F. Puisieux

University of Lille Nord de France, Lille, Nord-Pas-de-Calais, France

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Publications (90)129.93 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background It is well known that informal care giving for Alzheimer patients can be a burden and may result in caregivers’ distress and stress. Caring for a person with Alzheimer's disease (AD) is a difficult task, which can become overwhelming. Their caregivers need attention as well. Objectives The present study examines the socio-demographic characteristics and the quality of health and life of the sandwich grandparent generation (SGP) caregivers defined as providing care to both old demented parents and young grandchildren. Study design Multicentric, prospective and observational study over a one-year period. Setting Eleven voluntary Memory Clinics across the North of France. Participants Voluntary SGP caregivers recruited in Memory Clinics who completed an oral questionnaire, during an interview one to one with a physician. Results A vast majority of our SGP caregivers were women, mean age 59 years, married, retired, described in the literature as “women in the middle”, felling stressed and not sleeping well in more than half of the cases. They had three grandchildren, mean age 7 years. The AD patient, mean age 86-years-old, was most frequently the caregiver's mother. Many SGPs had been providing their help for 5 years or even longer. Nevertheless, the SGPs considered themselves satisfied about their health, and said they had a good quality of life. Conclusion Although SGP women caregivers reported high levels of perceived burden, they considered that their health and quality of life were good.
    European geriatric medicine 04/2015; 6(2):124-127. DOI:10.1016/j.eurger.2014.10.001 · 0.55 Impact Factor
  • Soins. Gérontologie 03/2015; 20(112):39-42. DOI:10.1016/j.sger.2014.09.014
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    ABSTRACT: Background Ageing is a determining factor in skin cancer, but the incidence and prevalence of skin cancer in elderly patients are not known.AimTo determine the prevalence of skin cancers in elderly patients and to assess their associated geriatric syndromes.Methods Between January and April 2013, all consecutive incident patients hospitalized in the Acute Geriatric Unit of Lille University Hospital underwent a geriatric assessment and a systematic dermatological examination. A biopsy was taken whenever there was any lesion with suspicion of malignancy.ResultsIn total, 204 patients (mean age 85.4 years) were included, and 16 cutaneous biopsies were taken from 15 patients. Histological examination confirmed skin cancer in 11 biopsies from 10 patients: 9 basal cell carcinomas, 1 squamous cell carcinoma (SCC) and 1 malignant lentigo. The prevalence of skin cancer was 4.9%. The geriatric assessment revealed severe geriatric syndromes in the 10 patients with skin cancer: severe dependence (8/10), possible cognitive impairment (10/10), and moderate or severe malnutrition (5/10).Conclusions The prevalence of skin cancer is high in frail elderly patients. The association of severe geriatric syndromes suggests that close collaboration between geriatricians and dermatologists is essential to optimize the treatment of skin carcinoma in elderly patients.
    Clinical and Experimental Dermatology 01/2015; 40(4). DOI:10.1111/ced.12562 · 1.23 Impact Factor
  • F. Puisieux · P. Lagardere · V. Beghin · V. Pardessus
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    ABSTRACT: L’éducation fait partie intégrante des interventions multifactorielles qui sont recommandées pour la prévention de la chute chez les patients à haut risque. Cette approche n’est pas fondamentalement différente de celles proposées dans le cadre des maladies chroniques, la chute devant être regardée comme une maladie chronique et non comme un accident isolé. Quelques équipes gériatriques françaises ont développé des programmes d’éducation du patient âgé chuteur. Nous décrivons celui que nous proposons aux patients de la consultation multidisciplinaire de la chute de Lille. Ce processus éducatif vise à accompagner la personne dans l’acquisition de nouvelles compétences, nécessaires à sa sécurité et à son devenir, à renforcer son estime de soi, sa motivation et sa capacité à faire des choix pour faire face au problème des chutes.
    Les cahiers de l année gérontologique 12/2014; 6(4). DOI:10.1007/s12612-014-0433-3
  • F Roca · N Grossin · P Chassagne · F Puisieux · E Boulanger
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    ABSTRACT: Angiogenesis is generally a quiescent process which, however, may be modified by different physiological and pathological conditions. The "angiogenic paradox" has been described in diabetes because this disease impairs the angiogenic response in a manner that differs depending on the organs involved and disease evolution. Aging is also associated with pro- and antiangiogenic processes. Glycation, the post-translational modification of proteins, increases with aging and the progression of diabetes. The effect of glycation on angiogenesis depends on the type of glycated proteins and cells involved. This complex link could be responsible for the "angiogenic paradox" in aging and age-related disorders and diseases. Using diabetes as a model, the present work has attempted to review the age-related angiogenic paradox, in particular the effects of glycation on angiogenesis during aging.
    Ageing research reviews 04/2014; 15. DOI:10.1016/j.arr.2014.03.009 · 7.63 Impact Factor
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    ABSTRACT: We assess orthostatic hypotension (OH) prevalence in elderly fallers and determine OH-associated risk factors in this patient population. A monocentric prospective study at Lille University Hospital Falls Clinic included 833 consecutive patients who had fallen or were at high risk of falls and who were assessed for the presence of OH. Among 833 patients aged 80.4±7.4 years, OH was found in 199 subjects (23.9% of cases). Multivariate analysis showed that selective serotonin reuptake inhibitors (odds ratio (OR) 2.42, 95% confidence interval (CI): 1.56-3.75), serotonin-norepinephrine reuptake inhibitors (OR 5.37, 95% CI: 1.93-14.97), Parkinsonian syndrome (OR 2.54, 95% CI: 1.54-4.19), excessive alcohol consumption (OR 2.17, 95% CI: 1.32-3.56), meprobamate (OR 2.65, 95% CI: 1.12-6.25) and calcium channel blockers (OR 1.79, 95% CI: 1.16-2.76) were all risk factors for OH. In contrast, angiotensin receptor blockers (OR 0.52, 95% CI: 0.30-0.91) appeared to be protective factors against OH. This study demonstrates that a systematic investigation should be made in all elderly fallers and those at high risk of falls to detect the presence of OH. In OH patients, in addition to the usual predisposing factors, excessive alcohol consumption and psychotropic drug intake-in particular, the intake of serotonergic antidepressants-should be taken into account as potential risk factors.Journal of Human Hypertension advance online publication, 19 September 2013; doi:10.1038/jhh.2013.82.
    Journal of human hypertension 09/2013; DOI:10.1038/jhh.2013.82 · 2.69 Impact Factor
  • 04/2013; 10(2):1-6. DOI:10.1016/S1762-0945(13)55894-3
  • European geriatric medicine 09/2012; 3:S109. DOI:10.1016/j.eurger.2012.07.254 · 0.55 Impact Factor
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    ABSTRACT: Background: Elopement is frequently observed among older adults with AD. Little work has been done on this significant problem. Objectives: to analyse the prevalence of the phenomenon, to define the profile of those who run away and to describe intervention strategies employed to prevent new intent to elope. Design and setting: Prospective study over one year (2009) of 6,649 participants living in nursing homes or long-term care units in the North of France. Participants: Prospective survey of elopement incidents that occurred among 65 licensed representative facilities in the North of France. Measurements: Our survey describes the circumstances, environmental risks and injuries sustained in 66 elopement incidents involving our residents. Results: The distinctive features of people who elope and elopement incidents are described in our communication. All residents who eloped had been diagnosed with AD or other forms of dementia. 35 % had a history of elopement. No resident was found dead. Once the patients got back, caregivers made significant changes (36 %): by adapting organization levels, pharmacological interventions, and activity programmes. However for those who had run away (64 %) and whose carers did not change their strategies; we noted 15 new elopement incidents (versus 3 when changes had been made). There was no legal investigation involved in the course of our study. Conclusion: Elopement can be dangerous. It puts both families and caregivers under a lot of stress. Physical restraints are used to prevent wandering and elopement. The problem for physicians, administrators and caregivers is working out how to improve safety enough to prevent elopement incidents for residents without encroaching upon their rights.
  • C. Pagniez · G. Mollet · I. Delabrière · F. Puisieux
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    ABSTRACT: La maladie d’Alzheimer touchant de plus en plus de personnes en France, il se développe des structures de répit, pour venir en aide à ces patients et à leurs proches. Les accueils de jour (AJ) font partie de ces structures. Ils affichent un triple objectif: « resocialisation de la personne » et « son adaptation à la vie quotidienne », mais également, « permettre un répit et une écoute des aidants » [1]. Une étude a été réalisée afin de dresser un état des lieux du mode de fonctionnement de ces structures, de la population accueillie, et des difficultés rencontrées. La méthode utilisée a consisté en un établissement de la liste des AJ régionaux par appel systématique aux EHPAD, et comparaison à la liste établie par Méotis en 2007. Puis, un questionnaire a été envoyé à ces structures pour déterminer leur mode de fonctionnement, les caractéristiques de la population qu’ils accueillent, les statistiques d’activité sur l’année 2009, et les difficultés qu’ils rencontrent. 85 accueils de jour ont été recensés dans la région. 30 ont répondu au questionnaire qui leur a été envoyé. Concernant le fonctionnement général, le nombre moyen de personnes pouvant être accueillies par jour est de 7,25 personnes/jour et par AJ. Le taux d’occupation moyen est de 60%. Les personnes accueillies ont une moyenne d’âge de 79,5 ans, et sont pour 70% d’entre elles en GIR 2 ou 3. La dépendance de la majorité des personnes accueillies mais aussi l’hétérogénéité dans leur niveau de dépendance et de sévérité de la maladie rend difficile l’atteinte des objectifs fixés aux AJ. Les autres difficultés décrites, qui en découlent en partie, sont les problèmes de transport et les difficultés de recrutement.
    Les cahiers de l année gérontologique 10/2011; 3(1). DOI:10.1007/s12612-011-0216-z
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    ABSTRACT: Swallowing disorders (or dysphagia) are common in the elderly and their prevalence is often underestimated. They may result in serious complications including dehydration, malnutrition, airway obstruction, aspiration pneumonia (infectious process) or pneumonitis (chemical injury caused by the inhalation of sterile gastric contents). Moreover the repercussions of dysphagia are not only physical but also emotional and social, leading to depression, altered quality of life, and social isolation. While some changes in swallowing may be a natural result of aging, dysphagia in the elderly is mainly due to central nervous system diseases such as stroke, parkinsonism, dementia, medications, local oral and oesophageal factors. To be effective, management requires a multidisciplinary team approach and a careful assessment of the patient's oropharyngeal anatomy and physiology, medical and nutritional status, cognition, language and behaviour. Clinical evaluation can be completed by a videofluoroscopic study which enables observation of bolus movement and movements of the oral cavity, pharynx and larynx throughout the swallow. The treatment depends on the underlying cause, extent of dysphagia and prognosis. Various categories of treatment are available, including compensatory strategies (postural changes and dietary modification), direct or indirect therapy techniques (swallow manoeuvres, medication and surgical procedures).
    Revue des Maladies Respiratoires 10/2011; 28(8):e76-93. DOI:10.1016/j.rmr.2011.09.007 · 0.49 Impact Factor
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    ABSTRACT: Fear of falling may be as debilitating as the fall itself, leading to a restriction in activities and even a loss of autonomy. The main objective was to evaluate the prevalence of the fear of falling among elderly fallers. The secondary objectives were to determine the factors associated with the fear of falling and evaluate the impact of this fear on the activity "getting out of the house". Prospective study conducted between 1995 and 2006 in which fallers and patients at high risk for falling were seen at baseline by the multidisciplinary falls consultation team (including a geriatrician, a neurologist and a physical medicine and rehabilitation physician) and then, again 6 month later, by the same geriatrician. The fear of falling was evaluated with a yes/no question: "are you afraid of falling?". Out of 635 patients with a mean age of 80.6 years, 502 patients (78%) expressed a fear of falling. Patients with fear of falling were not older than those who did not report this fear, but the former were mostly women (P<0,001), who experienced more falls in the 6 months preceding the consultation (P=0.01), reported more frequently a long period of time spent on the floor after a fall (P<0.001), had more balance disorders (P=0.002) and finally, were using more frequently a walking technical aid (P=0.02). Patients with fear of falling were not going out alone as much as the fearless group (31% vs 53%, P<0.0001). Eighty-two percent of patients in the fearful group admitted to avoiding going out because they were afraid of falling. The strong prevalence of the fear of falling observed in this population and its consequences in terms of restricted activities justifies systematically screening for it in fallers or patients at risk for falling.
    Annals of physical and rehabilitation medicine 06/2011; 54(4):248-58. DOI:10.1016/j.rehab.2011.04.002
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    ABSTRACT: Cited By (since 1996):23, Export Date: 18 October 2014
    American Journal of Clinical Nutrition 01/2011; 93(1):200-210. · 6.92 Impact Factor
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    ABSTRACT: Vascular accelerated aging represents the major cause of morbidity and mortality in subjects with diabetes mellitus. In the present study, our aim was to compare premature functional and morphological changes in the arterial wall resulting from streptozotocin (STZ)-induced diabetes mellitus in mice over a short-term period with those that develop during physiological aging. The effect of aminoguanidine (AG) on the prevention of these alterations in the diabetic group was also analyzed. The vascular relaxation response to acetylcholine (ACh) in the mouse was tested in isolated segments of phenylephrine (Phe)-precontracted aorta at 2, 4 and 8 weeks (wk) of STZ-induced diabetes and compare to 12- and 84-wk-old mice. Aortic structural changes were investigated, and receptor for AGE (RAGE) aortic expression was quantified by western blot. Compared to the 12-wk control group (76 ± 5%), significant endothelium-dependant relaxation (EDR) impairment was found in the group of 12-wk-old mice, which underwent a 4-wk diabetes-inducing STZ treatment (12wk-4WD) (52 ± 4%; P < 0.01) and was yet more apparent in the group of 16-wk-old mice, which underwent an 8-wk diabetes-inducing STZ treatment (16wk-8WD) (34 ± 4%; P < 0.001). The alteration in EDR was relatively comparable between the diabetic 12wk-4WD group and the 84-wk-old group (52.7 ± 4 vs. 48 ± 4%). Intima/media aortic thickening and aortic structural changes were significantly increased in the diabetic 12wk-4WD group and were even more apparent in the 84-wk group compared to the 12-wk controls. AG treatment in the 12wk-4WD+AG diabetic group significantly improved EDR, decreased RAGE expression and showed an aging preventive effect on the structural changes of the arterial wall. Our study compared EDR linked to physiological aging with that observed in the case of STZ-induced diabetes over a short-term period, and demonstrated the beneficial effect of AG.
    Diabetes & Metabolism 12/2010; 37(2):106-11. DOI:10.1016/j.diabet.2010.08.005 · 2.85 Impact Factor
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    E Cetin · J Muzembo · V Pardessus · F Puisieux · A Thevenon
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    ABSTRACT: In elderly individuals balance disorders and muscle weakness can lead to prescribing a walker. There are several different models. According to the very poor effort tolerance in this population, the energy cost necessary to operate walking technical aids should be taken into account when making a choice. Compare two types of walker in regards to energy cost produced during gait in weakened elderly individuals. Thirty subjects over the age of 65 (six men and 24 women, mean age 81.9 years) were admitted in geriatrics care. They all required a walker and performed the same 10-m course with a fixed walker, then with a model bearing front wheels. The walking speed (S) was computed, heart rate at rest (HRrest) and maximum heart rate (HRmax) were recorded during the test. The physiological cost index (PCI=HRmax-HRrest/S) was calculated. Finally a timed get-up-and-go (TGUG) test was performed with each of these technical aids. With a rollator walker, HRmax was lower (P<0.05) and S higher (P<0.001). It was 2.01 with a fixed walker versus 1.23 with a rollator walker (P<0.01). We found this speed difference during the TGUG test (72.26 sec vs. 82.93 sec, P=0.001). There are very little studies on the evaluation of physiological energy cost produced during gait with a walker. The characteristics of our population did not allow us to conduct our test without a technical aid. The use of a fixed walker leads to a major increase in gait PCI, probably due to the required repeated efforts for lifting the walker. This model must be avoided in case of cardiac or respiratory disorders.
    Annals of physical and rehabilitation medicine 08/2010; 53(6-7):399-405. DOI:10.1016/j.rehab.2010.06.003
  • BMJ quality & safety 04/2010; 19(Suppl 1):A37-A38. DOI:10.1136/qshc.2010.041616.14 · 3.28 Impact Factor
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    ABSTRACT: Seizures are frequent in the elderly, but their diagnosis can be challenging. The objective of this work was to develop and validate an expert-based algorithm for the diagnosis of seizures in elderly people. A multidisciplinary group of neurologists and geriatricians developed a diagnostic algorithm using a combination of selected clinical, electroencephalographical and radiological criteria. The algorithm was validated by multicentre retrospective analysis of data of patients referred for specific symptoms and classified by the experts as epileptic patients or not. The algorithm was applied to all the patients, and the diagnosis provided by the algorithm was compared to the clinical diagnosis of the experts. Twenty-nine clinical, electroencephalographical and radiological criteria were selected for the algorithm. According to criteria combination, seizures were classified in four levels of diagnosis: certain, highly probable, possible or improbable. To validate the algorithm, the medical records of 269 elderly patients were analyzed (138 with epileptic seizures, 131 with non-epileptic manifestations). Patients were mainly referred for a transient focal deficit (40%), confusion (38%), unconsciousness (27%). The algorithm best classified certain and probable seizures versus possible and improbable seizures, with 86.2% sensitivity and 67.2% specificity. Using logistical regression, 2 simplified models were developed, the first with 13 criteria (Se 85.5%, Sp 90.1%), and the second with 7 criteria only (Se 84.8%, Sp 88.6%). In conclusion, the present study validated the use of a revised diagnostic algorithm to help diagnosis epileptic seizures in the elderly. A prospective study is planned to further validate this algorithm.
    Epilepsy research 03/2010; 89(2-3):339-48. DOI:10.1016/j.eplepsyres.2010.02.008 · 2.19 Impact Factor
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    ABSTRACT: Background People with neurological disorders including stroke, dementia, Parkinson's disease, and polyneuropathy are known to have an increased risk of falls.
    Revue Neurologique 02/2010; 166(2):235-241. DOI:10.1016/j.neurol.2009.05.007 · 0.60 Impact Factor
  • C. Gaxatte · C. Olejnik · P. Renom · E. Boulanger · F. Puisieux
    La Revue de Médecine Interne 12/2009; 30. DOI:10.1016/j.revmed.2009.10.161 · 1.32 Impact Factor

Publication Stats

349 Citations
129.93 Total Impact Points

Institutions

  • 2010–2015
    • University of Lille Nord de France
      Lille, Nord-Pas-de-Calais, France
  • 1994–2015
    • Centre Hospitalier Régional Universitaire de Lille
      Lille, Nord-Pas-de-Calais, France
  • 2007
    • Centre Hospitalier Universitaire de Montpellier
      Montpelhièr, Languedoc-Roussillon, France
  • 1994–2001
    • CHRU de Strasbourg
      Strasburg, Alsace, France