Effect of a multimodal training on the ability of medical students to administer the MMSE: a comparative study.

Backgrounds: The Mini-Mental State Examination (MMSE) is the main screening and follow-up test for neurocognitive disorders. In France, it is often administered by medical students. Conditions allowing to administer the MMSE are strict but not well known by students, leading to mistakes in scoring.

[Deliberate intoxication with Datura Stramonium, a rare cause of confusion].

Many drugs can be responsible for this syndrome. Although it remains rare, poisoning by Datura Stramonium should be considered in the event of anticholinergic syndrome in the elderly, particularly in the event of anticholinergic manifestations.

Clinical Pharmacist Intervention Reduces Potentially Inappropriate Prescriptions in a Geriatric Perioperative Care Unit Dedicated to Hip Fracture.

Introduction: Clinical pharmacist (CP) intervention improves drug prescription by identifying potentially inappropriate prescriptions (PIPs). Geriatric perioperative care units (UPOGs) provide enhanced care for patients with hip fracture, including drug prescription. However, it is not known whether adding a CP intervention in a UPOG decreases the number of PIPs.

Association between orthostatic blood pressure dysregulation and geriatric syndromes: a cross-sectional study.

Background: Orthostatic blood pressure dysregulation, including orthostatic hypotension (OH) and orthostatic hypertension (OHT), is common in the elderly. The association between OH and, to a lesser extent, OHT with geriatric syndromes is controversial and little investigated. Our objective was to assess the association between orthostatic blood pressure dysregulation and geriatric syndromes in an ambulatory outpatient population.

Analysis of the impact of a medication reconciliation tool on the hospital-community interface.

Objective: To analyse the impact of a medication reconciliation tool (MRT), which contains information on all the treatments a patient is receiving upon admission as well as intra-hospital therapeutic adjustments and the rationale behind them, on the transmission and quality of the follow-up of prescribing recommendations outside the hospital setting.

Methods: The MRT involved the prescriptions of patients who were aged 75 and over, who were admitted to a geriatric short-stay unit, and who were referred to a general practitioner (GP) upon discharge. Drug discrepancies (DD) and polypharmacy after an intra-hospital medication reconciliation and at the time of renewing the out-patient prescription (one month after discharge) were measured.

[A rare but increasing aetiology of febrile dyspnea in the elderly].

Pneumocystis jirovecii pneumonia (PJP) is an opportunistic infectious disease well described in patients living with HIV (PLHIV) but that can occur in other immunosuppressed patients. Currently, its incidence decreases in PLHIV but increases in non-HIV immunosuppressed patients, particularly in case of hematological diseases. Thus, in elderly, the diagnosis of PJP should be evoked in case of subacute pneumonia rapidly evolving to an acute respiratory distress, with or without interstitial pneumonia at chest radiography, and a context of immunosuppression.

Consensus of experts from the French Society of Geriatrics and Gerontology on the management of heart failure in very old subjects.

The prevalence of heart failure increases with age. In France, the 1-year mortality rate is 35% in subjects aged 80-89 years with heart failure, and 50% after the age of 90 years. In octogenarians, heart failure is associated with high rates of cardiovascular and non-cardiovascular events, and is one of the main causes of hospitalization and disability.

[Analysis of the impact of a medication reconciliation toolkit in the hospital-community interface].

Objective: To analyse the impact of a medication reconciliation toolkit (OCM) which details all the treatment at the admission, intra-hospital therapeutic adjustment and their justifications, on the transmission and quality of extra-hospital follow-up of prescribing recommendations.

Methods: The OCM was fulfilled with the prescriptions of patient aged ≥75 years admitted to a geriatric short-stay unit and sent to general practitioners (GPs) upon discharge. Drug discrepancies (DD) and exposure to polypharmacy after intra-hospital medication conciliation and the ambulatory repeat prescribing (1 month after discharge) were measured.

Buccofacial Apraxia, Oropharyngeal Dysphagia, and Dementia Severity in Community-Dwelling Elderly Patients.

Apraxia occurs frequently in patients with dementia. Buccofacial apraxia (BFA) characteristics have been less investigated than limb or speech apraxia. An association between BFA and oropharyngeal dysphagia (OD) in old patients with dementia has not yet been explored.

[Frailty syndrome: evaluation of its knowledge and screening tools by general medicine interns].

Unlabelled: Screening and management of frail elderly patients is essential in general practice.

Objective: This study aims to describe and evaluate the knowledge about frailty, its screening tests and management in a population of general practice interns.

Method: A prospective, descriptive and mono-centric study using an online survey was conducted.

[Intraoperative hypotension and delirium in patients with hip fracture].

Postoperative delirium is common after hip fracture surgery in elderly patients and is associated with poor outcome (higher risk of mortality, institutionalization and length of stay). The relationship between modifiable intra-operative risk factors, such as intra-operative hypotension, and postoperative delirium is unclear. The main objective of this study was to evaluate the association between intra-operative hypotension and the development of a postoperative delirium in older patients with hip fracture.

Chronic neurological disorders and related comorbidities: Role of age-associated physiological changes.

Current knowledge indicates that the physiological aging process starts with subclinical changes at the molecular and cellular level, which affect nearly all physiological systems. For example, the age-associated remodeling of the immune system (i.e.

Using a structured reconciliation medication form improves medication transition from hospital to community care and primary care physicians' adherence with medication adaptations and recommendations.

Background: Hospital admission and discharge are weakness points in the transition of care.

Objective: To lower the risk of errors and improve medication information transfer to primary care physician (PCP), we conducted an experimental study using a structured medication reconciliation form (SMRF) in an Acute Care for Elders unit.

Results: 1242 drugs of 173 patients were reconciliated at admission, optimized during the stay, and transmitted via the SMRF to the 143 corresponding PCPs.

Oropharyngeal Dysphagia in Community-Dwelling Older Patients with Dementia: Prevalence and Relationship with Geriatric Parameters.

Objectives: To define the prevalence of oropharyngeal dysphagia (OD) in community-dwelling older persons with dementia, using V-VST (Volume-Viscosity Swallow Test), the reference clinical screening test for swallowing disorders, to assess the feasibility of the V-VST in an ambulatory care setting, to search for associations between geriatric parameters and OD, and to identify a relationship between severities of cognitive impairment and OD.

Design: Prospective, monocentric study.

Setting: Population from a geriatric outpatients clinic.

[Geriatric medicine].

2017 highlights benefits of prevention. Better control of cardiovascular risk reduces the incidence of dementia and monthly high-dose vitamin D the incidence of respiratory infections in nursing home. Pre-operative geriatric assessment lowers by 20% the rate of delirium after hip-fracture surgery and complications in vascular surgery.

Tracking tool for frailty: ABCDEF.

The aging population leads to psychological, medical and social reflection for optimal care of the elderly, especially characterized by a frailty state. The frailty is the cause of morbi-mortality require screening to anticipate these complications. The objective was to evaluate the statistical performance and feasibility of the tool "ABCDEF" to screen frailty defined by Fried's criteria.

Acute cardiac failure secondary to senile systemic amyloidosis.

Hereditary or senile transthyretin (TTR) cardiac amyloidosis is a rare and underestimated cause of heart failure in old patients. New diagnostic methods, particularly cardiac MRI and proteomic analysis, have been recently developed that enable both earlier identification and development of specific treatments.We report a case of cardiac amyloidosis revealed through late-onset heart failure.

[Anaemia and chronic diseases].

The prevalence of anemia in old patients is 20%. Anemia is mostly multifactorial associated with multiple comorbidities that are frequently observed in people of 65 years or older. Chronic renal failure, inflammatory diseases, nutrient deficiencies and especially iron deficiency are the most associated conditions with anemia.

Clinical symptoms, signs and tests for identification of impending and current water-loss dehydration in older people.

Background: There is evidence that water-loss dehydration is common in older people and associated with many causes of morbidity and mortality. However, it is unclear what clinical symptoms, signs and tests may be used to identify early dehydration in older people, so that support can be mobilised to improve hydration before health and well-being are compromised.

Objectives: To determine the diagnostic accuracy of state (one time), minimally invasive clinical symptoms, signs and tests to be used as screening tests for detecting water-loss dehydration in older people by systematically reviewing studies that have measured a reference standard and at least one index test in people aged 65 years and over.

Underuse of oral anticoagulation for individuals with atrial fibrillation in a nursing home setting in France: comparisons of resident characteristics and physician attitude.

Objectives: To describe the characteristics of nursing home residents diagnosed with atrial fibrillation (AF) and eligible for oral anticoagulants who did not receive these drugs and to detail the conditions that physicians who decide not to prescribe anticoagulants take into account.

Design: Cross-sectional.

Setting: Nursing home.

[Care of elderly subject with iron deficiency anaemia: evaluation of geriatric practice].

Unlabelled: The anemia with iron deficiency is frequent in the elder subjects. Few studies have reported the practice of the geriatric medicine about anemia.

Methods: A national survey asked geriatric medical practitioners of hospital geriatric ward from June till September, 2013.