Correlation between Muscle Mass and Physical Activity Level in Older Adults at Risk of Falling: The FITNESS Study.

Background: The study investigates the correlation between muscle mass and physical activity level measured objectively and subjectively in older adults who fall or are at high risk of falling.

Methods: FITNESS (Fall Interest to Target Newly Sarcopenic Society) is a multi-center (French university hospitals of Angers, Lille, Limoges and Orléans), cross-sectional, observational study of routine care within a French multidisciplinary hospital consultation. Inclusion criteria were ≥ 75 years old, living at home and consulting for fall or gait disorder.

Use of a clustering method to describe the clinical profiles of older fallers: the value of a multidisciplinary consultation.

Objectives: The population of older adults is particularly heterogeneous with regard to frailty and the risk of falling, the two of which are linked. We conducted an exploratory, analysis (with no preconceived ideas) of data collected during multidisciplinary falls consultations (MFCs), to identify people with similar profiles.

Materials And Methods: We performed an observational, multicentre study of older patients (aged 75 and over) having been evaluated in an MFC.

Collective memory shapes the organization of individual memories in the medial prefrontal cortex.

It has long been hypothesized that individual recollection fits collective memory. To look for a collective schema, we analysed the content of 30 years of media coverage of World War II on French national television. We recorded human brain activity using functional magnetic resonance imaging as participants recalled World War II displays at the Caen Memorial Museum following an initial tour.

2018 update of French recommendations on the management of postmenopausal osteoporosis.

Objectives: To update the 2012 recommendations on pharmacotherapy for postmenopausal osteoporosis, under the aegis of the Bone Task Force of the French Society for Rheumatology (SFR) and of the Osteoporosis Research and Information Group (GRIO), in collaboration with scientific societies (Collège national des généralistes enseignants, Collège national des gynécologues et obstétriciens français, Fédération nationale des collèges de gynécologie médicale, Groupe d'étude de la ménopause et du vieillissement hormonal, Société française de chirurgie orthopédique, Société française d'endocrinologie, and Société française de gériatrie et de gérontologie).

Methods: Updated recommendations were developed by a task force whose members represented the medical specialties involved in the management of postmenopausal osteoporosis. The update was based on a literature review and developed using the method advocated by the French National Authority for Health (HAS).

Trabecular Bone Score: Where are we now?

The Trabecular Bone Score is a rather new index obtained at the lumbar spine at the same time as a real bone mineral density. It was developed to reflect bone microarchitecture. It was proposed to be easily used in everyday practice as a surrogate of bone strength.

[Indicators of transfusion decision in acute geriatric ward with an exclusive emergency room recruitment].

Objective: Description of the transfusion practice and its specificities in a geriatric unit.

Patients And Methods: Prospective descriptive study realized by a single consultant.

Inclusion Criteria: patients admitted in the unit between 01/10/2011 and 31/01/2012 with hemoglobin level below 10 g/dL.

Physical exercise and weight loss for hip and knee osteoarthritis in very old patients: a systematic review of the literature.

Background: Rheumatologic and geriatric scholarly organisations recommendations for the management of hip and knee osteoarthritis, which emphasise the usefulness of non-pharmacological therapies, are not scaled according to patient's age and physical condition. We conducted a systematic review of clinical trials on exercise and weight loss in hip and knee osteoarthritis in very old patients.

Methods: Electronic search in MEDLINE, EMBASE, PASCAL database, systematic search of the Cochrane Reviews, manual search in guidelines, meta-analyses and identified relevant articles.

Usefulness of bone density measurement in fallers.

The objective of this systematic literature review is to discuss the latest French recommendation issued in 2012 that a fall within the past year should lead to bone mineral density (BMD) measurement using dual-energy X-ray absorptiometry (DXA). This recommendation rests on four facts. First, osteoporosis and fall risk are the two leading risk factors for nonvertebral fractures in postmenopausal women.

Six-month outcome of elderly people hospitalized via the emergency department: the SAFES cohort.

Background: The objective of the study was to identify factors predictive of 6-month institutionalization or mortality in frail elderly patients after acute hospitalization.

Methods: A prospective cohort of elderly subjects 75 years and older was set up in nine French teaching hospitals. Data obtained from a comprehensive geriatric assessment were used in a Cox model to predict 6-month institutionalization or mortality.

2012 update of French guidelines for the pharmacological treatment of postmenopausal osteoporosis.

Objectives: To update the evidence-based position statement published by the French National Authority for Health (HAS) in 2006 regarding the pharmacological treatment of postmenopausal osteoporosis, under the auspices of the French Society for Rheumatology and Groupe de Recherche et d'Information sur les Ostéoporoses (GRIO), and with the participation of several learned societies (Collège National des Gynécologues et Obstétriciens Français, Groupe d'Étude de la Ménopause et du Vieillissement hormonal, Société Française de Chirurgie Orthopédique, Société Française d'Endocrinologie, and Société Française de Gériatrie et de Gérontologie).

Methods: A multidisciplinary panel representing the spectrum of clinical specialties involved in managing patients with postmenopausal osteoporosis developed updated recommendations based on a systematic literature review conducted according to the method advocated by the HAS.

Results: The updated recommendations underline the need for osteoporosis pharmacotherapy in women with a history of severe osteoporotic fracture.

Vitamin D insufficiency: evaluation of an oral standardized supplementation using 100,000 IU vials of cholecalciferol, depending on initial serum level of 25OH vitamin D.

Objectives: There is no protocol of vitamin D supplementation used worldwide due to a great disparity of vitamin D supplements available in different countries. The aim of this study was to evaluate the efficiency of the protocol most often used in France to correct vitamin D deficiency defined by a serum 25-hydroxy vitamin D (25OHD) level of less than 30 ng/mL.

Methods: This was a pragmatic multicentric study of vitamin D supplementation in 257 osteopenic/osteoporotic, vitamin D deficient patients who received 100,000 UI vitamin D3 vials every two weeks according to their initial serum 25OHD level (four vials when 25OHD less than 10 ng/mL, three when 25OHD was 10-19 ng/mL, two when 25OHD was 20-29 ng/mL).

Rapid cognitive decline, one-year institutional admission and one-year mortality: analysis of the ability to predict and inter-tool agreement of four validated clinical frailty indexes in the SAFEs cohort.

Objectives: To evaluate the predictive ability of four clinical frailty indexes as regards one-year rapid cognitive decline (RCD - defined as the loss of at least 3 points on the MMSE score), and one-year institutional admission (IA) and mortality respectively; and to measure their agreement for identifying groups at risk of these severe outcomes.

Design: One-year follow-up and multicentre study of old patients participating in the SAFEs cohort study.

Setting: Nine university hospitals in France.

[Frailty: learnings from the SAFEs cohort study and future perspectives for the research].

Even though the efforts in research have detailed further the physiopathology and the dynamics of the frailty process an operational definition of frailty is still far from being unequivocal. Studies carried out from the SAFEs cohort study allowed a pragmatic approach in the identification of the at-risk groups for the lost of independency during the hospital stay and factors influencing their future at short-, mid- and long-term. Based upon these results, we propose to discuss the relevance of the current operational indicators of frailty in order to show that clinical markers or indicators are insufficient to differentiate the frailty process from normal ageing.

Predictors of institution admission in the year following acute hospitalisation of elderly people.

Objectives: The aim of the study was to identify factors related to institutionalisation within one-year follow up of subjects aged 75 or over, hospitalised via the emergency department (ED).

Design: Prospective multicentre cohort.

Setting: Nine French university teaching hospitals.

Nursing home admission in elderly subjects with dementia: predictive factors and future challenges.

Objectives: The aim of this study was to identify factors predictive of nursing home admission (NHA) over a period of 1 year among elderly subjects with dementia.

Methods: The study population was drawn from the SAFES cohort that was formed within a national research program into the recruitment of emergency departments in 9 teaching hospitals. Subjects were to have been hospitalized in a medical ward in the same hospital as the emergency department to which they were initially admitted.

The geriatric patient: use of acute geriatrics units in the emergency care of elderly patients in France.

We studied the factors influencing the choice of admission to Geriatrics units, instead of other acute hospital units after an emergency visit. We report the results from a cohort of 1283 randomly selected patients aged >75 years hospitalized in emergency and representative of the French University hospital system. All patients underwent geriatric assessment.

Potentially inappropriate use of psychotropic medications in hospitalized elderly patients in France: cross-sectional analysis of the prospective, multicentre SAFEs cohort.

Background: In France, there is evidence to suggest that 50% of elderly individuals are prescribed psychotropic medications. However, it is known that use of these agents increases the risk of falls, fractures and delirium in older people.

Objective: To study the consumption of 'potentially inappropriate medication' (PIM) among patients aged>or=75 years, paying particular attention to psychotropic drugs and the factors influencing the use of 'potentially inappropriate psychotropics' (PIPs).

Derivation and validation of a mortality-risk index from a cohort of frail elderly patients hospitalised in medical wards via emergencies: the SAFES study.

To identify predictive factors for 2-year mortality in frail elderly patients after acute hospitalisation, and from these to derive and validate a Mortality Risk Index (MRI). A prospective cohort of elderly patients was set up in nine teaching hospitals. This cohort was randomly split up into a derivation cohort (DC) of 870 subjects and a validation cohort (VC) of 436 subjects.

Predicting early mortality among elderly patients hospitalised in medical wards via emergency department: the SAFES cohort study.

Objectives: The aim of the study was, by early identification of deleterious prognostic factors that are open to remediation, to be in a position to assign elderly patients to different mortality risk groups to improve management.

Design: Prospective multicentre cohort.

Setting: Nine French teaching hospitals.

Prefracture syndrome of the hip fracture: a case control study.

Background: Hip fractures result from both bone fragility and trauma, more often a sideways fall. Spontaneous hip fractures have been described; in such cases, patients reported pain ("prefracture" syndrome) in the hip region for weeks before the fracture.

Objectives: To identify the proportion of patients who had a pain in the hip region before a hip fracture, to compare this proportion to the one observed in controls and to describe the characteristics of this pain.

Incidence and main factors associated with early unplanned hospital readmission among French medical inpatients aged 75 and over admitted through emergency units.

Background: among elderly patients, readmission in the month following hospital discharge is a frequent occurrence which involves a risk of functional decline, particularly among frail subjects. While previous studies have identified risk factors of early readmission, geriatric syndromes, as markers of frailty have not been assessed as potential predictors.

Objective: to evaluate the risk of early unplanned readmission, and to identify predictors in inpatients aged 75 and over, admitted to medical wards through emergency departments.