Trends of the potentially inappropriate medication consumption over 10 years in older adults in the East of France.

PURPOSE: To describe the trends of potentially inappropriate medication (PIM) use in older adults from 1995 to 2004 in the East of France, by using the 1997 Beers criteria and its French update, and to assess risk factors for this PIM use. METHODS: We carried out a repeated cross-sectional study using data collected among people aged >/=65 years, examined in the Center for Preventive Medicine. Studied variables were socio-demographic, clinical data, medication consumption and the self-health status. Joinpoint regression analysis was used to estimate the temporal changes in PIM rate. RESULTS: 30 683 participants were included. 51.2% were women. The mean age was 70.1 +/- 4.3 years [65-99]. The annual overall rate of PIM use decreased significantly during the study period. These rates range from 14.9% in 1995 to 9.0% in 2004 according the Beers criteria (-3.4% per year) and from 33.5% in 1995 to 19.3% in 2004 according to the French update criteria (-3.6% per year). The annual rate of medication users increased during the same period (+0.75% per year). The risk of PIM consumption increased with age, number of drugs and frequency of the visits to the physician (OR = 1.26 [1.18-1.35]). This risk was also higher among women (OR = 1.29 [1.18-1.40]), elderly living alone (OR = 1.09 [1.02-1.17]) and with those with low education level (OR = 1.19 [1.02-1.38]). CONCLUSION: This study shows a decrease in PIM consumption. Despite an increase of drug use in the elderly, an improving of the quality of this consumption remains possible.

[Assessment of cognitive complaints and depressive symptoms in health check-up centers]. / Exploration de la plainte cognitive dans une population de consultants de Centres d'examens de santé

UNLABELLED: Memory clinics, where cognitive impairment is diagnosed, have to deal with an increasing number of requests. In this context, this study was aimed to evaluate the feasibility of cognitive complaint assessment in a health check-up performed in preventive Health check-up centers. METHODS: The study population included 60-year and over subjects who were proposed a health check-up in the Health check-up centers of five French cities (Amiens, Nîmes, Longwy, Rennes and Sélestat). Cognitive complaint and anxio-depressive symptoms were collected for all participants. Subjects presenting a cognitive complaint fulfilled a neuropsychological screening including MMSE, 5-word test, Clock Drawing test, verbal fluencies and exploration of 4 Instrumental Activities of Daily Living. Subjects suspected to have cognitive impairment were then referred to a memory clinic. RESULTS: One thousand and twenty participants were included in the study; 31.5% had a cognitive complaint, and 12.3% of these subjects were referred to a memory clinic. A dementia was diagnosed in one third of them, corresponding to 1% of the study participants. However, all the patients with dementia were referred by the same check-up centre, which staff was well experienced in cognitive disorders. Moreover, 29.3% of the participants had a depressive symptomatology. CONCLUSION: exploration of cognitive functions in a preventive health check-up center for elderly people can be interesting, but requires a staff's former experience in cognitive disorders, especially for the diagnosis of Mild Cognitive Impairment. Moreover, depressive symptoms, which are frequent and can be cared for, should be explored in a health check-up for senior citizens.