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Biomedical subjects

B Vellas

Publications and source records attributed to B Vellas.

At least 127 records · Page 7Linked to original sources
PubMed1990

[Standardization of a modular and hierarchic cognitive evaluation scale applicable to dementia. A French version of the Hierarchic Dementia Scale].

We tested a revised version of the Hierarchic Dementia Scale (HDS), proposed by Cole and Dastoor (1980), in order to improve its clinical usefulness and to enrich our knowledge about ageing. The scale was built with 20 subtests which covered the entire range of cognitive and motor functions. Each subtest was hierarchically organized so that success in a item implied success in inferior items. This hierarchical principle was time-saving and was validated by Cole and Dastoor. 149 control subjects performed this test. They were equally divided in 4 age-groups (55-64, 65-74, 75-84, 85-97) and 2 educational levels. None of these subjects had previous history of somatic or neuropsychiatric disease. They were completely self-sufficient in daily life. A large part of the controls failed in the most difficult items of some subtests: Learning, Calculation, Mental Control, Drawing, Recall, Similarities, Constructional Praxis. For these subtests, significantly different mean-scores were observed between age-groups and educational levels. However, the influence of each factor was variable from one subtest to another. Moreover, subgroups seem to exist in our population according to specific difficulties in some of these subtests. This study calls for caution in the interpretation of results in demented patients. Comparisons with other psychometric tools remain to be performed. This scale seems to be more useful for the quantification and follow-up of cognitive deficits than for the early diagnosis of dementia. In addition, this scale, which briefly explores many aspects of cognitive functions, seems especially useful to approach the heterogeneity of DAT.

Aged↗
PubMed1989

[Psychological factors in falls in elderly patients].

This article recognizes the high incidence and prevalence of falls in the elderly. Psychological factors can play a definite role as part of the etiology. The fall can be a depressive signal or a cry for help from a demoralized elderly patient. The authors stress the importance of recognizing the depressive syndrome of the elderly. Psychological consequences of the falls are reviewed at three different levels. For the elderly, the consequences are frequently a fear that can lead to a sharp decrease in functional capacity. For the family, the fall can lead to the institutionalization of the elderly or a very restrictive surveillance. For the family physician, the fall is frequently perceived as an emergency that leads to immediate unwarranted admission. A rational approach, with education and guidelines, is proposed and can render this traumatic experience less dramatic at these three different levels.

Accidental Falls↗
PubMed1988

[Aging of the pancreas. Its implication in malnutrition states in elderly persons].

The influence of ageing on exocrine pancreatic function was investigated in rats and in men. Young rats (3-months old, 150-200 g) and old rats (24-month old, 400-500 g) were killed after fasting overnight. Small pancreatic fragments were removed and kept for stereological analysis both in light and electron microscopy; in addition, levels of tritium-labelled leucine uptake and protein synthesis were measured by quantitative histoautoradiography on isolated acini in vitro. The human study was conducted retrospectively in 27 adults (mean age 36 +/- 1.5 years) and in 28 elderly subjects (mean age 72 +/- 0.6 years) with no clinical or radiological evidence of pancreatitis. Duodenal aspirates were taken over a 90 min period under secretin (0.5 U/kg.h) and cerulein (75 U/kg.h) infusion for comparisons of bicarbonate, lipase, chymotrypsin and amylase concentrations and outputs in the two groups. Elderly people were found to have significant and parallel decreases in bicarbonate, lipase and amylase output as compared to younger subjects (-40 per cent, P less than 0.001). The pancreatic deficiency was confirmed in rats by a significant decrease in zymogen volume density and zymogen diameter and a defect of protein synthesis with significant slowing down (-70 per cent, P less than 0.001) of newly synthesized protein transfer to the Golgian zone of acinar cells. Signs of exocrine parenchyma dystrophy (pancreatitis?) were also observed.

Adult↗
PubMed1988

Exocrine pancreatic secretion in the elderly.

In order to evaluate impairment of exocrine pancreatic function during aging, 27 subjects (mean age: 36 years +/- 7.8) and 28 subjects (mean age: 72 years +/- 3.2), with no clinical or radiological evidence of digestive disease, were selected. Duodenal aspirates over a 60 min period were obtained during continuous IV infusion of secretin (0.5 U/kg/h) and caerulein (75 ng/kg/h). Bicarbonate, lipase, chymotrypsin amylase concentrations and output were measured. Bicarbonate, lipase, chymotrypsin concentrations in the aged group were significantly reduced by 17%, 15% and 23% respectively (P less than 0.05) as compared with those in the young group. In addition, a significant reduction of approximately 45% in bicarbonate and enzyme output levels was observed. This study provides strong evidence for a marked functional involution of the exocrine pancreatic secretion during aging. The potential consequences of this phenomenon on the nutritional status in the elderly are discussed.

Adult↗
PubMed1987

Prospective study of restriction of activity in old people after falls.

The levels of activity of two populations of fall victims (at home and in an institution) were studied before and then 6 months after an apparently minor fall, in comparison with a control group. The fall victims had a lower level of activity than the controls. They walked less indoors, and found it more difficult to get out. These differences may be considered predictive factors for falls. It was also found that the falls resulted in a restriction of activity and appear to be a factor that aggravates and accelerates the effects of ageing.

Accidental Falls↗
PubMedDate not supplied

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. We investigated balance using a one-leg balance test. PARTICIPANTS: 129 healthy women aged 75-89 years, volunteers, ambulatory and living at home. RESULTS: Total fat mass and appendicular skeletal muscle mass (ASM) were significantly lower in osteoporotic women than in the age- and sex-matched non-osteoporotic controls [18.7 +/- 4.6 vs. 22.2 +/- 6.6 for total fat mass (p < 0.01); 13.1 +/- 1.6 vs. 13.8 +/- 2.2 for ASM (p < 0. 05)]. We did not find a positive association between osteoporosis and sarcopenia (OR = 0.75, CI 0.3-1.84), osteoporosis and one-leg balance (OR = 1.27, CI 0.51-3.17), or sarcopenia and one-leg balance (OR = 1.31, CI 0.52-3.36). There were significant positive correlations between BMD in all areas and body measurements (weight, fat mass, lean tissue mass), but fat mass accounted for more of the variance in total body and femoral BMD than lean tissue mass. Total fat mass alone, in a multivariate model, was correlated with whole body BMD, whereas femoral BMD was associated with both fat mass and lean tissue mass. CONCLUSION: Higher values of fat mass and lean tissue mass may have a protective effect on femoral bone density. Sarcopenia and osteoporosis are not necessarily linked with balance.

Absorptiometry, Photon↗
PubMedDate not supplied

[Causes and consequences of elderly's agitated and aggressive behavior].

Agitation and aggressiveness are frequent in the elderly and often related to dementia. As a result of the ageing of the general population this is becoming a major public health concern. No or little epidemiological data, during primary health care, about symptoms, co-morbidity, nor medical and social consequences of elderlys' disruptive behavior have been gathered or published in the French literature. Thus, in order to describe these disorders, a survey in cooperation with general practitioners (GP) was conducted. A representative sample of 212 French GP's, all with preferential geriatric activity were asked to conduct a study by including retrospectively their two most recent patients older than 65, who had exhibited agitation and/or aggressiveness. From this cross sectional study, 410 patients (female: 61%, male: 39%) were included. The mean age was 81 years (sd: 7.65). The patients suffered from change in verbal behavior (80%), verbal aggressiveness (71%), physical agitation (60%), wandering (48%), and/or physical aggressiveness (31%). The average of disruptive behavior symptoms per patient was 2.9. The symptoms appeared progressively in 81% of patients, the mean duration was two years and it was the first episode in 40% of patients. Disruptive behaviors may be explained in view of organic illness in 62% of patients (cardiovascular disease: 37%, neurologic: 12%, diabetes: 7%, dehydratation: 5%), dementia (Alzheimer disease: 20%, vascular dementia: 18%, mixed dementia: 14%). In 54% of patients disruptive behavior may be explained in view of depression: 34%, and anxiety disorder: 31%. A triggering factor was observed in 57% of cases (psychosocial stress: 39%). Somatic consequences of the symptoms were frequently identified: decrease of alimentary intake: 39%, weight loss: 27%, dehydratation: 11%, falls: 32%, and irregular medication intake: 31%. Limitation of daily life activities: 85%, and family life: 97% were also noted. Acceptability of patient's symptoms by the family was good (no discomfort or transitory and mild irritability) in 61% of cases, and very bad (reactions of exhaustion, hospitalization requirement) in 13%. This study carried out during primary care, showed that the elderly's disruptive behaviors cause severe medical consequences and familial and social distress.

Age Factors↗
PubMedDate not supplied

Relationship between malnutrition and falls in the elderly.

Due to the multifactorial nature of falls in the elderly population, it is difficult to determine causal relationships for risk factors for falls. In some cases, other risk factors may play a role. For example, the association between poor nutrition status and falls has not been studied extensively. The association of commonly demonstrated nutritional deficiencies in the elderly with factors such as balance, gait, and mobility may lead to new insights into causes of falls in the elderly not previously established. In this article, we review how malnutrition can be a risk factor for falls, how falls can induce malnutrition, and the possible relationship between mobility and nutrition in the elderly.

Accidental Falls↗
PubMedDate not supplied

Nutritional intake and recreational physical activity in healthy elderly women living in the community.

PURPOSE: Recreational physical activity, which increases energy expenditure, may help to maintain proper food intake. To compare the nutritional intake of inactive, active and very active healthy elderly women. METHODS: Eighty-two women were recruited in the community. Participants had to be > or = 65 years and in good health (< or = 2 drugs, < or = 1 major illness, < or = 1 surgical operation, no disability in basic or instrumental activities of daily living and no cognitive impairment). We compared food intakes between the 26 inactive (age 73.9 +/- 7.7 y, BMI 24.3 +/- 3.2 kg/m2), the 29 active (age 71.5 +/- 5.6 y, BMI 23.2 +/- 3.5 kg/m2) and the 27 very active (age 70.9 +/- 4.8 y, BMI 24.3 +/- 3.2 kg/m2) healthy women. The nutritional intake was evaluated by a three-day food record. Macronutrient, mineral and vitamin content were derived from tables. Self-reported type, duration and frequency of recreational physical activities during the last month were converted into energy expenditures. RESULTS: Despite high levels of energy intake (mean 1743.9 kcal/d), mean intakes of calcium, vitamin B1, E and folic acid were lower than Recommended Dietary Allowances (-26.2%, -12%, -50.8%, -2.4% respectively) in the whole sample. There were no significant differences of energy intake and quantities of nutrients between the groups except for calcium intake which was significantly higher in inactive women (p=0.04). CONCLUSION: Active healthy elderly women do not have a better nutritional profile than their inactive peers.

Aged↗
PubMedDate not supplied

Disease modifying trials in Alzheimer disease: methodological and statistical issues.

In order to establish that a drug has an impact on disease progression, a clinical trial must study both the symptomatic and the disease modifying effect of the drug. Disease modifying trials raise some methodological issues with regard to the choice of the design (parallel arm versus two- period design), of the outcome (clinical versus surrogate) and of the statistical analysis (management of missing data).

Alzheimer Disease↗