F. Puisieux

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

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Publications (114)124.72 Total impact

  • S. Schoenenburg · C. Corteel · V. Pardessus · F. Puisieux

    No preview · Article · Nov 2015 · Journal de Réadaptation Médicale Pratique et Formation en Médecine Physique et de Réadaptation
  • F. Puisieux · E. Boulanger · J.-B. Beuscart
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    ABSTRACT: Parmi les personnes de 65 ans et plus, deux tiers sont hypertendus et un tiers tombe chaque année. Hypertension artérielle (HTA) et chutes coexistent fréquemment chez un même patient, portant chacun un risque de déclin fonctionnel et de mortalité. La majorité des chutes résultent de l’interaction de multiples facteurs prédisposants et précipitants. L’hypotension orthostatique est reconnue comme un facteur de risque de chute. Bien que les traitements antihypertenseurs puissent contribuer à l’hypotension orthostatique, les études suggèrent que les liens unissant HTA, médicaments antihypertenseurs, hypotension orthostatique et chutes sont plus complexes qu’attendu. Le traitement de l’HTA est bénéfique pour la prévention des accidents vasculaires cérébraux et l’insuffisance cardiaque même chez les sujets âgés fragiles à haut risque de chutes, mais représente dans ce groupe de patients un challenge en termes de sécurité et de qualité de vie. La confirmation du diagnostic par une mesure ambulatoire de la pression artérielle est indispensable. La prescription doit être prudente, avec des objectifs tensionnels raisonnables, en évitant des traitements trop intensifs. Les cardiologues doivent prêter plus d’attention au risque de chute de leurs patients âgés hypertendus dans le but de prévenir le risque de chute et de chute grave.
    No preview · Article · Oct 2015 · Archives des Maladies du Coeur et des Vaisseaux - Pratique

  • No preview · Article · Sep 2015 · European geriatric medicine
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    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.
    No preview · Article · Apr 2015 · European geriatric medicine
  • F. Puisieux

    No preview · Article · Mar 2015

  • No preview · Article · Mar 2015 · Soins. Gérontologie
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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.
    No preview · Article · Jan 2015 · Clinical and Experimental Dermatology
  • 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.
    No preview · Article · Dec 2014 · Les cahiers de l année gérontologique
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    ABSTRACT: Background: Improuing drug prescription and medication compliance among the elderly is a public health priority. The monitoring table "My Treatment" has been developed to help the prescribing physician reassess a prescription and to improve patient adherence. The table is filled in after a hospital stay and is shown to the patient. It is then sent over to his or her general physician who will have to ensure the patient's good comprehension and adhesion. Objectives: The study aimed at evaluating the feasibility and quality of the process. It also helped understanding potential issues faced when filling in the questionnaires. Methods: The monitoring table has been tested in partnership with OMEDIT Nord-Pas-de-Calais, Reseau Sante-Qualite and URPS Medecins Liberaux Nord-Pas-de-Calais, in 8 hospitals between February and June 2012. Physicians' opinions along with the quality of the forms were evaluated. Results: Thanks to the 8 hospitals who took part in the study, 384 tables were analyzed. Hospital and general physicians found the tool useful and considered it contributed to a better communication between hospitals and town. They also considered it provided patient with better information the other, that is to say, its irreducible otherness. Positive treatment is no longer an assertiveness in the name of good, but the respectful reception of the other's speech, and silent response to his call.
    No preview · Article · Dec 2014
  • 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.
    No preview · Article · Apr 2014 · Ageing research reviews
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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.
    No preview · Article · Sep 2013 · Journal of human hypertension

  • No preview · Article · Apr 2013
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    ABSTRACT: Falls are a major health problem among elderly people due to their high incidence and serious consequences: injuries, fractures, loss of autonomy, poor quality of life, and institutionalization. Most of the falls are a result of multiple risk factors. The objective of fall management is to identify predisposing and precipitating, individual and environmental risk factors. The first step in the fall management consists of a comprehensive multidisciplinary assessment to evaluate the risk level and to identify the risk factors related to the individual. In a second time, modifiable risk factors for fall should be reduced and patients should receive an adapted progressive physiotherapy to recover function and regain self-confidence. There is evidence that multicomponent fall prevention programs may reduce falls and risk of falling in the community and may do so in nursing care facilities. Education is often part of these programs and is recommended at national level. However, few studies have specifically addressed the question of fall prevention education. © La Revue de Gériatrie, Tome 38, No l JANVIER 2013 Consequently, the content of these educational programs and their modalities of delivery have not been well defined. We describe here the education program for patients attending the multidisciplinary fall consultation of Lille. This program includes initial and final individualized evaluations, and 12 weekly two-hour group sessions. It aims at informing elderly people about their fall risk and at improving competencies, self-efficacy, and self-confidence to deal with the problem.
    No preview · Article · Jan 2013

  • No preview · Article · Oct 2012 · Journal of Geriatric Oncology

  • No preview · Article · Sep 2012 · European geriatric medicine
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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.
    Full-text · Article · Mar 2012

  • No preview · Article · Dec 2011
  • 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.
    No preview · Article · Oct 2011 · Les cahiers de l année gérontologique
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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).
    No preview · Article · Oct 2011 · Revue des Maladies Respiratoires
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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.
    Full-text · Article · Jun 2011 · Annals of physical and rehabilitation medicine

Publication Stats

312 Citations
124.72 Total Impact Points


  • 2005-2015
    • University of Lille Nord de France
      Lille, Nord-Pas-de-Calais, France
  • 1994-2015
    • Centre Hospitalier Régional Universitaire de Lille
      • Division of Internal Medicine
      Lille, Nord-Pas-de-Calais, France
  • 2014
    • Université du Droit et de la Santé Lille 2
      Lille, Nord-Pas-de-Calais, France
  • 2007
    • Centre Hospitalier Universitaire de Montpellier
      Montpelhièr, Languedoc-Roussillon, France
  • 1994-2001
    • CHRU de Strasbourg
      Strasburg, Alsace, France