Skip to main content
SpringerLink
Log in

Comment prévenir la « dépendance iatrogène » lors de l’hospitalisation d’un patient atteint de la maladie d’Alzheimer?

  • Chapter
Traité sur la maladie d’Alzheimer

  • 908 Accesses

Résumé

Parmi les sujets âgés hospitalisés dans les services de soins aigus, 20 à 40 % ont une démence déjà diagnostiquée [1], qu’il s’agisse d’une maladie d’Alzheimer ou d’une démence apparentée. À comorbidité égale, leur statut fonctionnel à l’admission est moins bon que celui des patients de même âge sans troubles cognitifs et leur niveau de dépendance plus élevé à la sortie [1]. On observe chez ces malades des durées de séjour supérieures [2], des hospitalisations itératives et le pronostic à moyen terme est moins favorable: taux d’institutionnalisation et de décès majoré. Ces sujets constituent donc une population à haut risque de déclin fonctionnel lors de l’hospitalisation. En effet, si leur état de santé diffère peu de celui de la population générale [3], ils ont en revanche une altération de la réponse au stress et une mauvaise tolérance vis-à-vis de certains médicaments. Ils disposent aussi de faibles capacités d’adaptation aux changements d’environnement et aux modifications de rythme de vie expliquant leur grande vulnérabilité vis-à-vis des complications liées à la prise en charge hospitalière.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Références

  1. Zekry D, et al. (2008) Demented versus non-demented very old inpatients: the same comorbidities but poorer functional and nutritional status. Age Ageing 37(1): 83–9

    Article  PubMed  Google Scholar 

  2. Albert SM, et al. (1999) Hospitalization and Alzheimer’s disease: results from a community-based study. J Gerontol A Biol Sci Med Sci 54(5): M267–71

    Article  CAS  PubMed  Google Scholar 

  3. Sanderson M, et al. (2002) Co-morbidity associated with dementia. Am J Alzheimers Dis Other Demen 17(2): 73–8

    Article  PubMed  Google Scholar 

  4. Lafont C, et al. (2011) Reducing ‘iatrogenic disability’ in the hospitalized frail elderly. J Nutr Health Aging 15(8): 640–55

    Article  Google Scholar 

  5. Natalwala A, et al. (2088) Reasons for hospital admissions in dementia patients in Birmingham, UK, during 2002–2007. Dement Geriatr Cogn Disord 26(6): 499–505

    Article  Google Scholar 

  6. Sampson EL, et al. (2006) Differences in care received by patients with and without dementia who died during acute hospital admission: a retrospective case note study. Age Ageing 35(2): 187–9

    Article  PubMed  Google Scholar 

  7. Nourhashemi F, et al. (2001) Descriptive analysis of emergency hospital admissions of patients with Alzheimer disease. Alzheimer Dis Assoc Disord 15(1): 21–5

    Article  CAS  PubMed  Google Scholar 

  8. Voisin T, et al. (2009) Descriptive analysis of hospitalizations of patients with Alzheimer’s disease: a two-year prospective study of 686 patients from the REAL.FR study. J Nutr Health Aging 13(10): 890–2

    Article  CAS  PubMed  Google Scholar 

  9. Voisin T, et al. (2010) Predictive factors of hospitalizations in Alzheimer’s disease: a two-year prospective study in 686 patients of the REAL.FR study. J Nutr Health Aging 14(4): 288–91

    Article  CAS  PubMed  Google Scholar 

  10. Soto ME, et al. (2008) Special acute care unit for older adults with Alzheimer’s disease. Int J Geriatr Psychiatry 23(2): 215–9

    Article  PubMed  Google Scholar 

  11. Inouye SK, et al. (1993) A predictive index for functional decline in hospitalized elderly medical patients. J Gen Intern Med 8(12): 645–52

    Article  CAS  PubMed  Google Scholar 

  12. Sager MA, et al. (1996) Functional outcomes of acute medical illness and hospitalization in older persons. Arch Intern Med 156(6): 645–52

    Article  CAS  PubMed  Google Scholar 

  13. McCusker J, et al. (2001) Delirium in older medical inpatients and subsequent cognitive and functional status: a prospective study. Cmaj 165(5):575–83

    CAS  PubMed Central  PubMed  Google Scholar 

  14. Volpato S, et al. (2007) Characteristics of nondisabled older patients developing new disability associated with medical illnesses and hospitalization. J Gen Intern Med 22(5): 668–74

    Article  PubMed Central  PubMed  Google Scholar 

  15. Chang HH, Tsai SL, Chen CY, Liu WJ (2010) Outcomes of hospitalized elderly patients with geriatric syndrome: report of a community hospital reform plan in Taiwan. Arch Gerontol Geriatr 50 Suppl 1: S30–3

    Article  PubMed  Google Scholar 

  16. Pedone C, et al. (2005) Elderly patients with cognitive impairment have a high risk for functional decline during hospitalization: The GIFA Study. J Gerontol A Biol Sci Med Sci 60(12): 1576–80

    Article  PubMed  Google Scholar 

  17. Sands LP, et al. (2002) The effects of acute illness on ADL decline over 1 year in frail older adults with and without cognitive impairment. J Gerontol A Biol Sci Med Sci 57(7): M449–54

    Article  PubMed  Google Scholar 

  18. Inouye SK, et al. (1998) Does delirium contribute to poor hospital outcomes? A three-site epidemiologic study. J Gen Intern Med 13(4): 234–42

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Sager MA, et al. (1996) Hospital admission risk profile (HARP): identifying older patients at risk for functional decline following acute medical illness and hospitalization. J Am Geriatr Soc 44(3): 251–7

    CAS  PubMed  Google Scholar 

  20. McCusker J, et al. (1999) Detection of older people at increased risk of adverse health outcomes after an emergency visit: the ISAR screening tool. J Am Geriatr Soc 47(10): 1229–37

    CAS  PubMed  Google Scholar 

  21. Cornette P, et al. (2006) Early evaluation of the risk of functional decline following hospitalization of older patients: development of a predictive tool. Eur J Public Health 16(2): 203–8

    Article  PubMed  Google Scholar 

  22. Hustey FM, et al. (2007) A brief risk stratification tool to predict functional decline in older adults discharged from emergency departments. J Am Geriatr Soc 55(8): 1269–74

    Article  PubMed  Google Scholar 

  23. Rubenstein LZ, et al. (1984) Effectiveness of a geriatric evaluation unit. A randomized clinical trial. N Engl J Med 311(26): 1664–70

    Article  CAS  PubMed  Google Scholar 

  24. Stuck AE, et al. (1993) Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet 342(8878): 1032–6

    Article  CAS  PubMed  Google Scholar 

  25. Calkins E, NB (1998) Care of older people in the hospital. In: New ways to care for older people. Building systems based on evidence, BC Calkins E, Wagner EH, Pacala JT (Editor) Springer, New York, p. 99–111

    Google Scholar 

  26. Ellis G, Langhorne P (2004) Comprehensive geriatric assessment for older hospital patients. Br Med Bull 71: 45–59

    Article  PubMed  Google Scholar 

  27. Parker SG, Fadayevatan R, Lee SD (2006) Acute hospital care for frail older people. Age Ageing 35(6): 551–2

    Article  PubMed  Google Scholar 

  28. Palmer RM, CS, Landefeld SC (2003) Acute care for elders units. Practical considerations for optimizing health outcomes. Dis manage health outcomes (11): 507–17

    Google Scholar 

  29. Inouye SK, et al. (2000) The Hospital Elder Life Program: a model of care to prevent cognitive and functional decline in older hospitalized patients. Hospital Elder Life Program. J Am Geriatr Soc 48(12): 1697–706

    CAS  PubMed  Google Scholar 

  30. Inouye SK, et al. (1999) A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med 340(9): 669–76

    Article  CAS  PubMed  Google Scholar 

  31. Vidan MT, et al. (2009) An intervention integrated into daily clinical practice reduces the incidence of delirium during hospitalization in elderly patients. J Am Geriatr Soc 57(11): 2029–36

    Article  PubMed  Google Scholar 

  32. Landefeld CS, et al. (1995) A randomized trial of care in a hospital medical unit especially designed to improve the functional outcomes of acutely ill older patients. N Engl J Med 332(20): 1338–44

    Article  CAS  PubMed  Google Scholar 

  33. Covinsky KE, et al. (1997) Do acute care for elders units increase hospital costs? A cost analysis using the hospital perspective. J Am Geriatr Soc 45(6): 729–34

    CAS  PubMed  Google Scholar 

  34. Counsell SR, et al. (2000) Effects of a multicomponent intervention on functional outcomes and process of care in hospitalized older patients: a randomized controlled trial of Acute Care for Elders (ACE) in a community hospital. J Am Geriatr Soc 48(12): 1572–81

    CAS  PubMed  Google Scholar 

  35. Parke B., Brand P (2004) An Elder-Friendly Hospital: translating a dream into reality. Nurs Leadersh (Tor Ont) 17(1): 62–76

    Article  Google Scholar 

  36. Rizzo JA, et al. (2001) Multicomponent targeted intervention to prevent delirium in hospitalized older patients: what is the economic value? Med Care 39(7): 740–52

    Article  CAS  PubMed  Google Scholar 

  37. Inouye SK (2006) Delirium in older persons. N Engl J Med 354(11): 1157–65

    Article  CAS  PubMed  Google Scholar 

  38. Fick DM, Agostini JV, Inouye SK (2002) Delirium superimposed on dementia: a systematic review. J Am Geriatr Soc 50(10): 1723–32

    Article  PubMed  Google Scholar 

  39. Wenger NS, Roth CP, Shekelle P (2007) Introduction to the assessing care of vulnerable elders-3 quality indicator measurement set. J Am Geriatr Soc 55 (Suppl 2): S247–52

    Article  PubMed  Google Scholar 

  40. Carr M, PH (2003) Report and Recommandations: Acute care geriatric nurse network, T.N.D.M.o.H. Planning, Editor. CNS Collaborative

    Google Scholar 

  41. AHMAC (2007) Best practice approaches to minimise functional decline in the older person across the acute, sub-acute and residential care settings, t.V.G.D.o.H. Services, Editor. Victorian Government Department of Human Services, p. 29

    Google Scholar 

  42. Care Quality Commission (2010) Essential standards of quality and safety, SC National Health Service, Public Health, England, Editor, Parliament of United Kingdom

    Google Scholar 

  43. Marcantonio ER, et al. (2001) Reducing delirium after hip fracture: a randomized trial. J Am Geriatr Soc 49(5): 516–22

    Article  CAS  PubMed  Google Scholar 

  44. Britton A, Russell R (2004) Multidisciplinary team interventions for delirium in patients with chronic cognitive impairment. Cochrane Database Syst Rev (2): p. CD000395

    Google Scholar 

  45. Fong TG, et al. (2009) Delirium accelerates cognitive decline in Alzheimer disease. Neurology 72(18): 1570–5

    Article  CAS  PubMed  Google Scholar 

  46. Jackson JC, et al. (2004) The association between delirium and cognitive decline: a review of the empirical literature. Neuropsychol Rev 14(2): 87–98

    Article  PubMed  Google Scholar 

  47. Fick D, Foreman M (2000) Consequences of not recognizing delirium superimposed on dementia in hospitalized elderly individuals. J Gerontol Nurs 26(1): 30–40

    CAS  PubMed  Google Scholar 

  48. Grumback R, Blanc A (1973) The immobilization syndrome in the aged. Nouv Presse Med 2(30): 1989–91

    CAS  PubMed  Google Scholar 

  49. Siebens H, et al. (2000) A randomized controlled trial of exercise to improve outcomes of acute hospitalization in older adults. J Am Geriatr Soc 48(12): 1545–52

    CAS  PubMed  Google Scholar 

  50. Jones CT, et al. (2006) A randomized controlled trial of an exercise intervention to reduce functional decline and health service utilization in hospitalized elderly. Australas. J Ageing 25: 126–33

    Article  Google Scholar 

  51. de Morton NA, et al. (2007) Additional exercise does not change hospital or patient outcomes in older medical patients: a controlled clinical trial. Aust J Physiother 53(2): 105–11

    Article  PubMed  Google Scholar 

  52. de Morton NA, Keating JL, Jeffs K (2007) Exercise for acutely hospitalised older medical patients. Cochrane Database Syst Rev (1): CD005955

    Google Scholar 

  53. Mudge AM, Giebel AJ, Cutler AJ (2008) Exercising body and mind: an integrated approach to functional independence in hospitalized older people. J Am Geriatr Soc 56(4): 630–5

    Article  PubMed  Google Scholar 

  54. Haines TP, et al. (2004) Effectiveness of targeted falls prevention programme in subacute hospital setting: randomised controlled trial. BMJ 328(7441): 676

    Article  PubMed  Google Scholar 

  55. Milne AC, Avenell A, Potter J (2006) Meta-analysis: protein and energy supplementation in older people. Ann Intern Med 144(1): 37–48

    Article  CAS  PubMed  Google Scholar 

  56. Lauque S, et al. (2004) Improvement of weight and fat-free mass with oral nutritional supplementation in patients with Alzheimer’s disease at risk of malnutrition: a prospective randomized study. J Am Geriatr Soc 52(10): 1702–7

    Article  PubMed  Google Scholar 

  57. Keller HH, et al. (2003) Prevention of weight loss in dementia with comprehensive nutritional treatment. J Am Geriatr Soc 51(7): 945–52

    Article  PubMed  Google Scholar 

  58. Nourhashemi F, et al. (2010) Effectiveness of a specific care plan in patients with Alzheimer’s disease: cluster randomised trial (PLASA study). BMJ 340: c2466

    Article  PubMed Central  PubMed  Google Scholar 

  59. Callahan CM, et al. (2006) Effectiveness of collaborative care for older adults with Alzheimer disease in primary care: a randomized controlled trial. Jama 295(18): 2148–57

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Unité cognitivo-Comportementale, CHU Toulouse. Gérontopôle, 170 avenue de casselardit, 31059, Toulouse cedex, France

    C. Lafont & T. Voisin

Authors
  1. C. Lafont
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Voisin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Lafont .

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Paris

About this chapter

Cite this chapter

Lafont, C., Voisin, T. (2013). Comment prévenir la « dépendance iatrogène » lors de l’hospitalisation d’un patient atteint de la maladie d’Alzheimer?. In: Traité sur la maladie d’Alzheimer. Springer, Paris. https://doi.org/10.1007/978-2-8178-0443-9_20

Download citation

  • DOI: https://doi.org/10.1007/978-2-8178-0443-9_20

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0442-2

  • Online ISBN: 978-2-8178-0443-9

Publish with us

Policies and ethics

Search

Navigation