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Advanced cancers are associated with a chronic inflammation, especially high interleukin-6 (IL-6) and with various levels of adipokines (leptin and adiponectin), while ghrelin counteracts the anorexigenic effect of leptin in cancer-induced anorexia-cachexia syndrome. We aimed to understand how IL-6, adipokines and ghrelin plasma levels could be influenced by cancer on the one hand, and by age, frailty, and nutritional status in old cancer patients on the other hand. Ninety-nine patients aged 79[76-83] years old were included. Sixty-six percent had advanced stages of cancer, and 34% had cachexia. Fifty percent were at risk of malnutrition, and 10% had overt malnutrition. None of the variables studied was significantly correlated with the advanced stage, or cachexia. In multiple regression, the only parameter significantly and positively associated with age was adiponectin (p = 0.008). Despite a high prevalence of frailty in our study, we did not find any independent association of frailty (assessed by G8) with IL-6, leptin, adiponectin, or ghrelin in multivariate analysis. We observed that a low albumin level was independently associated with a higher level of IL-6 (p < 0.0001), but not with the MNA score. However, leptin showed a positive correlation with BMI (p < 0.0001), confirming the persistence of a relationship between leptin and adiposity, even in older cancer patients. Finally, high IL-6 level was associated with a higher mortality rate (p = 0.027). In conclusion, IL-6, leptin, adiponectin, and ghrelin are not associated with advanced stages of cancer or cancer-induced cachexia in older subjects with cancer, but they are significantly correlated with anthropometric factors and body composition., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Introduction: Older people suffer more often and from more severe infections than do younger people. Several studies have shown a correlation between higher white blood cell count (WBCC) and the presence of infection. The usefulness of increased WBCC to assess the presence of infection in geriatric patients is debated. To answer this question, we investigated the correlation between the total and differential WBCC and documented infection in hospitalized geriatric individuals., Population and Methods: Clinical data (medical history, comorbidities, treatments, geriatric syndromes) and biological parameters were collected from 166 hospitalized geriatric patients (67-106 yrs) presenting with acute inflammation (C-reactive protein (CRP) > 10 mg/l) and were compared according to the presence/absence of infection., Results: The mean WBCC was not significantly different (p = 0.71) according to the presence of infection or not, although the mean CRP level was higher in the infected group compared to the non-infected group (p = 0.0019). In regression analyses, the presence of infection was not associated with an increase in total and differential WBCC. Additionally, we found a positive correlation between cardiovascular risk factor and diseases (CVRF & diseases) and WBCC., Conclusion: In geriatric patients, WBCC is not a reliable biomarker for infection; however, combined with CRP, it represents a marker of cardiovascular disorders., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background/objectives: Geriatric patients are highly susceptible to infections. While reduced lymphocyte count has been associated with age, other studies found no change in WBC counts with age. Increased circulating white blood cell (WBC) count has been associated with cardiovascular (CV) diseases and frailty but there are discrepancies. Frailty, geriatric conditions, cardiovascular diseases and WBC count have also been associated with low grade inflammation. Association between geriatric conditions and WBC has been scarcely studied. The aim of the study is to assess the association between WBC and geriatric conditions, CV diseases, and seric IL-6 levels., Design, Setting, Participants, Measurements: We recruited 100 subjects in the general population and hospitalized for chronic medical conditions (age, 23-96years). We collected information on clinical status (medical history, comorbidities, treatments and geriatric syndromes), biological parameters (hematological tests, cytomegalovirus serology) and cytokine production (basal IL-6). Using stepwise backward multivariate analyses, we defined which set of clinical and biological variables could be predictive of increased total and differential WBC counts., Results: We found that low-grade inflammation is independently associated with total WBC, monocyte and neutrophil counts, but not geriatric conditions. CV diseases were the only significant associated factor for high monocyte count., Conclusion: In this study, we observed that differential and total WBC counts do not seem to be associated with geriatric conditions but with CV diseases, low-grade inflammation and telomere length., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Delirium is common in older people. It is a crucial diagnosis because it raises the morbidity and the mortality. Diagnostic tools like Mini Mental State Examination (MMSE), the confusion assessment method (CAM), and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSMIV), can help with the diagnosis. We report a case of a woman with neurological symptoms which look like dementia. We diagnosed systemic lupus erythematosus (SLE). The apparition of late-onset SLE is more insidious, which leads to misdiagnosis. We will discuss about the difficulty of the differential diagnosis between delirium, depression and dementia in our patient and the difficulty to manage treatment of neurolupus in older people., (Copyright © 2012 Elsevier Inc. All rights reserved.)