Think Forward.

GERIATRIE : LA NUTRITION FACE AU VIEILLISSEMENT PHYSIOLOGIQUE DES PERSONNES ÂGÉES - PARTIE 1 2455

Dr Moussayer khadija, 1 y.
- Science - Society - Health -
3.5 min read.
«QUAND ON AVANCE EN ÂGE, MIEUX VIVRE C’EST MIEUX SE NOURIR» L’équilibre nutritionnel de la personne âgée (PA) est plus précaire car tributaire de modifications physiologiques et de l’émergence de pathologies. Les personnes âgées ont tendance par ailleurs à diminuer leur apport alimentaire sans que leurs besoins énergétiques ne soient réduits : leurs réserves étant amoindries, tout incident rompt un équilibre déjà précaire et la dénutrition fait son apparition. L'IMPACT DU VIELLISSEMENT PHYSIOLOGIQUE SUR LA NUTRITION Avec l’âge, l’altération des perceptions des odeurs et du goût stimule moins l’appétit : la capacité discriminative s’affaiblit d’où une difficulté à identifier les aliments ; le seuil de détection des 4 saveurs de base augmente (multiplié par 11,6 pour le salé, 7 pour l’amer, 4,3 pour l’acide et 2,7 pour le sucré). Près de 400 médications (anti-inflammatoires, antidiabétiques oraux, inhibiteurs de l’enzyme de conversion…), des carences en zinc ou en vitamine B3, la cirrhose du foie ou la déshydratation perturbent le goût. La malnutrition aggrave ces déficiences, ralentissant ainsi le renouvellement cellulaire indispensable à la régénération des acteurs sensoriels. La perte d’appétit découle aussi d’une sénescence des glandes salivaire. Les aliments n’étant plus correctement imbibés, les molécules porteuses de saveurs appétissantes sont moins actives. De plus, la dégradation dentaire et la prédilection pour des aliments plus liquides diminuent les mouvements masticatoires ce qui va encore réduire cette sécrétion. La sécheresse buccale (xérostomie) est alors fréquente, exacerbée par de nombreux médicaments (diurétiques, benzodiazépines, antihistaminiques…), elle va favoriser les caries dentaires, les mycoses buccales et œsophagiennes, occasionnant des brûlures lors de l’ingestion et, in fine, gênant l’élocution et la déglutition. La muqueuse gastrique, en s’atrophiant, sécrète moins d’acide chlorhydrique, d’où une pullulation bactérienne consommatrice de nutriments (folates) et un retard à l’évacuation gastrique de 2 à 3 fois plus long, qui prolonge la phase d’anorexie post-prandiale. L’accélération plus importante chez la PA du transfert du chyme de la partie supérieure de l’estomac (le fundus) à la partie inférieure (l’antre) avec une distension précoce de cette dernière joue par ailleurs un rôle prépondérant dans le sentiment précoce de satiété. Un peptide, le CCK sérique (cholecystokime -pancreozymine), produit par le duodénum au cours du repas, stimule la sécrétion par le pancréas de la trypsine qui inhibe en retour la sécrétion de CCK. L’insuffisance pancréatique exocrine, liée à l’âge ou aggravée par une dénutrition, lève ce rétrocontrôle, d’où une production accrue de CCK à l’origine elle aussi d’une satiété précoce. La survenue plus fréquente chez la PA d’ulcères et de gastrites chroniques, en liaison avec une incidence plus élevée d’infection par Hélicobacter pylori, renforce encore le risque anorexique. Le vieillissement musculaire et la diminution du capital musculaire (sarcopénie) est un phénomène presque inéluctable qui commence à 40 ans pour l’homme contre 50 ans pour la femme. La perte -de 3 à 8 % tous les dix ans- s’accélère après 60 ans et réduit la musculature à 17% du poids du corps à 70 ans contre 30% à 30 ans. La composition en fibres du muscle se modifie : les fibres de type II, ou fibres blanches, à contraction rapide, mais peu résistantes à la fatigue, s’atrophient ; les fibres de type I ou fibres rouges, à contraction lente, générant peu de force, mais une forte endurance, sont moins affectées et leur densité serait même plus importante. Outre cette réduction de la force musculaire malgré une certaine préservation de l’endurance, le système nerveux contrôle moins bien ces contractions. Plusieurs facteurs génétiques, médicamenteux, nutritionnels ainsi que l’augmentation des cytokines (état inflammatoire provenant de l’accroissement de la masse grasse) conditionnent l’apparition de cette sarcopénie. Les hormones sexuelles joueraient aussi un rôle dans le contrôle de l’appétit au cours du vieillissement. La diminution des taux circulants de testostérone observée au moment de l’andropause induirait la perte d’appétit chez l’homme âgé et précipiterait le développement de la sarcopénie. À l’inverse, la réduction de sécrétion des œstrogènes à la ménopause protégerait les femmes de cette perte. Les répercussions de la sarcopénie sont considérables : risques infectieux par baisse des réserves protéiques nécessaires aux défenses immunitaires, chutes et fractures éventuelles compromettant l’autonomie de la PA… Un moindre volume musculaire expose aussi la PA aux troubles de la thermorégulation, la baisse de l’intensité du frissonnement qui en découle rendant la PA plus démunie face à l’exposition au froid. Dr MOUSSAYER KHADIJA الدكتورة خديجة موسيار Spécialiste en médecine interne et en Gériatrie en libéral à Casablanca. Présidente de l’Alliance Maladies Rares Maroc (AMRM) et de l’association marocaine des maladies auto-immunes et systémiques (AMMAIS), Vice-présidente du Groupe de l’Auto-Immunité Marocain (GEAIM) - REFERENCE MOUSSAYER KHADIJA Doctinews N° 25 Août/Septembre 2010, ACTUALISATION JUIN 2024 - POUR EN SAVOIR PLUS : La plupart des personnes âgees souffrent de maladies chronique le plus souvent d'origine auto-immune Les maladies auto-immunes résultent d’un dysfonctionnement du système immunitaire, censé nous protéger des agressions extérieures, qui va le conduire à s’attaquer à notre propre organisme. Elles constituent un important problème de santé publique du fait de leur poids économique et humain : 3ème cause de morbidité dans le monde après les maladies cardiovasculaires et les cancers, elles touchent en effet près de 10 % de la population mondiale et occupent le deuxième ou le troisième poste du budget de la santé dans beaucoup de pays. Enfin, dernier point méconnu mais pas le moindre, ces maladies concernent les femmes dans plus de 75 % des cas : une femme sur six en est atteinte au cours de sa vie ! Passons donc en revue ce que sont ces pathologies et les actions de l’associations AMMAIS UN PROCESSUS D'AUTODESTRUCTION DE L'ORGANISME Notre système immunitaire est composé notamment de cellules spécialisées comme les lymphocytes et de substances (les anticorps) chargées normalement de nous défendre contre toute attaque extérieure provenant de différents virus, bactéries, champignons et autres produits délétères. Lors d’une maladie auto-immune (MAI) ou à manifestations auto-immunes, des éléments de ce système se trompent d’ennemi et s’en prennent à nos tissus et cellules. Certains anticorps devenus nos adversaires s’appellent alors « auto-anticorps ». Au total, il existe près d’une centaine de ces troubles.
Dr Moussayer khadija

Dr Moussayer khadija

Dr MOUSSAYER KHADIJA الدكتورة خديجة موسيار Spécialiste en médecine interne et en Gériatrie en libéral à Casablanca. Présidente de l’Alliance Maladies Rares Maroc (AMRM) et de l’association marocaine des maladies auto-immunes et systémiques (AMMAIS), Vice-présidente du Groupe de l’Auto-Immunité Marocain (GEAIM)


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Moroccans’ Relationship to the Law: A Great Misunderstanding… 141

Aziz Daouda, 12 h.
- Politics - Society - Lifestyle -
3.2 min read.
The relationship between Moroccans and the law reveals a profound ambiguity, fueled by a build-up of paradoxes and historical, cultural, and political contradictions. It cannot be explained solely by a lack of communication or pedagogy, but by a deeply rooted perception in which the law is not seen as a collective framework to be respected out of conviction, but as an external constraint, often imposed and rarely internalized. First, one must highlight the ignorance—sometimes deliberate—of the very existence of many laws. In numerous cases, the Moroccan citizen only discovers a text when it is opposed to them in a conflictual situation. This reactive, rather than proactive, relationship with the law generates paradoxical behaviors: resigned acceptance when it imposes itself forcefully, but also recourse to excuses, justifications, or feigned ignorance whenever its application becomes restrictive. To this lack of knowledge is added an ambivalent attitude: the law is respected not out of moral adherence, but out of fear of sanction. Road traffic provides the clearest illustration: the presence of a police officer results in scrupulous respect for the code, while their absence unleashes anarchic behavior. In other words, authority substitutes for civic conviction. But the problem does not lie solely in individual behavior. The legal framework itself suffers from a lack of updating and adaptation. Many Moroccan laws are inherited from a bygone era, conceived in another social context, and struggle to address today’s realities. The legislative process, too slow and often opaque, widens the gap between texts and citizens’ aspirations. Public debates on bills are rare, if not nonexistent, and civil society finds only a marginal place in them. This democratic shortfall is compounded by the chronic passivity of political parties and the decline of union membership, depriving the public arena of genuine contradictory debate. The situation is also aggravated by the language issue: when debates do take place, laws are written, discussed, published, and applied in a language that is not the everyday language of Moroccans. Added to this is the perception of institutional inefficiency: a parliament marked by a lack of competence and seriousness, a political elite sometimes disconnected, and local authorities unable to translate citizens’ needs into effective texts and decisions. Thus, some laws appear disconnected—or even foreign—to social realities. They sometimes criminalize harmless behaviors that harm neither the individual nor the community, but instead reflect the imposition of a conservative morality at the expense of individual freedom. Religious morality is never far away. Hence the crucial question: where does law end and morality begin? And above all, what place should ethics have in the governance of a country in transition, a country aspiring to development and modernity and making colossal efforts in that direction? Faced with these gaps, citizens develop strategies of adaptation, sometimes of survival. The law becomes flexible, respected or not depending on the situation, depending on the eye of authority. Respect is no longer a conviction but a calculation. But can one demand respect for a law perceived as illegitimate, useless, or unjust? Can texts be maintained in force when the majority of citizens systematically bypass them, and even the agents charged with enforcing them transgress them individually? This ambiguous relationship is built from childhood, in the transmission of social norms. A child learns at school that alcohol is forbidden out of respect for religion and the law, but at home or nearby sees it consumed casually. They are taught respect for the traffic code, but their father runs red lights whenever the police are not around. This contradictory education creates lasting confusion between proclaimed values and lived practices, reinforcing the idea that the law is not a universal rule but a contextual constraint. Thus emerges a sense of fear rather than respect for laws, a belief that they are meant for others and not oneself; a perception that the law is imposed rather than serving to protect everyone’s rights. Social networks and certain public voices, as YouTuber Maysa recently did, contribute to exposing these inconsistencies. In a video, she highlighted the multiple Moroccan laws that, although still in force, are almost never applied. This illustrates an implicit permissiveness that undermines the credibility of the rule of law. A law that exists without being enforced becomes a mere symbol, even an instrument of arbitrary selectivity. It should at the very least be revised. Law is not meant to be a mere tool of control, much less an end in itself. It must enable social harmony, protect freedoms, and regulate collective life. It must evolve with its time, reflect society’s aspirations, and avoid imposing outdated modes of thought. Today, Moroccans have changed, their lifestyles have evolved, but the legal framework and collective mentality remain frozen in old representations. Many openly speak of “social hypocrisy,” denouncing the double language between words and deeds in public, between official discourse and actual practices. Breaking out of this ambiguity requires a twofold shift: on the one hand, a bold legal reform that adapts laws to social realities and contemporary values; on the other, an effort of awareness-raising and education to reconcile citizens with the law. This transformation can only succeed if Moroccans agree to break with the social ambivalence and split personality that corrode daily behaviors. Reflection on the relationship between Moroccan citizens and the law thus opens a broader field: that of ethics, social evolution, and modernization of the legal framework. A state of law cannot thrive without collective adherence, and a society cannot be built on rules that everyone strives to circumvent. Restoring the law’s legitimacy and credibility is to lay the foundations for a more coherent, just, and respected coexistence. Judging from the clashes around the *Moudawana* and other legislative projects—between the Minister of Justice and certain parliamentarians of a political current that sees itself as guardian of the temple—it seems difficult to move forward at the necessary speed in today’s world.

Heinrich Cornelius Agrippa 421

Tupan, 2 d.
Heinrich Cornelius Agrippa von Nettesheim (1486–1535) was a German polymath, physician, soldier, and occult philosopher whose writings laid the intellectual foundations for much of the Western esoteric tradition. He is best known for his magnum opus, *De Occulta Philosophia Libri Tres* (Three Books of Occult Philosophy), a comprehensive synthesis of magic, Kabbalah, Neoplatonism, Hermeticism, and Christian mysticism. In Agrippa, the currents of the Renaissance—scientific curiosity, classical revival, and spiritual yearning—converged in a deep and somewhat controversial body of work. Born in Cologne in 1486, Agrippa was educated in classical literature, theology, and law, but he also immersed himself in the esoteric arts—alchemy, astrology, angelology, and ceremonial magic. He traveled widely across Europe, engaging with scholars, nobility, and religious authorities. He often served as a physician and lecturer, while simultaneously pursuing his deeper passion for the hidden structure of reality that he believed could be revealed through magickal philosophy. Agrippa was a direct student and correspondent of Johannes Trithemius (1462-1516), the abbot of Sponheim and a key figure in early modern magical and cryptographic studies. Trithemius, known for his own influential work *Steganographia*, served as a mentor who inspired Agrippa’s lifelong pursuit of hidden knowledge and spiritual science. He also encouraged Agrippa to refine his ideas on occult philosophy into a systematic form, which would later become *De Occulta Philosophia*. In *De Occulta Philosophia*, Agrippa organizes magick into three interconnected worlds: 1) The Elemental world, governed by natural philosophy and the powers of the four elements (earth, water, air, fire). 2) The Celestial world, influenced by the movements of the stars and planets—i.e., astrology. 3) The Intellectual or Divine world, ruled by angelic hierarchies, divine archetypes, and the mysteries of the Kabbalah. For Agrippa, true magick was not superstition but a sacred science, a means by which the human soul could ascend through the created order toward union with the divine. He viewed the magician not as a manipulator of forces for selfish ends, but as a philosopher-priest who, through study, virtue, and divine illumination, could harmonize with the cosmos and act as a mediator between heaven and earth. Yet Agrippa’s life was marked by tension and contradiction. He often ran into problems with church authorities, accused of heresy or subversion. In his later years, he published *De Incertitudine et Vanitate Scientiarum* (On the Uncertainty and Vanity of the Sciences), a scathing critique of dogmatic knowledge, including his own magickal writings—though many scholars interpret this as rhetorical irony or spiritual disillusionment rather than renunciation. Agrippa died in 1535, likely in Grenoble. Though seen by some as a charlatan and heretic, his influence endures until today. His Occult Philosophy became a cornerstone of Renaissance magic, shaping later figures like John Dee, Giordano Bruno, and Eliphas Levi. Even modern Hermetic and ceremonial traditions—such as the Hermetic Order of the Golden Dawn—owe much to Agrippa’s system of correspondences and metaphysical cosmology. Nowadays, Agrippa is recognized not merely as a magician, but as a pioneer of symbolic thought, a bridge between medieval mysticism and modern esotericism. His work continues to guide and inspire those who seek the hidden harmonies of the universe—through reason, reverence, and the transformative power of the imagination.

Perfect Imperfection 537

El Hombre Galan, 2 d.
- Poetry -
0.4 min read.
She has beautiful imperfection The right kind of right The sad song played happily when the black dog critic cries here after her Fragility and lies from un-cropped truth- this is something entirely surreal Hold on to embrace her necessity, and life gives life to her again The failed faucets of memories are for the taking- hurry up, love and let’s start to make mementos See the seas to sight and songs played loudly, quiet between the space of us I am trust and bare bones, I see the perfect imperfection in passing lines formed on your face Imperfection by society's eyes and mouth, unmoved and unbreakable determination - you make the bitter taste sweet. You are perfect imperfection.