[Sleep, an issue for nurses and patients].

A three-day training programme on sleep in hospitals was created in 2008 on the initiative of the national association for the continuing training of hospital staff, in collaboration with the French ministry of health. 448 nurses have been trained thanks to a participative programme integrating new, interactive pedagogical tools.

[Nutrition and Alzheimer's disease].

Weight loss is frequent in Alzheimer's disease. Its severity increases with the progression of the disease and may be a predictor of patients' mortality. Weight loss often precedes the diagnosis and may be considered as a feature of the disease itself.

Impact of nutritional status on the evolution of Alzheimer's disease and on response to acetylcholinesterase inhibitor treatment.

Background: Weight loss is frequently observed in patients with Alzheimer's disease (AD), as observed in clinical practice and reported in the literature. However, information on the evolution of nutritional status and its impact on the prognosis of AD is still scarce.

Objective: Our aim was to determine the impact of nutritional status on the evolution of AD and on the response to treatment with acetylcholinesterase inhibitors (AChEI) by prospective one-year follow-up of AD patients living at home.

The practice of obtaining approval from medical research ethics committees: a comparison within 12 European countries for a descriptive study on acetylcholinesterase inhibitors in Alzheimer's dementia.

Across Europe the protection of research subjects with dementia has to meet a variety of national legislation and ethical codes. This research project compared how in different EU countries one single descriptive multinational study on dementia treatment strategies was evaluated by medical ethical committees and how the issues of informed consent and capacity to consent were dealt with. The study that was evaluated is the ICTUS study, which studies the impact of treatment with acetylcholinesterase inhibitors (AChE-I) on Europeans with mildly or moderately severe Alzheimer's disease (AD).

Improvement of weight and fat-free mass with oral nutritional supplementation in patients with Alzheimer's disease at risk of malnutrition: a prospective randomized study.

Objectives: To study the effects of oral nutritional supplements (OS) on body weight, body composition, nutritional status, and cognition in elderly patients with Alzheimer's disease (AD).

Design: Prospective, randomized, controlled study.

Setting: Geriatric wards and day care centers in the Toulouse area, France.

Identifying the elderly at risk for malnutrition. The Mini Nutritional Assessment.

In more than 10,000 elderly persons, the mean prevalence of malnutrition is 1% in community-healthy elderly persons, 4% in outpatients receiving home care, 5% in patients with Alzheimer's disease living at home, 20% in hospitalized patients, and 37% in institutionalized elderly persons. In community-dwelling elderly persons, the MNA detects risk of malnutrition and life-style characteristics associated with nutritional risk while albumin levels and the BMI are still in the normal range. In outpatients and in hospitalized patients, the MNA is predictive of outcome and cost of care.

Cognitive function and caregiver burden: predictive factors for eating behaviour disorders in Alzheimer's disease.

Background: Patients with Alzheimer's disease (AD) commonly develop aversive feeding behaviours. These behaviours lead to weight loss and frequently to physicians using tube feeding. Little is known about factors correlated with feeding difficulties during AD.

A nutritional education program could prevent weight loss and slow cognitive decline in Alzheimer's disease.

Background: Weight loss is a common problem in patients with Alzheimer's Disease (AD). It is a predictive factor of mortality and it decreases patients' and caregivers' quality of life.

Objective: To determine if a nutritional education program can prevent weight loss in AD patients.

Relationships between nutritional markers and the mini-nutritional assessment in 155 older persons.

Objective: To investigate the relationships between nutritional status measured by a comprehensive nutritional assessment including anthropometric measurements, nutritional biological markers, evaluation of dietary intake, and the Mini-Nutritional Assessment (MNA) nutrition screening tool.

Design: A prospective study.

Participants: One hundred fifty-five older subjects (53 men and 102 women; mean age = 78 years; range = 56-97 years).

Changes in dietary intakes with age.

The aim of this study was to describe changes in dietary intakes with age in subjects aging normally within the Toulouse study. Daily caloric intakes were constant in both sexes and in the three age classes considered. Energy distributions among the meals were rather clearly modified in men: the contribution of breakfast and afternoon snacks increased while those of lunch and dinner decreased.

Assessment of the effectiveness of drug therapies on nutritional status in the elderly: "concerning a randomised, double-blind clinical study of the activity of pancreatic extracts and a placebo during the renutrition of elderly subjects suffering from protein caloric undernutrition".

Aims: to study, versus placebo, the value of administering pancreatic extracts in elderly subjects suffering from denutrition.

Methods: 52 subjects over 70 years of age, living in the Toulouse region of France, were included in this study. Each subject was required to present with an impaired nutritional status of their food intake, anthropometric and laboratory markers.

A prospective study of changes on nutritional patterns 6 months before and 18 months after retirement.

To present results from a two year prospective study on diet, 6 months before and 18 months after retirement. The studied population exhibited an increase in social and physical activities over time after retirement. A significant decrease in weight was found in men 18 months after retirement.

[Falls, frailty and osteoporosis in the elderly: a public health problem].

Introduction: Elderly people can be subdivided into three groups: healthy elderly persons (65-70% of the population), elderly subjects with diseases (about 5%) and frail old people. Frailty represents "age-related physiologic vulnerability resulting from impaired homeotasic stock and a reduced capacity of the organism to withstand stress". It could lead elderly subjects to pathological, barely reversible, ageing.

Body composition and osteoporosis in elderly women.

Objectives: To study body composition in elderly osteoporotic women to determine the relationship of body weight, body fat mass and lean mass to bone mineral density (BMD), and to investigate the association between one-leg balance, osteoporosis and sarcopenia.

Design And Setting: A cross-sectional study of a community-based population in Toulouse, France.

Methods: For each participant, whole body composition and BMD were estimated using a dual-energy x-ray absorptiometry scanner.

Protein-energy oral supplementation in malnourished nursing-home residents. A controlled trial.

Objectives: To validate a nutritional intervention programme for elderly people living in nursing homes.

Design: In a prospective, randomized, controlled study of 88 residents, we determined nutritional status at day 0 and day 60 using a record of dietary intake, anthropometry, hand-grip strength and mini-nutritional assessment. Dietary intake, grip strength and body weight were also recorded at day 30.

Nutrition assessment in the elderly.

The prevalence of malnutrition, which is relatively low in free-living elderly persons (5-10%), is considerably higher (30-60%) in hospitalized or institutionalized elderly persons. As a result, nutritional assessment should be part of routine clinical practice in elderly patients who are frail, sick or hospitalized. A comprehensive screening tool for assessment of nutritional status is needed that is clinically relevant and cost-effective to perform.

[A tool for nutritional anamnesis of elderly patients].

Malnutrition is frequent in the elderly, especially if frail or hospitalized. Nutritional evaluation tools allow the early detection of malnutrition and should be incorporated into the standard gerontological work-up as a basis for preventive action or rapid appropriate intervention. We review the various nutritional evaluation tools available, in particular the Mini Nutritional Assessment (MNA) which both evaluates nutritional status and guides nutritional intervention.

The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients.

The Mini Nutritional Assessment (MNA) has recently been designed and validated to provide a single, rapid assessment of nutritional status in elderly patients in outpatient clinics, hospitals, and nursing homes. It has been translated into several languages and validated in many clinics around the world. The MNA test is composed of simple measurements and brief questions that can be completed in about 10 min.

Nutrition and successful aging: a study of 520 elderly persons from the Toulouse and New-Mexico Aging Process Study.

Epidemiological studies of aging are usually confronted with the presence of numerous pathologies or environmental factors which make it difficult to identify the effects of aging individually. One way of reducing the variability among individuals is to use well defined criteria to select the study population. This is the choice that was made for the New Mexico and Toulouse Aging Process Studies, which were particularly turned towards successful aging.