Geriatrie et psychologie neuropsychiatrie du vieillissement最新文献

{"title":"[Digital twins: an innovative and promising option to optimize care pathways for older patients].","authors":"Bastien Genet, Jacques Boddaert, Lorène Zerah","doi":"10.1684/pnv.2025.1242","DOIUrl":"10.1684/pnv.2025.1242","url":null,"abstract":"<p><p>The digital transformation of healthcare, which has been continuously evolving for over two decades, has recently paved the way for major innovations, notably through the emergence of the digital twin (DT) concept. Originating from self-supervised machine learning, the DT involves creating a virtual replica (virtual product) of a patient, organ, or healthcare system (real product) to predict its evolution based on real-life data. It is based on clinical, biological, environmental data, as well as data from sensors and medico-administrative databases (e.g., SNDS) and relies on various digital technologies. Initially applied in aerospace, industry, and agriculture, DTs have recently gained traction in healthcare, particularly for the personalization of care plans and pathways. In geriatrics, DTs could help model the functional or clinical evolution of older adults, optimize healthcare resources, and adapt therapeutic protocols. The development of DTs in geriatrics involves addressing several major challenges, including older adults' acceptance of technology, building multidisciplinary teams, accurately modelling the complexity of aging, and considering the environmental impact of DT technologies. In summary, the digital twin represents a promising tool to support healthy aging and care pathways, provided its clinical integration and social acceptability are strengthened.</p>","PeriodicalId":520632,"journal":{"name":"Geriatrie et psychologie neuropsychiatrie du vieillissement","volume":"23 3","pages":"313-319"},"PeriodicalIF":0.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysexecutive mild cognitive impairment does not impact outcomes one year after a TAVR procedure in older patients.","authors":"Jérémie Huet, Guillaume Chapelet, Thierry Le Tourneau, Thibaut Manigold, Laure de Decker, Anne Sophie Boureau","doi":"10.1684/pnv.2025.1243","DOIUrl":"https://doi.org/10.1684/pnv.2025.1243","url":null,"abstract":"<p><p>Many geriatric syndromes are associated with poor prognosis after transcatheter aortic valve replacement (TAVR) in patients aged 75 and older. But none has yet focused on patients with mild cognitive impairment (MCI), especially dysexecutive MCI (d-MCI). The main objective was to evaluate the impact of d-MCI on death or hospitalisation one year after a TAVR procedure. All patients aged > 75 with a normal Katz and Lawton's instrumental activities of daily living index referred for a TAVR between 2012 and 2018 at the Nantes University Hospital were included. Dysexecutive syndrome was defined by a frontal assessment battery (FAB) under 16. One-year mortality and hospitalisation were recorded. A multivariable analysis was conducted to analyse the prognostic value of d-MCI. Among the 494 patients included (median age=85), 18% were hospitalised or died in the first year after the TAVR procedure. In a multivariable logistic regression model, only the Charlson comorbidity index [OR=1.36, 95% CI (1.20-1.56), p<0.001], the mean aortic transvalvular pressure gradient [OR=0.98, 95% CI (0.97-1.00), p=0.04] and a history of chronic respiratory failure (CRF) [OR=1.98, 95% CI (1.03-3.8), p=0.04] were significantly associated with poor outcomes. There was no association between d-MCI and rehospitalisation or death 1 year after a TAVR procedure. However, this study confirmed the prognostic importance of Charlson comorbidity index and mean aortic transvalvular pressure gradient before TAVR.</p>","PeriodicalId":520632,"journal":{"name":"Geriatrie et psychologie neuropsychiatrie du vieillissement","volume":"23 3","pages":"369-377"},"PeriodicalIF":0.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[End of life, assisted dying and geriatrics: results of a national survey conducted by the French Society of Geriatrics and Gerontology].","authors":"Cédric Annweiler, Sophie Moulias, Tristan Cudennec, Jean-Pierre Aquino, Jacques Boddaert, Nathalie Salles, Sylvie Bonin-Guillaume","doi":"10.1684/pnv.2025.1238","DOIUrl":"https://doi.org/10.1684/pnv.2025.1238","url":null,"abstract":"<p><p>In the context of ongoing societal and legislative debates in France on end-of-life care, the French Society of Geriatrics and Gerontology (SFGG) conducted a national survey to assess the perceptions and expectations of professionals working in the field of ageing regarding assisted dying (AD). An anonymous online questionnaire was distributed in November-December 2024 to all 1,600 SFGG members. The survey collected 471 responses, 90% of which were from physicians, on knowledge of the current legal framework, positions on changes in legislation, anticipated professional impacts, and patient feedback. Among respondents, 58.6% report having a clear understanding of the current legal framework and applying it regularly, while 39.7% have only partial knowledge of it. Regarding the desired evolution of the law, 27.5% wish to maintain the current legislative framework, and 41.8% of respondents reject all proposed forms of assisted dying. This suggests that the very way the debate is framed may not align with their clinical or ethical perspectives. Should the law evolve, 25.9% would support assisted suicide supervised by a medical team, 17.8% would favor assisted suicide facilitated by an association, 9.1% would support the issuance of a lethal prescription for self-administration by the patient, and 7.2% would favor euthanasia, defined as the direct administration of a lethal substance by a healthcare professional. Only 12.5% reported not having a definitive opinion. In the event of legalization of assisted dying, 48.2% of respondents would consider invoking a conscience clause, 24.0% might consider leaving their position, and 21.9% would be willing to participate in its implementation. Finally, 68.2% believe that the SFGG should take an active part in the public debate. The national French survey highlights a wide range of opinions among geriatric professionals, reflecting both cautious support for certain forms of AD and deep ethical and professional concerns. These findings underscore the need for a well-informed, ethically grounded debate that carefully considers the specific vulnerabilities of older adults.</p>","PeriodicalId":520632,"journal":{"name":"Geriatrie et psychologie neuropsychiatrie du vieillissement","volume":"23 3","pages":"283-288"},"PeriodicalIF":0.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[How family caregivers adapt to Lewy body disease - tracking family caregivers' perceptions of their caregiving relationships].","authors":"Emmanuel Monfort","doi":"10.1684/pnv.2025.1247","DOIUrl":"https://doi.org/10.1684/pnv.2025.1247","url":null,"abstract":"<p><p>This one-year longitudinal study examined the relationship between caregivers' perceptions of their caregiving role and their psychological health when supporting individuals with Lewy body disease. The findings indicate that a lack of time and family support significantly affects caregivers' psychological health. Additionally, prioritizing emotion-focused coping strategies over problem-focused strategies is associated with a deterioration in psychological health over time. The study also identified distinct caregiver profiles based on variations in the financial consequences of caregiving, self-esteem evolution, and perceived family support over time. These findings highlight the necessity of personalized interventions tailored to the specific needs of caregivers of individuals with Lewy body disease. Overall, this study emphasizes the dynamic and complex nature of caregiving for individuals with Lewy body disease and underscores the importance of long-term support strategies to mitigate stress and promote caregivers' psychological health. Effective support programs should not only promote adaptive coping strategies but also foster intrafamilial communication to improve recognition of caregiving constraints. Given the heterogeneous nature of caregiving experiences, interventions should be adapted to different caregiver profiles.</p>","PeriodicalId":520632,"journal":{"name":"Geriatrie et psychologie neuropsychiatrie du vieillissement","volume":"23 3","pages":"331-339"},"PeriodicalIF":0.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Rethinking Physical Activity for Active Cognitive Aging through Exergames: An Innovative Approach].","authors":"Néva Béraud-Peigné, Pauline Maillot, Alexandra Perrot","doi":"10.1684/pnv.2025.1230","DOIUrl":"https://doi.org/10.1684/pnv.2025.1230","url":null,"abstract":"<p><p>The aging of the French population raises new challenges. The search for effective interventions to preserve autonomy and to decrease the risk of physical and cognitive disorders represents a priority. Several studies have suggested that multidomain training involving physical, motor, and cognitive stimulation could benefit maintaining cognitive vitality. In particular, exergames, active video games, could be effective for training purposes. This narrative review aims to provide an overview of the effects of different types of stimulation (aerobics, muscle strengthening, complex motor skills, open activities, combined training) and associated mechanisms, focusing on active video games as well as a new generation of exergames assisted by an immersive and interactive wall. These new technologies are promising and motivational tools for multidomain training (i.e., physical, motor, cognitive) for older adults.</p>","PeriodicalId":520632,"journal":{"name":"Geriatrie et psychologie neuropsychiatrie du vieillissement","volume":"23 2","pages":"255-265"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Treatment of psychological and behavioral symptoms in dementia with Lewy bodies and Parkinson's disease dementia: Review of the literature and consensus using the Delphi method].","authors":"Frédéric Blanc, Antoine Brangier, Aurélie Mouton, Nathaniel Magnan, Kevin Rabiant, Pauline Auxire, Benoît Schorr, Jean Roche, Maria Soto, Julien Delrieu","doi":"10.1684/pnv.2025.1231","DOIUrl":"10.1684/pnv.2025.1231","url":null,"abstract":"<p><p>Dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD) have frequent psychological and behavioral symptoms (PBS). Treatment of these PBS is variably validated We carried out a review of the treatment of PBS in DLB and PDD from 2009 to 2023. Where the literature allowed, we made treatment recommendations. When the literature was insufficient, we used the Delphi method. The following proposals were made: for pervasive and criticized hallucinations, donepezil or rivastigmine; for delusion, and Capgras syndrome (Delphi), low doses of clozapine; for depression, sertraline, venlafaxine or mirtazapine (Delphi); for RBD, immediate-release melatonin; for frontal syndrome, sertraline or paroxetine first then trazodone (Delphi); for catatonia, lorazepam. Our group's proposals should help to improve the care of DLB and PDD PBS, and thus enhance the quality of life of patients and caregivers.</p>","PeriodicalId":520632,"journal":{"name":"Geriatrie et psychologie neuropsychiatrie du vieillissement","volume":"23 2","pages":"235-253"},"PeriodicalIF":0.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Speech therapy after memory consultation: characteristics of patients receiving speech therapy sessions].","authors":"Floriane Delphin-Combe, Frederic Gervais, Juliette Petit, Claire Moutet, Antoine Garnier-Crussard, Virginie Dauphinot","doi":"10.1684/pnv.2025.1232","DOIUrl":"https://doi.org/10.1684/pnv.2025.1232","url":null,"abstract":"<p><p>This real-life study aims to describe and compare the characteristics of patients who do or do not receive speech therapy after a memory consultation. Socio-demographic and medical data from the MEMORA cohort were matched with speech therapy reimbursement data from the French caisse primaire d'assurance maladie. Univariate analyses showed that speech therapy was more frequent in men, in patients with higher or secondary education, in patients suffering from Alzheimer's disease (AD) and having a higher MMSE. The multivariate model showed that only the diagnosis of AD remained strongly associated with the presence of speech therapy. The diagnosis of AD is the characteristic associated with the highest probability of future speech therapy. Female gender, lower level of education and lower cognitive efficiency appear to be associated with a lower probability of speech therapy.</p>","PeriodicalId":520632,"journal":{"name":"Geriatrie et psychologie neuropsychiatrie du vieillissement","volume":"23 2","pages":"161-167"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Catatonia and dementia: a case series].","authors":"Benoit Schorr, Amandine Hantz, Alexandre Gueremy, Jean-Christophe Boulard, Arnaud Lardin, Frédéric Blanc","doi":"10.1684/pnv.2025.1233","DOIUrl":"https://doi.org/10.1684/pnv.2025.1233","url":null,"abstract":"<p><p>Catatonia is a syndrome combining a variety of psychomotor and behavioral symptoms. It is underdiagnosed in the elderly and associated with significant morbidity and mortality. Little is known about the links between catatonia and dementia. We propose a \"real-life\" case series of five patients with dementia and catatonia, in order to explore the links between catatonia and dementia. Major depression was strongly associated with catatonia in our cases (4/5) and two patients had bipolar disorder. Iatrogenicity was linked to catatonia in three patients, particularly with antipsychotics. Two patients had dementia with Lewy bodies and one was suspected with frontotemporal degeneration. These are the two dementia most frequently associated with catatonia. Catatonia had been mistaken for confusional syndrome in one of our patients. It is important to look for it and treat it in this context.</p>","PeriodicalId":520632,"journal":{"name":"Geriatrie et psychologie neuropsychiatrie du vieillissement","volume":"23 2","pages":"186-198"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Goodbye!]","authors":"Gilles Berrut","doi":"10.1684/pnv.2025.1234","DOIUrl":"https://doi.org/10.1684/pnv.2025.1234","url":null,"abstract":"","PeriodicalId":520632,"journal":{"name":"Geriatrie et psychologie neuropsychiatrie du vieillissement","volume":"23 2","pages":"139-140"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Ambitions and main conclusions of the conference \"Global health, local decisions\" organized by the Digital Health Network].","authors":"Robert Picard, Vincent Augusto, Mathias Béjean, Antoine Bertrand, Dominique Bicout, Vincent Bonneterre, Bernard Castells, Julien Didry, Jean Charles Dron, Ahmed Bakali El Kassimi, Guillaume Facchi, Emmanuelle Fourneyron, Thierry Garaix, Véronique Garnier, François Guerder, Michaël Harbouche, Dimitri Heintz, François Achille Husson, Bénédicte Jacquemin, Françoise Jeanson, Martin Kervadec, David Laplanche, Daniel Laune, Pascale Levet, Xavier Maître, Sébastien Massart, Grégoire Mercier, Pierre-Yves Noël, Alain Olympie, Nicolas Pécuchet, Pascal Petit, Bénédicte Poumarède, Mariline Poupaud, Mélanie Prague, Anne Quesnel-Barbet, Ulysse Rodts, Michel Samson, Vincent Siess, Mircea Sofonea, Rodolphe Thiébaut, Pierre-Yves Traynard, Laura Uhl, François Versini, Xiaolan Xie, William Zanotti, Gilles Berrut, Hubert Blain, Jean Sibilia, Jean Bousquet","doi":"10.1684/pnv.2025.1236","DOIUrl":"https://doi.org/10.1684/pnv.2025.1236","url":null,"abstract":"<p><p>Health is \"a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity\". Health must therefore be considered in its entirety. To begin with, however, it is vital to move swiftly from the concept of holistic health to its practical implementation. This is what the first Digital Health Network symposium proposed on May 30 and 31, 2024. The Digital Health Network was originally set up by a group of players from the healthcare sector, industry, research and elected representatives, with the aim of pooling feedback from experience as close as possible to local realities. The following points were addressed: i) rebalancing the curative approach with a greater emphasis on prevention and health promotion; ii) rebalancing the genetic approach with a greater emphasis on exposomics; iii) insufficient use of digital technology to improve the health of local populations; iv) governance and organizational challenges from the point of view of local decision-makers and observers, with a focus on research; and v) the ambitions of the Digital Health Network. The symposium provided an opportunity to share case studies of public health challenges in local areas, and possible responses in terms of infrastructure and stakeholder participation: citizens, patients, healthcare professionals, service providers, experts and other stakeholders. The challenges of ageing and geriatric frailty underline the importance of a global, preventive and multidisciplinary approach to promote successful, independent ageing.</p>","PeriodicalId":520632,"journal":{"name":"Geriatrie et psychologie neuropsychiatrie du vieillissement","volume":"23 2","pages":"141-152"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}