Cued and uncued memory tests: norms in elderly adults from the 3 Cities epidemiological study

INTRODUCTION: The free and cued reminding test is often considered to be essential in the neuropsychological examination of elderly people consulting Memory Clinics. One of the reasons is that this test maximizes learning by inducing deep semantic processing and by controlling encoding and retrieval conditions. The aim of this study was to produce age, sex and educational level-adjusted normative data for this test. METHODS: These data were collected as part of the Three-City (3C) Study, a French population-based study on aging. RESULTS: The subsample of subjects analysed for this study included 1 458 non-institutionalised and non-demented elderly adults aged 65 and over. Norms were calculated according to age (65-70, 70-74, 74-78, 78-90), sex and educational level of the subjects (primary level versus and secondary or university level). CONCLUSION: The interest of this work is to provide to clinicians normative scores on the free and cued reminding test which can be used as an aid to interpret a patient's performance on a test widely used to detect episodic memory deficits in aging.     

Dépistage des cancers chez le sujet âgé

Cancer-screening programmes are public health action for a target population. It guarantees an equal access to screening throughout the country with a high level of quality for every person of the target population. Given the heterogeneity of older subjects and the variability of the expected benefits of cancer-screening programmes, this collective public health action may not have a collective benefit for the population. However, for older person with a life expectancy of five years or more, it would be possible to propose an individualized cancer-screening decision. This cancer-screening approach must respect the ethical principles of avoiding harm and supporting autonomy. In addition, it is important to consider the goals and values of patients to take an individualized decision. Patients with the same profile may not take the same decision of individualized cancer screening.     

Hypofractionated radiotherapy for invasive squamous cell carcinoma of the scalp in the elderly: Efficacy and tolerance,preliminary results

PurposeSkin squamous cells carcinomas (SCC) are frequently tumor, especially in the elderly population. Surgical excision is the standard treatment. But for patients suffering large tumor or/with comorbidity, a conservative approach with irradiation can be proposed. The hypofractionated schedule is used to shorten the overall treatment time with same results and without compromising therapeutic outcomes. The aim of this study is to assess the efficacy and tolerance of hypofractionated radiotherapy for invasive SCC of the scalp in elderly.Patients and methodsWe included patients suffering from SCC of the scalp and treated by hypofractionated radiotherapy at the Institut de cancérologie de Lorraine or centre Émile-Durkeim d’Épinal, from January 2019 to December 2021. Characteristics of patients, size of the lesion and side effects were collected retrospectively. Tumor size at 6 months corresponded to the primary endpoint. Toxicity was collected for the secondary endpoint.ResultsTwelve patients with a median age of 85 years old were included. The mean size was 4,5 cm with a bone invasion in 2/3 of cases. Radiotherapy was delivered after surgical excision for half of the patient. The dose delivered was 54 Gy in 18 daily fractions size. Six months after irradiation: 6/11 patients had no residual lesion, 2/11 had a partial response with a residual lesion of about 1 cm. 3 patients presented local recurrence. One patient died within 6 months of radiotherapy because of another comorbidity. In total, 25% had presented a grade 3 acute radiation dermatitis, no grade 4 toxicity.ConclusionShort term of moderately hypofractionated schedule radiotherapy was a success with complete or partial response for more than 70% of the patients in squamous cell carcinomas. There is no major side effect.