Noëlle Cardinaud

Efficacy of simple home-based technologies combined with a monitoring assistive center in decreasing falls in a frail elderly population (results of the Esoppe study).

BACKGROUND Increasing age often implies increasing frailty, and the oldest old are often described as a frail group with a high risk of developing functional impairments and multi-morbidities like falls at home, which often result in dependence in daily activities. This preliminary study evaluate the efficacy of light path coupled with tele-assistance service for preventing unintentional falls at home in a frail elderly population. METHODS Study design is a longitudinal prospective cohort study from 1st July 2009 to 30 June 2010. The program included 194 adults aged 65 and over living at home and registered on a list of frail elderly people. Participants were uniformly asked about their history of falls during the year prior to their most recent health examination. The recall period was one year. RESULTS We observed that 77 (40.5%) elderly fell at home, 29 (30.9%) in the exposed group and 48 (50.0%) in the unexposed group. The use of light path coupled with tele-assistance was significantly associated with the reduction in falls at home, odd ratio=0.33 95%CI [0.17-0.65] p value=0.0012. There was also a greater reduction in post-fall hospitalization rate among exposed group with odd ratio=0.30 95%CI [0.12-0.74] p value=0.0091. CONCLUSIONS This preliminary study showed that the use of light path coupled with tele-assistance service significantly reduced the incidence of unintentional falling at home among frail elderly population. This result should be confirmed by a randomized trial.

Preventing and Managing Indoor Falls with Home-Based Technologies in Mild and Moderate Alzheimer's Disease Patients: Pilot Study in a Community Dwelling

Background: Alzheimers disease (AD) is known to increase the risk of falls. We aim to determine the effectiveness of home-based technologies coupled with teleassistance service (HBTec-TS) in older people with AD. Methods: A study of falls and the HBTec-TS system (with a light path combined with a teleassistance service) was conducted in the community. The 96 subjects, drawn from a random population of frail elderly people registered as receiving an allocation for lost autonomy from the county, were aged 65 or more and had mild-to-moderate AD with 1 year of follow-up; 49 were in the intervention group and 47 in the control group. Results: A total of 16 (32.7%) elderly people fell in the group with HBTec-TS versus 30 (63.8%) in the group without HBTec-TS. The use of HBTec-TS was significantly associated with a reduction in the number of indoor falls among elderly people with mild-to-moderate AD (OR = 0.37, 95% CI = 0.15-0.88, p = 0.0245). Conclusion: The use of the HBTec-TS significantly reduced the incidence of primary indoor falling needing GP intervention or attendance at an emergency room among elderly people with AD and mild-to-moderate dementia.

Effectiveness of light paths coupled with personal emergency response systems in preventing functional decline among the elderly

Introduction: The elderly population is at high risk of functional decline, which will induce significant costs due to long-term care. Dependency could be delayed by preventing one of its major determinants: falls. Light paths coupled with personal emergency response systems could prevent the functional decline through fall prevention. Methods: This study aimed to evaluate the effectiveness of light paths coupled with personal emergency response systems on the functional decline in an elderly population living at home. It is a secondary analysis on data from a previous cohort. In all, 190 older adults (aged 65 years or more) living at home participated. Participants in the exposed group were equipped with home-based technologies: light paths coupled with personal emergency response systems. The participants’ functional status was assessed using the Functional Autonomy Measurement System scale at baseline (T0) and at the end of the study (T12-month). Baseline characteristics were evaluated by a comprehensive geriatric assessment. Results: After 1 year, 43% of the unexposed group had functional decline versus 16% of the exposed group. Light paths coupled with personal emergency response systems were significantly associated with a decrease in the functional decline (Δ Functional Autonomy Measurement System ⩾ 5) at home (odds ratio = 0.24, 95% confidence interval (0.11–0.54), p = 0.002). Discussion: This study suggests that light paths coupled with personal emergency response systems prevent the functional decline over 12 months. This result may encourage the prescription and use of home-based technologies to postpone dependency and institutionalization, but they need a larger cost-effectiveness study to demonstrate the efficiency of these technologies.

Physical activity and prevalence of cognitive impairment in community-dwelling very old individuals

analyses were performed in which the volume of white matter hyperintensities (WMH) was used as the dependent variable.Results: In women, brain atrophy at an average age of 75.7 was negatively associated with both minutes of walking (p1⁄40.02) and the mean number of grams of fish consumed (p1⁄40.04) at age 50. No association of walking and fish consumption with brain atrophy was evident in men. In both men and women, increased age was associated with greater brain atrophy. Neither walking nor fish consumption was associated with WMH volume. Conclusions: The findings are consistent with previous studies showing that consumption of foods containing high amounts of omega 3 fatty acids as well as increased physical exercise are associated with reduction in brain atrophy with age. The fact that this association was only evident in women may be related to the interaction of female gender with exercise (Eur J Neurosci 2001;14(12): 1992-2002) and omega 3 fatty acids (Aging Res Rev 2011;10: 124-131) in the upregulation of BDNF.