Dynamic Predictions of the Links Between Psychological and Physical Health of Older Patients in Nursing Home

NCT ID: NCT05729906

Last Updated: 2024-12-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-03-28

Study Completion Date

2024-07-19

Brief Summary

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Taking the older person as a whole is now essential to age well and prevent loss of functional independence. However, the relationship between physical and mental health remains not well understood. Combining the exploration of markers of inflammation, endocrine, nutritional, and metabolic functions, along with long-term monitoring of older persons, could allow for a comprehensive understanding of the biological phenotype, regardless of underlying pathologies. The primary objective will be to simultaneously test the psychosomatic model and the disability model in order to more fully account for the dynamic causal relationships between physical and mental health in older people. The investigators will investigate the mediating role of the biological phenotype on these relationships between mental and physical health. The independent and then combined analysis of specific candidate biomarkers will open up the possibility of identifying a biological mediation between mental and physical health. Furthermore, this will also allow us to deepen our understanding of the evolution of the immune-endocrine-metabolic state and, more broadly, of the biological phenotype of older people during aging.

Detailed Description

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Promoting the health of older people to better support them remains one of the major challenges of the 21st century. More and more experts in gerontology (doctors, psychologists, sociologists, ...) are now advocating a holistic approach to older people. The recent recommendations of the WHO (2016) also invite us to favor an approach to aging centered on the potentialities and resources of older people more than on their deficiencies and diseases. Thus, taking into account the older person in his or her entirety ("body and mind") is a must for aging well and preventing the loss of functional independence. However, the relationship between physical and mental health remains poorly understood.

The psychosomatic model postulates that well-being and positive affects have an impact on physical health. It has thus been shown that good psychological health (e.g., positive mood, hope, optimism) has long-term beneficial effects on longevity, cardiovascular health, and chronic diseases. Conversely, poor mental health (e.g., presence of depressive symptoms) affects the health of older subjects and increases mortality risk. These results are in line with the so-called top-down approaches which postulate that well-being is a psychological trait that is the cause of future personal evaluations. In this psychosomatic approach, well-being, positive affect (i.e., good psychological health), is seen as antecedent to physical health. Naturally, it would seem unlikely that well-being would predict improved health for older people. However, well-being or the presence of positive affect could well predict different trajectories of "health" in ill older people.

In contrast, the so-called disability model postulates that physical health problems have an impact on psychological health, including well-being. This bottom-up approach considers physical health problems as antecedents of well-being. A study conducted by members of the laboratory supporting this project argues for this approach. The results show that poor physical health would unidirectionally predict poor life satisfaction over the long term.However, no study to date has been able to confirm the prevalence of one model over the other.

The main hypothesis of this research is based on the presence of a bi-directional pattern between physical and psychological health, and thus on the absence of a unique prevalence of one pattern over the other for the entire target elderly population. The investigators also hypothesize that the causal links between physical and psychological health may vary over time as a function of specific mediators, including inflammatory and metabolomic profiles. Our second hypothesis thus postulates that biological profiles could mediate the bi-directional links between physical and psychological health. For example, the investigators know that negative psychological affects have a negative impact on our "physical" health, so the investigators can assume that positive psychological affects can produce an anti-inflammatory effect, thus allowing us to be in better physical health (protective factor).

Conditions

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Psychological Health Physical Health

Keywords

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mental health physical health psychosomatic model disability model inflammation metabolomics nursing home frailty inflamm'aging

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Interventions

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psychological and physical tests

Once included (T0), participants will be reviewed at 6 (T1), and 12 (T2) months. At the three measurement times, research professionals (belonging to the PAVeA laboratory) will carry out, within the nursing home the physical and psychological measurements (classic standardized tests for the population). These measurements will be carried out in parallel with the routine biological explorations performed in the institution.

At each visit, the remaining blood sampled in routine will be frozen in 2 aliquots for metabolomic and spectrometric analyses at the end of the study by the iBrain and Research Center for Respiratory Diseases laboratories.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Institutionalized older adults over 65

Exclusion Criteria

* older adults in palliative care
* older adults with severe cognitive impairment (MMSE \<11)
* Opposition to data processing from the older adult or his/her guardian/trustee if under legal protection
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institut National de la Santé Et de la Recherche Médicale, France

OTHER_GOV

Sponsor Role collaborator

Research Center for Respiratory Diseases, Inserm U1100

UNKNOWN

Sponsor Role collaborator

University Hospital, Tours

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Wassim GANA

Role: PRINCIPAL_INVESTIGATOR

CHRU de Tours

Locations

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EHPAD CHIC Amboise/Chateau-Renault

Château-Renault, , France

Site Status

EHPAD Les Groussins

Chinon, , France

Site Status

EHPAD Paul Martinais

Loches, , France

Site Status

EHPAD Le Clos Mignot

Luynes, , France

Site Status

EHPAD l'Ermitage

Tours, , France

Site Status

Countries

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France

References

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Other Identifiers

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DR220209-BioMIND

Identifier Type: -

Identifier Source: org_study_id