Somatotrope GHRH/GH/IGF-1 axis at the crossroads between immunosenescence and frailty.

Immunosenescence, characterized by complex modifications of immunity with age, could be related to frailty syndrome in elderly individuals, leading to an inadequate response to minimal aggression. Functional decline (i.e.

[Do the structure and functioning of the elderly's social network influence functional health: a preliminary study].

We examined structural and functional characteristics of social networks related to health and well-being among community-dwelling older adults. A survey was performed in Brussels, using an original name-generating network inventory, to explore the structure and types of social ties (e.g.

Changes in the clinical features of older patients admitted from the emergency department.

Demographic changes and healthcare reforms may impact the profile of hospitalized older persons. In this study, we sought to compare the characteristics of two prospective cohorts recruited at a ten-year interval (1999, n=253-2009, n=355). They included older patients (≥75 years) admitted through the emergency department for at least 48 h in acute non-geriatric wards in the same university hospital.

The prevalence of sarcopenia in very old individuals according to the European consensus definition: insights from the BELFRAIL study.

Background: the prevalence of sarcopenia varies widely between studies. The objective of this study was to assess the prevalence of sarcopenia in a representative sample of persons aged 80 years and older according to the European Working Group on Sarcopenia in Older People (EWGSOP) algorithm and the proposed cut-off values. A secondary aim was to investigate the relationship between different individual criteria and low physical performance capacity.

Health outcomes of older patients colonized by multi-drug resistant bacteria (MDRB): a one-year follow-up study.

The objective of this study was to examine whether asymptomatic colonization with MDRB would affect outcomes in older patients one year after hospitalization in a geriatric ward. Patient samples were analyzed to identify specific MDRBs, including methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamase-producing Enterobaceriaceae (ESBLE), and vancomycin-resistant enterococci (VRE). Among 337 patients screened at hospital admission, 62 (18%) carried one or more MDRB isolates (MRSA: n=23; ESBLE: n=39; VRE: n=2).

[The Get-up early test, elaboration process of a new screening tool for psychomotor disadaptation syndrome].

Major features of the psychomotor disadaptation syndrome (SDPM) include motor skill dysfunctions with alteration of postural capabilities, walking abilities and psychomotric automatisms. Mini motor test (TMM) is the gold standard used by skilled physiotherapists in order to assess the syndrome. The aim of this article is to present the elaboration process of a new SDPM screening tool, called the Get-up early test.

Multidrug-resistant bacteria colonization amongst patients newly admitted to a geriatric unit: a prospective cohort study.

Objectives: To determine prevalence, incidence and risk factors of colonization by extended-spectrum β-lactamase-producing Enterobacteriacae (ESBLE), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococcus (VRE) in aged subjects admitted to an acute geriatric unit at a teaching hospital.

Methods: During 12 months, 337 patients were screened by nasal, oropharyngeal, groin, axillary and rectal swabs upon admission and at discharge.

Results: The prevalence of ESBLE, MRSA and VRE carriage upon admission was 11.

Transcriptomic biomarkers of the response of hospitalized geriatric patients admitted with heart failure. Comparison to hospitalized geriatric patients with infectious diseases or hip fracture.

The abundance of a preselection of transcripts involved in inflammation, immunosenescence and stress response was compared between PBMC of healthy aged donors and aged patients in acute phase of heart failure and at recovery. This study identified 22 transcripts differentially abundant in acute phase of heart failure versus healthy aged subjects. Transcripts involved in inflammation and oxidative stress were more abundant.

Clinical profiles of patients colonized or infected with extended-spectrum beta-lactamase producing Enterobacteriaceae isolates: a 20 month retrospective study at a Belgian University Hospital.

Background: Description of the clinical pictures of patients colonized or infected by ESBL-producing Enterobacteriaceae isolates and admitted to hospital are rather scarce in Europe. However, a better delineation of the clinical patterns associated with the carriage of ESBL-producing isolates may allow healthcare providers to identify more rapidly at risk patients. This matter is of particular concern because of the growing proportion of ESBL-producing Enterobacteriaceae species isolates worldwide.

Differentially abundant transcripts in PBMC of hospitalized geriatric patients with hip fracture compared to healthy aged controls.

The abundance of a selection of transcript species involved in inflammation, immunosenescence and stress response was compared between PBMC of 35 geriatric patients with hip fracture in acute phase (days 2-4 after hospitalization) or convalescence phase (days 7-10) and 28 healthy aged controls. Twenty-nine differentially abundant transcripts were identified in acute phase versus healthy ageing. Twelve of these transcripts remained differentially abundant in convalescence phase, and 22 were similarly differentially abundant in acute phase of geriatric infectious diseases.

Transcriptomic biomarkers of the response of hospitalized geriatric patients with infectious diseases.

Background: Infectious diseases are significant causes of morbidity and mortality among elderly populations. However, the relationship between oxidative stress, immune function and inflammatory response in acute phase of the infectious disease is poorly understood.

Results: Herein the abundance of a selection of 148 transcripts involved in immunosenescence and stress response was compared in total RNA of PBMC of 28 healthy aged probands and 39 aged patients in acute phase of infectious disease (day 2-4 after hospitalization) or in convalescence phase (day 7-10).

Serum IL-6 and IGF-1 improve clinical prediction of functional decline after hospitalization in older patients.

Background And Aims: Although inflammatory and hormonal markers have been associated with further functional adverse outcomes in community- dwelling seniors, these markers have not been studied from this perspective in acutely ill older patients. This prospective study was designed to determine whether biological markers can improve the predictive value of a clinical screening tool to assess the risk of functional decline in hospitalized older patients.

Methods: Patients aged 75 years and over admitted for hip fracture, acute heart failure or infection (n=118) were recruited.

Transcriptomic biomarkers of human ageing in peripheral blood mononuclear cell total RNA.

Age-related changes of gene expression contribute to the physiological alteration observed with human ageing. Herein, the abundance of a selection of 148 transcripts involved in immunosenescence and stress response was compared in total RNA of PBMC of healthy young to middle-age probands (35.0 +/- 6.

Caring, employment and health among adults of working age: evidence from Britain and Belgium.

Background: For those of working age, results are inconclusive when exploring the health impact of providing care. Moreover, population data is lacking and the impact of welfare policies on the caregivers' health has not been yet analysed.

Methods: Associations between general health and care giving, adjusting for differences in employment and socio-economic position, were explored for working age adults using logistic regression models.

Combined effects of functionally-oriented exercise regimens and nutritional supplementation on both the institutionalised and free-living frail elderly (double-blind, randomised clinical trial).

Background: Consistently swelling proportion of the frail elderly within a modern society challenges the overstrained public health sector to provide both adequate medical care and comprehensive assistance in their multiple functional deficits of daily living. Easy-to-apply and task-specific ways of addressing this issue are being sought out, with a view to proposing systemic solutions for nationwide application.

Methods: The present randomised, double-blind, placebo-controlled, 7-week clinical trial aimed to determine whether specifically structured, intensive exercise regimens, combined with nutritional supplementation, might improve and help sustain individual muscle strength and mobility, and possibly enhance individual functional capabilities in an on-going quest for active prevention of care-dependency.

Appropriate prescribing in elderly people: how well can it be measured and optimised?

Prescription of medicines is a fundamental component of the care of elderly people, and optimisation of drug prescribing for this group of patients has become an important public-health issue worldwide. Several characteristics of ageing and geriatric medicine affect medication prescribing for elderly people and render the selection of appropriate pharmacotherapy a challenging and complex process. In the first paper in this series we aim to define and categorise appropriate prescribing in elderly people, critically review the instruments that are available to measure it and discuss their predictive validity, critically review recent randomised controlled intervention studies that assessed the effect of optimisation strategies on the appropriateness of prescribing in elderly people, and suggest directions for future research and practice.

Effect of a collaborative approach on the quality of prescribing for geriatric inpatients: a randomized, controlled trial.

Objectives: To evaluate the effect of pharmaceutical care provided in addition to acute Geriatric Evaluation and Management (GEM) care on the appropriateness of prescribing.

Design: Randomized, controlled trial, with the patient as unit of randomization.

Setting: Acute GEM unit.

Implementation of ward-based clinical pharmacy services in Belgium--description of the impact on a geriatric unit.

Background: Patient-centered clinical pharmacy services are still poorly developed in Europe, despite their demonstrated advantages in North America and the UK. Reporting European pilot experiences is, therefore, important to assess the usefulness of clinical pharmacy services in this specific context.

Objective: To report the results of the first implementation of Belgian clinical pharmacy services targeting patients at high risk of drug-related problems.

Differential risk factors for early and later hospital readmission of older patients.

Background And Aims: This study aimed at analyzing rates and factors associated with early and later readmission (0-1 month and 2-3 months after discharge, respectively) of older people after index hospitalization.

Methods: This prospective observational study was conducted in two teaching hospitals. People 70 years and over were interviewed within 48 h of emergency admission.

Appropriateness of use of medicines in elderly inpatients: qualitative study.

Objectives: To explore the processes leading to inappropriate use of medicines for elderly patients admitted for acute care.

Design: Qualitative study with semistructured interviews with doctors, nurses, and pharmacists; focus groups with inpatients; and observation on the ward by clinical pharmacists for one month.

Setting: Five acute wards for care of the elderly in Belgium.