Jean Louis Albarede

Body composition in French women 75+ years of age: the EPIDOS study.

BACKGROUND There are presently no published data on age-related changes in body composition in French individuals older than 65 or 80 years. This paper presents a cross-sectional study of 7518 community-residing French women older than 75 years. METHODS We examined age differences changes in body composition and anthropometry between age groups (76-80, 81-85, and 86-95 years of age). Whole body composition was estimated using a dual energy X-ray absorptiometry (DXA) scanner. Measurements of appendicular skeletal muscle (ASM) mass and sarcopenia were performed for a subsample of 1321 women. RESULTS Significant age differences exist in total fat mass and total bone mineral content in elderly women between 76 and 95 years of age. There was also a significant decreased in fat free soft tissue mass from 76 to 85. The decline in fat free mass may be reduced over 85 years of age. The prevalence of low muscle mass, or sarcopenia, increased with age from 8.9 in 76-80 to 10.9% in 86-95 age group, but the difference was not statistically significant. CONCLUSIONS Interventional programs developed to prevent or reduce sarcopenia would have a better influence on population under 85 years, i.e. when the decline in ASM mass is the most severe. Others longitudinal studies could be performed to confirm our results.

A prospective study of chances in the nutritional status of Alzheimer's patients

Summary The evolution of nutritional parameters was studied over 1 year in patients with Alzheimers disease (AD). Seventy-six community dwelling patients with probable AD underwent a comprehensive nutritional assessment at entry into the study and 1 year later. The nutritional assessment included anthropometric and biological markers, as well as a complete dietary assessment. A comprehensive functional and neuropsychological evaluation was performed on each patient using a number of standardized and validated tools, as well as a scale to evaluate caregiver burden. Just over 44 % of our subjects experienced a greater than 4 % weight loss in 1 year. Over 13 % of our subjects lost more than 10 % body weight. Patients having lost weight resembled patients without weight loss, except that caregiver burden was perceived to be higher in the weight loosing group, they tended to lose independence in activities of daily living (ADL). This group also had a decrease in daily caloric intake (−400 kCal/day). In 1 year, a large number of AD patients lose weight. Given the seriousness of the problems associated with weight loss it seems to be prudent to recommend a regular monitoring of the nutritional status in AD patients, as soon as the diagnosis is suspected, and instituting a weight loss prevention program where caregiver burden is perceived as the greatest.

Life expectancy, comorbidity, and quality of life. A framework of reference for medical decisions.

The treatment of cancer in the elderly can benefit from increasingly sophisticated methods that measure a patients quality of life. These measures are both general and cancer specific and herald a new and enlightened approach to patient care. The care of the older patient must be seen in light of what is known about life expectancy, the outcome of treatment, an awareness of comorbidity, and the importance of informed consent and respect for the values and preferences of the individual patient. This article reviews the growing literature on quality of life research in cancer patients.