In 2004, the integrated European project GEHA (Genetics of Healthy Ageing) was initiated with the aim of identifying genes involved in healthy ageing and longevity. The first step in the project was the recruitment of more than 2500 pairs of siblings aged 90 years or more together with one younger control person from 15 areas in 11 European countries through a coordinated and standardised effort. A biological sample, preferably a blood sample, was collected from each participant, and basic physical and cognitive measures were obtained together with information about health, life style, and family composition. From 2004 to 2008 a total of 2535 families comprising 5319 nonagenarian siblings were identified and included in the project. In addition, 2548 younger control persons aged 50–75 years were recruited. A total of 2249 complete trios with blood samples from at least two old siblings and the younger control were formed and are available for genetic analyses (e.g. linkage studies and genome-wide association studies). Mortality follow-up improves the possibility of identifying families with the most extreme longevity phenotypes. With a mean follow-up time of 3.7 years the number of families with all participating siblings aged 95 years or more has increased by a factor of 5 to 750 families compared to when interviews were conducted. Thus, the GEHA project represents a unique source in the search for genes related to healthy ageing and longevity.

BackgroundIn 2009, case management interventions were a new social service in France implemented within the framework of the PRISMA-France program (2006–2010). People who had benefitted from case management intervention were individuals, over 60 years old living at home in situations deemed complex by professionals. Their informal caregivers were also considered as users of the service. This research accompanied the interventions during the implementation of PRISMA-France attempting to explore the users’ (old people and their informal caregivers) and case managers’ first experiences of case management. Its aim is to provide a thorough knowledge of the dispositive in order to reveal any initial failings and to ensure optimum conditions for the onset of full implementation.MethodsThe study had a qualitative explorative design. Cross-linked representations of case-management were obtained through opened-ended and guided interviews with three types of informants: old people (19), their informal caregivers (11) and the case managers (5) who participated in the program during the first 6 months. Thematic analysis of the data was carried out.ResultsThe analysis revealed that each group of people generated its own representations of the case manager’s role, even though the three groups of informants shared the idea that the case manager is first and foremost a helper. The case managers insisted on their proximity to the old people and their role as coordinators. The informal caregivers saw the professional as a partner and potential provider of assistance in accompanying old people. The old people focused on the personal connections established with the case manager.ConclusionThe innovative and experimental dimension of case management in France and the flexible nature of the role generated a broad spectrum of representations by those involved. These different representations are, in part, the fruit of each individual’s projected expectations of this social service.Analyzing the first representations of the case manager’s role during the implementation phase of the CM service appears as a necessary step before considering the effects of the services. The implementation and the success of a case management model have to be evaluated regarding the previous healthcare context and the expectations of the people involved.

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Since the 1990s, several studies involving French centenarians have shown a gender paradox in old age. Even if women are more numerous in old age and live longer than men, men are in better physical and cognitive health, are higher functioning, and have superior vision. If better health should lead to a longer life, why are men not living longer than women? This paper proposes a hypothesis based on the differences in the generational habitus between men and women who were born at the beginning of the 20th century. The concept of generational habitus combines the generation theory of Mannheim with the habitus concept of Bourdieu based on the observation that there exists a way of being, thinking, and doing for each generation. We hypothesized that this habitus still influences many gender-linked behaviours in old age. Men, as “oaks,” seem able to delay the afflictions of old age until a breaking point, while women, as “reeds,” seem able to survive despite an accumulation of health deficits.

IntroductionThe PRISMA integration model is a promising method to implement integration in health and social services for elderly people. In the PRISMA-France study, we qualitatively studied the implementation process of this model in French settings.MethodOur analyses were based on in-depth interviews, meeting observations and the documentation produced.ResultsWe adapted the implementation scale inherent to the PRISMA model to fit the French context and, using this scale, were able to appreciate a 15% progression of implementation, from 5% to 20%, in the first 18 months of the study. The factors that contributed to this rate of progression are of three main types. To begin with, contextual factors intrinsic to the French setting complexified the incorporation of integration into the public policy agenda and the means to achieve this feat. Secondly, factors related to the background of the concerned managers and professionals were identified. Thirdly, factors related to the particularities of the PRISMA-Experiment's governance were noted. Our experience leads to consider time as the answer to these hindering contextual, professional and governance issues.ConclusionThese observations hold an important strategic value in a time where a wider integration experimentation is planned by the ‘plan-Alzheimer’ in France.

Cet article aborde la problématique du refus d’aide et de soin des personnes âgées en situation complexe. En se basant sur l’analyse du discours de ces individus âgés et de leur entourage, il s’agit de décrire les manifestations de ce refus puis d’en analyser ses différents sens.This paper tackles the problem of assistance and care being denied to elderly people whose situation is complex. Based on an analysis of the views expressed by elderly individuals and their entourage, it describes the manifestations of denial and analyses its various meanings

Fondé sur des entretiens réalisés avec 37 résidents vivant dans 15 établissements d’hébergement pour personnes âgées dépendantes (Ehpad), cet article se propose d’analyser leurs expériences variées du premier confinement. Dans un premier temps, il montre que l’expérience du confinement a pris des formes différentes en fonction des modes d’habiter en Ehpad. Ceux qui vivaient repliés dans leur chambre voient peu de différences avec la vie d’avant. Ceux qui habitaient l’Ehpad en s’appropriant les espaces collectifs tendent à percevoir le confinement comme une privation de ces espaces. Enfin, ceux qui étaient tournés vers l’extérieur de l’établissement insistent plutôt sur l’absence de liberté de circuler en dehors de l’Ehpad qui a marqué la période. Dans un second temps, l’article explore trois autres facteurs qui éclairent également les expériences du confinement : les modalités de confinement mises en place par l’Ehpad dans lequel ils résident, les ressources occupationnelles ou relationnelles que les Ehpad ont pu mobiliser et la trajectoire antérieure des résidents.

Le territoire est toujours de l’ordre de la construction géographique, politique, administrative, sociale ou sanitaire. Cependant, peut-on construire un territoire gérontologique sans prendre en compte les représentations portées par les personnes âgées ? Les entretiens menés avec des personnes âgées fragiles montrent que celles-ci intègrent une représentation du territoire dans leurs modes de vie et logiques d’action qui leur est propre. L’avancée en âge va de pair avec une restriction de la mobilité qui concourt à la survalorisation de certains lieux à commencer par le « chez soi ». L’ailleurs, l’extérieur deviennent chaque jour un peu moins familiers, un peu moins intégrés dans les habitudes corporelles. Confrontées à leur fragilité sociale, culturelle et identitaire, les personnes âgées se construisent un univers dont les fondements sont les habitudes de vie et certaines formes de ritualisation et des croyances qui les rassurent et concourent à leur empowerment. La mise en place d’un dispositif structurant de l’offre gérontologique aussi rationalisé soit-il comporte le risque de ne pas faire sens pour les usagers âgés et ainsi d’être ignoré voire rejeté s’il est vécu comme un obstacle à la satisfaction de leurs besoins.