Platelet aggregation inhibitors (PAI) have widely proven their efficiency for the prevention of ischemic cardiovascular events. We aimed to describe PAI prescription in an elderly multimorbid population and to determine the factors that influence their prescription, including the impact of age, comorbidities and frailty, evaluated through a comprehensive geriatric assessment. This cross-sectional study included all patients admitted to the acute geriatric department of a university hospital from November 2016 to January 2017. We included 304 consecutive hospitalized patients aged 88.7 ± 5.5 years. One third of the population was treated with PAI. A total of 133 (43.8%) patients had a history of cardiovascular disease, 77 of whom were on PAI. For 16 patients, no indication was identified. The prescription or the absence of PAI were consistent with medical history in 61.8% of patients. In the multivariate analysis, among the 187 patients with an indication for PAI, neither age (odds ratio (OR) = 1.00; 95% confidence interval (CI): [0.91–1.08], per year of age), nor comorbidities (OR = 0.97; 95% CI: [0.75–1.26], per point of Charlson comorbidity index), nor cognitive disorders (OR = 0.98; 95% CI [0.91–1.06] per point of Mini Mental State Examination), nor malnutrition (OR = 1.07; 95% CI [0.96–1.18], per g/L of albumin) were significantly associated with the therapeutic decision. PAI were less prescribed in primary prevention situations, in patients taking anticoagulants and in patients with a history of bleeding. In conclusion, a third of our older comorbid population of inpatients was taking PAI. PAI prescription was consistent with medical history for 61.8% of patients. Age, multimorbidity and frailty do not appear to have a significant influence on therapeutic decision-making. Further research is needed to confirm such a persistence of cardiovascular preventive strategies in frail older patients from other settings and to assess whether these strategies are associated with a clinical benefit in this specific population.

Drug-related iatrogenesis is an important issue in the elderly population, and preventing iatrogenic accidents helps to reduce hospitalizations. Our study’s objective was to evaluate prescriptions in the geriatric population of our establishment. The study conducted is a targeted clinical audit. Ten criteria were tested on the hospital prescriptions of people over 75 years old in 11 medical departments, before and after improvement actions. The non-compliance threshold was set at 10% of prescriptions for each criterion. In each phase, 165 patients were included. Four criteria were non-compliant (NC) in the first phase: the presence of Potentially Inappropriate Medications for the Elderly (PIMs) (NC = 57.6%), the adaptation of the medication to renal clearance (NC = 24.9%), the presence of illogical combination (NC = 9.7%), and the total anti-cholinergic score of the prescription (NC = 12.1%). After the implementation of improvement actions, the number of non-compliant criteria decreased between the two phases, from four to two. We obtained a significant improvement for three of the four criteria found to be non-compliant in the first phase. The criterion adaptation to renal function is close to compliance (NC = 10.1%) and the PIMs criterion remained non-compliant after reassessment (NC = 32.1%). Vigilance must be ongoing in order to limit drug iatrogeny, particularly in frail elderly patients.

Objective. AVK could be prescribed in elderly patients over 75 years for the prevention of thromboembolic complications of atrial fibrillation (AF). The objective of this study was to study the quality of the anticoagulation balance by AVK and its determinants. Method. Inclusion of all patients >= 75 years of age treated with AVK for an AF hospitalized in the acute geriatric department of the University hospital of Dijon. The balance of the AVK treatment was determined by the input INR and the calculation of the TTR. The last four INRs prior to admission were retrospectively collected for its calculation. Each patient had a standardized geriatric evaluation (EGS): lifestyle, MMSE, nutritional status (albumin), polypathology (Charlson), level of dependence (ADL-IADL). Bleeding complication were collected. Results. 155 patients aged over 75 years (87 +/- 5.6 years, 88 women and 67 men) were included. The mean TTR was 55.4 +/- 31.2%. Only 46% of patients had a correct TTR (>= 75%). The balance was significantly worse in women than in men (49.3 +/- 29.5 vs 60.1 +/- 31.8%; p=0.0326), and in case of haematological pathology (41.7 +/- 27.1 vs 57.2 +/- 9.8; p=0.047) but better with high BMI (r=0.416, p=0.001). No EGS parameters were associated with the quality of anticoagulation. Conclusion. The control of AVK therapy is insufficient in geriatric elderly subjects. No modifiable explicative geriatric factor has been identified. If AVK remains a therapeutic option, direct oral anticoaulants should be considered as the first choice.

Oxidative stress accelerates skin aging by causing damage to DNA, lipids and proteins in skin cells. Exacerbated by environmental factors such as UV rays, pollution and smoking, it leads to loss of elasticity, the appearance of wrinkles, cutaneous dryness, pigmentation spots and a general weakening of the skin's natural defenses. These changes, accumulated over time, are responsible for premature or accelerated aging. Against this backdrop, PAOTScan is an innovative, non-invasive technology for assessing the oxidative state of the skin in real time. The device is based on a patch equipped with microelectrodes and an electrochemical gel. It provides two essential scores: the PAOTScore, which measures the skin's Total Antioxidant Power to neutralize free radicals, and the POTScore (Total Oxidant Power), which quantifies the level of oxidants. These data provide a detailed analysis of the skin's redox balance, enabling early detection of imbalances responsible for premature aging. The PAOTScan not only measures the speed of skin ageing, but also enables prevention and treatment strategies to be adapted. It is therefore an invaluable tool in dermatology and dermato-cosmetics, making it easier to monitor the effectiveness of anti-aging interventions and helping to preserve the skin's health and youthfulness.