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  1. Article ; Online: Quality of Life and Health Determinants of Informal Caregivers Aged 65 Years and Over.

    Buckinx, Fanny / Adam, Stéphane / Aubertin-Leheudre, Mylène / De Saint Hubert, Marie / Mouton, Alexandre / Potier, Florence / Reginster, Jean-Yves / Bruyere, Olivier

    Epidemiologia (Basel, Switzerland)

    2023  Volume 4, Issue 4, Page(s) 464–482

    Abstract: Informal caregivers' own quality of life, health status, and determinants are poorly understood despite their concern for the health of the individuals they assist. To compare the quality of life and the health determinants of older informal caregivers ... ...

    Abstract Informal caregivers' own quality of life, health status, and determinants are poorly understood despite their concern for the health of the individuals they assist. To compare the quality of life and the health determinants of older informal caregivers with those of older adults without caregiving responsibilities. An online survey was designed to investigate the quality of life and the health determinants of people aged 65 years and over, with a focus on informal caregivers. In addition to socio-demographic data, the number of informal caregivers was ascertained and the Zarit scale of caregiver burden was applied. Quality of life (SF-12) and health determinants (access to technology and level of physical activity (IPAQ)) were assessed and compared between informal caregivers and non-caregivers. A total of 111 participants were included in the study (70 ± 3.83 years, 71.2% women). The majority of respondents (91.8%) were Belgian. One-third of the respondents identified themselves as informal caregivers and declared themselves as having a severe burden (61.9 ± 15.2/88). Socio-demographic characteristics and access to technology were similar between informal caregivers and non-caregivers (
    Language English
    Publishing date 2023-11-06
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2673-3986
    ISSN (online) 2673-3986
    DOI 10.3390/epidemiologia4040039
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  2. Article ; Online: SPICT as a predictive tool for risk of 1-year health degradation and death in older patients admitted to the emergency department: a bicentric cohort study in Belgium.

    Bourmorck, Delphine / de Saint-Hubert, Marie / Desmedt, Marianne / Piers, Ruth / Flament, Julien / De Brauwer, Isabelle

    BMC palliative care

    2023  Volume 22, Issue 1, Page(s) 79

    Abstract: Background: Older patients are increasingly showing multi-comorbidities, including advanced chronic diseases. When admitted to the emergency department (ED), the decision to pursue life-prolonging treatments or to initiate a palliative care approach is ... ...

    Abstract Background: Older patients are increasingly showing multi-comorbidities, including advanced chronic diseases. When admitted to the emergency department (ED), the decision to pursue life-prolonging treatments or to initiate a palliative care approach is a challenge for clinicians. We test for the first time the diagnostic accuracy of the Supportive and Palliative Care Indicators Tool (SPICT) in the ED to identify older patients at risk of deteriorating and dying, and timely address palliative care needs.
    Methods: We conducted a prospective bicentric cohort study on 352 older patients (≥ 75 years) admitted to two EDs in Belgium between December 2019 and March 2020 and between August and November 2020. SPICT (French version, 2019) variables were collected during the patients' admission to the ED, along with socio-demographic, medical and functional data. The palliative profile was defined as a positive SPICT assessment. Survival, symptoms and health degradation (≥ 1 point in ADL Katz score or institutionalisation and death) were followed at 12 months by phone. Main accuracy measures were sensitivity, specificity and likelihood ratios (LR) as well as cox regression, survival analysis using the Kaplan Meier method, and ordinal regression.
    Results: Out of 352 patients included in the study (mean age 83 ± 5.5 years, 43% male), 167 patients (47%) had a positive SPICT profile. At one year follow up, SPICT positive patients presented significantly more health degradation (72%) compared with SPICT negative patients (35%, p < 0.001). SPICT positivity was correlated with 1-year health degradation (OR 4.9; p < 0.001). The sensitivity and specificity of SPICT to predict health degradation were 0.65 (95%CI, 0.57-0.73) and 0.72 (95%CI, 0.64-0.80) respectively, with a negative LR of 0.48 (95%CI, 0.38-0.60) and a positive LR of 2.37 (1.78-3.16). The survival time was shorter in SPICT positive patients than in SPICT negative ones (p < 0.001), the former having a higher 1-year mortality rate (HR = 4.21; p < 0.001).
    Conclusions: SPICT successfully identifies older patients at high risk of health degradation and death. It can support emergency clinicians to identify older patients with a palliative profile and subsequently initiate a palliative care approach with a discussion on goals of care.
    MeSH term(s) Humans ; Male ; Aged ; Aged, 80 and over ; Female ; Palliative Care ; Cohort Studies ; Prospective Studies ; Belgium ; Emergency Service, Hospital
    Language English
    Publishing date 2023-06-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 2091556-1
    ISSN 1472-684X ; 1472-684X
    ISSN (online) 1472-684X
    ISSN 1472-684X
    DOI 10.1186/s12904-023-01201-9
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  3. Article ; Online: Current practice in benzodiazepine receptor agonists deprescribing on acute geriatric wards: a cohort study.

    Sibille, François-Xavier / Spinewine, Anne / Zerah, Lorène / Maljean, Laurentine / Schoevaerdts, Didier / de Saint-Hubert, Marie

    BMC geriatrics

    2022  Volume 22, Issue 1, Page(s) 88

    Abstract: Background: Benzodiazepine receptor agonist (BZRA) use is highly prevalent in hospitalised older people although these drugs are associated with numerous and serious adverse events. Deprescribing can reduce risks associated with chronic BZRA use. The ... ...

    Abstract Background: Benzodiazepine receptor agonist (BZRA) use is highly prevalent in hospitalised older people although these drugs are associated with numerous and serious adverse events. Deprescribing can reduce risks associated with chronic BZRA use. The aim of this study was to measure the prevalence of, and factors associated with, BZRA deprescribing in acute geriatric units.
    Methods: During a one-year period, this multicentre retrospective study included patients aged ≥70 years, hospitalised in acute geriatric units, and using ≥1 BZRA on admission. BZRA deprescribing at discharge was defined as: ≥25% decrease in lorazepam-equivalent admission dose; discontinuation of all BZRAs; or cessation of a rescue prescription at discharge. BZRA cessation was defined as discontinuation of all BZRAs at discharge. We identified social, medical, geriatric and medication factors associated with BZRA deprescribing using logistic regression.
    Results: In total, 561 patients were included (mean age: 85.3±5.9 years, 70% of women). BZRA deprescribing occurred in 240 (42.8%), including 85 with BZRA cessation (15.2%). Deprescribing occurred more frequently in patients with a BZRA-related adverse event on admission or during hospital stay (odds ratio (OR) 4.5; 95% confidence interval [2.6; 7.9]), with an antidepressant (1.6 [1.1; 2.4]) and a higher lorazepam-equivalent dosage on admission (OR 1.2 [1; 1.4]), and less frequently in patients with antipsychotic drug (OR 0.5 [0.3; 0.8]). BZRA cessation was more likely in patients with a BZRA-related adverse event (OR 2.2 [1.2; 4.3]) and a lower lorazepam-equivalent dosage on admission (OR 0.5 [0.3; 0.6]).
    Conclusions: During hospitalisation in the acute geriatric units of our hospital, BZRA deprescribing occurred in 42.8% of the patients. Identification of an BZRA-related adverse event by the treating physician appears to be a major factor: this reactive deprescribing accounted for 74% of cases in our study. Further prospective studies are needed to measure long-term persistence of in-hospital deprescribing and encourage proactive management.
    MeSH term(s) Aged ; Aged, 80 and over ; Cohort Studies ; Deprescriptions ; Female ; Hospitals ; Humans ; Receptors, GABA-A ; Retrospective Studies
    Chemical Substances Receptors, GABA-A
    Language English
    Publishing date 2022-02-01
    Publishing country England
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2059865-8
    ISSN 1471-2318 ; 1471-2318
    ISSN (online) 1471-2318
    ISSN 1471-2318
    DOI 10.1186/s12877-022-02753-w
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  4. Article ; Online: Palliative profile, one-year mortality and quality of life in older inpatients according to Be-PICT: a multicenter prospective cohort study.

    De Brauwer, Isabelle / Henrard, Séverine / Baeyens, Hilde / Van Den Noortgate, Nele / De Saint-Hubert, Marie / Piers, Ruth

    Acta clinica Belgica

    2022  , Page(s) 1–9

    Abstract: Background: A palliative care approach (PCA), including advanced care planning (ACP), should be considered for patients with limited life expectancy. The Belgian Palliative Care Indicators Tool (Be-PICT) has been released to help identify patients who ... ...

    Abstract Background: A palliative care approach (PCA), including advanced care planning (ACP), should be considered for patients with limited life expectancy. The Belgian Palliative Care Indicators Tool (Be-PICT) has been released to help identify patients who may benefit from such approach. This study aimed at measuring 1-year mortality and describe the quality of life in older inpatients, according to baseline Be-PICT results.
    Methods: Prospective multicentre cohort study in older patients (≥ 75 years) admitted at geriatrics and cardiology wards of four Belgian hospitals. The palliative profile was defined as a positive Be-PICT.1, defined by the presence of its three criteria, i.e. a negative physician's answer to the surprise question '
    Results: Of the 379 patients (50% aged ≥85 years; 51% female), 52 (14%) presented a palliative profile and 83 (23%) died within 1 year. Be-PICT.1 showed the following characteristics to predict 1-year mortality: sensitivity 0.54, specificity 0.83, positive and negative predictive values 0.48 and 0.86, positive and negative likelihood ratios 3.22 and 0.55. The patients with a palliative profile were at higher mortality risk (hazard ratio 4.79 p < 0.001) and 1-year mortality rate (45%). Not using the SQ allowed to improve sensitivity to include a larger number of patients who may benefit from ACP and PCA.
    Conclusions: Be-PICT.1 is a simple case-finding tool to identify older inpatients being at high mortality risk and candidates for ACP and PCA.
    Language English
    Publishing date 2022-03-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 390201-8
    ISSN 2295-3337 ; 0001-5512 ; 1784-3286
    ISSN (online) 2295-3337
    ISSN 0001-5512 ; 1784-3286
    DOI 10.1080/17843286.2022.2053812
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  5. Article ; Online: Benzodiazepine Receptor Agonists Use and Cessation Among Multimorbid Older Adults with Polypharmacy: Secondary Analysis from the OPERAM Trial.

    Sibille, François-Xavier / de Saint-Hubert, Marie / Henrard, Séverine / Aubert, Carole Elodie / Goto, Namiko Anna / Jennings, Emma / Dalleur, Olivia / Rodondi, Nicolas / Knol, Wilma / O'Mahony, Denis / Schwenkglenks, Matthias / Spinewine, Anne

    Drugs & aging

    2023  Volume 40, Issue 6, Page(s) 551–561

    Abstract: Background: Benzodiazepine receptor agonists (BZRAs) are commonly prescribed in older adults despite an unfavorable risk-benefit ratio. Hospitalizations may provide a unique opportunity to initiate BZRA cessation, yet little is known about cessation ... ...

    Abstract Background: Benzodiazepine receptor agonists (BZRAs) are commonly prescribed in older adults despite an unfavorable risk-benefit ratio. Hospitalizations may provide a unique opportunity to initiate BZRA cessation, yet little is known about cessation during and after hospitalization. We aimed to measure the prevalence of BZRA use before hospitalization and the rate of cessation 6 months later, and to identify factors associated with these outcomes.
    Methods: We conducted a secondary analysis of a cluster randomized controlled trial (OPtimising thERapy to prevent Avoidable hospital admissions in the Multimorbid elderly [OPERAM]), comparing usual care and in-hospital pharmacotherapy optimization in adults aged 70 years or over with multimorbidity and polypharmacy in four European countries. BZRA cessation was defined as taking one or more BZRA before hospitalization and not taking any BZRA at the 6-month follow-up. Multivariable logistic regression was performed to identify factors associated with BZRA use before hospitalization and with cessation at 6 months.
    Results: Among 1601 participants with complete 6-month follow-up data, 378 (23.6%) were BZRA users before hospitalization. Female sex (odds ratio [OR] 1.52 [95% confidence interval 1.18-1.96]), a higher reported level of depression/anxiety (OR up to 2.45 [1.54-3.89]), a higher number of daily drugs (OR 1.08 [1.05-1.12]), use of an antidepressant (OR 1.74 [1.31-2.31]) or an antiepileptic (OR 1.46 [1.02-2.07]), and trial site were associated with BZRA use. Diabetes mellitus (OR 0.60 [0.44-0.80]) was associated with a lower probability of BZRA use. BZRA cessation occurred in 86 BZRA users (22.8%). Antidepressant use (OR 1.74 [1.06-2.86]) and a history of falling in the previous 12 months (OR 1.75 [1.10-2.78]) were associated with higher BZRA cessation, and chronic obstructive pulmonary disease (COPD) (OR 0.45 [0.20-0.91]) with lower BZRA cessation.
    Conclusion: BZRA prevalence was high among included multimorbid older adults, and BZRA cessation occurred in almost a quarter of them within 6 months after hospitalization. Targeted BZRA deprescribing programs could further enhance cessation. Specific attention is needed for females, central nervous system-acting co-medication, and COPD co-morbidity.
    Registration: ClinicalTrials.gov identifier: NCT02986425. December 8, 2016.
    MeSH term(s) Aged ; Humans ; Female ; Receptors, GABA-A ; Polypharmacy ; Multimorbidity ; Pulmonary Disease, Chronic Obstructive ; Risk Assessment ; Hospitalization
    Chemical Substances Receptors, GABA-A
    Language English
    Publishing date 2023-05-23
    Publishing country New Zealand
    Document type Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1075770-3
    ISSN 1179-1969 ; 1170-229X
    ISSN (online) 1179-1969
    ISSN 1170-229X
    DOI 10.1007/s40266-023-01029-1
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  6. Article ; Online: Impact of caregiving for older people and pro-inflammatory biomarkers among caregivers: a systematic review.

    Potier, Florence / Degryse, Jean-Marie / de Saint-Hubert, Marie

    Aging clinical and experimental research

    2018  Volume 30, Issue 2, Page(s) 119–132

    Abstract: Introduction: Evidence suggests that providing care for an older loved one may present a risk to the health of the caregiver. To understand the link between the psychosocial stress of caregiving and damage to the health of caregivers, numerous studies ... ...

    Abstract Introduction: Evidence suggests that providing care for an older loved one may present a risk to the health of the caregiver. To understand the link between the psychosocial stress of caregiving and damage to the health of caregivers, numerous studies have assessed the presence of inflammatory biomarkers among caregivers. These biomarkers are measured to understand the relationships between the social stress of caregiving and the health of caregivers.
    Objective: To provide a complete summary of the current literature regarding the most clinically relevant pro-inflammatory biomarkers associated with caregiving.
    Methods: We searched articles in MEDLINE and EMBASE from January 1980 to 30 April 2016 for all studies that assessed biomarkers (cortisol, interleukin-6 and c-reactive protein) among caregivers of community-dwelling older persons. The quality of the selected studies was assessed by two reviewers using the STROBE or CONSORT checklist.
    Results: Twenty-four studies were included. Most of the studies were cross-sectional and focused on dementia caregiving. Increases in biomarkers were associated with problems such as disturbed sleep, burden or pain and caregiving characteristics, including daily stressors and the duration of caregiving. Cognitive-behavioural therapy and participation in leisure activities were associated with significantly lower levels of cortisol and IL-6, respectively.
    Discussion: We found little evidence concerning the association between caregiving status and biomarkers of stress and inflammation. We discuss potential sources of bias and suggest some directions for further research. This stress model can be expanded by taking into account the positive aspects of caregiving and the potential resources of caregivers.
    MeSH term(s) Aged ; Aged, 80 and over ; Biomarkers/blood ; C-Reactive Protein/analysis ; Caregivers/psychology ; Cross-Sectional Studies ; Dementia/nursing ; Dementia/psychology ; Female ; Humans ; Hydrocortisone/blood ; Interleukin-6/blood ; Male ; Stress, Psychological/blood
    Chemical Substances Biomarkers ; Interleukin-6 ; C-Reactive Protein (9007-41-4) ; Hydrocortisone (WI4X0X7BPJ)
    Language English
    Publishing date 2018-02
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 2104785-6
    ISSN 1720-8319 ; 1594-0667
    ISSN (online) 1720-8319
    ISSN 1594-0667
    DOI 10.1007/s40520-017-0765-0
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    Zs.A 3343: Show issues Location:
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  7. Article ; Online: Inappropriate low dosing of direct oral anticoagulants in older patients with non-valvular atrial fibrillation: Impact on plasma drug levels.

    Comans, Anne-Lore / Sennesael, Anne-Laure / Bihin, Benoît / Regnier, Maxime / Mullier, François / de Saint-Hubert, Marie

    Thrombosis research

    2021  Volume 201, Page(s) 139–142

    MeSH term(s) Administration, Oral ; Aged ; Anticoagulants/therapeutic use ; Atrial Fibrillation/complications ; Atrial Fibrillation/drug therapy ; Hemorrhage/drug therapy ; Humans ; Pharmaceutical Preparations ; Stroke/drug therapy ; Stroke/prevention & control
    Chemical Substances Anticoagulants ; Pharmaceutical Preparations
    Language English
    Publishing date 2021-03-03
    Publishing country United States
    Document type Letter
    ZDB-ID 121852-9
    ISSN 1879-2472 ; 0049-3848
    ISSN (online) 1879-2472
    ISSN 0049-3848
    DOI 10.1016/j.thromres.2021.02.034
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    Zs.A 863: Show issues Location:
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  8. Article ; Online: Prognostic value of the Surprise Question for one-year mortality in older patients: a prospective multicenter study in acute geriatric and cardiology units.

    Maes, Hanne / Van Den Noortgate, Nele / De Brauwer, Isabelle / Velghe, Anja / Desmedt, Marianne / De Saint-Hubert, Marie / Piers, Ruth

    Acta clinica Belgica

    2020  Volume 77, Issue 2, Page(s) 286–294

    Abstract: Objectives: To determine the prognostic value of the Surprise Question (SQ) in older persons.: Methods: A multicenter prospective study, including patients aged 75 years or older admitted to acute geriatric (AGU) or cardiology unit (CU). The SQ was ... ...

    Abstract Objectives: To determine the prognostic value of the Surprise Question (SQ) in older persons.
    Methods: A multicenter prospective study, including patients aged 75 years or older admitted to acute geriatric (AGU) or cardiology unit (CU). The SQ was answered by the treating physician. Patients or relatives were contacted after 1 year to determine 1-year survival. Logistic regression was used to explore parameters associated with SQ. Summary ROC curves were constructed to obtain the pooled values of sensitivity and specificity based on a bivariate model.
    Results: The SQ was positive (death within 1 year is no surprise) in 34.7% AGU and 33.3% CU patients (p = 0.773). Parameters associated with a positive SQ were more severe comorbidity, worse functionality, significant weight loss, refractory symptoms and the request for palliative care by patient or family. One-year mortality was, respectively, 24.9% and 20.2% for patients hospitalized on AGU and CU (p = 0.319). There was no difference in sensitivity or specificity, respectively, 64% and 77% (AUC 0.635) for AGU versus 63% and 76% (AUC 0.758) for CU (p = 0.870). A positive SQ is associated with a significant shorter time until death (HR 5.425 (95% CI 3.332-8.834), p < 0.001) independently from the ward.
    Conclusion: The Surprise Question is moderately accurate to predict 1-year mortality in older persons hospitalized on acute geriatric and cardiologic units.
    MeSH term(s) Aged ; Aged, 80 and over ; Cardiology ; Hospitalization ; Humans ; Palliative Care ; Prognosis ; Prospective Studies
    Language English
    Publishing date 2020-10-12
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 390201-8
    ISSN 2295-3337 ; 0001-5512 ; 1784-3286
    ISSN (online) 2295-3337
    ISSN 0001-5512 ; 1784-3286
    DOI 10.1080/17843286.2020.1829869
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  9. Article ; Online: A high sense of coherence protects from the burden of caregiving in older spousal caregivers.

    Potier, Florence / Degryse, Jean-Marie / Henrard, Séverine / Aubouy, Geneviève / de Saint-Hubert, Marie

    Archives of gerontology and geriatrics

    2017  Volume 75, Page(s) 76–82

    Abstract: Objectives: Caregiving is often associated with burden and chronic stress. Sense of coherence (SOC) may help the caregivers in coping with their stress and was identified as a positive factor for health outcomes and quality of life. We aimed to study ... ...

    Abstract Objectives: Caregiving is often associated with burden and chronic stress. Sense of coherence (SOC) may help the caregivers in coping with their stress and was identified as a positive factor for health outcomes and quality of life. We aimed to study the links between SOC, burden, depression and positive affects among caregivers of frail older patients.
    Methods: Seventy-nine spousal caregivers were recruited via the geriatric outpatient clinic.
    Data collected: Zarit Burden Inventory, SOC-13, Geriatric Depression Scale, Caregiver Reaction Assessment (CRA), sleep, time of supervision, Katz Index, Global Deterioration Scale and Neuropsychiatric Inventory.
    Analyses: Caregiver's characteristics were analyzed by burden severity and SOC level. Multivariable logistic regressions were used in order to identify the variable that best predict caregiver burden and high SOC.
    Results: The mean age was 79.4±5.3; 53% were women. Among care-recipient, 82% had cognitive impairment and the median Katz Index was 3. Caregivers with a high SOC and an older age reported a lower burden (Odds Ratio (OR) 0.18, 95% confidence interval (CI) 0.04-0.65 and OR 0.87, 95% CI 0.76-0.98, respectively). A higher burden was associated with patient functional limitations (OR 8.69, 95% CI 2.28-40.46).
    Discussion: Having a high sense of coherence seems to be a protective factor against the burden. To support caregivers, health providers should recognize the expertise of the caregivers and the meaningfulness of this care situation.
    MeSH term(s) Adaptation, Psychological ; Aged ; Aged, 80 and over ; Caregivers/psychology ; Cross-Sectional Studies ; Depression/prevention & control ; Depression/psychology ; Female ; Follow-Up Studies ; Humans ; Male ; Odds Ratio ; Quality of Life ; Retrospective Studies ; Sense of Coherence
    Language English
    Publishing date 2017-11-24
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 603162-6
    ISSN 1872-6976 ; 0167-4943
    ISSN (online) 1872-6976
    ISSN 0167-4943
    DOI 10.1016/j.archger.2017.11.013
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  10. Article ; Online: Interprofessional Teamwork in Acute Geriatric Care: Where Are the Pharmacists?

    Spinewine, Anne / Mouzon, Ariane / Dalleur, Olivia / de Saint Hubert, Marie / Cornette, Pascale / Schoevaerdts, Didier

    Journal of the American Geriatrics Society

    2017  Volume 66, Issue 2, Page(s) 416–417

    MeSH term(s) Aged ; Belgium ; Humans ; Interprofessional Relations ; Patient Care Team ; Pharmacists
    Language English
    Publishing date 2017-11-20
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 80363-7
    ISSN 1532-5415 ; 0002-8614
    ISSN (online) 1532-5415
    ISSN 0002-8614
    DOI 10.1111/jgs.15177
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