Motifs d’adhésion à une activité physique adaptée chez des seniors en ALD

International audienc

Retour d’expérience sur la mise en œuvre d’une action départementale d’activité physique pour les seniors

International audienc

Alzheimer's disease: Estimating its prevalence rate in a French geographical unit using the National Alzheimer Data Bank and national health insurance information systems.

BackgroundReliable epidemiological data on Alzheimer's disease are scarce. However, these are necessary to adapt healthcare policy in terms of prevention, care and social needs related to this condition. To estimate the prevalence rate in the Alpes-Maritimes on the French Riviera, with a population of one million, we present a capture-recapture procedure applied to cases of Alzheimer's disease, based on two epidemiological surveillance systems.MethodsTo estimate the total number of patients affected by Alzheimer's disease, a capture-recapture study included a cohort of patients with Alzheimer's disease or receiving medications only eligible for use for this condition, recorded by a specific health insurance information system (Health Insurance Cohort, HIC), and those registered in the French National Alzheimer's Data Bank ("Banque Nationale Alzheimer", BNA) in 2010 and 2011. We applied Bayesian estimation of the Mt ecological model, taking into account age and gender as covariates, i.e. factors of inhomogeneous catchability.ResultsOverall, 5,562 patients with Alzheimer's disease were recorded, of whom only 856 were common to both information systems. Mean age and F/M sex ratio differed between BNA and HIC surveillance systems, 81 vs 84 years and 2.7 vs 3.2, respectively. A Bayesian estimation, with age and gender as covariates, yields an estimate of 15,060 cases of Alzheimer's disease [95%HPDI: 14,490-15,630] in the Alpes-Maritimes. The completeness of the HIC and BNA databases were respectively of 25.4% and 17.2%. The estimated prevalence rate among the population over 65 years old was 6.3% in 2010-2011.ConclusionsThis study demonstrates that it is possible to determine the number of subjects affected by Alzheimer's disease in a geographical unit, using available data from two existing surveillance systems in France, i.e. 15,060 cases in the Alpes-Maritimes. This is the first stage of a population-based approach in view of adapting available resources to the population's needs

Protocol of the “As du Coeur” study: a randomized controlled trial on physical activity maintenance in cardiovascular patients

International audienceAlthough the benefits of supervised physical activity programs in cardiac rehabilitation have been well documented, the amount of physical activity often drops quickly after the end of the supervised period. This trial (registered as ISRCTN77313697 ) will evaluate the effectiveness of an experimental intervention based on habit formation theory applied to physical activity maintenance

“As du Coeur” study: a randomized controlled trial on physical activity maintenance in cardiovascular patients

Abstract Background The benefits of supervised physical activity programs in cardiac rehabilitation have been amply demonstrated, but the quantity of physical activity often declines quickly once supervision ends. This trial assesses the effectiveness of an experimental intervention drawing on habit formation theory to maintain physical activity. Methods Cardiovascular patients (N = 47) were randomly assigned to one of two groups. The first group participated in two supervised physical activity (SPA) sessions per week for 20 weeks. The second group was offered a progressively autonomous physical activity (PAPA) program as follows: the same supervised program as the SPA group for 10 weeks and then a further 10 weeks with one supervised session replaced by a strategy to build and sustain the habit of autonomous physical activity. The International Physical Activity Questionnaire (IPAQ; Craig et al. Med Sci Sports Exerc 35(8):1381–1395, 2003) was used to measure the quantity of physical activity, which was the primary outcome. The number of participants was limited, and we thus took multiple IPAQ measurements (at 0, 5, 7, 9 and 12 months after the start of the intervention) and used a mixed model for analysis. Physical condition, automaticity of the physical activity behavior, motivation, and quality of life were examined for changes. Results No significant between-group differences were noted for physical activity behaviors after the program, physical condition, motivation, or behavioral automaticity. The PAPA group nevertheless completed more PA sessions during the intervention, and their quality of life was significantly higher than that of the SPA group at 12 months. Conclusion Although the number of supervised sessions was lower, the progressively autonomous PA program resulted in the same or even higher positive outcomes than the fully supervised PA program. Trial registration Current Controlled Trials ISRCTN77313697, retrospectively registered on 20 November 2015

: Evaluate the socio-economic impacts of health-enhancing-physical activity in France

There is strong evidence that physical activity has various benefits on health in primary, secondary and tertiary prevention. However, studies on the socio-economic impacts of Health-Enhancing Physical Activity (HEPA) still remains scant, particularly in the French context. The aim of this report was to explore the grey and scientific literature to identify studies evaluating the socio-economic impacts of HEPA policies and to put forward some research perspectives. Based on twenty studies conducted in France, this report showed that reducing sedentary behavior and promoting of HEPA might generate substantial savings. Nevertheless, new studies must leaded to estimate more precisely the extent of the savings that could be generated according to the environments and populations targeted by HEPA policies.Il existe un haut niveau de preuve scientifique sur les effets bénéfiques sur la santé desactivités physiques et/ou sportives en prévention primaire, secondaire et tertiaire. Cependant, les études portant sur l’évaluation des différents impacts socio-économiques des activités dites de sport-santé sont encore rares, en particulier dans le contexte français. L'objectif de ce rapport est d'explorer la littérature afin de recenser les travaux qui évaluent les impacts socio- économiques des actions relevant de la politique nationale sport-santé en France afin d’avancer des pistes de réflexion sur le sujet et de favoriser le déploiement de ce type de recherche. En se basant sur une vingtaine d’études menées en France, ce rapport montre que la lutte contre la sédentarité et la promotion des activités physiques et sportives relevant de la politique sport-santé peut générer des économies substantielles. Néanmoins, de nouvelles études doivent êtreencore développées afin d’estimer plus précisément l’ampleur des économies qui pourraient être générées en fonction des milieux et des populations ciblés

: Evaluate the socio-economic impacts of health-enhancing-physical activity in France

There is strong evidence that physical activity has various benefits on health in primary, secondary and tertiary prevention. However, studies on the socio-economic impacts of Health-Enhancing Physical Activity (HEPA) still remains scant, particularly in the French context. The aim of this report was to explore the grey and scientific literature to identify studies evaluating the socio-economic impacts of HEPA policies and to put forward some research perspectives. Based on twenty studies conducted in France, this report showed that reducing sedentary behavior and promoting of HEPA might generate substantial savings. Nevertheless, new studies must leaded to estimate more precisely the extent of the savings that could be generated according to the environments and populations targeted by HEPA policies.Il existe un haut niveau de preuve scientifique sur les effets bénéfiques sur la santé desactivités physiques et/ou sportives en prévention primaire, secondaire et tertiaire. Cependant, les études portant sur l’évaluation des différents impacts socio-économiques des activités dites de sport-santé sont encore rares, en particulier dans le contexte français. L'objectif de ce rapport est d'explorer la littérature afin de recenser les travaux qui évaluent les impacts socio- économiques des actions relevant de la politique nationale sport-santé en France afin d’avancer des pistes de réflexion sur le sujet et de favoriser le déploiement de ce type de recherche. En se basant sur une vingtaine d’études menées en France, ce rapport montre que la lutte contre la sédentarité et la promotion des activités physiques et sportives relevant de la politique sport-santé peut générer des économies substantielles. Néanmoins, de nouvelles études doivent êtreencore développées afin d’estimer plus précisément l’ampleur des économies qui pourraient être générées en fonction des milieux et des populations ciblés

“As du Coeur” study: a randomized controlled trial on quality of life impact and cost effectiveness of a physical activity program in patients with cardiovascular disease

Abstract Background Physical activity programs (PAP) in patients with cardiovascular disease require evidence of cost-utility. To assess improvement in health-related quality of life (QoL) and reduction of health care consumption of patients following PAP, a randomized trial was used. Methods Patients from a health insurance company who had experienced coronary artery disease or moderate heart failure were invited to participate (N = 1891). Positive responders (N = 50) were randomly assigned to a progressively autonomous physical activity (PAPA) program or to a standard supervised physical activity (SPA) program. The SPA group had two supervised sessions per week over 5 months. PAPA group had one session per week and support to aid habit formation (written tips, exercise program, phone call). To measure health-related quality of life EQ-5D utility score were used, before intervention, 6 months (T6) and 1 year later. Health care costs were provided from reimbursement databases. Results Mobility, usual activities and discomfort improved significantly in both group (T6). One year later, EQ-5D utility score was improved in the PAPA group only. Total health care consumption in the intervention group decreased, from a mean of 4097 euros per year before intervention to 2877 euros per year after (p = 0.05), compared to a health care consumption of 4087 euros and 4180 euros per year, in the total population of patients (N = 1891) from the health insurance company. The incremental cost effectiveness ratio was 10,928 euros per QALYs. Conclusion A physical activity program is cost-effective in providing a better quality of life and reducing health care consumption in cardiovascular patients. Trial registration ISRCTN77313697, retrospectively registered on 20 November 2015