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The aim of this study was to describe the predictive role of the modified SEGA frailty scale on nursing home admission, readmission to hospital, falls and mortality. Material and methods We performed a prospective, single-centre cohort study in patients discharged from a geriatric hospital ward between July 2016 and February 2017, with follow-up of six months. Patients aged 65 and over who were returning home from hospital were included. The primary outcome measure was admission to a nursing home at six months. We used a Cox model to explore the predictive nature of the variables. Results Thirty-three patients (18.4%) with a mean age of 80.9 years (± 6.5) were classified as not very frail and 146 (81.6%) with a mean age of 86 years (± 6.5) as frail/very frail. After six months, 13.5% of the frail/very frail patients and 1.2% of the not very frail patients had entered a nursing home (p = 0.169). Frailty status was significantly associated with readmission to hospital at three months (p = 0.026) and single or multiple falls at six months (p = 0.003). Conclusion The modified SEGA scale may predict the occurrence of adverse events and improve the transition to home.

The aim of this study was to describe the predictive role of the modified SEGA fragility score on nursing home admission, rehospitalization, falls and mortality.We performed a prospective, single-center cohort study in patients leaving geriatric hospitalization between July 2016 and February 2017, with follow-up at 6 months. Patients 65 years of age and over, returning home, were included. The primary outcome measure was admission to an institution at 6 months. We realized a Cox model to explore the predictive character of the variables.Thirty-three patients (18.4%), mean age 80.9 years (± 6.5), were not very fragile. At 6 months, 13.5% of the fragile or very fragile patients and 1.2% of the patients who were not very fragile had entered the institution (p = 0.169). Fragility status was statistically significantly associated with rehospitalization at 3 months (p = 0.026) and single or multiple drop at 6 months) month (p = 0.003).The SEGAm grid would predict the occurrence of derogatory events and improve return home.

La prise en charge de la population âgee de plus de 75 ans se doit d’etre specifique et pluridisciplinaire. Un service d’urgences, qui fait face a une augmentation de son flux, notamment avec la permanence des soins ambulatoires, apparait comme un lieu d’accueil inadapte pour cette population fragile et souvent polypathologique. Une etude se penche sur la pertinence du passage aux urgences des residents d’Ehpad, ces derniers ayant acces a des soins medicaux reguliers, a la difference des personnes âgees vivant au domicile. (R.E.)

The care provided to elderly people aged over 75 must be specific and multidisciplinary. An emergency department, which is seeing increasing numbers of patients passing through its doors, notably with the provision of an ambulatory care service, would not appear to be a suitable place for this fragile population, often with multiple pathologies. A study is looking at the suitability of the emergency department for nursing home residents, who have regular access to medical care, unlike elderly people living at home.

International audience; Falls are a major cause of death in older people. One method used to predict falls is analysis of Centre of Pressure (CoP) displacement, which provides a measure of balance quality. The Balance Quality Tester (BQT) is a device based on a commercial bathroom scale that calculates instantaneous values of vertical ground reaction force (Fz) as well as the CoP in both anteroposterior (AP) and mediolateral (ML) directions. The entire testing process needs to take no longer than 12 s to ensure subject compliance, making it vital that calculations related to balance are only calculated for the period when the subject is static. In the present study, a method is presented to detect the stabilization period after a subject has stepped onto the BQT. Four different phases of the test are identified (stepping-on, stabilization, balancing, stepping-off), ensuring that subjects are static when parameters from the balancing phase are calculated. The method, based on a simplified cumulative sum (CUSUM) algorithm, could detect the change between unstable and stable stance. The time taken to stabilize significantly affected the static balance variables of surface area and trajectory velocity, and was also related to Timed-up-and-Go performance. Such a finding suggests that the time to stabilize could be a worthwhile parameter to explore as a potential indicator of balance problems and fall risk in older people.

International audience; Grip-strength, walking speed and weight-loss are key measurements in the evaluation of frailty. According to L. Fried, these quantities are compared with thresholds, leading to associated frailty indices that would afterwards be combined to establish an overall decision. One of the consequences of frailty is an increasing risk of falls, which are a major cause of death of older people. The purpose of this study is to examine the possible relationships that could exist between grip-strength, walking speed, weight-loss and other parameters extracted from balance quality assessment for older subjects. The study shows that a relationship does exist between the balance quality parameters and the frailty indices.

International audience; Frailty is an increasingly common geriatric condition that results in an increased risk of adverse health outcomes such as falls. The most widely-used means of detecting frailty is the Fried phenotype, which includes several objective measures such as grip strength and gait velocity. One method of screening for falls is to measure balance, which can be done by a range of techniques including the assessment of the Centre of Pressure (CoP) during a balance assessment. The Balance Quality Tester (BQT) is a device based on a commercial bathroom scale that can evaluate balance quality. The BQT provides instantaneously the position of the CoP (stabilogram) in both anteroposterior (AP) and mediolateral (ML) directions and can estimate the vertical ground reaction force. The purpose of this study was to examine the relationship between balance quality assessment and physical frailty. Balance quality was compared to physical frailty in 186 older subjects. Rising rate (RR) was slower and trajectory velocity (TV) was higher in subjects classified as frail for both grip strength and gait velocity (p