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O Beauchet

Publications and source records attributed to O Beauchet.

15 recordsLinked to original sources
PubMed2005

Dual-task-related gait changes in the elderly: does the type of cognitive task matter?

Dual-task-related gait changes among older adults while they perform spoken verbal tasks have been reported frequently. The authors examined whether the type of walking-associated spoken verbal task matters for dual-task-related gait changes in 16 older adults classified as transitionally frail. Mean stride time increased significantly when they walked and performed an arithmetic or a verbal fluency task compared with when they only walked (p < .001), whereas the coefficients of variation increased significantly only when they walked and performed the arithmetic task (p = .005) but not the verbal fluency task (p = .134). Those findings suggest that stride time variability under a dual-task condition depends on the type of walking-associated spoken verbal task.

Adult↗
PubMed2004

[Gait analysis and tailored exercise prescription in older adults].

Examining gait characteristics in older adults enhances our understanding of movement control in this population and helps to better target preventive interventions. Walking is a highly automated, regular motor behavior that is mostly controlled by subcortical locomotor brain regions. With increasing age, walking requires higher levels of attention and thus more cortical involvement in motor control. This can affect gait regularity by increasing stride-to-stride variability that is characteristically high among fallers. A growing number of clinical gait analysis systems is now available to determine gait variability and thus the falling risk in older adults. Interventions targeting high gait variability in older adults need to consider basic principles of motor learning. Previously common and automatic gait patterns have to be relearned and again brought up to a highly automated level of motor control. Regular walking exercise, and particularly T'ai Chi with its emphasis on sequenced, slow, and highly controlled movements, might be helpful in this relearning process. Further research is needed to explore other interventions that could favorably affect stride-to-stride variability of older adults.

Accidental Falls↗
PubMed2004

Energy and nutrient intake of elderly hospitalized patients in a steady metabolic status versus catabolic status.

Protein undernutrition enhances frailty and aggravates intercurrent diseases generally observed in elderly patients. Undernutrition results from insufficient food intake and catabolic status. Daily nutrient intakes were explored for hospitalized geriatric patients. Nutrient intake (carbohydrates, lipids, proteins, and calcium) was determined in randomly selected geriatric patients (n=49) over five consecutive days by weighting food in the plate before and after meals. For each geriatric patient, catabolic status and risk factors of undernutrition were considered. Results were compared between patients in a steady status or catabolic status. In steady status patients, protein, lipid and carbohydrate intake but not calcium intake, met recommended dietary allowances (total caloric intake:1535 +/- 370 Cal/day ; protein:1+/- 0.4 g/kg/day ; carbohydrates:55 +/- 7.7 % ; lipids: 30 +/- 6.3 % ; calcium:918 +/- 341 mg/day) . Patients in catabolic status (cardiopulmonary deficiency , neurologic disease , inflammatory process) had lower total caloric intake, lower protein intake and dramatically lower calcium intake (total caloric intake : 1375 +/- 500 Cal/day ; protein :0.9 +/- 0.4 g/kg/day ; carbohydrates : 54 +/- 8.3 % ; lipids : 31 +/-6.2 % ; calcium : 866 +/- 379 mg/day). Nutrient intake was lower in elderly patients hospitalized in short stay care units, perhaps due to failure to recognize suitable nutrient requirements. Protein-caloric undernutrition should be diagnosed early during hospitalization in order to allow appropriate dietary supplementation. However the incidence of protein undernutrition among elderly patients as a cause or a consequence of adverse pathophysiological processes remains a cause of debate.

Aged↗
PubMed2002

[Influence of a specific cognitive task on spatial-temporal walking parameters in elderly frail individuals].

OBJECTIVE: Walking is a complex voluntary rhythmic motor behaviour. Its implicit nature suggests that reduced attention resources are required for its execution. The aim of this study was to demonstrate that, to perform a mental calculation while walking, might modify the spatial-temporal parameters of walking in fragile elderly patients. METHODS: We compared the walking, in a straight line over a distance of 10 meters, of 30 fragile elderly subjects (mean age 82.6 +/- 7.1 years) with that of 30 healthy controls (mean age 37.5 +/- 11.5 years). Two walking conditions were studied: with and without a counting task. The time, number of steps, lateral deviations and stops were recorded on a video camera. RESULTS: The condition of a double-task provoked three types of effects on walking: an increase in time and the number of steps in both groups, but significantly greater in the elderly patients than in the control group of patients (6.4 s and 4.6 steps in the elderly versus 0.5 s and 0.4 steps in the controls); a reduction in the cadence and length of the step, only significant in the elderly patients, and a significant increase in the number of lateral deviations and stops in the double-task condition in the elderly patients. CONCLUSION: Globally, these results indicate that walking requires more attention resources in the elderly than in the middle-aged. The loss of the implicit character of walking to the benefit of cognitive attention resources may partly explain the high risk of falling in fragile elderly subjects.

Adult↗
PubMed2002

[Development of a clinical test of gait in frail elderly by a cognitive approach of locomotion].

OBJECTIVE: From a cognitive approach of locomotion, we studied the feasibility and the reproducibility of a clinical test of gait which is devoted to predict fall. METHODOLOGY: With a cross-sectional design, we studied the gait of 30 old subjects (average age 82.6+/-7.1 years). The gait course consisted of a 10m length in a well light room, with regular walking shoes. Two conditions were examined: walking with and without explicit cognitive task (mental arithmetic and verbal flow task). Time (seconds) and number of steps were collected by two operators Deviations and stops were video-taped. Number of figures was recorded with a tape recorder. The difficulty to perform gait conditions was estimated by each subject with a quotation ranging from 0 (easy gait) to 10 (difficult gait). RESULTS: Increases of time, steps, deviations and stops were observed when gait was associated to a cognitive task (6.4 seconds and 4.6 steps with mental arithmetic; 10.5 seconds and 6.7 steps with verbal flow task). All subjects managed this test. These results were reproducible across tests and operators. Walking with mental arithmetic was the most easy gait condition for subjects. CONCLUSIONS: The simplicity and the reproducibility of this test make it as adequate instrument of gait evaluation in geriatrics. Walking with mental arithmetic is the condition that must to be used. Validation of its predictive value for fall in frail elderly subjects remains to be shown.

Accidental Falls↗
PubMed2002

[Effectiveness of falls prevention strategies for elderly subjects who live in the community with performance assessment of physical activities (before-after)].

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.

Accidental Falls↗
PubMed2002

[Diogenes syndrome in the elderly: clinical form of frontal dysfunction? Report of 4 cases].

PURPOSE: Diogenes syndrome is characterised by self-neglect and domestic squalor which leads to unhealthy living conditions. It seems that no single model satisfactorily explains the development of Diogenes syndrome. METHODS: We report four cases of Diogenes syndrome discovered during a short-stay geriatric hospitalization. We were able to analyse them as regards social, physical, psychiatric and cognitive aspects. RESULTS: The results showed absence of socioeconomic precariousness, psychiatric and physical pathologies which generate handicaps. A dementia characterised by a frontal dysfunction was constantly found. CONCLUSION: Diogenes syndrome seems to be a particular behavioural demonstration of a frontal lobe dementia. It does not correspond to a lucid life choice, which must encourage a medico-social assumption.

Aged↗
PubMed2002

[Combined sclerosis of the spinal cord revealing vitamin B 12 deficiency: geriatric characteristics apropos of a case evaluated by MRI].

INTRODUCTION: Cobalamin deficiency is common in the elderly. However, most of the patients are asymptomatic or present with few symptoms. A subacute combined degeneration of the spinal cord accounts for only 10% of the neurological complications. Revealing forms of this myelopathy are exceptional, and were rarely documented by magnetic resonance imaging (MRI) study. EXEGESIS: We report a case of subacute combined degeneration of spinal cord in an 81-year-old woman evaluated by a spinal cord MRI. We discuss the role of the spinal cord radiographic study in the diagnosis, the etiopathogeny of cobalamin deficiency and the benefit of vitamin supplementation even at a late stage of the disease in geriatrics patients. CONCLUSION: The spinal cord MRI is useful in the diagnosis of late-form combined spinal cord degeneration. The high frequency of atrophic gastritis in elderly prevents the identification of a deficiency of the cobalamin etiology. The treatment relies on vitamin therapy even in the late stages. The severe disability of cobalamin deficiency neurological complications must encourage an earlier diagnosis in elderly patients.

Age Factors↗
PubMed2002

[First epileptic seizure in the elderly: electroclinical and etiological data in 341 patients].

This study included 341 subjects aged over 60 years, 174 females and 167 males, (mean age 72-years), who experienced their first epileptic seizure and fulfilled all inclusion criteria over an 8-year period. Data were available from the physical examination, EEG, laboratory tests and CT scan or MRI for all patients. The international classification of epileptic seizures was applied, 41 p.cent of the seizures were generalized and 59 p.cent were partial. Status epilepticus occurred in 8 p.cent of the patients. The EEG recording was contributive to diagnosis or helpful for localizing the epileptic focus in 55 p.cent of the patients. Normal brain imaging was observed in 40 p.cent of the patients. The main etiology was cerebrovascular disease (33 p.cent), acute stroke (27 patients), or more often postvascular epilepsy (87 patients). Other etiologies were degenerative cortical dementia in 7 p.cent of the patients, metabolic and toxic disorders in 11 p.cent, and benign or malignant brain tumors in 6.5 p.cent. Thirty-two percent of the seizures were of unknown origin (cryptogenic seizures). No correlation was found between sex, age, and etiology. An antiepileptic drug treatment was initiated in 77 p.cent of the patients who were given either valproate (43 p.cent), carbamazepine (26 p.cent) or barbiturates (7 p.cent). These findings are in agreement with those reported in the reviewed literature.

Aged↗
PubMed2000

[Factors contributing to falls in elderly subjects leading to acute-care hospitalization].

OBJECTIVE: Falls are a frequent reason for hospitalization in short-stay geriatric units. Paradoxically, the factors determining such hospitalization remain unknown. The objective of our study was to identify the explanatory factors of falls leading to acute-care hospitalization of elderly subjects. PATIENTS AND METHODS: We prospectively compared patients hospitalized for falls and those hospitalized for another reason in a short-stay geriatric unit. Data were collected over a 6-month period starting with a questionnaire and a physical examination. RESULTS: Patients admitted for falls were predominantly women (76.9%) living alone (76.9%). Falls depended mainly on intrinsic factors. The precipitating factor was a medical condition (84%) and acute (96%). The pattern of multiple disease conditions was not specific for patients who fell. Inversely, osteoarthritis and visual and auditory deficits with direct effects on motor functions were correlated with falls. The environment played a determining role, but was primarily a predisposing and not a precipitating factor as is was directly the cause of falls in only 4% of cases. The loss of self-sufficiency for daily activities was also significantly more frequent in patients who fell. DISCUSSION: The explanatory factors of falls as the reason for hospitalization of elderly subjects in short-stay geriatric units are intrinsic factors. They are associated with a precipitating factor which is usually an acute medical condition and a chronic multiple disease state having an effect on postural balance leading to the fall. These factors are combined in a context of social and environmental isolation.

Accidental Falls↗
PubMed2000

[Hypernatremia in the aged: clinical characteristics].

OBJECTIVE: Hypernatremia in young adults is a rare condition, sometimes occurring after gastrointestinal diseases, osmotic diuresis or diabetes insipidus. The clinical characteristics and prognosis of hypernatremia in geriatric patients would be different. Each case must be examined separately. PATIENTS AND METHODS: We conducted a prospective uncontrolled study among patients over 70 with sodium levels equal to or greater than 150 mmol/l (at admission or during the hospitalization). RESULTS: Hypernatremia was found in 77 patients. Mean age was 84.1 +/- 6.7 years. The mean peak serum sodium level was 157.3 +/- 7.4 mmol (two-thirds ranged from 150 to 160). Hypernatremia onset was produced by a wide range of symptoms: 48% had a febrile illness, 470% were on diuretics, 15% had had a stroke, but only 9% were suffering from diarrhea or vomiting. Most of the patients had disabling chronic illnesses (62% loss of two or more ADL of Katz), severe dementia (84% level = 6 on the Reisberg global deterioration scale). In spite of fluid replacement and follow-up treatment, outcome was poor: 62% of the patients died within three months. CONCLUSION: Besides digestive and renal losses, hypernatremia in elderly patients is increased by fluid supply disorders consecutive to hypodipsia contracted at the same time as disability and dementia. Hypodipsia is a sign of poor prognosis. Prevention must be undertaken early, emphasizing the importance of identifying dehydration early among elderly people with chronic disabling illnesses.

Adult↗
PubMed2000

[Roles of arterial dysplasia, chronic ergotism and other factors in a case multiple spontaneous arterial dissections].

INTRODUCTION: Spontaneous dissection of cervical and visceral arteries are rare and usually associated with an underlying arterial disease. EXEGESIS: The authors report the unusual case of a 50-year-old woman with high blood pressure who presented spontaneous dissection of cervico-cephalic, renal and hepatic arteries and of the descending aorta. She had been taking ergotamine tartrate for ten years for migraine. She also suffered from Raynaud's syndrome worsened by treatment. CONCLUSION: The respective roles of arterial dysplasia, chronic ergotism, renovascular hypertension and migraine are discussed.

Aortic Dissection↗