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753. Validation of a new data-driven method for identification of muscular activity in REM sleep behaviour disorder

Author

Matteo Cesari, Christensen, Julie A. E., Mayer, G., Oertel, W. H., Sixel-Doering, F., Trenkwalder, C., Helge Bjarup Dissing Sørensen, and Jennum, P.

Abstract

Objectives/Introduction:REM sleep behaviour disorder (RBD) isa parasomnia characterized by lack of atonia during REM sleep. Gold standard methods for RBD diagnosis require manual REM sleep without atonia (RSWA) scoring, which is time‐consuming and subjective. We propose and validate a new data‐driven algorithm and com-pare it to other automatic methods based on RSWA detection for identifying RBD patients.Methods:We included 27 control subjects (C), 29 idiopathic RBDpatients and 36 patients with periodic limb movement disorder(PLMD). After artefact removal, mean absolute amplitude values of1‐s windows of chin, tibialis left and right EMG signals during REMfrom 9 randomly selected controls were used to define a probabilistic model delineating atonia. For the remaining subjects, each 1‐s window was labelled as movementif its probability of being atonia was lower than an optimized threshold. For each EMG signal, we calculated the percentages of 1‐s windows with movements and themedian intra‐movement distance during REM and NREM. Usingthese indices, a classification algorithm was trained and tested (5‐fold cross‐validation) to distinguish the three subject groups. For comparison, the REM atonia index (RAI), Frandsen index (FRI) and Kempfner index (KEI) were calculated for the same cohort and ananalogous classification algorithm was applied to each of them. The overall test accuracies, sensitivities and specificities for C, RBD and PLMD were calculated for each method.Results:The following test performances were achieved (mean and standard deviation across the five folds in %): Overall accuracy:79.58±9.16 (this work), 44.56±6.27 (RAI) 46.73±5.40 (FRI),49.08±11.82 (KEI); RBD sensitivity: 81.67±17.08 (this work),53.67±13.03 (RAI), 58.71±10.94 (FRI), 58.81±28.37 (KEI); RBD speci-ficity: 83.98±5.09 (this method), 83.59±4.12 (RAI), 85.48±4.18 (FRI),77.80±5.54 (KEI). Further, the proposed method achieved higher sen-sitivity and specificity for identifying C and PLMD than the other ones.Conclusions:The proposed data‐driven method outperforms other automatic methods in distinguishing C, RBD and PLMD subjects andis more sensitive for RBD detection. Compared to the other meth-ods based only on RSWA detection, this method uses also NREM muscular activity to characterize patients groups. The obtained high performances thus confirm previous findings of increased NREM muscular activity in RBD patients.

754. MACVIA-LR (Fighting Chronic Diseases for Active and Healthy Ageing in Languedoc-Roussillon): A Success Story of the European Innovation Partnership on Active and Healthy Ageing

Author

C Heroum, P. Martin-Gousset, P Coignard, J. Mercier, M. Danko, R Sicard, Bernard Guillot, K Bakhti, Christian Jorgensen, William Camu, David Guiraud, M Meissonnier, J.-E. de La Coussaye, Jerôme Morel, David Morquin, P Gabrion, M Fouletier, Marie-Christine Picot, Davide Caimmi, M.S. Léglise, Jean-Marie Robine, L Schifano, I Tavares, Samir Jaber, V. Bruguière, Patrick Messner, G. Canovas, V Tribout, Isabelle Quéré, Bertrand Coulet, Jean-Paul Cristol, Claude Jeandel, M.C. Courrouy-Michel, P G Claret, Kjerstin Torre, R Lamoureux, Jacques Reynes, F. Gressard, Denis Sablot, V. Attalin, S. Jacquemin, M. Lapierre, O. Engberink, Jean Ribstein, V. Bouix, A Makinson, G. Dupeyron, F Leclercq, Hervé Tassery, G. Pandraud, A. Bedbrook, V Carre, S Boichot, Philippe Courtet, A. L. Coupet, Joël Ankri, Philippe Augé, A Y Goucham, S. Cade, T. Camuzat, H Y Bonnin, D. Strubel, S. Granier, Karen Ritchie, A Gelis, J.M. Davy, Laurence Vian, J.L. Pujol, F. Portejoie, D. Heve, L Landreau, Hubert Blain, K Patte, Frédéric Cuisinier, F Rivier, C. Laurent, A. Uziel, Jean-Luc Pasquié, C Fattal, Giacomo Cavalli, Didier Delignières, J. Millot-Keurinck, Jacques Touchon, P Kouyoudjian, D. Paccard, R Morales, G. Mathieu, J. Pelissier, Pierre Costa, Michel Mondain, F Coroian, Matteo Cesari, Xavier Quantin, M.P. Pasdelou, Cj M Lussert, Sofiane Ramdani, P Dujols, C Hérisson, Denis Mottet, Philippe Fraisse, Guillaume Cayla, Jean Bousquet, Claudine Berr, Gregoire Mercier, Béatrice Lognos, C Genis, Jean-Marc Lemaitre, Pierre Fesler, Christine Azevedo, C. Rolland, M. Nogues, Olivier Guérin, Kevin Mandrick, J P Riso, D. Hoa, M. Gellerat-Rogier, X Bobia, F Venail, A. Matheron, B Galan, Olivier Jonquet, Grégoire Vergotte, P. Nerin, Isabelle Laffont, J. Desplan, Gérard Bourrel, Nicolas Giraudeau, G. Tallon, Céline Vergne-Richard, C. Boubakri, M Ychou, P.A. Adnet, Pierre Senesse, J. C. Reuzeau, E. Viollet, Yannick Stephan, Raphaël Chiron, Gérard Dray, Daniel Laune, Pascal Demoly, Michel Amouyal, E. Royère, François Roubille, Sylvie Arnavielhe, I. Rédini-Martinez, M.P. Battesti, Jean-Luc Bourrain, Arnaud Dupeyron, P.L. Bernard, Y.M. Pers, F. Viart, Dominique Larrey, D. J. Costa, Sylvain Lehmann, A. Le Quellec, Ariane Sultan, Jean-Christophe Gris, Fares Gouzi, M Tanfin, C Marion, N. Raffort, Jérôme Cottalorda, J.L. Savy, P. Van de Perre, Grégory Ninot, M. Villain, Christine Meunier, V Cros, Maurice Hayot, Sylvain Richard, M Enjalbert, Rodolphe Bourret, Michel David, V. Handweiler, Bruno Vellas, Benoit Bardy, Bernard Combe, P. Dauenhauer, A. Avignon, Pierre Marès, E. Pastor, S Bouly, Jacques Bringer, J Fernandes, F. Nouvel, Claire Daien, François Vialla, B. Alomène, Mélanie Badin, C. Boegner, S. Perrey, D. Jakovenko, Michel Dauzat, P Nicolas, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Biocommunication en Cardio-Métabolique (BC2M), Université de Montpellier (UM), Laboratoire de magnétisme et d'optique de Versailles (LMOV), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Centre National de la Recherche Scientifique (CNRS), Department of Geriatrics - Efficiency and Deficiency Laboratory, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), CHU Bordeaux [Bordeaux], Hôpital Lapeyronie [Montpellier] (CHU), Service de Médecine Physique et de Réadaptation, Centre Hospitalier Universitaire de Nîmes (CHU de Nîmes), Géosciences Environnement Toulouse (GET), Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Observatoire Midi-Pyrénées (OMP), Université Fédérale Toulouse Midi-Pyrénées-Centre National d'Études Spatiales [Toulouse] (CNES)-Centre National de la Recherche Scientifique (CNRS), Centre d'Estudis del Risc Tecnològic, Universitat Politècnica de Catalunya [Barcelona] (UPC), Hôpital Arnaud de Villeneuve, Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), RN, Sciences pour l'environnement (SPE), Université Pascal Paoli (UPP)-Centre National de la Recherche Scientifique (CNRS)-Université Pascal Paoli (UPP)-Centre National de la Recherche Scientifique (CNRS), Conduites Addictives, de Performance et Santé, Université Montpellier 1 (UM1), Neuroscience Paris Seine (NPS), Centre National de la Recherche Scientifique (CNRS)-Institut de Biologie Paris Seine (IBPS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Neuropsychiatrie : recherche épidémiologique et clinique, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), EDF (EDF), Institut de génétique humaine (IGH), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Épilepsie de l'enfant et plasticité cérébrale (Inserm U663), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Euromov (EuroMov), Service de chirurgie pédiatrique [Hôpital Lapeyronie-Arnaud de Villeneuve], Polymer Institute (PI), Slovak Academy of Science [Bratislava] (SAS), Centre Sciences des Processus Industriels et Naturels (SPIN-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Laboratoire de Physique Nucléaire et de Hautes Énergies (LPNHE (UMR_7585)), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Paris Diderot - Paris 7 (UPD7)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Centre de recherche du CHUM (CR), CHUM-Hôpital Notre-Dame, Thermodynamique des solutions et des polymères (TSP), Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Centre National de la Recherche Scientifique (CNRS), Département d'anesthésie-réanimation[Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier], Dept. of Microelectronics, Czech Technical University in Prague (CTU), foreign laboratories (FL), CERN [Genève], Service de Pancréatologie [Hôpital Beaujon], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Beaujon, Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Laboratoire de Spectrochimie Infrarouge et Raman - UMR 8516 (LASIR), Centre National de la Recherche Scientifique (CNRS)-Université de Lille, University of Agricultural Sciences and Veterinary Medicine, Institut de biologie moléculaire des plantes (IBMP), Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Centre de Spectrométrie Nucléaire et de Spectrométrie de Masse (CSNSM), Université Paris-Sud - Paris 11 (UP11)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Service d'ORL, Hôpital Gui de Chauliac (CHRU de Montpellier), Laboratoire d'Etudes et de Recherche en Informatique d'Angers (LERIA), Université d'Angers (UA), Laboratoire composants et systèmes pour télécommunications (LCST), Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES), Institut de l'Elevage, Département de médecine interne, centre d'investigation clinique, CHU de Montpellier, Service de gérontologie et de prévention du vieillissement, Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Hôpital de la Timone [CHU - APHM] (TIMONE), Institut de Recherche en Sciences de la Santé (IRSS) / Centre Muraz, Pathogénèse et contrôle des infections chroniques (PCCI), Centre Hospitalier Universitaire de Montpellier (CHU Montpellier )-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Laboratoire Pierre Aigrain (LPA), Fédération de recherche du Département de physique de l'Ecole Normale Supérieure - ENS Paris (FRDPENS), Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Paris (ENS Paris)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Paris (ENS Paris)-Université Paris Diderot - Paris 7 (UPD7)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Institut de biologie et chimie des protéines [Lyon] (IBCP), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre National d'Études Spatiales [Toulouse] (CNES)-Observatoire Midi-Pyrénées (OMP), Institut de Recherche pour le Développement (IRD)-Centre National de la Recherche Scientifique (CNRS)-Université Fédérale Toulouse Midi-Pyrénées-Centre National d'Études Spatiales [Toulouse] (CNES)-Météo France-Institut de Recherche pour le Développement (IRD)-Centre National de la Recherche Scientifique (CNRS)-Université Fédérale Toulouse Midi-Pyrénées-Météo France-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS), Hôpital Arnaud de Villeneuve [CHRU Montpellier], Neurosciences Paris Seine (NPS), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Biologie Paris Seine (IBPS), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Beaujon [AP-HP], Laboratoire Avancé de Spectroscopie pour les Intéractions la Réactivité et l'Environnement - UMR 8516 (LASIRe), Ecole Nationale Supérieure de Chimie de Lille (ENSCL)-Université de Lille-Centre National de la Recherche Scientifique (CNRS), Institut de l'élevage (IDELE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Institut de Recherche pour le Développement (IRD)-Centre National de la Recherche Scientifique (CNRS)-Université Fédérale Toulouse Midi-Pyrénées-Centre National d'Études Spatiales [Toulouse] (CNES)-Météo France-Institut de Recherche pour le Développement (IRD)-Centre National de la Recherche Scientifique (CNRS)-Centre National d'Études Spatiales [Toulouse] (CNES)-Météo France, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut de Biologie Paris Seine (IBPS), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), Dynamique des capacités humaines et des conduites de santé (EPSYLON), Université Montpellier 1 (UM1)-Université Paul-Valéry - Montpellier 3 (UPVM)-Université de Montpellier (UM), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre National de la Recherche Scientifique (CNRS)-Observatoire Midi-Pyrénées (OMP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Centre National d'Études Spatiales [Toulouse] (CNES), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon ( MACVIA-LR ), Université Montpellier 1 ( UM1 ) -World Health Organization ( WHO/OMS ) -Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre Hospitalier Régional Universitaire de Nîmes ( CHRU Nîmes ) -Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ) -European Innovation Partnership on Active and Healthy Ageing Reference Site, Biocommunication en Cardio-Métabolique ( EA 7288 ), Université de Montpellier ( UM ), Laboratoire de magnétisme et d'optique de Versailles ( LMOV ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Centre National de la Recherche Scientifique ( CNRS ), IRAMAT-Centre de recherche en physique appliquée à l’archéologie ( IRAMAT-CRP2A ), Institut de Recherches sur les Archéomatériaux ( IRAMAT ), Université de Technologie de Belfort-Montbeliard ( UTBM ) -Université d'Orléans ( UO ) -Université Bordeaux Montaigne-Centre National de la Recherche Scientifique ( CNRS ) -Université de Technologie de Belfort-Montbeliard ( UTBM ) -Université d'Orléans ( UO ) -Université Bordeaux Montaigne-Centre National de la Recherche Scientifique ( CNRS ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] ( PhyMedExp ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Montpellier ( UM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hôpital Lapeyronie [Montpellier] ( CHU ), Centre Hospitalier Universitaire de Nîmes ( CHU de Nîmes ), Géosciences Environnement Toulouse ( GET ), Institut de Recherche pour le Développement ( IRD ) -Université Paul Sabatier - Toulouse 3 ( UPS ) -Observatoire Midi-Pyrénées ( OMP ) -Centre National de la Recherche Scientifique ( CNRS ), Universitat Politècnica de Catalunya [Barcelona] ( UPC ), Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] ( CAPS ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Anthropologie bio-culturelle, Droit, Ethique et Santé ( ADES ), Aix Marseille Université ( AMU ) -EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique ( CNRS ), Sciences pour l'environnement ( SPE ), Université Pascal Paoli ( UPP ) -Centre National de la Recherche Scientifique ( CNRS ) -Université Pascal Paoli ( UPP ) -Centre National de la Recherche Scientifique ( CNRS ), Université Montpellier 1 ( UM1 ), Neuroscience Paris Seine ( NPS ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ), Departement de Cardiologie, Université Montpellier 1 ( UM1 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Montpellier ( UM ), EDF ( EDF ), Institut de génétique humaine ( IGH ), Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ), Épilepsie de l'enfant et plasticité cérébrale ( Inserm U663 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale, Euromov ( EuroMov ), Université de Montpellier ( UM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Polymer Institute ( PI ), Slovak Academy of Science [Bratislava] ( SAS ), Centre Sciences des Processus Industriels et Naturels ( SPIN-ENSMSE ), École des Mines de Saint-Étienne ( Mines Saint-Étienne MSE ), Institut Mines-Télécom [Paris]-Institut Mines-Télécom [Paris], Laboratoire de Physique Nucléaire et de Hautes Énergies ( LPNHE ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de Physique Nucléaire et de Physique des Particules du CNRS ( IN2P3 ) -Université Paris Diderot - Paris 7 ( UPD7 ) -Centre National de la Recherche Scientifique ( CNRS ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Arnaud de Villeneuve, Centre de recherche du CHUM ( CR ), Département de Physique des Matériaux ( DPM ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon, Thermodynamique des solutions et des polymères ( TSP ), Université Blaise Pascal - Clermont-Ferrand 2 ( UBP ) -Centre National de la Recherche Scientifique ( CNRS ), Université Montpellier 1 ( UM1 ) -Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Gui de Chauliac, Czech Technical University in Prague ( CTU ), foreign laboratories ( FL ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Beaujon, Laboratoire de Mécanique et Technologie ( LMT ), École normale supérieure - Cachan ( ENS Cachan ) -Centre National de la Recherche Scientifique ( CNRS ), Laboratoire de Spectrochimie Infrarouge et Raman - UMR 8516 ( LASIR ), Université de Lille-Centre National de la Recherche Scientifique ( CNRS ), Institut de biologie moléculaire des plantes ( IBMP ), Université de Strasbourg ( UNISTRA ) -Centre National de la Recherche Scientifique ( CNRS ), Centre de Spectrométrie Nucléaire et de Spectrométrie de Masse ( CSNSM ), Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de Physique Nucléaire et de Physique des Particules du CNRS ( IN2P3 ) -Centre National de la Recherche Scientifique ( CNRS ), Service d'ORL, Hôpital Gui de Chauliac ( CHRU de Montpellier ), Laboratoire d'Etudes et de Recherche en Informatique d'Angers ( LERIA ), Université d'Angers ( UA ), Laboratoire composants et systèmes pour télécommunications ( LCST ), Institut National des Sciences Appliquées ( INSA ), Centre de Thermique de Lyon ( CETHIL ), Centre National de la Recherche Scientifique ( CNRS ) -Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon ( INSA Lyon ), Université de Lyon-Institut National des Sciences Appliquées ( INSA ) -Institut National des Sciences Appliquées ( INSA ), Centre Hospitalier Régional Universitaire de Nîmes ( CHRU Nîmes ), Hôpital de la Timone [CHU - APHM] ( TIMONE ), Centre Muraz, Laboratoire Pierre Aigrain ( LPA ), Fédération de recherche du Département de physique de l'Ecole Normale Supérieure - ENS Paris ( FRDPENS ), Centre National de la Recherche Scientifique ( CNRS ) -École normale supérieure - Paris ( ENS Paris ) -Centre National de la Recherche Scientifique ( CNRS ) -École normale supérieure - Paris ( ENS Paris ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris Diderot - Paris 7 ( UPD7 ) -Centre National de la Recherche Scientifique ( CNRS ), Institut de biologie et chimie des protéines [Lyon] ( IBCP ), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique ( CNRS ), Institut de recherche en cancérologie de Montpellier ( IRCM ), and Université Montpellier 1 ( UM1 ) -CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Montpellier ( UM )

Subjects
Gerontology, medicine.medical_specialty, Aging, media_common.quotation_subject, [SDV]Life Sciences [q-bio], Respiratory Tract Diseases, [SHS.PSY]Humanities and Social Sciences/Psychology, Oral Health, Comorbidity, Health Promotion, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Promotion (rank), Medicine, media_common.cataloged_instance, Humans, 030212 general & internal medicine, European Union, Multiple Chronic Conditions, European union, Health policy, health care economics and organizations, ComputingMilieux_MISCELLANEOUS, Preventive healthcare, media_common, Aged, Aged, 80 and over, [ SDV ] Life Sciences [q-bio], business.industry, Health Policy, General Medicine, 3. Good health, Hospitalization, Health promotion, 030228 respiratory system, General partnership, Chronic Disease, Personal Autonomy, Polypharmacy, Quality of Life, Accidental Falls, France, Independent Living, Preventive Medicine, business, Independent living
Abstract

Bousquet J, Bourret R, Camuzat T, Augé P, Bringer J, Noguès M, Jonquet O, de la Coussaye JE, Ankri J, Cesari M, Guérin O, Vellas B, Blain H, Arnavielhe S, Avignon A, Combe B, Canovas G, Daien C, Dray G, Dupeyron A, Jeandel C, Laffont I, Laune D, Marion C, Pastor E, Pélissier JY, Galan B, Reynes J, Reuzeau JC, Bedbrook A, Granier S, Adnet PA, Amouyal M, Alomène B, Bernard PL, Berr C, Caimmi D, Claret PG, Costa DJ, Cristol JP, Fesler P, Hève D, Millot-Keurinck J, Morquin D, Ninot G, Picot MC, Raffort N, Roubille F, Sultan A, Touchon J, Attalin V, Azevedo C, Badin M, Bakhti K, Bardy B, Battesti MP, Bobia X, Boegner C, Boichot S, Bonnin HY, Bouly S, Boubakri C, Bourrain JL, Bourrel G, Bouix V, Bruguière V, Cade S, Camu W, Carre V, Cavalli G, Cayla G, Chiron R, Coignard P, Coroian F, Costa P, Cottalorda J, Coulet B, Coupet AL , Courrouy-Michel MC, Courtet P, Cros V, Cuisinier F, Danko M, Dauenhauer P, Dauzat M, David M, Davy JM, Delignières D, Demoly P, Desplan J, Dujols P, Dupeyron G, Engberink O, Enjalbert M, Fattal C, Fernandes J, Fouletier M, Fraisse P, Gabrion P, Gellerat-Rogier M, Gelis A, Genis C, Giraudeau N, Goucham AY, Gouzi F, Gressard F, Gris JC, Guillot B, Guiraud D, Handweiler V, Hayot M , Hérisson C, Heroum C, Hoa D, Jacquemin S, Jaber S, Jakovenko D, Jorgensen C, Kouyoudjian P, Lamoureux R, Landreau L, Lapierre M, Larrey D, Laurent C, Léglise MS, Lemaitre JM, Le Quellec A, Leclercq F, Lehmann S, Lognos B, Lussert CM, Makinson A, Mandrick K, Mares P, Martin-Gousset P, Matheron A, Mathieu G, Meissonnier M, Mercier G,Messner P, Meunier C, Mondain M, Morales R, Morel J, Mottet D, Nérin P, Nicolas P, Nouvel F, Paccard D, Pandraud G, Pasdelou MP, Pasquié JL, Patte K, Perrey S, Pers YM, Portejoie F, Pujol JL, Quantin X, Quéré I, Ramdani S, Ribstein J, Rédini-Martinez I, Richard S, Ritchie K, Riso JP, Rivier F, Robine JM, Rolland C, Royère E, Sablot D, Savy JL, Schifano L, Senesse P, Sicard R, Stephan Y, Strubel D, Tallon G, Tanfin M, Tassery H, Tavares I, Torre K, Tribout V, Uziel A, Van de Perre P, Venail F, Vergne-Richard C, Vergotte G, Vian L, Vialla F, Viart F, Villain M, Viollet E, Ychou M, Mercier J.; International audience; The Région Languedoc Roussillon is the umbrella organisation for an interconnected and integrated project on active and healthy ageing (AHA). It covers the 3 pillars of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA): (A) Prevention and health promotion, (B) Care and cure, (C) and (D) Active and independent living of elderly people. All sub-activities (poly-pharmacy, falls prevention initiative, prevention of frailty, chronic respiratory diseases, chronic diseases with multimorbidities, chronic infectious diseases, active and independent living and disability) have been included in MACVIA-LR which has a strong political commitment and involves all stakeholders (public, private, patients, policy makers) including CARSAT-LR and the Eurobiomed cluster. It is a Reference Site of the EIP on AHA. The framework of MACVIA-LR has the vision that the prevention and management of chronic diseases is essential for the promotion of AHA and for the reduction of handicap. The main objectives of MACVIA-LR are: (i) to develop innovative solutions for a network of Living labs in order to reduce avoidable hospitalisations and loss of autonomy while improving quality of life, (ii) to disseminate the innovation. The three years of MACVIA-LR activities are reported in this paper.

755. CAN WE SEE GAIT AND COGNITION RELATIONSHIP AS AN EMERGING GERIATRIC SYNDROME? A ROUNDTABLE DEBATE

Author

Matteo Cesari, Manuel Montero-Odasso, J.M. Hausdorff, Joe Verghese, Michele L. Callisaya, E. Marzetti, and Caterina Rosano

Subjects
Abstracts, Health (social science), Gait (human), Cognitive frailty, Settore MED/09 - MEDICINA INTERNA, Cognition, Neurodegeneration, Life-span and Life-course Studies, Psychology, Health Professions (miscellaneous), Gait speed, Cognitive psychology, Developmental psychology
Abstract

A roundtable discussion and debate will summarize the evidence in favor of and against considering “gait and cognition” as an emerging geriatric syndrome. Specifically, we will discuss whether there is sufficient evidence to support the idea that gait and cognitive impairments among older individuals in the absence of an overt neurological disease represent a distinct phenotype caused by shared mechanisms. Potential clinical applicability of the construct will be discussed.

757. Comparison of automated methods forREM sleep without atonia detection

Author

Matteo Cesari, Christensen, Julie A. E., Mayer, G., Oertel, W. H., Sixel-Döring, F., Trenkwalder, C., Helge Sorensen, and Poul Jennum

Abstract

Objectives/Introduction:REM sleep without atonia (RSWA) detection is a prerequisite for REM sleep behaviour disorder (RBD)diagnosis. Since current visual methods for RSWA detection are sub-jective and tedious, several automated methods have been proposed.This study aims to compare their accuracies in identifying RSWA and to analyse the influence of respiration and arousal‐related movements in such accuracies. Methods:In a cohort including 27 healthy control subjects (C), 25 Parkinson's disease (PD) patients without RBD (PD‐RBD), 29 PD patients with RBD (PD+RBD), 29 idiopathic RBD patients and 36 patients with periodic limb movement disorder (PLMD), the following indices were calculated: The REM atonia index (RAI), the supra‐threshold‐REM‐activity metric (STREAM), the Frandsen index (FRI),the short/long muscle activity indices (sMAI/lMAI) and the Kempfner index (KEI). The indices were calculated in various cases: 1) considering all muscle activities; 2) excluding the ones related to arousals; 3)excluding the ones during apnea events; 4) excluding the ones before and after apnea events; 5) combining cases 2 and 3; and 6)combining cases 2 and 4. In each case, each index was used to train and test a logistic regression model with 10‐fold cross‐validationscheme to calculate accuracies in the followingcomparisons:1(C, PD-RBD, PLMD) vs (PD+RBD, RBD);2C vs RBD;3PLMD vs RBD;4C vs PD-RBD;5C vs PLMD;6PD-RBD vs PD+RBD; and7C vs PLMD vs RBD.Kruskal‐Wallis tests were used to assess whether the accuracies for each index and comparison were varying significantly across the cases.Results:The indices showed varying performances across cases and comparisons, making it impossible to identify one index as significantly better than the others. In all comparisons and cases, the average test accuracy of each index was lower than 80%. Moreover, apnea and arousal‐related movements did not influence significantly the performance of the algorithms in group distinctions.Conclusions:None of the automated method can be elected asthe optimal one for RSWA detection and the accuracies suggest the need of improvements. Automated methods seem robust towards respiration and arousal‐related movements.

758. Dose-related impact of alcohol consumption on cognitive function in advanced age: Results of a multicenter survey

Author

Francesco Landi, Claudio Pedone, Alberto Cocchi, Graziano Onder, Giuseppe Zuccalà, Matteo Cesari, and Roberto Bernabei

Subjects
Gerontology, medicine.medical_specialty, Temperance, Medicine (miscellaneous), Alcohol abuse, Toxicology, Abbreviated mental test score, Cognition, Alzheimer Disease, Internal medicine, medicine, Humans, Dementia, Effects of sleep deprivation on cognitive performance, Aged, Sex Characteristics, Dose-Response Relationship, Drug, Ethanol, Cognitive disorder, Pharmacoepidemiology, medicine.disease, Psychiatry and Mental health, Logistic Models, Cardiovascular Diseases, Alzheimer's disease, Cognition Disorders, Psychology
Abstract

Moderate alcohol consumption has been associated in several studies with decreased risk of cardiovascular and cerebrovascular events; however, available data on the effects of alcohol intake on cognitive functioning are conflicting. We assessed the association between alcohol consumption and cognitive impairment in a series of older subjects enrolled in a multicenter pharmacoepidemiology survey.The association between average alcoholic intake and cognitive performance was assessed in 15,807 patients admitted to participating centers during the survey periods. Demographic variables, comorbid conditions, medications, and objective tests that were associated with cognitive impairment (as indicated by a Hodkinson Abbreviated Mental Test score7) in separate logistical regression models were examined as potential confounders in a summary model.Cognitive impairment was detected in 1693 (19%) of 8755 drinkers and 2008 (29%) of 7052 nondrinkers (Fisher's exact test, p0.0001). After adjusting for potential confounders, alcohol consumption was associated with decreased probability of cognitive impairment (odds ratio, 0.75; 95% confidence interval, 0.66-0.85). The relationship between drinking level and cognitive dysfunction was nonlinear, because the probability of cognitive impairment was decreased for moderate alcohol use as compared with abstinence, but it was increased for daily consumption exceeding one wine-equivalent liter among men and 0.5 liter among women. This nonlinear association persisted when cerebrovascular and Alzheimer's disease were considered separately.Alcohol abuse is associated with increased prevalence of cognitive dysfunction among older subjects; however, a daily alcohol consumption of less than 40 g for women and 80 g or less for men might be associated with a decreased probability of cognitive impairment. This possible protective effect of alcohol consumption should be further assessed by prospective studies.

759. Frailty syndrome and skeletal muscle: Results from the Invecchiare in Chianti study

Author

Graziano Onder, Jack M. Guralnik, Stefania Bandinelli, Marco Pahor, Fulvio Lauretani, Luigi Ferrucci, Cinzia Maraldi, Matteo Cesari, and Christiaan Leeuwenburgh

Subjects
FRAILTY, AGING, EPIDEMIOLOGY, BODY COMPOSITION, medicine.medical_specialty, Nutrition and Dietetics, business.industry, Frailty syndrome, Medicine (miscellaneous), Skeletal muscle, medicine.disease, Logistic regression, Preferred walking speed, Grip strength, medicine.anatomical_structure, Weight loss, Hand strength, medicine, Physical therapy, medicine.symptom, business, human activities, Body mass index
Abstract

Background Frailty is a common condition in elders and identifies a state of vulnerability for adverse health outcomes. Objective Our objective was to provide a biological face validity to the well-established definition of frailty proposed by Fried et al. Design Data are from the baseline evaluation of 923 participants aged > or =65 y enrolled in the Invecchiare in Chianti study. Frailty was defined by the presence of > or =3 of the following criteria: weight loss, exhaustion, low walking speed, low hand grip strength, and physical inactivity. Muscle density and the ratios of muscle area and fat area to total calf area were measured by using a peripheral quantitative computerized tomography (pQCT) scan. Analyses of covariance and logistic regressions were performed to evaluate the relations between frailty and pQCT measures. Results The mean age (+/-SD) of the study sample was 74.8 +/- 6.8 y, and 81 participants (8.8%) had > or =3 frailty criteria. Participants with no frailty criteria had significantly higher muscle density (71.1 mg/cm(3), SE = 0.2) and muscle area (71.2%, SE = 0.4) than did frail participants (69.8 mg/cm(3), SE = 0.4; and 68.7%, SE = 1.1, respectively). Fat area was significantly higher in frail participants (22.0%, SE = 0.9) than in participants with no frailty criteria (20.3%, SE = 0.4). Physical inactivity and low walking speed were the frailty criteria that showed the strongest associations with pQCT measures. Conclusion Frail subjects, identified by an easy and inexpensive frailty score, have lower muscle density and muscle mass and higher fat mass than do nonfrail persons.

761. Use of calcium antagonists and worsening renal function in patients receiving angiotensin-converting-enzyme inhibitors

Author

Matteo Cesari, Giuseppe Zuccalà, Pierugo Carbonin, Claudio Pedone, Graziano Onder, Emanuele Marzetti, Roberto Bernabei, and Alberto Cocchi

Subjects
Male, Renal failure, medicine.medical_specialty, chemistry.chemical_element, Renal function, Angiotensin-Converting Enzyme Inhibitors, Angiotensin-converting enzyme inhibitors, Calcium antagonists, Elderly, Calcium, Gastroenterology, chemistry.chemical_compound, Internal medicine, medicine, Odds Ratio, Humans, Multicenter Studies as Topic, Pharmacology (medical), Renal Insufficiency, Aged, Pharmacology, Creatinine, Kidney, biology, Dose-Response Relationship, Drug, business.industry, Settore MED/09 - MEDICINA INTERNA, Angiotensin-converting enzyme, General Medicine, Odds ratio, medicine.disease, Calcium Channel Blockers, Endocrinology, medicine.anatomical_structure, Logistic Models, chemistry, ACE inhibitor, biology.protein, Drug Therapy, Combination, Female, business, medicine.drug, Kidney disease
Abstract

Objective: The objective of this study was to assess whether calcium antagonists, which have been proven to dilate the afferent glomerular arteriole, might prevent increases in serum creatinine levels among older subjects who started treatment with angiotensin-converting enzyme (ACE) inhibitors. Methods: We explored the association between use of calcium antagonists and incident increases in serum creatinine in 780 elderly patients with baseline creatinine levels

762. Validity of digital Trail Making Test and Bells Test in elderlies

Author

Matteo Luperto, Katia Daniele, Carlo Abbate, Sarah Damanti, Nicola Basilico, Matteo Cesari, Daniela Mari, Simona Ferrante, Nunzio Alberto Borghese, Francesca Lunardini, Lunardini, F, Luperto, M, Daniele, K, Basilico, N, Damanti, S, Abbate, C, Mari, D, Cesari, M, Ferrante, S, and Borghese, N

Subjects
050103 clinical psychology, Trail Making Test, Applied psychology, Concurrent validity, Digital neuropsychological tests, Cognitive decline, Elderlies, digital neuropsychological test, 03 medical and health sciences, 0302 clinical medicine, medicine, Dementia, 0501 psychology and cognitive sciences, 030212 general & internal medicine, Neuropsychological assessment, medicine.diagnostic_test, business.industry, 05 social sciences, Neuropsychology, Usability, medicine.disease, 3. Good health, Test (assessment), business, Psychology
Abstract

Digital neuropsychological tests self-Administered at home have the potential to detect early signs of cognitive decline in the elderlies, thus allowing to adopt preventive measures. Usability tests and clinical validation are required before computerized assessment could juxtapose traditional paper-And-pencil tests to spot early signs of decline. We have developed a tablet-based digitized version of two neuropsychological tests commonly used in screening for dementia: Trail Making Test (A and B versions) and Bells Test. We studied system usability and acceptance, and concurrent validity of the computerized assessment compared with the corresponding paper-And-pencil tests. Results show a very high system acceptance, notwithstanding the patients' low familiarity with technology. System validation reports a good ability of the digital tests to retain the same predictive power of the corresponding paper-based tests. Altogether, results suggest that computerized neuropsychological assessment may represent an adequate, ecological and cost-effective solution for home monitoring of the elder's cognitive status, thus supporting clinicians in the identification of early signs of cognitive decline.

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763. Non-scientific drug prescription in demented older people living in the community: An Italian perspective

Author

Andrea Russo, Matteo Cesari, Graziano Onder, Francesco Landi, Roberto Bernabei, Giuseppe Zuccalà, and Fabrizia Lattanzio

Subjects
Drug, medicine.medical_specialty, business.industry, media_common.quotation_subject, Pharmacology toxicology, General Medicine, Pharmacotherapy, Family medicine, Medicine, Pharmacology (medical), Medical prescription, Older people, business, media_common

765. A Clinically Applicable Interactive Micro and Macro-Sleep Staging Algorithm for Elderly and Patients with Neurodegeneration

Author

Claudia Trenkwalder, Helge Bjarup Dissing Sørensen, Matteo Cesari, Julie Anja Engelhard Christensen, Brit Mollenhauer, Maria-Lucia Muntean, Friederike Sixel-Döring, and Poul Jennum

Subjects
Polysomnography, 0206 medical engineering, REM Sleep Behavior Disorder, 02 engineering and technology, Electroencephalography, REM sleep behavior disorder, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Aged, Sleep Stages, medicine.diagnostic_test, business.industry, Eye movement, Neurodegenerative Diseases, Parkinson Disease, Electrooculography, medicine.disease, 020601 biomedical engineering, Sleep in non-human animals, Case-Control Studies, Wakefulness, business, Algorithm, Algorithms, 030217 neurology & neurosurgery
Abstract

Elderly and patients with neurodegenerative diseases (NDD) often complain about sleep problems and show altered sleep structure. Automated algorithms for efficient and specific sleep staging are needed. We propose a new algorithm using only one electroencephalographic and two electrooculographic channels to score wakefulness, rapid eye movement (REM) sleep and non-REM sleep in a cohort of elderly healthy controls (HC), patients with Parkinson's disease (PD), isolated REM sleep behavior disorder (iRBD), considered the prodromal stage of PD, and patients with PD and RBD (PD+RBD). The proposed method scores both standard 30-s epochs (macro-staging) and 5-s mini-epochs (micro-staging), whose evaluation may help to better understand sleep micro-structure. Moreover, the algorithm is interactive, as it labels the classified sleep epochs as either certain or uncertain, so that experts can manually review the uncertain ones. The algorithm performances were evaluated for macro-sleep staging, where it achieved overall accuracies of 0.87±0.05 in 41 HC, 0.86±0.10 in 57 PD, 0.76±0.10 in 31 iRBD and 0.77±0.10 in 30 PD+RBD patients when all 30-s epochs were considered. The accuracies increased to 0.91±0.05, 0.90±0.08, 0.85±0.09, 0.88±0.08 respectively when considering only the certain ones. The epochs labeled as uncertain were 9.95±4.15%, 11.13±7.86%, 18.39±7.38% and 18.90±8.00% in HC, PD, iRBD and PD+RBD respectively. The proposed interactive micro and macro sleep staging algorithm can be used in clinics to reduce the burden of manual sleep staging in elderly and patients with NDD.

766. Older Adults’ and Clinicians’ Perspectives on a Smart Health Platform for the Aging Population: Design and Evaluation Study

Author

Alessia Cristiano, Stela Musteata, Valerio Bellandi, Paolo Ceravolo, Sara De Silvestri, Matteo Cesari, Alberto Sanna, Domenico Azzolino, and Diana Trojaniello

Subjects
Gerontology, Population ageing, Health (social science), Health Informatics, Preprint, Geriatrics and Gerontology, Psychology
Abstract

Background Over recent years, interest in the development of smart health technologies aimed at supporting independent living for older populations has increased. The integration of innovative technologies, such as the Internet of Things, wearable technologies, artificial intelligence, and ambient-assisted living applications, represents a valuable solution for this scope. Designing such an integrated system requires addressing several aspects (eg, equipment selection, data management, analytics, costs, and users’ needs) and involving different areas of expertise (eg, medical science, service design, biomedical and computer engineering). Objective The objective of this study is 2-fold; we aimed to design the functionalities of a smart health platform addressing 5 chronic conditions prevalent in the older population (ie, hearing loss, cardiovascular diseases, cognitive impairments, mental health problems, and balance disorders) by considering both older adults’ and clinicians’ perspectives and to evaluate the identified smart health platform functionalities with a small group of older adults. Methods Overall, 24 older adults (aged >65 years) and 118 clinicians were interviewed through focus group activities and web-based questionnaires to elicit the smart health platform requirements. Considering the elicited requirements, the main functionalities of smart health platform were designed. Then, a focus group involving 6 older adults was conducted to evaluate the proposed solution in terms of usefulness, credibility, desirability, and learnability. Results Eight main functionalities were identified and assessed—cognitive training and hearing training (usefulness: 6/6, 100%; credibility: 6/6, 100%; desirability: 6/6, 100%; learnability: 6/6, 100%), monitoring of physiological parameters (usefulness: 6/6, 100%; credibility: 6/6, 100%; desirability: 6/6, 100%; learnability: 5/6, 83%), physical training (usefulness: 6/6, 100%; credibility: 6/6, 100%; desirability: 5/6, 83%; learnability: 2/6, 33%), psychoeducational intervention (usefulness: 6/6, 100%; credibility: 6/6, 100%; desirability: 4/6, 67%; learnability: 2/6, 33%), mood monitoring (usefulness: 4/6, 67%; credibility: 4/6, 67%; desirability: 3/6, 50%; learnability: 5/6, 50%), diet plan (usefulness: 5/6, 83%; credibility: 4/6, 67%; desirability: 1/6, 17%; learnability: 2/6, 33%), and environment monitoring and adjustment (usefulness: 1/6, 17%; credibility: 1/6, 17%; desirability: 0/6, 0%; learnability: 0/6, 0%). Most of them were highly appreciated by older participants, with the only exception being environment monitoring and adjustment. The results showed that the proposed functionalities met the needs and expectations of users (eg, improved self-management of patients’ disease and enhanced patient safety). However, some aspects need to be addressed (eg, technical and privacy issues). Conclusions The presented smart health platform functionalities seem to be able to meet older adults’ needs and desires to enhance their self-awareness and self-management of their medical condition, encourage healthy and independent living, and provide evidence-based support for clinicians’ decision-making. Further research with a larger and more heterogeneous pool of stakeholders in terms of demographics and clinical conditions is needed to assess system acceptability and overall user experience in free-living conditions.

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767. Resilience: Biological Basis and Clinical Significance - A Perspective Report from the International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force.

Author

Cesari M, Azzolino D, LeBrasseur NK, Whitson H, Rooks D, Sourdet S, Angioni D, Fielding RA, Vellas B, and Rolland Y

Subjects
Humans, Aged, Advisory Committees, Adaptation, Psychological, Frailty, Sarcopenia prevention & control, Geriatrics
Abstract

The Resilience is a construct receiving growing attention from the scientific community in geriatrics and gerontology. Older adults show extremely heterogeneous (and often unpredictable) responses to stressors. Such heterogeneity can (at least partly) be explained by differences in resilience (i.e., the capacity of the organism to cope with stressors). The International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force met in Boston (MA,USA) on April 20, 2022 to discuss the biological and clinical significance of resilience in older adults. The identification of persons with low resilience and the prompt intervention in this at-risk population may be critical to develop and implement preventive strategies against adverse events. Unfortunately, to date, it is still challenging to capture resilience, especially due to its dynamic nature encompassing biological, clinical, subjective, and socioeconomic factors. Opportunities to dynamically measure resilience were discussed during the ICFSR Task Force meeting, emphasizing potential biomarkers and areas of intervention. This article reports the results of the meeting and may serve to support future actions in the field., Competing Interests: The Task Force was partially funded by registration fees from industrial participants. These corporations placed no restrictions on this work. Dr. Rooks is employees of Novartis Institutes for BioMedical Research. Dr. Vellas is an investigator in clinical trials sponsored by the Toulouse University Hospital (Inspire Geroscience Program). Dr. Fielding reported grants from National Institutes of Health, grants from USDA Agricultural Research Service, grants, personal fees and other from Axcella Health, Juvicell, Inside Tracker, grants and personal fees from Biophytis, personal fees from Amazentis, Nestlé and Pfizer, outside the submitted work. No conflict of interest declared by the other authors.

Published
2022
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768. Challenges in the Development of Drugs for Sarcopenia and Frailty - Report from the International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force.

Author

Cesari M, Bernabei R, Vellas B, Fielding RA, Rooks D, Azzolino D, Mariani J, Oliva AA, Bhasin S, and Rolland Y

Subjects
Advisory Committees, Humans, Pandemics, COVID-19, Frailty, Sarcopenia drug therapy
Abstract

Sarcopenia and frailty represent two burdensome conditions, contributing to a broad spectrum of adverse outcomes. The International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force met virtually in September 2021 to discuss the challenges in the development of drugs for sarcopenia and frailty. Lifestyle interventions are the current mainstay of treatment options in the prevention and management of both conditions. However, pharmacological agents are needed for people who do not respond to lifestyle modifications, for those who are unable to adhere, or for whom such interventions are inaccessible/unfeasible. Preliminary results of ongoing trials were presented and discussed. Several pharmacological candidates are currently under clinical evaluation with promising early results, but none have been approved for either frailty or sarcopenia. The COVID-19 pandemic has reshaped how clinical trials are conducted, in particular by enhancing the usefulness of remote technologies and assessments/interventions., Competing Interests: The Task Force was partially funded by registration fees from industrial participants. These corporations placed no restrictions on this work. Dr. Cesari has received honoraria from Nestlé Health Sciences for serving as consultant and member of a Scientific Advisory Board. Dr Bernabei declares no conflicts of interest; Dr. Vellas is an investigator in clinical trials sponsored by the Toulouse University Hospital (Inspire Geroscience Program); Dr. Fielding reports grants from National Insitutes of Health, the USDA Agricultural Research Service, Biophytis, Axcella Health, and Pfizer; he has received personal fees from Axcella Health, Biophytis, Amazentis, and Nestlé; he has stock options from Axcella Health, Juvicell, and Inside Tracker. Dr. Rooks is employees of Novartis Institutes for BioMedical Research; Dr. Azzolino declares no conflicts of interest; Dr. Mariani is member of the Board of Trustees of Biophythis; Dr. Oliva is employed at Longeveron Inc.; he reports grants from National Institute on Aging (NIA) / National Institutes of Health (NIH), Alzheimer’s Association, Alzheimer’s Association, Maryland Stem Cell Research Fund (MSCCRF), Maryland Stem Cell Research Fund (MSCCRF), National Heart, Lung, and Blood Institute (NHHBL); in addition, Dr. Oliva has a patent MSC Potency Assay pending; Dr. Bashin has received grants from AbbVie and MIB; he has equity interest in FPT and Xyone.

Published
2022
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770. On Schrödinger's Cat and Evaluation of Trials Disrupted by the Covid19 Pandemic: A Critical Appraisal.

Author

Cesari M, Calvani R, Canevelli M, Aprahamian I, de Souto Barreto P, Azzolino D, Fielding RA, Vanacore N, Inzitari M, and Marzetti E

Subjects
Humans, Pandemics, SARS-CoV-2, COVID-19
Abstract

Competing Interests: MC has received honoraria from Nestlè Health Sciences for presentations at scientific meetings and serving as a member of Expert Advisory Boards. MI has received honoraria from Nestlé Health Sciences for serving as an expert advisor. EM has received honoraria from Abbott, Nestlè, Nutricia, and Thermofisher for presentations at scientific meetings. RAF received grants and personal fees from Nestlé. RAF also reports grants from National Institutes of Health (National Institute on Aging), during the conduct of the study; grants, personal fees and other from Axcella Health, other from Inside Tracker, grants and personal fees from Biophytis, grants and personal fees from Astellas, personal fees from Cytokinetics, personal fees from Amazentis, personal fees from Glaxo Smith Kline, personal fees from Juvicell, outside the submitted work. No conflict of interest reported by the other authors.

Published
2021
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771. Overtreating Alzheimer's Disease.

Author

Canevelli M, Vanacore N, Blasimme A, Bruno G, and Cesari M

Subjects
Aged, Aged, 80 and over, Evidence-Based Medicine, Humans, Quality of Life psychology, Aging physiology, Alzheimer Disease drug therapy, Frail Elderly, Multimorbidity, Polypharmacy
Abstract

The management of frailty in older persons is not easy, implying interventions beyond the simple prescription of medications. Biological complexity, multimorbidity, polypharmacy, and social issues often hamper the possibility to directly translate the evidence coming from research into clinical practice. Frailty indeed represents the most relevant cause of the “evidence-based medicine issue” influencing clinical decisions in geriatric care. Today, patients with Alzheimer’s disease (AD) are much older and frailer than some decades ago. They also tend to have more drugs prescribed. In parallel, research on AD has evolved over the years, hypothesizing that anticipating the interventions to the earliest stages of the disease may provide beneficial effects (to date, still lacking). In this article, we argue that, by focusing exclusively on “the disease” and pushing to anticipate its detection (sometimes even before the appareance of its clinical manifestations) may overshadow the person’s values and priorities. Research should be developed for better integrating the concept of aging and frailty in the design of clinical trials in order to provide results that can be implemented in real life. On the other hand, clinicians should be less prone to the easy (but unsupported by evidence) pharmacological prescription., Competing Interests: Marco Canevelli is supported by a research grant of the Italian Ministry of Health (GR-2016-02364975) for the project “Dementia in immigrants and ethnic minorities living in Italy: clinical-epidemiological aspects and public health perspectives” (ImmiDem). Matteo Cesari has received honoraria for presentations at scientific meetings and/or research funding from Nestlé. No specific conflict of interest declared by the other authors.

Published
2021
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773. Nutritional Interventions for Early Dementia.

Author

Cesari M, Azzolino D, Arosio B, and Canevelli M

Subjects
Aging, Cognition Disorders, Female, Humans, Male, Nutrition Assessment, Nutritional Status, Dementia therapy
Abstract

Nutrition plays a critical role in the definition of the individual's wellbeing. Nutritional interventions have been repeatedly advocated as of potential interest for preventing or delaying the cognitive decline, also in the context of neurodegenerative conditions. The idea of targeting the initial phases of dementia, when the process is theoretically still amenable of correction, via lifestyle modifications (including healthy diet or supplementation of specific micro-/macro-nutrients) is extremely appealing. In this perspective paper, we describe the most recent evidence on the topic and discuss how the nutritional assessment should be nested within a comprehensive approach to the aging person with initial signs of dementia for promoting his/her optimal management., Competing Interests: Dr. Cesari has received honoraria by Nestlé Health Sciences for presentations at scientific meetings and to serve as member of Expert Advisory Boards. No conflict of interest declared by the other authors.

Published
2021
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775. COVID-19 and Intrinsic Capacity.

Author

Nestola T, Orlandini L, Beard JR, and Cesari M

Subjects
Aged, Aged, 80 and over, COVID-19, Humans, Pandemics, SARS-CoV-2, Social Isolation, Aging psychology, Betacoronavirus, Coronavirus Infections epidemiology, Coronavirus Infections virology, Healthy Aging, Pneumonia, Viral epidemiology, Pneumonia, Viral virology
Abstract

The SARS-CoV-2 infection is particularly associated with negative outcomes (i.e., serious disease, death) in frail older people, independently of where they live. Furthermore, the period of pandemic (with its lockdowns, social distancing, fragmentation of care…) has significantly changed the environment in which older people live. It is likely that, when the pandemic will be over, an acceleration of the aging process will be observed for many persons, independently of whether they have been infected or not by the SARS-CoV-2. The World report on ageing and health, published by the World Health Organization, proposes the concept of intrinsic capacity (i.e., the composite of all the physical and mental capacities of the individual) as central for healthy ageing. The routine assessment of biological age through constructs such as intrinsic capacity might have allowed a better understanding of the functional trajectories and vulnerabilities of the individual, even during a catastrophic event as the one we are currently living. In the present article, we describe how COVID-19 has affected the persons' intrinsic capacity, and how the wide adoption of the intrinsic capacity model may support the modernization of our systems and bring them closer to the individual., Competing Interests: No conflicts of interest to declare by the authors

Published
2020
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779. Prevalence of Frailty and Mobility Limitation in a Rural Setting in France.

Author

Cesari M, Demougeot L, Boccalon H, and Vellas B

Abstract

Background: The prevalence of frailty is variable according to the adopted operational definition, the tested population, and the setting where it is explored., Objective: To estimate the prevalence of frailty and mobility disability in community-dwelling persons aged 60 years and older., Design: Cross-sectional analyses., Setting: The rural area of Labastide-Murat (France)., Participants: All community-dwelling persons aged 60 years and older living in the area and answering to the study survey (n=572/1022)., Measurements: The study questionnaire included questions defining mobility disability (as ability to walk 400 meters and climb up 2 flights of stairs) and frailty (according to the FRAIL instrument and a modified version of the original definition proposed by Fried and colleagues)., Results: Mean age of participants was 72.4 years old. Mobility disability was reported by 47 (8.3%) participants. The sedentariness criterion of frailty was the most prevalent in the present population. Overall, according to the FRAIL instrument, 77.6%, 14.0%, and 8.3% could be defined as robust, pre-frail/frail, and disabled, respectively. When the alternative definition of frailty mirroring the definition proposed in the Cardiovascular Health Study was adopted, the prevalence of frailty increased and showed gender-specific differences (p=0.02)., Conclusions: A relevant number of older persons living in rural areas experiences physical impairments and presents an increased risk for major negative health-related events. These results may support the ongoing clinical and research actions aimed at preventing the functional decline in elders.

Published
2012
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