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Relations between sensory functions and Alzheimer's disease are still under explored.To understand them better, theFondation MédfJricAlzheimer has brought together a multi-disciplinary expert group. Aristote's five senses must be enhanced by today's know ledge of proprioception, motor cognition and pain perception. When cognition breaks dawn, the persan with dementia perceives the world around her with her sensory experience, yet is unable to intagratB all this information to understand the contaxt.The trBBtment of mul tiple sensory inputs by the brain is closely linked to cognitive processes. Sensory deficits reduce considerably the autonomy of people with dementia in their daily fife and their rela tions with others, increase their social isolation and the risk of accidents. Professionals involved with neurodegenerative diseases remain poorly aware of sensory deficits, which can bias the results of cognitive tests. However. there are simple tools to detect these deficits, notably for vision, hearing and balance disorders, which can be corrected. Many interventions for cognitive rehabilitation or quality of fife improvement are based on sen sory functions. The environment of people with dementia must be adapted to become understandable, comfortable, safe and eventually therapeutic.; Afin de mieux comprendre les relations, encore insuffisamment étudiées, entre les fonctions sensorielles et la maladie d'Alzheimer, la Fondation Médéric Alzheimer a réuni un groupe d'experts multi-disciplinaire. Aux cinq sens d'Aristote, il faut aujourd'hui ajouter la proprioception, la cognition motrice et la perception de la douleur. Lorsque la cognition se détériore, la personne atteinte de la maladie d'Alzheimer voit le monde qui l'entoure avec son expérience sensorielle, sans qu'elle puisse toutefois intégrer toutes ces informations pour comprendre le contexte. Le traitement des multiples informations sensorielles par le cerveau est étroitement lié à des processus cognitifs. Les déficits sensoriels réduisent considérablement l'autonomie des personnes malades dans la vie quotidienne, leurs relations avec autrui, augmentent leur isolement social et le risque d'accidents. Les professionnels impliqués dans les maladies neurodégénératives restent insuffisamment sensibilisés aux déficits sensoriels, qui peuvent fausser l'évaluation de la cognition. Il existe pourtant des outils de repérage simples de ces déficits, notamment pour les troubles de la vision, de l'audition et de l'équilibre qui peuvent être corrigés. De nombreuses interventions pour la réhabilitation cognitive ou l'amélioration de la qualité de vie s'appuient sur les fonctions sensorielles. L'environnement des personnes malades doit être adapté pour le rendre compréhensible, confortable, sûr et si possible thérapeutique.

Dans un contexte de vieillissement de la population, différents scenarii sont envisagés pour réformer l’organisation et le financement de la prise en charge des personnes âgées dépendantes. La place de la prévoyance individuelle dans le financement de la dépendance est à ce titre largement débattue. À l’heure actuelle, malgré des restes à charge potentiellement conséquents, peu d’individus disposent d’une couverture assurantielle. Cet article vise à enrichir la littérature existante en évaluant dans quelle mesure les préférences observées dans la population limitent cette couverture. Nous mobilisons pour cela l’enquête Patrimoine et préférences vis-à-vis du temps et du risque (Pater) de 2011. À la demande de la Fondation Médéric Alzheimer, la vague 2011 de l’enquête Pater a intégré un questionnaire complémentaire relatif à la perception du risque dépendance et aux comportements d’assurance (Pated). L’enquête Pater permet la construction de scores quantifiant quatre dimensions des préférences susceptibles d’influencer la perception du risque et la probabilité de souscrire une assurance parmi les individus percevant le risque : la préférence pour le présent, l’aversion au risque, l’altruisme familial et le goût présumé pour l’aide informelle. Les résultats des estimations montrent le rôle significatif de chacune de ces dimensions dans la demande d’assurance. Néanmoins, même au sein d’une population présentant les préférences les plus favorables à la souscription d’une assurance, les simulations montrent que le taux d’équipement ne dépasserait pas 20 %. Le recours accru à la prévoyance individuelle par le biais d’une généralisation des couvertures assurantielles privées apparaît donc difficilement envisageable à moins d’une forte évolution de l’offre d’assurance ou d’une régulation publique incitant ou contraignant la souscription d’une assurance., Fontaine Roméo, Plisson Manuel, Zerrar Nina. Dans quelle mesure les préférences individuelles contraignent‑elles le développement du marché de l’assurance dépendance ?. In: Economie et statistique, n°474, 2014. PIB par habitant en longue période - Assurance dépendance - Durée de la retraite et espérance de vie - Mesure de la concentration spatiale. pp. 35-68.

rapport d’étude de la Fondation Médéric Alzheimer

Rapport d’étude de la Fondation Médéric Alzheimer

How to respect the freedom of the people who suffer from the disease of Alzheimer and who are under the legal protection brings up a question that must be considered today as that of the need of those who are helping. Ten monographs and two panels with experts, patients and professionnal and home help, and the legal analysis of the rules relating to the usable law entitled a narrow articulation of the "empirical" and "legal" aspects. The main results of the study affect several dilemmas of the action. For example : which place finds the person who are under the legal protection ... to take care and think its future : which projects ? How to deal between freedom and protection and/or the watching over the patient, for instance, as far as the risks that may induce a lack of watching and, a contrario, an extreme watching. Another example: to say or not the diagnosis ; the importance of the information in the matter of diagnosis is concerned has turned out crucial as to grasp and to understand the changes that have been already lived and those that will be lived in order to consider the future, to make projects necessary to nurse respectively the achievement of the person and her family and professional circle. Discussions with professionals useful/y enriched the results and led in complement of this report a note of recommendations concerning the actions to carry out which would answer waitings of the institutional ones as well as of the patients and their family, without making double use with what right now is existing, as regards legal protection or concerning the disease. There is a booklet of recommendations with the report.; La question du respect des libertés et de la protection juridique des personnes atteintes de la maladie d'Alzheimer se pose nettement aujourd'hui tout comme celle du besoin des aidants familiaux et professionnels à cet égard. Dix monographies et deux tables-rondes réunissant des experts, des personnes malades et des aidants professionnels et familiaux, et l'analyse juridique des règles de droit mobilisables ont permis d'articuler étroitement les aspects "empiriques" et "légaux". Les principaux résultats de l'étude concernent plusieurs dilemmes de l'action. Pour exemple : Quelle place trouve la personne protégée et représentée lorsqu'il y a mise en place d'une mesure juridique ... Prendre soin et se projeter dans l'avenir : Quels projets vis-à-vis de la personne et pour eux-mêmes s'agissant des protagonistes aidants familiaux et professionnels ; comment se situer entre liberté et protection et/ou surveillance, par exemple, au regard des risques que peuvent introduire un défaut de vigilance et, a contrario, une veille excessive ; autre exemple : dire ou ne pas dire le diagnostic ; l'importance de l'information en matière de diagnostic est apparue cruciale afin de saisir et de réaliser les changements vécus, les changements à venir, afin d'envisager l'avenir, de former des projets utiles, quoiqu'il en soit, à nourrir les accomplissements respectifs de la personne et de son entourage familial et professionnel. Des entretiens avec les institutionnels et les acteurs du champ ont utilement enrichi les résultats de la recherche et abouti en complément de ce rapport à une note de préconisations concernant la problématique des actions à mener qui répondraient aux attentes des institutionnels aussi bien que des malades et de leur famille, sans faire double emploi avec ce qui est d'ores et déjà existant, en matière de protection juridique des majeurs ou concernant la maladie. Voir, joint au rapport, le fascicule de préconisations.

BACKGROUND Nutrition plays an important role in the aging process. Adherence to the Mediterranean diet (MedDiet) has been shown to be associated with lower rates of diseases. Cognitive status seems to be strongly interrelated with physical well-being, so that one influences the other. Physical performance measures are not only associated with clinical and subclinical age-related modifications, but are also able to predict disability, institutionalization, and mortality. OBJECTIVE To evaluate prospectively the associations between Mediterranean-Style Dietary Pattern Score (MSDPS), clinical characteristics, and cognition of the population sample of The TREVISO LONGEVA (TRELONG) Study, in Treviso, Italy. METHODS Global cognition, physical performance measures, MSDPS, and other clinical features were detected in 2010 in 82 men and 108 women. These characteristics were evaluated in relation to the physical performance measures identified 3.8 years later in 2013 in the same subjects, using a semantic connectivity map, through Auto-CM system, to grasp further and non-linear associations between variables which might remain, otherwise, undetected. RESULTS The Auto-CM system's map showed a close association between better levels of global cognition and MSDPS in 2010 and higher physical performance in 2013. On the other hand, worse levels of global cognition and MSDPS in 2010 were associated with lower physical performance in 2013. CONCLUSION The prevention models for successful aging may benefit from integrated programs that include cognitive, physical, and dietary interventions, since these aspects are mutually interrelated.

International audience; The COVID-19 epidemic that started in November in China became a national epidemic from March 16, 2020 with the declaration of population containment in order to reduce the spread of the virus in France. From March 17 to March 27, 2020, the monitoring unit of the French society of geriatrics and gerontology decided to conduct a survey to analyze the implementation of the mobilization of geriatric units, given that this epidemic had shown that it resulted in excess mortality mainly among the elderly. The survey was able to bring together the response of 34 services, nine of which were located in a high epidemic cluster zone. Dedicated acute geriatric units for patients infected with COVID-19 were present in eight facilities, only outside the cluster zones. Nine geriatric follow-up and rehabilitation services were dedicated, an additional telemedicine activity concerned 35% of the facilities, and family listening and tablet communication facilities concerned 36% of the facilities. This survey is a snapshot of an initial moment in the epidemic. It provides an opportunity to describe the context in which this epidemic occurred in terms of geriatric policy, and to assess the responsiveness and inventiveness of these services in meeting the needs of the elderly.; L’épidémie de Covid-19 qui avait débuté en novembre en Chine est devenue une épidémie en France à partir du 16 mars 2020 avec la déclaration du confinement de la population afin de diminuer la propagation du virus. Dès le 17 mars et jusqu’au 27 mars 2020, la cellule de veille de la Société française de gériatrie et gérontologie décide de mener une enquête pour analyser la mise en place de la mobilisation des structures de gériatrie, étant donné que cette épidémie avait montré qu’elle entraînait une surmortalité majoritairement chez les personnes âgées. L’enquête a pu réunir la réponse de 34 structures, dont neuf étaient situées en zone cluster de forte épidémie. Des services de court séjour gériatriques dédiés pour les patients infectés par le Covid-19 étaient présents dans huit établissements, uniquement hors des zones clusters. Neuf soins de suite et de rééducation gériatriques ont été dédiés, une activité supplémentaire de télémédecine concernait 35 % des établissements, et des moyens d’écoute des familles, d’animation et de communication par tablettes concernaient 36 % des établissements. Cette enquête est une photographie d’un moment initial de l’épidémie. Elle donne l’occasion de décrire le contexte dans lequel cette épidémie est survenue en ce qui concerne la politique gériatrique, et d’apprécier la réactivité et l’inventivité de ces services pour répondre aux besoins des personnes âgées.

Through a national and international press review (about 60 pages monthly, and 2 000 sources), the Foundation Médéric Alzheimer (FMA) found that Alzheimer's disease continues to supply an abundant media and cultural production. Therefore FMA wished to understand how the social perceptions on Alzheimer's disease, subjects with Alzheimer's disease and their caregivers, have evolved since 2010. We reviewed printed press, documentaries, and awareness campaigns. Cultural productions included fiction materials such as novels, theatre plays, films, television series etc. We estimated at about one hundred and fifty the number of articles that were analyzed. Observed trends show that Alzheimer's disease has been trivialized, becoming a "background noise" both in media (coverage of research advances, local stories) and fiction works (in particular by singers and comedians, development of child literature etc.). Meanwhile, the disease is represented in a more sophisticated way, for instance addressing the specific needs of certain groups (young persons with dementia, person with sensory deficits, or cultural groups…). Alzheimer's associations are notably faced to critical issues (What to show? What and how to communicate?), without pessimism or overly naïve optimism. Representations of people with Alzheimer's disease are highly contrasted, between incarnation of heroism and figure of undesirable, as representations of caregivers (between sacrifice and abuse). Changes in Alzheimer disease representation will continue, thanks to the advocacy of persons with dementia themselves, activists and founders of groups and associations, in a society that some people appeal to become more dementia-friendly.

International audience; Une présentation du concept de la société "amie de la démence", dont le but est de permettre un meilleur accueil aux personnes atteintes d'Alzheimer ou des maladies apparentées, et de les aider à s'intégrer dans la vie sociale, en leur offrant des services plus adaptés.

It is well-known that the ageing process disrupts episodic memory. The aim of this study was to use an fMRI visual recognition task to characterize age-related changes in cerebral regions activated, during encoding, for images that would subsequently lead to a recollection-based or to a familiarity-based recognition. Results show that, for subsequent recollection, young adults activated regions related to semantic processing more extensively than older ones. On the other hand, despite putatively producing less semantic elaboration, older adults activated contralateral regions supplementary to those found in young adults (which might represent attempted compensation), as well as regions of the default-mode network. These results suggest older adults could achieve subsequent recollection through different processes, for instance an appraisal of the self-relevance of the stimuli. For subsequent familiarity, the comparisons only revealed greater activations in young adults, in the dorsal frontoparietal attention system as well as in the hippocampus, again suggesting that, even if older adults are able to produce recollection- and familiarity-based recognition, the semantic processing might still be weaker in old adults, who might nonetheless use qualitatively different strategies in order to produce such responses. Further studies are necessary in order to characterize those strategies.

International audience; Little is known about the price sensitivity of demand for home care of the disabled elderly. We partially ll this knowledge gap by using administrativedata on the beneficiaries of the main French home care subsidy program in a department and exploiting inter|individual variation in provider prices. We address the potential endogeneity of prices by taking advantage of the unequal spatial coverage of providers and instrumenting price by the number of municipalities served by a provider. We estimate a price elasticity of around -0.4 that is significantly different from both 0 and -1. This less than proportionate response of consumption to price has implications for the efficiency and redistributive impact of variation in the level of co-payments in home care subsidy schemes.

Assistive technologies became pervasive and virtually present in all our life domains. They can be either an enabler or an obstacle leading to social exclusion. The Fondation Médéric Alzheimer gathered international experts of dementia care, with backgrounds in biomedical, human and social sciences, to analyze how assistive technologies can address the capabilities of people with dementia, on the basis of their needs. Discussion covered the unmet needs of people with dementia, the domains of daily life activities where assistive technologies can provide help to people with dementia, the enabling and empowering impact of technology to improve their safety and wellbeing, barriers and limits of use, technology assessment, ethical and legal issues. The capability approach (possible freedom) appears particularly relevant in person-centered dementia care and technology development. The focus is not on the solution, rather on what the person can do with it: seeing dementia as disability, with technology as an enabler to promote capabilities of the person, provides a useful framework for both research and practice. This article summarizes how these concepts took momentum in professional practice and public policies in the past 15 years (2000–2015), discusses current issues in the design, development and economic model of assistive technologies for people with dementia, and covers how these technologies are being used and assessed.

International audience; In this article, we analyse the different stages of freedom of movement of the elderly debate as it has occurred in the French gerontological world over a ten-year period (2004-2015). We are particularly interested in regulatory actors in this domain and the questions they ask themselves: How can we frame the restriction on freedom of movement practices like those in nursing homes? Should there be specific legislation for seniors whose state of health appears to especially diminish their faculties? Do these impairments justify the development of specific legal statutes? Retracing the evolution of how legal figures and responses were questioned, and considering their contributions to the stages of debate, allows us, beyond the notion of freedom of movement, to highlight a broader issue: Ageing, in relation to the law.

Being present near absentees. Rethinking caring relationship in nursing homes for dependent elderly peopleBased on ethnographic fieldwork undertaken into two long term care facilities for elderly people in France, this paper explores how the “feeling of absence” experienced by professional caregivers facing Alzheimer’s patients “tests” their professionalism, both in terms of ethics and inter-relations. One of their answers to such professional tests is to try revealing a preserved presence of theses patients, or even sometimes producing it performatively. Carers' work on presence provides the analysis with an interesting insight on how much of a test the absence is to them. It leads to re-think what care means when the caregivers face elderly persons who seem not to be able to fit into the ordinary caring relationship., Estar presente entre los ausentes. Repensar la relación de salud en las instituciones residenciales para personas mayoresA partir de una investigación etnográfica hecha en dos establecimientos geriátricos en Francia, el articulo examina las dificultades profesionales tanto éticas como relacionales, generadas por el « sentimiento de ausencia », percibido por profesionales dedicados al tratamiento de adultos mayores viviendo con Alzheimer. Revelar una presencia mantenida de los pacientes, e incluso producirla de manera performativa, constituye, como lo veremos, un objetivo primordial para el citado personal sanitario. Analizado como una forma de regulación frente a las dificultades profesionales, el trabajo de producción de presencia conlleva, en definitiva, a reflexionar de otra manera la relación misma de cuidado., À partir d’une enquête ethnographique menée dans deux établissements d’hébergement, l’article propose d’explorer les « épreuves de professionnalité », tant relationnelles qu’éthiques, générées par le « sentiment d’absence » perçu par les professionnels dans la prise en charge de personnes âgées considérées comme malades d’Alzheimer. Révéler une présence maintenue chez les patients qui leur sont adressés, voire éventuellement la produire de manière performative, constitue, on le verra, un objectif fort pour les soignants. Ce travail sur la présence est intéressant à analyser comme une forme de régulation de l’épreuve produite par l’absence. Il constitue une manière de repenser à nouveaux frais la notion même de relation de soin.

Given that there may well be no significant advances in drug development before 2025, prevention of dementia–Alzheimer’s disease through the management of vascular and lifestyle-related risk factors may be a more realistic goal than treatment. Level of education and cognitive reserve assessment in neuropsychological testing deserve attention, as well as cultural, social, and economic aspects of caregiving. Assistive technologies for dementia care remain complex. Serious games are emerging as virtual educational and pleasurable tools, designed for individual and cooperative skill building. Public policies are likely to pursue improving awareness and understanding of dementia; providing good quality early diagnosis and intervention for all; improving quality of care from diagnosis to the end of life, using clinical and economic end points; delivering dementia strategies quicker, with an impact on more people. Dementia should remain presented as a stand-alone concept, distinct from frailty or loss of autonomy. The basic science of sensory impairment and social engagement in people with dementia needs to be developed. E-learning and serious games programs may enhance public and professional education. Faced with funding shortage, new professional dynamics and economic models may emerge through coordinated, flexible research networks. Psychosocial research could be viewed as an investment in quality of care, rather than an academic achievement in a few centers of excellence. This would help provide a competitive advantage to the best operators. Stemming from care needs, a logical, systems approach to dementia care environment through organizational, architectural, and psychosocial interventions may be developed, to help reduce symptoms in people with dementia and enhance quality of life. Dementia-friendly environments, culture, and domesticity are key factors for such interventions.

Le deficit de prise en charge de la maladie d’Alzheimer chez les migrants âges pose l’epineuse question de la gestion des relations interculturelles entre les patients, leurs aidants et les soignants. Une etude de la Fondation Mederic Alzheimer permet de mettre en lumiere le role crucial des differences de representations de la maladie. La vision biomedicale qui prevaut en Occident demande a etre nuancee. Une veritable prise en compte du vecu des patients repose sur une meilleure ecoute des personnes atteintes de la maladie d'Alzheimer et de leurs proches.

Konfigurationen der familiären Hilfen für pflegebedürftige ältere Menschen in Europa. Anhand der Erhebung Share lässt sich untersuchen, welche Hilfe die Kinder den pfl egebedürftigen älteren Menschen von mindestens 65 Jahren in den europäischen Ländern leisten. Welche individuellen Verhaltensweisen führen zu Konfi gurationen familiärer Hilfe? Zwei Arten der Unterstützung kommen in Betracht, je nach dem, ob die Kinder mit ihren pfl egebedürftigen Eltern zusammenleben oder nicht. Der Anteil der älteren pfl egebedürftigen Menschen, die von ihrer Umgebung in irgendeiner Form Hilfe erhalten, ist bemerkenswert homogen: von 79 % in Schweden und in den Niederlanden bis 87 % in Italien. In den nordeuropäischen Ländern wird das seltenere Zusammenleben verschiedener Generationen durch eine häufi gere Hilfe der Kinder kompensiert. In den sechs untersuchten Ländern ist die Unterstützung der Kinder größer, wenn der Grad der Pfl egebedürftigkeit des Elternteils höher ist oder letzterer ohne Ehepartner lebt. Allerdings spiegelt sich das Nord-Süd-Gefälle in der Art und Weise wider, in der die Kinder bei Fehlen des Ehepartners ihren pfl egebedürftigen Elternteil unterstützen: vermehrtes Zusammenleben der Töchter im Süden und Ausweitung der Hilfe "von Fern“ durch die Söhne wie auch die Töchter im Norden. Lebt der Ehepartner beim pfl egebedürftigen Elternteil, ändert sich die Unterstützungslogik der Kinder. Bei Unterstützung des pfl egebedürftigen Elternteils durch seinen Ehepartner hängt die Hilfe der Kinder von individuellen Entscheidungen ab, deren Wahrscheinlichkeit mit der Zahl der Kinder zunimmt. Die Unterstützung von Elternteilen ohne Ehepartner würde dagegen einer Geschwisterlogik folgen, die ihnen unabhängig von der Zahl ihrer Kinder eine gleichwertige Hilfe gewährleistet. Bei zwei Geschwistern, deren Elternteil allein lebt, ist eine asymmetrische Wechselwirkung zwischen den Verhaltensweisen des älteren und des jüngeren Kinds festzustellen. Im Schnitt würde die Unterstützung des jüngeren von derjenigen des älteren Kinds abhängen (die Wahrscheinlichkeit der Unterstützung durch das jüngere Kind ist geringer, wenn sich das ältere um die Eltern kümmert), aber nicht umgekehrt., Family Assistance Configurations for Dependent Older People in Europe. The Share survey allows us to analyse the assistance given by their children to dependent persons aged 65 and over in European countries. How is individual behaviour structured to give rise to family assistance frameworks? Two relationships are envisaged, according to whether children live with their dependent parent or not. The proportion of dependent older people receiving support from their entourage in one form or another is remarkably constant, ranging from 79% in Sweden and the Netherlands to 87% in Italy. In northern countries, the lower level of intergenerational cohabitation is offset by the more frequent assistance given by non-cohabiting children. In the six countries studied here, children’s involvement is greater when the degree of dependence of the parent is higher and when the parent has no spouse. However, the north-south divide is apparent in the way in which children adapt to their dependent parent’s lack of a spouse: increased cohabitation of female children in southern countries, increased •remote” assistance from male and female children in northern countries. The presence of a dependent parent’s spouse seems to change children’s involvement relationships. If the dependent parent receives assistance from his or her spouse, children’s involvement depends on individual decisions, leading to an increasing probability of support where the number of children is higher. Support for single parents on the other hand seems to be driven by a sibling logic where the probability that the parent will be supported is identical however many children there are. Where a single parent has two children, there is a difference between the behaviour of the elder child and the younger. On average, the involvement of the younger child seems to depend on that of the elder (the probability that the younger becomes involved seems to be lower if the elder becomes involved), but the reverse is not true., L'enquête Share permet d'étudier l'aide apportée par leurs enfants aux personnes dépendantes âgées d'au moins 65 ans, dans les pays d'Europe. Comment les comportements individuels s'articulent-ils pour donner lieu à des configurations familiales d'aide ? Deux modalités d'implication sont envisagées, selon que les enfants cohabitent ou non avec leur parent dépendant. La proportion de personnes âgées dépendantes recevant un soutien de leur entourage, sous une forme ou sous l'autre, est remarquablement homogène : de 79 % en Suède et aux Pays-Bas à 87 % en Italie. Dans les pays du Nord, la moindre cohabitation inter-générationnelle est en effet compensée par une aide plus fréquente des enfants non cohabitants. Dans les six pays étudiés ici, l'implication des enfants est plus forte lorsque le degré de dépendance du parent est plus élevé et lorsqu'il n'a pas de conjoint. Cependant, le gradient Nord-Sud se retrouve dans la manière dont les enfants s'adaptent à l'absence de conjoint auprès de leur parent dépendant : accroissement de la cohabitation des filles au Sud, accroissement de l'aide « à distance » des fils comme des filles au Nord. La présence d'un conjoint auprès du parent dépendant semble modifier les logiques d'implication des enfants. Si le parent dépendant bénéficie de l'aide de son conjoint l'implication des enfants relève de décisions individuelles conduisant à une probabilité de soutien croissante avec le nombre d'enfants. L'implication auprès des parents sans conjoint relèverait au contraire d'une logique de fratrie visant à leur assurer une probabilité de soutien identique quel que soit le nombre de leurs enfants. Dans les fratries de deux enfants dont le parent est seul, une interaction asymétrique se dessine entre les comportements de l'aîné et du cadet. En moyenne, l'implication du cadet dépendrait de celle de l'aîné (la probabilité de s'impliquer du cadet serait plus faible si l'aîné s'implique lui-même), mais non l'inverse., La configuración de las ayudas familiares movilizadas entorno a los mayores dependientes en Europa . La encuesta Share permite estudiar la ayuda proporcionada por los hijos a las personas dependientes mayores de 65 años en los países europeos. ¿ Cómo se articulan los comportamientos individuales para dar lugar a confi guraciones familiares de ayuda? Existen dos modalidades de implicación según los hijos cohabiten o no con su progenitor dependiente. La proporción de personas mayores dependientes que reciben el apoyo de su entorno, bajo una forma u otra, es considerablemente homogénea: del 79 % en Suecia y en los Países Bajos al 87 % en Italia. En los países del norte, la menor cohabitación inter-generacional se compensa, en efecto, por una ayuda más frecuente de los hijos no cohabitantes. En los diez países estudiados, la implicación de los hijos es mayor cuando el grado de dependencia del progenitor es más elevado y cuando éste no tiene cónyuge. No obstante, el gradiente norte-sur se encuentra en la manera en qué los hijos se adaptan a la ausencia del cónyuge junto al progenitor dependiente: incremento de la cohabitación de las hijas al sur, incremento de la ayuda "a distancia” de los hijos e hijas al norte. La presencia de un cónyuge junto al progenitor dependiente parece modifi car la lógica de implicación de los hijos. Si el progenitor dependiente cuenta con la ayuda de su cónyuge, la implicación de los hijos depende de decisiones individuales que conlleva una probabilidad de apoyo creciente con el número de hijos. La implicación ante los progenitores sin cónyuge dependería, por el contrario, de una lógica de hermandad que pretenda garantizar una probabilidad de apoyo idéntica, independientemente del número de hijos. En las hermandades de dos hijos en que sólo queda un progenitor, se dibuja una interacción asimétrica entre los comportamientos del primogénito y del benjamín. En promedio, la implicación del menor dependería de la del mayor (la probabilidad de implicación del menor sería más baja si el mayor se implica él mismo), pero no la inversa. Agnès Wittwer, Fontaine Roméo, Gramain Agnès, Wittwer Jérôme. Les configurations d'aide familiales mobilisées autour des personnes âgées dépendantes en Europe. In: Economie et statistique, n°403-404, 2007. Santé, vieillissement et retraite en Europe. pp. 97-115.

International audience; Alzheimer's disease and other related disorders (ADRD) represent a major challenge for health care systems within the aging population. It is therefore important to develop better instruments to assess the disease severity and progression, as well as to improve its treatment, stimulation, and rehabilitation. This is the underlying idea for the development of Serious Games (SG). These are digital applications specially adapted for purposes other than entertaining; such as rehabilitation, training and education. Recently, there has been an increase of interest in the use of SG targeting patients with ADRD. However, this field is completely uncharted, and the clinical, ethical, economic and research impact of the employment of SG in these target populations has never been systematically addressed. The aim of this paper is to systematically analyze the Strengths, Weaknesses, Opportunities, and Threats (SWOT) of employing SG with patients with ADRD in order to provide practical recommendations for the development and use of SG in these populations. These analyses and recommendations were gathered, commented on and validated during a 2-round workshop in the context of the 2013 Clinical Trial of Alzheimer's Disease (CTAD) conference, and endorsed by stakeholders in the field. The results revealed that SG may offer very useful tools for professionals involved in the care of patients suffering from ADRD. However, more interdisciplinary work should be done in order to create SG specifically targeting these populations. Furthermore, in order to acquire more academic and professional credibility and acceptance, it will be necessary to invest more in research targeting efficacy and feasibility. Finally, the emerging ethical challenges should be considered a priority.

International audience; Alzheimer disease (AD) and other related dementia represent a major challenge for health care systems within the aging population. It is therefore important to develop better instruments for assessing disease severity and disease progression to optimize patient's care and support to care provide rs, and also provide better tools for clinical research. In this area, Information and Communication Technologies (ICT) are of particular interest. Such techniques enable accurate and standardized assessments of patients' performance and actions in real time and real life situations. The aim of this article is to provide basic recommendation concerning the development and the use of ICT for Alzheimer's disease and related disorders. During he ICT and Mental Health workshop (CTAD meeting held in Monaco on the 30th October 2012) an expert panel was set up to prepare the first recommendations for the use of ICT in dementia research. The expert panel included geriatrician, epidemiologist, neurologist, psychiatrist, psychologist, ICT engineers, representatives from the industry and patient association. The recommendations are divided into three sections corresponding to 1/ the clinical targets of interest for the use of ICT, 2/ the cond itions, the type of sensors and the outputs (scores) that could be used and obtained, 3/ finally the last section concerns specifically the use of ICT within clinical trials.

International audience; The present experiment aimed to investigate age differences in the neural correlates of familiarity and recollection, while keeping performance similar across age groups by varying task difficulty. Twenty young and 20 older adults performed an episodic memory task in an event-related functional magnetic resonance imaging (fMRI) design. At encoding, participants were presented with pictures, either once or twice. Then, they performed a recognition task, with a Remember/Know paradigm. A similar performance was observed for the two groups in the Easy condition for recollection and in the Hard condition for familiarity. Imaging data revealed the classic recollection-related and familiarity-related networks, common to young and older groups. In addition, we observed that some activity related to recollection (left frontal, left temporal, left parietal cortices and left parahippocampus) and familiarity (bilateral anterior cingulate, right frontal gyrus and left superior temporal gyrus) was reduced in older compared to young adults. However, for recollection processes only, older adults additionally recruited the right precuneus, possibly to successfully compensate for their difficulties, as suggested by a positive correlation between recollection and precuneus activity.

Cet article analyse l’evolution des dispositifs de repit proposes aux aidants familiaux des personnes atteintes d’une maladie d’Alzheimer. Depuis dix ans, l’offre de repit a considerablement evolue. Les dispositifs classiques (accueil de jour, hebergement temporaire) se sont renforces et diversifies, et de nouvelles formules (itinerantes, de nuit, favorisant la vie sociale) sont apparues. A l’heure actuelle, les dispositifs de repit ne visent plus seulement a reduire le « fardeau » de l’aidant principal. Ils tiennent compte des dimensions positives de l’aide, de la multiplicite des aidants familiaux et se focalisent sur le binome aidant-aide, dans une logique qui n’est plus uniquement une logique d’assistance, mais une logique plus dynamique d’« encapacitation » des aidants et des personnes malades.

Objectives: The aim of this overview is to present the developments of music therapy in France, its techniques, mechanisms and principal indications, mainly in the context of Alzheimer's disease. Methods: An international review of the literature on music therapy applied to Alzheimer's disease was conducted using the principal scientific search engines. A work group of experts in music therapy and psychosocial techniques then considered the different points highlighted in the review of literature and discussed them. Results and Discussion: Clinical and neurophysiological studies have enlightened some positive benefits of music in providing support for people with Alzheimer's disease or related disorders. Music therapy acts mainly through emotional and psycho-physiological pathways. It includes a series of techniques that can respond to targeted therapeutic objectives. Some studies have shown that music therapy reduces anxiety, alleviates periods of depression and aggressive behaviour and thus significantly improves mood, communication and autonomy of patients. Conclusion: Psychosocial interventions, such as music therapy, can contribute to maintain or rehabilitate functional cognitive and sensory abilities, as well as emotional and social skills and to reduce the severity of some behavioural disorders.

To reduce the potential burden of the ageing population on public finances, the European Council set EU member states the target of increasing the senior employment rate. Considering that seniors play a major role in caring for dependent elderly people, it is appropriate to ask whether a policy aimed at extending the working lives of seniors is compatible with a policy to support informal care forelderly people. Won’t informal care decrease if the senior employment rate rises? Or, looking at it from the opposite angle, won’t shifting the burden of care for elderly people to families hamper growth in senior employment?In order to answer these questions, this article proposes a quantitative study basedon data from SHARE (Wave 2). The analysis first identifies differences betweenEuropean countries with respect to care that seniors provide to their elderly singleparents: caring for an elderly parent is more frequent in northern Europe than in southern Europe, but the care provided by senior carers is far more “intensive” in southern Europe. Countries in continental and eastern Europe occupy an intermediateposition. An econometric assessment of the trade-off between elder care andemployment also shows that spending more than one hour per day on averagehelping an elderly single parent reduces the probability of having a job in southernand eastern Europe, where public support for dependency is more limited, whereas this does not seem to have a significant impact in northern and continental Europe., Le vieillissement de la population apparaît en Europe comme un des principaux enjeux des prochaines décennies. Il fait craindre dans lamajorité des pays une pression difficilement soutenable sur les systèmes publics de protection sociale. Afin de relever ce défi démographique, le Conseil européen de Stockholm (2001) a donné pour objectif aux États membres de l’Union européenne (UE) de porter le taux d’emploi à une moyenne européenne de 67 %, en fixant des objectifs particuliers pour la population dite des seniors. La question est alors de savoir si une politique visant à prolonger l’activité des seniors est compatible avec une politique visant à entretenir l’aide informelle dont peuvent bénéficier les personnes âgées nécessitant une prise en charge. Ne peut-on pas craindre une diminution de l’aide informelle en cas d’augmentation du taux d’emploi des seniors ? Ou au contraire, faire essentiellement reposer la prise en charge des personnes âgées sur les familles n’est-il pas un frein à l’augmentation du taux d’emploi des seniors ? Cet article propose une analyse du lien en offre de travail et offre d'aide informelle au niveau individuel à partir des données de l'enquête SHARE

International audience