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Aim: Adherence to Mediterranean Diet (Med-Diet) has been associated with a lower incidence of chronic diseases and may be associated with lower risk for depression. The aim of the present study was to investigate (i) the association of adherence to Med-Diet with depressive symptoms and multimorbidity in a cohort of geriatric medical outpatients, and (ii) the role of Med-Diet in mediating the association between depressive symptoms and multimorbidity., Methods: A total of 143 geriatric patients (mean age: 73.1 ± 8.35) were included. Adherence to Med-Diet was evaluated using a validated 14-item questionnaire; depressive and cognitive symptoms were assessed through the 15-item Geriatric Depression Scale (GDS) and Mini Mental State Examination (MMSE) respectively; multimorbidity was evaluated using the Cumulative Illness Rating Scale for Geriatrics (CIRSG-SI)., Results: Significant associations were found between MDQ score, GDS and CIRSG-SI (MDQ score and GDS: r= -0.206, p = 0.014; MDQ score and CIRSG-SI: r= -0.247, p = 0.003; GDS and CIRSG-SI: r = 0.251; p = 0.003). These associations remained significant after adjusting for potential confounding factors. A mediational model analysis showed that the direct effect of CIRSG-SI on GDS was significant (b = 1.330; se = 0.59; p = 0.028) with this effect being counterbalanced by higher MDQ scores (indirect effect of CIRS-G on GDS through MDQ: b = 0.382; se = 0.19; p = 0.048)., Conclusion: These findings (i) add to the accumulating evidence that Med-Diet may have a positive impact on mental health in the elderly, and (ii) suggest that Med-Diet may contribute, at least in part, to protect geriatric patients with multimorbidity from the development of depressive symptoms, ultimately promoting healthy aging., Competing Interests: Declaration of Competing Interest There are not potential conflicts of interest to disclose. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. This research was presented in abstract form at the 25th European Congress of Psychiatry., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background and Purpose: Nonalcoholic fatty liver disease (NAFLD) is one of the causes of a fatty liver, occurring when fat is deposited (steatosis) in the liver not due to excessive alcohol use. It is related to insulin resistance and the metabolic syndrome. The purpose of the present study was to evaluate the impact of combination therapy with alpha-lipoic acid (ALA) and ursodeoxycholic acid (UDCA) on NAFLD., Methods: Alpha-lipoic acid 400 mg/day plus UDCA 300 mg/day (ALAUDCA) was investigated in patients over a period of 12 months using a randomized, placebo (PLA)-controlled study with four parallel groups. Serum concentration of gamma-glutamyl transpeptidase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin and platelets (PLT) were measured at the beginning and at the end of the treatment. Moreover, the AST/ALT ratio and the NAFLD fibrosis score were examined., Results: A total of 120 patients were randomly assigned to the four groups. ALA and UDCA were safe and well tolerated in the oral daily administration only. AST, ALT, GGT (p < 0.001) showed a significant difference between ALAUDCA and other three groups. Besides, NAFLD fibrosis score underlined a significant reduction (p < 0.04) in the ALAUDCA group, while AST/ALT ratio presented a moderate decline (p > 0.05)., Conclusion: ALAUDCA therapy reduced AST, ALT, GGT values and improved NAFLD fibrosis score and AST/ALT ratio, especially in patients who were on a hypocaloric diet. These findings will be useful in patient selection in future clinical trials with ALAUDCA in long-term studies.

Aims: Evaluating the prevalence and the degree of steatosis in geriatric patients (65 to 85 years of age) with Metabolic Syndrome (defined by ATP III criteria); searching for metabolic factors which are predictive for the degree of steatosis; evaluating the efficacy of Ursodeoxycholic Acid (UDCA) for 6 months in the treatment of patients with NAFLD or NASH., Materials and Methods: We studied 87 geriatric patients with Metabolic Syndrome. Steatosis was diagnosed and graded by laboratory assessment and ultrasonography, method based on the determination of liver/kidney ratio through grey-scale intensity, which was calculated as an index of the severity of the steatosis: it could oscilates from 0 (none) to 3 (severe). We randomized the geriatric patients into two groups: Ursodeoxycholic Acid (UDCA)-treated group (n=43 pz) and diet-treated group (1200 Kcal/die for female, 1500 Kcal/die for male) (n=44 pz), for a period of 6 months. BMI, principal symptoms, liver function, blood lipids, ultrasonography liver were evaluated respectively before and after treatment., Results: The prevalence of steatosis was 100% (26 mild steatosis cases, 38 moderate cases and 23 severe cases) in our patients with Metabolic Syndrome. Of the 43 subjects assigned to receive 300-450 mg/d of UDCA and diet, the hepatic steatosis index decreased on the average, of the 75%. Serum AST, ALT and γ-GT decreased significantly at 3 months already (p<0.001)., Conclusions: UDCA improves liver enzymes and ultrasonography immaging in geriatric patients with NAFLD or NASH. Unexpectedly, UDCA has resulted in beneficial effects on glycemic control and insulin sensitivity.

This is a case of 89 years old patient suffering by chronic obstructive pulmonary disease and affected by acute respiratory failure characterized by hypoxemia and hipercapnia. It is interesting because, comparing oxygen therapy and non invasive ventilation, the best results were reached with the last technique, in an elder patient.

Metabolic Syndrome (Metabolic Syndrome, MS) is associated with many other diseases in the elderly. We have studied a possible correlation between this disorder and depression in a Geriatric Centre. The study was conducted on a random sample of 30 geriatric patients, then divided into 2 groups according to clinical and instrumental diagnostic investigations: 15 patients affected MS according to the criteria of NCEP ATP III, and 15 controls without MS. Then it's administered the Geriatric Depression Scale (GDS). Elaboration of the results it appears statistically significant correlation (t=2.05, p=0.0495) between MS and depression in the elderly.