Background: Alzheimer's disease (AD) is known to increase the risk of falls.We aim to determine the effectiveness of home-based technologies coupled with teleassistance service (HBTec-TS) in older people with AD. Methods: A study of falls and the HBTec-TS system (with a light path combined with a teleassistance service) was conducted in the community. The 96 subjects, drawn from a random population of frail elderly people registered as receiving an allocation for lost autonomy from the county, were aged 65 or more and hadmild-to-moderate AD with 1 year of follow-up; 49 were in the intervention group and 47 in the control group. Results: A total of 16 (32.7%) elderly people fell in the group withHBTec-TS versus 30 (63.8%) in the group without HBTec-TS. The use of HBTec-TS was significantly associated with a reduction in the number of indoor falls among elderly people with mild-to-moderate AD (OR = 0.37, 95% CI = 0.15-0.88, p = 0.0245). Conclusion: The use of the HBTec-TS significantly reduced the incidence of primary indoor falling needing GP intervention or attendance at an emergency room among elderly people with AD and mild-to-moderate dementia.

BackgroundThe worldwide population is ageing and the proportion of elderly aged 60 and over is expected to dramatically rise in Low and Middle Income Countries (LMIC). The epidemic of dementia will not spare those countries, where the largest increases in numbers of people affected are estimated. Besides, dementia is still understudied in sub-Saharan Africa (SSA) compared to other regions. This paper describes the protocol for the ‘Epidemiology of Dementia in Central Africa’ population-based study, which aims at estimating the prevalence of dementia in two countries of Central Africa and investigating possible risk factors.Methods/DesignA multicenter population-based study was carried out in Central African Republic and Republic of Congo between 2011 and 2012 including both urban and rural sites in each country. Around 2000 participants aged ≥65 years old were interviewed in total using the Community Screening Interview for Dementia (CSI-D), the GMS-AGECAT and the CERAD’s 10-word list. Elderly with low performance to the cognitive part of the CSI-D (COGSCORE ≤ 24.5) were then clinically assessed by neurologists and underwent further psychometrical tests. DSM-IV and NINCDS-ADRDA criteria were required for dementia and Alzheimer’s disease (AD) diagnoses respectively. The algorithmic 10/66 dementia diagnosis was also determined. Petersen’s criteria were required for the diagnosis of Mild Cognitive Impairment. Sociodemographic, and environmental factors including vascular, nutritional, biological, psychosocial and lifestyle factors were collected in each setting in order to investigate factors associated with dementia. Blood sampling was realized to investigate genetic variations that could modify the risk of dementia.DiscussionFor now, no large epidemiological study has been undertaken to compare the prevalence of dementia in both rural and urban areas within SSA countries. This programme will provide further evidence regarding the prevalence of dementia in SSA, and also the possible rural/urban disparities existing with associated factors. Furthermore, the genetics of AD in those populations will be addressed.

Teledentistry showed excellent accuracy for diagnosing dental pathology in older adults living in nursing homes; its use may allow more regular checkups to be carried out by dental professionals.

Conflicting data on the relationship between antihypertensive medications and falls in elderly people may lead to inappropriate under-treatment of hypertension in an effort to prevent falls. We aimed to clarify the relationships between the chronic use of different classes of antihypertensive medications and different types of falls, determine the effect of medication dose, and assess whether falls risk is associated with differences in cerebral blood flow. We assessed demographics, clinical characteristics, and chronic antihypertensive medication use in 598 community-dwelling people with hypertension, aged 70 to 97, then followed them prospectively for self-reported falls using monthly calendar postcards and telephone interviews. Antihypertensive medication use was not associated with an increased risk of falls. Participants reporting use of Angiotensin Converting Enzyme Inhibitors (ACEI) had a significanty decreased one-year risk of injurious falls (Odds Ratio = 0.62, 95% confidence interval = 0.39-0.96), while those using Calcium Channel Blockers had a decreased risk of all falls (OR = 0.62, 95% CI = 0.42 - 0.91) and indoor falls (OR = 0.57, 95% CI = 0.36-0.91), compared to participants not taking these drugs. Larger doses of these classes were associated with a lower falls risk. Participants taking calcium channel blockers had higher cerebral blood flow than those not taking these medications. In relatively healthy community-dwelling elderly people, high doses of antihypertensive agents are not associated with an increased risk of falls.