression, with those having cachexia experiencing a higher mortality risk within 6 months.
Article Synopsis
- COVID-19 impacts patients with haematologic malignancies more severely than those without malignancies, showing a significantly higher mortality rate (40% vs. 4%).
- These patients experience a longer duration of RT-PCR positivity and higher viral loads, indicating more severe infections.
- There is a need for clinicians to be trained to recognize and manage the unique COVID-19 disease course in this vulnerable population.
Background: Functional Status (FS) is an important domain in Comprehensive Geriatric Assessment (CGA) and is most often evaluated using the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales separately.
Method And Objectives: This secondary analysis of a previous prospective cohort study was conducted between September 2015 and May 2018 at Marseille University Hospital, France, on 613 cancer outpatients aged ≥70 years. The first objective of this study was to determine the prevalence of FS impairment in older outpatients with cancer using a combination of the information collected with the ADL and short IADL scales.
Article Synopsis
- The study aimed to analyze the clinical features and management of nursing home residents in France with suspected or confirmed COVID-19, identifying risk factors for hospitalization and death in this demographic.
- A cohort of 480 residents was observed over several months, revealing that the majority were symptomatic, with common symptoms including fatigue, fever, and difficulty breathing.
- Key findings indicated that male gender, diabetes, altered consciousness, and dyspnea increased the likelihood of hospitalization, while factors like age over 85 and thermal dysregulation were linked to higher mortality rates.
Article Synopsis
- This study assessed the effectiveness and safety of stereotactic body radiotherapy (SBRT) for treating frail patients with primary renal cell carcinoma (RCC) who cannot undergo surgery or standard treatments.
- A total of 23 patients were treated, with promising outcomes including high local control rates (96%) and no severe side effects or treatment-related deaths reported.
- The findings suggest that SBRT may serve as a viable alternative treatment option for this patient population, highlighting its potential for good oncological outcomes and tolerable toxicity.
Purpose: Assessment of vulnerability with the G8 screening tool according to cancer localization and weight of the G8 items when screening frailty in thoracic and lung cancer (TLC) compared to other cancer localizations.
Methods: This study was conducted retrospectively on all G8 data collected for older cancer patients between April 2015 and December 2019 at Marseille University Hospital.
Results: One thousand four hundred and thirty-one patients were included; the median age was 80.