Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Telemedicine is increasingly evaluated for rehabilitation of stroke survivors. However, little is known about the utility of telerehabilitation in stroke survivors. Objective: To summarize the evidence on the utility of telerehabilitation in stroke survivors. Methods: Eligible randomized controlled trials (RCTs) were selected from Medline, Cochrane Central and Web of Science databases. Continuous data on the outcomes were analyzed using the RevMan software as standardized mean difference (SMD) and 95% confidence interval (95% CI) in a fixed effect meta-analysis model. Results: Fifteen studies, providing data on 1,339 stroke survivors were eligible for inclusion. The combined effect estimate showed that telerehabilitation is as good as usual care as Barthel index (SMD = -0.05, 95% CI [-0.18, 0.08]), Berg Balance Scale (SMD = -0.04, 95% CI [-0.34, 0.26]), Fugl-Meyer Upper Extremity (SMD = 0.50, 95% CI [-0.09, 1.09]) and Stroke Impact Scale [mobility] (SMD = 0.18, 95% CI [-0.13, 0.48]) scores were statistically similar in both groups. Further, quality of life (of the stroke survivor), caregiver strain index and patients' satisfaction with care scores were also similar for both the groups. One study showed that the cost of telerehabilitation was lower than usual care by $654. Conclusions: Telerehabilitation can be a suitable alternative to usual rehabilitation care in post-stroke patients, especially in remote or underserved areas.

Geriatric syndromes (GSs) are often the result of cumulative insults to multiple organ systems and are considered common in older adults. However, their frequency and co-occurrence are not well known in the elderly population. This study aimed to determine the prevalence of several GSs and to analyze the co-occurrence of these syndromes in a general population of elderly individuals. A cross-sectional analysis of 630 adults aged 75 years or older participating in the 10-year follow-up of the Bordeaux sample of the French Three-City Study was conducted. The following 10 GSs were assessed: physical frailty, dementia and cognitive impairment, depressive symptoms, polymedication, social isolation, thinness, falls, dependence, sensory deficit, and incontinence. The prevalence of the 10 GSs was estimated, and multiple correspondence analysis (MCA) models were used to explore the mutual associations between these GSs. The mean age of the participants was 83.3 years; 69% were women, and 80.5% [95% confidence interval (CI) = 76.3–82.7] had at least one GS. The most frequent GSs were polymedication (50.6% 95%CI = 46.7–54.5) and falls (43.1% 95%CI = 38.4–46.1). The MCA models identified two major dimensions of the 10 GSs: “Dementia–Dependence–Incontinence” and “Frailty–Depression–Isolation.” GSs were very common in this French elderly population and were grouped into two major dimensions: the “Dementia–Dependence–Incontinence” and “Frailty–Depression–Isolation.”

While physical frailty and malnutrition/obesity (parameters easily measured by a nurse) are not the same, older persons who are malnourished/obese are more likely to be frail and there is a potential overlap between these conditions. The objective was to examine the relationship between gait speed (GS) and body mass index (BMI) in men and women aged 75 years and older. Cross-sectional analysis. Data from the Aging Multidisciplinary Investigation (AMI), a French prospective cohort study with participants randomly selected from the farmer Health Insurance rolls. Usual GS was measured over a 4 meters-track. BMI was categorized using clinical cut-points for European populations: (e.g, <20.0 kg/m²; 20.0–24.9 kg/m²; 25.0–29.9 kg/m²; 30.0–34.9 kg/m²; ≥35.0 kg/m²). The current analyses were performed in 449 participants. Mean age was 81 years. Being malnourished/obese was significantly associated with slow GS. Unadjusted and age-adjusted models showed that underweight, overweight and obesity statuses were significantly associated with slow GS for both women (0.83m/s [0.61; 1.04], 0.87m/s [0.72; 1.02], 0.70 m/s [0.41; 0.98], respectively) and men (0.83m/s [0.61; 1.04], 1.11m/s [1.03; 1.20], 0.97m/s [0.75; 1.19], respectively). Malnourished/obese are associated with slow GS in older persons. These variables could be contributed at comprehensively and complementarily assessing the older person.

The aim of this study was to explore whether multidomain intervention (MI) and Omega-3 Polyunsaturated Fatty Acids supplementation can modify the cognitive function on elderly according to frail status.

Background: Gait speed (GS) and psychomotor speed (PS) could be considered as two different dimensions of age-related slowness and both measures are associated with higher risk of adverse health-related outcomes among elderly people. Objective: To determine the association between GS, PS, and incident dementia among community-dwelling older adults. Methods: Twelve-year longitudinal study of 1,265 participants in the Bordeaux Three-City Study, a French prospective cohort designed to determine the risk of dementia and cognitive impairment attributable to cardiovascular risk factors. Participants completed a battery of cognitive tests, including time to complete the Trail Making Test A, and a walking speed test. The incidence of dementia was determined over the 12-year follow-up period. Cox proportional hazards models with delayed entry were used to estimate the cumulative risk of dementia and were adjusted for sex, education, and ApoE4 genotype. Results: Mean age of participants was 74.0 years (SD 4.8). Over the 12-year follow-up, 203 participants developed dementia. GS and PS were both independent predictors of incident all-cause dementia after 12 years of follow-up. For a one SD increase of either GS or PS, the hazard ratio (HR) for Alzheimer’s disease was 1.2 (95% CI = 1.02–1.32) and 1.4 (95% CI = 1.2–1.61), respectively; whereas for incident vascular dementia, the HR was 1.3 (95% CI = 1.05–1.71) and 1.5 (95% CI = 1.16–2.08), respectively. No significant interaction between GS and PS was observed. Conclusions: In older French people aged 65+, our findings showed that both low GS and PS were independently associated with risk of incident Alzheimer’s disease and vascular dementia.