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Highlights • A 100% COVID-19 probability was found in residents younger than 90 with dyspnea and falls. • A 100% COVID-19 probability was found in residents older than 90 with anorexia. • A 100% COVID-19 probability was found in residents older than 90 without anorexia but with altered consciousness. • Mass screening should prioritize residents with combinations of symptoms including dyspnea, falls, anorexia and/or altered consciousness., Background/objective The COVID-19 epidemic is particularly serious in older adults. The symptomatology and epidemic profile remain little known in this population, especially in disabled oldest-old people with chronic diseases living in nursing homes. The objective of the present study was to comprehensively describe symptoms and chronological aspects of the diffusion of the SARS-CoV-2 virus in a nursing home, among both residents and caregivers. Design Five-week retrospective cohort study. Setting A middle-sized nursing home in Maine-et-Loire, west of France. Participants Eighty-seven frail older residents (87.9 ± 7.2years; 71 % female) and 92 staff members (38.3 ± 11.7years; 89 % female) were included. Measurements Mass screening for SARS-CoV-2 was performed in both residents and staff. Attack rate, mortality rate, and symptoms among residents and staff infected with SARS-CoV-2 were recorded. Results The attack rate of COVID-19 was 47 % in residents (case fatality rate, 27 %), and 24 % in staff. Epidemic curves revealed that the epidemic started in residents before spreading to caregivers. Residents exhibited both general and respiratory signs (59 % hyperthermia, 49 % cough, 42 % polypnea) together with geriatric syndromes (15 % falls, 10 % altered consciousness). The classification tree revealed 100 % COVID-19 probability in the following groups: i) residents younger than 90 with dyspnea and falls; ii) residents older than 90 with anorexia; iii) residents older than 90 without anorexia but with altered consciousness. Finally, 41 % of staff members diagnosed with COVID-19 were asymptomatic. Conclusions The pauci-symptomatic expression of COVID-19 in older residents, together with the high prevalence of asymptomatic forms in caregivers, justifies mass screening in nursing homes, possibly prioritizing residents with suggestive combinations of clinical signs including dyspnea, falls, anorexia and/or altered consciousness.

Our objective was to bridge the gap between gerontechnology developers and hospitalized frail elderly people, in order to promote open gerontechnology innovation in hospitals. We designed a hospital-based living lab that provides reflexive "idea incubator workshops" that gather both the users and the developers of technology, supplemented with an "experimental hospital room" for the testing of devices by older inpatients. The ALLEGRO living lab was delivered in 2018 at the Geriatric Department of Angers University Hospital, France. The workshops and experimental hospital room should help frail older inpatients to participate in the co-design and co-development of new technologies to improve hospital care and promote successful aging.

A translational approach for the clinical application of recently updated definitions of malnutrition (GLIM) and sarcopenia (EWGSOP2)

International audience; The growing number of seniors worldwide is the source of many challenges for our society. The first one is epidemiological and relies on the constitution of a group of older adults considered frail because of specific medico-social attributes, combining an accumulation of advanced chronic diseases, reduced resilience, loss of independence, and changes in the social and family environment. The second challenge is economic and corresponds on one hand to the financial costs of medical and social care for frail older adults, and on the other hand to the growth of an economic sector – the “silver economy” – based on the development of new services and new technologies to compensate for the disabilities of frail older adults.

Objectives Vitamin D is involved in visual health and function. Our objective was to determine whether age-related vitamin D insufficiency was associated with the presence and the severity of primary open angle glaucoma (POAG) in a case-control study of older adults. Study design Case-control study. Main outcome measures. One hundred fifty cases diagnosed with moderate-to-severe POAG (mean, 75.1 ± 8.5 years; 42.0% female) and 164 healthy controls (mean, 73.0 ± 7.9 years; 59.8% female) were included. POAG diagnosis was based on classical diagnostic criteria of optic nerve cupping and/or RNFL thinning, measured with optical coherence tomography. Severe POAG was defined as Humphrey visual field mean deviation (MD) worse than −12 dB. Vitamin D insufficiency was defined as serum 25OHD ≤ 75 nmol/L. Age, gender, mean arterial pressure, vitamin D supplementation, visual acuity, and intraocular pressure were used as potential confounders. Results POAG cases had lower mean serum 25OHD concentration than controls (42.9 ± 25.7 nmol/L versus 49.4 ± 29.5 nmol/L, P = 0.039) and a greater prevalence of vitamin D insufficiency (90.7% versus 82.3%, P = 0.032). Increased mean serum 25OHD concentrations were associated with lower POAG frequency, even after adjustment for potential confounders (OR = 0.89 per 10 nmol/L of 25OHD, P = 0.045). Similarly, vitamin D insufficiency was associated with POAG (OR = 2.09, P = 0.034). Among POAG cases, no 25OHD difference was observed between moderate and severe POAG cases (respectively, 39.2 ± 23.3 nmol/L versus 45.1 ± 26.7 nmol/L, P = 0.188); and no between-group difference regarding the prevalence of vitamin D insufficiency (88.9% versus 94.0%, P = 0.313). Conclusions Decreased serum 25OHD concentration was associated with POAG. There was no 25OHD difference between moderate and severe POAG.