Exercise Frequency Determines Heart Rate Variability Gains in Older People: A Meta-Analysis and Meta-Regression.

Background: Previous studies have suggested that exercise training improves cardiac autonomic drive in young and middle-aged adults. In this study, we discuss the benefits for the elderly.

Objectives: We aimed to establish whether exercise still increases heart rate variability (HRV) beyond the age of 60 years, and to identify which training factors influence HRV gains in this population.

[Improving fall prevention in the elderly].

The prevention of falls in the elderly requires action on several levels. Firstly, it is essential to identify those at risk of a fall. They must then be encouraged to do appropriate physical and sports activities, a factor of prevention.

Assessment of Health Inequalities Among Older People Using the EPICES Score: A Composite Index of Social Deprivation.

BACKGROUND: Most of the indicators commonly used to assess social deprivation are poorly suited to study health inequalities in older people. The EPICES (Evaluation of Deprivation and Inequalities in Health Examination Centres) score is a new composite index commonly used to measure individual deprivation. OBJECTIVE: To assess the relationships between health indicators and the EPICES score in older people.

Visual acuity thresholds associated with activity limitations in the elderly. The Pathologies Oculaires Liées à l'Age study.

Purpose: Activity limitations, which induce loss of autonomy in the elderly, are a major public health problem. We investigated the associations between objectively determined visual impairments and activity limitations and assessed the visual acuity thresholds associated with these restrictions.

Methods: The study sample consisted of 1887 people aged 63 years and over from a population-based cohort.

Potentially inappropriate drug prescription in the elderly in France: a population-based study from the French National Insurance Healthcare system.

Background: Inappropriate prescribing is a known risk factor for adverse drug event occurrence in the elderly. In various countries, several studies have used insurance healthcare databases to estimate the national prevalence of potentially inappropriate medications (PIM) in the elderly, as defined by explicit PIM lists. Recently, a representative sample of the French National Insurance Healthcare database, known as the "Echantillon Généraliste des Bénéficiaires" (EGB), was created, making it possible to assess the quality of drug prescription in France.

A screening tool with five risk factors was developed for fall-risk prediction in community-dwelling elderly.

Objective: To develop a simple clinical screening tool for community-dwelling older adults.

Study Design And Setting: A prospective multicenter cohort study was performed among healthy subjects of 65 years and older, examined in 10 health examination centers for the French health insurance. Falls were ascertained monthly by telephone for 12-month follow-up.

Association between benzodiazepines and recurrent falls: a cross-sectional elderly population-based study.

Background: While the association between benzodiazepines (BZD) and single fall is long-known, the association between BZD and recurrent falls has been few studied.

Objective: The aims of this study were 1) to examine whether BZD were associated with recurrent falls while taking into account the effect of potential confounders, and 2) to determine whether there was an interaction in terms of risk of falls between BZD and balance impairment in a community-dwelling population-based adults aged 65 and older.

Study Design: Cross-sectional.

Balance and walking speed predict subsequent 8-year mortality independently of current and intermediate events in well-functioning women aged 75 years and older.

Background: Physical performance may predict survival independently of other current predictors in non selected elderly subjects. We determined if poor balance and decreased gait speed may predict mortality after adjustment for both baseline and follow-up confounders in well-functioning elderly women.

Methods: A subgroup of participants in the Epidemiology of osteoporosis (EPIDOS) study (N = 1,300) was followed for 8 years.

Trends of the potentially inappropriate medication consumption over 10 years in older adults in the East of France.

Purpose: To describe the trends of potentially inappropriate medication (PIM) use in older adults from 1995 to 2004 in the East of France, by using the 1997 Beers criteria and its French update, and to assess risk factors for this PIM use.

Methods: We carried out a repeated cross-sectional study using data collected among people aged >/=65 years, examined in the Center for Preventive Medicine. Studied variables were socio-demographic, clinical data, medication consumption and the self-health status.

[Assessment of cognitive complaints and depressive symptoms in health check-up centers].

Unlabelled: Memory clinics, where cognitive impairment is diagnosed, have to deal with an increasing number of requests. In this context, this study was aimed to evaluate the feasibility of cognitive complaint assessment in a health check-up performed in preventive Health check-up centers.

Methods: The study population included 60-year and over subjects who were proposed a health check-up in the Health check-up centers of five French cities (Amiens, Nîmes, Longwy, Rennes and Sélestat).

[Early indicators of prolonged hospitalization of the elderly: pilot study at Strasbourg University Hospital].

Objectives: The aim of this study was to identify early indicators of prolonged hospital stays by elderly patients.

Methods: This prospective pilot study, conducted at Strasbourg University Hospital, included patients aged 75 years or older who were hospitalized via the emergency department (SAFES cohort: Sujet Agé Fragile: Evaluation et suivi, that is, Frail Elderly Subjects: Evaluation and Follow-up). A gerontologic evaluation of these patients during the first week of their hospitalization furnished the data for an exact logistic regression.

Decision-making process, outcome, and 1-year quality of life of octogenarians referred for intensive care unit admission.

Objective: To describe triage decisions and subsequent outcomes in octogenarians referred to an ICU.

Design And Setting: Prospective observational study in the medical ICU in a tertiary nonuniversity hospital.

Participants: Cohort of 180 patients aged 80 years or over who were triaged for admission.

Reliability of a new instrument for measuring maximum rising strength.

Objective: To assess the intrarater test-retest reliability of a newly developed instrument for measuring maximum rising strength (MRS) in comparison with that of maximum knee extension strength (KES).

Design: Three replications of isometric MRS and KES were measured on three test occasions separated by 1 wk in 97 healthy men and women aged 23-90. MRS was measured in seated subjects using a dynamometer fixed on the ground and connected by an adjustable nonelastic cord to a padded belt.

Hierarchical components of physical frailty predicted incidence of dependency in a cohort of elderly women.

Objective: To identify the most important predictors of early disability incidence and devise a simple score of physical frailty.

Methods: A cohort of 545 high-functioning women aged 75 years and older was followed for 7 years. Every year, the self-reported loss of at least one instrumental activity of daily living was chosen as definition of disability.

[What is dementia? 8. Alzheimer's disease early diagnosis: a public health point of view].

It is justified to develop early diagnosis for Alzheimer disease and related disorders in order to offer professional support to patients and informal caregivers. On the other hand, the usefulness of screening cases, which have no repercussion on daily life, is not proven considering the difficulty to discriminate early stages from age-related intellectual performance decline. Taking into account a general population point of view, we assume that there is a risk to evolve from early diagnosis to screening.

[Recovery from disability in an older population. Results of long-term follow-up in Upper-Normandy (France)].

Background: The recovery of people initially disabled was addressed using the National Institute of Health and Medical Research Upper-Normandy survey, conducted on a representative sample of the older population from 1978 to 1999.

Methods: The survey was based on 1082 older people aged 65 and over. A follow-up was organized to register mortality and disability at point 3, 6, 10 and 20 years.

Functional autonomy measurement system: development of a social subscale.

The purpose of this study was to develop a subscale assessing social functioning for the functional autonomy measurement system (SMAF). The development of this new dimension was based on consultations (focus groups and nominal groups) of experts from different health care disciplines in Quebec, Canada, and France. Two interrater reliability studies were carried out with older people presenting a loss of functional autonomy and living either in an institution or at home.

[In search of a typology of drugs used by the aged living in the community].

Background: The objective was to identify the determining factors of drug utilization in the elderly by using several classes of drugs.

Methods: We studied drug utilization in 1373 women, aged 75 and over, selected in the EPIDOS study concerning hip fractures in the Languedoc-Roussillon region (France) and in 2525 men and women, aged 60 and over selected for the POLA study (age-related eye diseases) in the town of Sete. We defined a priori three types of drugs considering the perceived risk by the physician, and the potential demand from the patient (I - Etio-pathogenic drugs with iatrogenic risk; II - Symptomatic drugs without perceived risk; III - Psychotropic drugs).

Health status and work burden of Alzheimer patients' informal caregivers: comparisons of five different care programs in the European Union.

Background: In 1998, a research study was conducted to compare existing programs in the European Union providing both care to people with senile dementia of the Alzheimer type, and support to their informal caregiver.

Method: Five programs were selected in seven centres. Home social services (Denmark), Day centres (Germany), Expert Centres (Belgium, Spain), Group Living/Cantou (Sweden, France), Respite hospitalization (France).

Associations of cardiovascular disease and its risk factors with age-related macular degeneration: the POLA study.

The POLA study (June 1995 through July 1997) is a population-based study on cataract and age-related macular degeneration (AMD) and their risk factors in 2584 residents of Séte (South of France), aged 60--95 years. Classification of AMD was performed on 50 degrees fundus photographs, according to an international classification. The presence of cardiovascular disease and its risk factors was determined by interviewer-based questionnaire, clinical examination (anthropometry, blood pressure) and fasting plasma measurements.

Quality of life in spinal cord injury patients with urinary difficulties. Development and validation of qualiveen.

Background: Quality of life (QoL) may be severely affected in patients with spinal cord injury (SCI) and resulting urinary difficulties (UD). There is, however, a need for instruments capable of measuring QoL in these patients. The aim of this study was to develop and validate a questionnaire suitable for use in SCI patients with urinary disorders.

Social disadvantage in the international classification of impairments, disabilities, and handicap.

The revision process of the international classification of impairments, disabilities and handicaps (ICIDH) is now in progress. Major changes are being considered which question one of the main fields, that of handicap, or social disadvantage. The scope of these changes goes beyond simple technical adjustments.

Risk of syncope in the elderly and consumption of drugs: a case-control study.

A multicenter case-control study (588 cases and 1807 controls) was performed to assess the risk of syncope in the elderly according to drug consumption within the three days before syncope, controlling the underlying cardiovascular diseases. Pair-matched and non-pair-matched analyses using logistic regression were performed, providing consistent results. After adjustment for age, sex, and cardiovascular disease, cases were shown to consume more often than non-cases drugs in classes of non-tricyclic antidepressants, neuroleptic drugs, and antiparkinsonians.