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Copyright of EMC-Medecine is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Douleur et Analgésie is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Objectives: The aging of the population has seen an increase in the number of elderly patients admitted to reanimation units. We sought to know the outcomes and evolution of the quality of life of a population of elderly patients after their experience with this type of service. Method: We included all patients older than 80 years who had been in two intensive care units in the Loire region of France between October 2005 and May 2006. We studied their state of mind 3 months after they exited the service. Then, for the survivors, we used the Activities of Daily Living (ADL) scale and the generic questionnaire of health, the SF-36, to evaluate the evolution of their degree of autonomy and quality of life related to health compared to that one month prior to entry in the reanimation unit. Results: We included 70 patients (mean age 85.2±4.5 years). At 3 months after exiting reanimation, the survival rate was 57%, and 28 survivors underwent rating scale testing. The physical score of the SF-36 and the ADL score were significantly decreased as compared with that one-month before admission, with no significant difference in mental score of the SF-36. Physical deterioration did not have a significant effect on the evolution of perceived health (dimension GH of the SF-36), life and relations with others (dimension SF) or mental health (dimension MH). The decreased ADL score was correlated with that of the two physical dimensions of the SF-36, with no correlation with the four psychic dimensions. A total of 92% of patients were satisfied with their care in reanimation and three of four would agree to go back if their state required it. For the others, it is a question of respecting the will of the elderly patients confronted with reanimation care. Conclusion: Three months after intensive care with reanimation, elderly patients do not have significantly modified perceived health and psychic state as compared with objective deteriorated physical capacity. The absence of consensus on the threshold of old age and the quality-of-life instrument to use prevents a comparison of our results with those in the literature. However, others have shown and we agree that elderly people could benefit from reanimation therapy. [Copyright &y& Elsevier]

Abstract: Aim. – To determine whether very old age, older than 80 years, after a stroke is a significant predictor of mortality, orientation to a specific care pathway after the acute phase and functional status at 6 months after the stroke. Patients. – A sample of 112 consecutive patients admitted to the emergency department because of a first stroke, with hemiplegia and/or aphasia over 6 months, who satisfied strict inclusion/exclusion criteria. Forty-seven patients were older than 80. Method. – After initial diagnosis and enrolment in the study, follow-up assessments were conducted at 48 hours, 15 days and 6 months. Demographic, medical, and radiographic data were collected, and patients were evaluated on the NIHSS, MMSE, Barthel Index, FIMTM and FAM scales. Descriptive statistics were generated, as were uni- and multivariate between group comparisons. Results. – Our study shows that after a first stroke, old age is significantly associated with a high rate of death, a low rate of orientation to a physical medicine and rehabilitation unit and return to home but not poorer functional outcome. Conclusion. – Old age is therefore a determinant of post stroke management. Further studies are needed to evaluate whether in patient rehabilitation would result in significant functional benefit, considering the high cost of care, high risk of recurrent stroke, and high rate of death. [Copyright &y& Elsevier]

Objectives: The development of falls prevention strategies is an essential health concern in elderly people. However, a global consensus does not exist for elderly subjects who live independently in the community. The aim of the study was to evaluate the benefit of an exercises program.Materials and methods: A control group (153 subjects) and an “Intervention” group (150 subjects) were tested before and after a 1-year prospective study. The “Intervention” group performed ten training sessions of physical activity, based on balance, muscular activity and coordination. We compared the incidence of falls, and the performances in several tests between the two groups.Results: The clinical features were similar between the two groups: mean age 71 years, 83% of females, subjects who were independent for activities of daily living. However, all subjects presented risk for factors for falls: 38% were not able to maintain the unipodal position more than five seconds, 29% had already fallen during the previous year. For the “Intervention” group, the comparison of the performances before and after the physical activity program showed significant increases (p < 0.001) for all the tests, and specifically for the unipodal position and for the exercises performed with eyes closed. After one year follow-up, the incidence rate of falls was lower in the “Intervention” group compared with the control group, but the difference was not significant (p = 0.32). However, falls occurred significantly latter in the “Intervention” group (p = 0.02).Conclusion: Ten training sessions of physical activity allowed to improve the performance of elderly people in several tests. This result suggests that a fall prevention program based on collective and regular exercises, may be efficient for elderly subjects who still have an active and independent way of live. [Copyright &y& Elsevier]