Search

Your search keyword '"Vetrano, D. L."' showing total 36 results
Start Over Author "Vetrano, D. L."
36 results on '"Vetrano, D. L."'

1. Delirium and frailty in older adults: Clinical overlap and biological underpinnings

Author

Bellelli, G, Triolo, F, Ferrara, M, Deiner, S, Morandi, A, Cesari, M, Davis, D, Marengoni, A, Inzitari, M, Watne, L, Rockwood, K, Vetrano, D, Bellelli G., Triolo F., Ferrara M. C., Deiner S. G., Morandi A., Cesari M., Davis D., Marengoni A., Inzitari M., Watne L. O., Rockwood K., Vetrano D. L., Bellelli, G, Triolo, F, Ferrara, M, Deiner, S, Morandi, A, Cesari, M, Davis, D, Marengoni, A, Inzitari, M, Watne, L, Rockwood, K, Vetrano, D, Bellelli G., Triolo F., Ferrara M. C., Deiner S. G., Morandi A., Cesari M., Davis D., Marengoni A., Inzitari M., Watne L. O., Rockwood K., and Vetrano D. L.

Abstract

Frailty and delirium are two common geriatric syndromes sharing several clinical characteristics, risk factors, and negative outcomes. Understanding their interdependency is crucial to identify shared mechanisms and implement initiatives to reduce the associated burden. This literature review summarizes scientific evidence on the complex interplay between frailty and delirium; clinical, epidemiological, and pathophysiological commonalities; and current knowledge gaps. We conducted a PubMed systematic search in June 2023, which yielded 118 eligible articles out of 991. The synthesis of the results—carried out by content experts—highlights overlapping risk factors, clinical phenotypes, and outcomes and explores the influence of one syndrome on the onset of the other. Common pathophysiological mechanisms identified include inflammation, neurodegeneration, metabolic insufficiency, and vascular burden. The review suggests that frailty is a risk factor for delirium, with some support for delirium associated with accelerated frailty. The proposed unifying framework supports the integration and measurement of both constructs in research and clinical practice, identifying the geroscience approach as a potential avenue to develop strategies for both conditions. In conclusion, we suggest that frailty and delirium might be alternative—sometimes coexisting—manifestations of accelerated biological aging. Clinically, the concepts addressed in this review can help approach older adults with either frailty or delirium from a different perspective. From a research standpoint, longitudinal studies are needed to explore the hypothesis that specific pathways within the biology of aging may underlie the clinical manifestations of frailty and delirium. Such research will pave the way for future understanding of other geriatric syndromes as well.

Published
2024

2. Comorbidity patterns and health-related outcomes in older adults with atrial fibrillation: nationwide population-based findings from swedish national patient register

Author

Dai, L, primary, Larranaga, A C, additional, Damiano, C, additional, Cordsen, P, additional, Luo, H, additional, Wastesson, J, additional, Johnell, K, additional, Onder, G, additional, Triolo, F, additional, Amrouch, C, additional, Petrovic, M, additional, Lip, G, additional, Johnsen, S P, additional, and Vetrano, D L, additional

Published
2023
Full Text
View/download PDF

8. Biomarkers shared by frailty and sarcopenia in older adults: A systematic review and meta-analysis

Author

Picca, A., Coelho-Junior, H. J., Calvani, Riccardo, Marzetti, Emanuele, Vetrano, D. L., Calvani R. (ORCID:0000-0001-5472-2365), Marzetti E. (ORCID:0000-0001-9567-6983), Picca, A., Coelho-Junior, H. J., Calvani, Riccardo, Marzetti, Emanuele, Vetrano, D. L., Calvani R. (ORCID:0000-0001-5472-2365), and Marzetti E. (ORCID:0000-0001-9567-6983)

Abstract

Background: Physical frailty and sarcopenia show extensive clinical similarities. Whether biomarkers exist that are shared by the two conditions is presently unclear. Methods: We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated the association of frailty and/or sarcopenia with biomarkers as a primary or secondary outcome in adults aged 60 years and older. Only studies published in English that defined frailty using a validated scale and/or questionnaire and diagnosed sarcopenia according to the presence of muscle atrophy plus dynapenia or low physical function were included. Studies were identified from a systematic search of MEDLINE and SCOPUS databases from inception through August 2020. The quality of reporting of each study was assessed by using the Quality Assessment Tool for Observational Cohort, Cross-Sectional and Case-Control studies of the National Institute of Health. A meta-analysis was conducted when at least three studies investigated the same biomarker in both frailty and sarcopenia. Pooled effect size was calculated based on standard mean differences and random-effect models. Sensitivity analysis was performed based on age and the setting where the study was conducted. Results: Eighty studies (58 on frailty and 22 on sarcopenia) met the inclusion criteria and were included in the qualitative analysis. Studies on frailty included 33,160 community-dwellers, hospitalized, or institutionalized older adults (60–88 years) from 21 countries. Studies on sarcopenia involved 4904 community-living and institutionalized older adults (68–87.6 years) from 9 countries. Several metabolic, inflammatory, and hematologic markers were found to be shared between the two conditions. Albumin and hemoglobin were negatively associated with both frailty and sarcopenia. Interleukin 6 was associated with frailty and sarcopenia only in people aged < 75. Community-dwelling older adults with frailty and sarcopenia had

Published
2022

10. The sarcopenia and physical frailty in older people: multi-component treatment strategies (SPRINTT) project: description and feasibility of a nutrition intervention in community-dwelling older Europeans

Author

Jyvakorpi S. K., Ramel A., Strandberg T. E., Piotrowicz K., Blaszczyk-Bebenek E., Urtamo A., Rempe H. M., Geirsdottir O., Vagnerova T., Billot M., Larreur A., Savera G., Soriano G., Picauron C., Tagliaferri S., Sanchez-Puelles C., Cadenas V. S., Perl A., Tirrel L., Ohman H., Weling-Scheepers C., Ambrosi S., Costantini A., Pavelkova K., Klimkova M., Freiberger E., Jonsson P. V., Marzetti E., Pitkala K. H., Landi F., Calvani R., Bernabei R., Boni C., Brandi V., Broccatelli M., Celesti C., Cicchetti A., Collamati A., Coretti S., D'Angelo E., D'Elia M., Landi G., Lorenzi M., Mariotti L., Martone A. M., Ortolani E., Pafundi T., Picca A., Ruggeri M., Salini S., Tosato M., Vetrano D. L., Lattanzio F., Baldoni R., Bernabei S., Bonfigli A. R., Bustacchini S., Carrieri B., Cassetta L., Cherubini A., Cucchi M., Cucchieri G., Costantini A. R., Dell'Aquila G., Espinosa E., Fedecostante M., Fraternali R., Galeazzi R., Mengarelli A., Piomboni S., Posacki E., Severini E., Tregambe T., Trotta F., Maggio M., Lauretani F., Butto V., Fisichella A., Guareschi C., Longobucco Y., Di Bari M., Rodriguez-Manas L., Alamo S., Bouzon C. A., Gonzales Turin J., Zafra O. L. L., Picazo A. L., Sepulveda L. P., SanchezSanchez J. L., Puelles C. S., Aragones M. V., CruzJentoft A. J., Santos J. A., Alvarez-Nebreda L., JimenezJimenez N. F., Nozal J. M. -D., Montero-Errasquin B., Moreno B. P. B. P., Roldan-Plaza C., Vicente A. R. -D., Sanchez-Cadenas V., Sanchez-Castellano C., Sanchez-Garcia E., Vaquero-Pinto M. N., Topinkova E., Bautzka L., Blechova K., Gueye T., Juklickova I., Klbikova T., Krenkova J. J., Madlova P., Mejstrikova H., Melcova R., Michalkova H., Ryznarova I., Drastichova I., Hasalikova E., Hucko R., Jakub S., Janacova M., Kilmkova M., Parizkova M., Redrova M., Ruskova P. P., Sieber C. C., Auerswald T., Engel C., Franke A., Freibergen E., Freiheit U., Gotthardt S., Kampe K., Kob R., Kokott C., Kraska C., Meyer C., Reith V., Rempe H., Schoene D., Sieber G., Zielinski K., Anker S. D., Ebner N., Grutz R., von Haehling S., Schols A. M. W. J., Gosker H., Huysmans S., Quaaden S., Schols J. M., Smeets N., Stevens P., van de Bool C., Weling C., Strandberg T., Jyvakorpi S., Hallikas K., Herranen M., Huusko T., Hytonen L., Ikonen K., Karppi-Sjoblom A., Karvinen K., Kayhty M., Kindsted T., Landstrom E., Leirimaa S., Pitkala K., Punkka A., Saavalainen A. -M., Salo T., Sepa M., Sohlberg K., Vaatamoinen E., Venalainen S., Vanhanen H., Vellas B., Van Kan G. A., Biville V., Brigitte L., Cervera C., Cesari M., Champarnaud M., Cluzan C., Croizet M., Dardenne S., Dorard M., Dupuy C., Durand E., Faisant C., Fougere B., Girard P., Guyonnet S., Hoogendijk E., Mauroux R., Milhet A., Montel S., Ousset P. -J., Teguo M. T., Teysseyre B., Andrieu S., Blasimme A., Dray C., Rial-Sebbag E., Valet P., Dantoine T., Cardinaud N., Castelli M., Charenton-Blavignac M., Ciccolari-Micaldi C., Gayot C., Laubarie-Mouriet C., Marchesseau D., Mergans T., Nguyen T. B., Papon A., Ribet J., Saulinier I., Tchalla A., Rapp T., Sirven N., Skalska A., Blaszcyk E., Cwynar M., Czesak J., Fatyga P., Fedyk-Lukasik M., Grodzicki T., Jamrozik P., Janusz Z., Klimek E., Komoniewska S., Kret M., Ozog M., Parnicka A., Petitjean K., Pietrzyk A., Skalska-Dulinska B., Starzyk D., Szczerbinska K., Witkiewicz B., Wlodarczyk A., Sinclair A., Harris S., Ogborne A., Ritchie S., Sinclair C., Sinclair H., Bellary S., Worthington H., Derejczyk J., Roller-Wirnsberger R., Jonsson P., Bordes P., Arnaud S., Asbrand C., Bejuit R., Durand S., Flechsenhar K., Joly F., Lain R. L., Moncharmont M., Msihid J., Ndja A., Riche B., Weber A. C., Yuan J., Roubenoff R., Kortebein P., Miller R. R., Gorostiaga C., Belissa-Mathiot P., Hu H., Laigle L., Melchor I. M., Russel A., Bennecky M., Haws T., Joshi A., Philpott K., Walker A., Zia G., Giorgi S. D., Feletti L., Marchioro E., Mocci F., Varesio M. G., Cesario A., Cabin B., de Boer W. P., Ignaszewski C., Klingmann I., Vollenbroek-Hutten M., Hermens T., Jansen-Kosterink S., Tabak M., Blandin P., Coutard L., Lenzotti A. -M., Mokhtari H., Rodon N., RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: CAPHRI - R1 - Ageing and Long-Term Care, Health Services Research, Handicap, Activité, Vieillissement, Autonomie, Environnement (HAVAE), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Clinicum, Department of General Practice and Primary Health Care, University of Helsinki, HUS Internal Medicine and Rehabilitation, Timo Strandberg / Principal Investigator, Department of Medicine, Helsinki University Hospital Area, Teachers' Academy, Jyvakorpi S.K., Ramel A., Strandberg T.E., Piotrowicz K., Blaszczyk-Bebenek E., Urtamo A., Rempe H.M., Geirsdottir O., Vagnerova T., Billot M., Larreur A., Savera G., Soriano G., Picauron C., Tagliaferri S., Sanchez-Puelles C., Cadenas V.S., Perl A., Tirrel L., Ohman H., Weling-Scheepers C., Ambrosi S., Costantini A., Pavelkova K., Klimkova M., Freiberger E., Jonsson P.V., Marzetti E., Pitkala K.H., Landi F., Calvani R., Bernabei R., Boni C., Brandi V., Broccatelli M., Celesti C., Cicchetti A., Collamati A., Coretti S., D'Angelo E., D'Elia M., Landi G., Lorenzi M., Mariotti L., Martone A.M., Ortolani E., Pafundi T., Picca A., Ruggeri M., Salini S., Tosato M., Vetrano D.L., Lattanzio F., Baldoni R., Bernabei S., Bonfigli A.R., Bustacchini S., Carrieri B., Cassetta L., Cherubini A., Cucchi M., Cucchieri G., Costantini A.R., Dell'Aquila G., Espinosa E., Fedecostante M., Fraternali R., Galeazzi R., Mengarelli A., Piomboni S., Posacki E., Severini E., Tregambe T., Trotta F., Maggio M., Lauretani F., Butto V., Fisichella A., Guareschi C., Longobucco Y., Di Bari M., Rodriguez-Manas L., Alamo S., Bouzon C.A., Gonzales Turin J., Zafra O.L.L., Picazo A.L., Sepulveda L.P., SanchezSanchez J.L., Puelles C.S., Aragones M.V., CruzJentoft A.J., Santos J.A., Alvarez-Nebreda L., JimenezJimenez N.F., Nozal J.M.-D., Montero-Errasquin B., Moreno B.P.B.P., Roldan-Plaza C., Vicente A.R.-D., Sanchez-Cadenas V., Sanchez-Castellano C., Sanchez-Garcia E., Vaquero-Pinto M.N., Topinkova E., Bautzka L., Blechova K., Gueye T., Juklickova I., Klbikova T., Krenkova J.J., Madlova P., Mejstrikova H., Melcova R., Michalkova H., Ryznarova I., Drastichova I., Hasalikova E., Hucko R., Jakub S., Janacova M., Kilmkova M., Parizkova M., Redrova M., Ruskova P.P., Sieber C.C., Auerswald T., Engel C., Franke A., Freibergen E., Freiheit U., Gotthardt S., Kampe K., Kob R., Kokott C., Kraska C., Meyer C., Reith V., Rempe H., Schoene D., Sieber G., Zielinski K., Anker S.D., Ebner N., Grutz R., von Haehling S., Schols A.M.W.J., Gosker H., Huysmans S., Quaaden S., Schols J.M., Smeets N., Stevens P., van de Bool C., Weling C., Strandberg T., Jyvakorpi S., Hallikas K., Herranen M., Huusko T., Hytonen L., Ikonen K., Karppi-Sjoblom A., Karvinen K., Kayhty M., Kindsted T., Landstrom E., Leirimaa S., Pitkala K., Punkka A., Saavalainen A.-M., Salo T., Sepa M., Sohlberg K., Vaatamoinen E., Venalainen S., Vanhanen H., Vellas B., Van Kan G.A., Biville V., Brigitte L., Cervera C., Cesari M., Champarnaud M., Cluzan C., Croizet M., Dardenne S., Dorard M., Dupuy C., Durand E., Faisant C., Fougere B., Girard P., Guyonnet S., Hoogendijk E., Mauroux R., Milhet A., Montel S., Ousset P.-J., Teguo M.T., Teysseyre B., Andrieu S., Blasimme A., Dray C., Rial-Sebbag E., Valet P., Dantoine T., Cardinaud N., Castelli M., Charenton-Blavignac M., Ciccolari-Micaldi C., Gayot C., Laubarie-Mouriet C., Marchesseau D., Mergans T., Nguyen T.B., Papon A., Ribet J., Saulinier I., Tchalla A., Rapp T., Sirven N., Skalska A., Blaszcyk E., Cwynar M., Czesak J., Fatyga P., Fedyk-Lukasik M., Grodzicki T., Jamrozik P., Janusz Z., Klimek E., Komoniewska S., Kret M., Ozog M., Parnicka A., Petitjean K., Pietrzyk A., Skalska-Dulinska B., Starzyk D., Szczerbinska K., Witkiewicz B., Wlodarczyk A., Sinclair A., Harris S., Ogborne A., Ritchie S., Sinclair C., Sinclair H., Bellary S., Worthington H., Derejczyk J., Roller-Wirnsberger R., Jonsson P., Bordes P., Arnaud S., Asbrand C., Bejuit R., Durand S., Flechsenhar K., Joly F., Lain R.L., Moncharmont M., Msihid J., Ndja A., Riche B., Weber A.C., Yuan J., Roubenoff R., Kortebein P., Miller R.R., Gorostiaga C., Belissa-Mathiot P., Hu H., Laigle L., Melchor I.M., Russel A., Bennecky M., Haws T., Joshi A., Philpott K., Walker A., Zia G., Giorgi S.D., Feletti L., Marchioro E., Mocci F., Varesio M.G., Cesario A., Cabin B., de Boer W.P., Ignaszewski C., Klingmann I., Vollenbroek-Hutten M., Hermens T., Jansen-Kosterink S., Tabak M., Blandin P., Coutard L., Lenzotti A.-M., Mokhtari H., Rodon N., Epidemiology and Data Science, APH - Aging & Later Life, and APH - Quality of Care

Subjects
0301 basic medicine, Gerontology, Sarcopenia, [SDV]Life Sciences [q-bio], Population, PROTEIN, RECOMMENDATIONS, law.invention, SUPPLEMENTATION, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Intervention (counseling), Cultural diversity, medicine, Nutrition counselling, Nutrition intervention, Humans, 030212 general & internal medicine, Medical prescription, education, Exercise, Aged, 2. Zero hunger, education.field_of_study, 030109 nutrition & dietetics, Frailty, business.industry, Settore MED/09 - MEDICINA INTERNA, ADULTS, medicine.disease, mobility, 3. Good health, Feasibility Studie, Malnutrition, SPRINTT, resistance exercise, muscle mass, Protein intake, 3121 General medicine, internal medicine and other clinical medicine, Feasibility Studies, Energy intake, Independent Living, business, Nutrition counseling, Research Paper, Human
Abstract

Aim To describe the methods and feasibility of the nutritional intervention carried out within the SPRINTT Randomized cotrolled trial. We also illustrate how nutrition interventionists identified participants at risk of malnutrition and the lessons learnt from the nutrition intervention. Findings SPRINTT nutrition intervention was well-received by the majority of the participants. It was mainly carried out using tailored nutrition counselling, but also other means of delivering the intervention were successfully used. Compared with a standard nutrition prescription, an individualized protocol to diagnose malnutrition and follow-up by tailored nutrition counselling helped achieve nutritional targets more effectively in spite of diversity of population in nutritional habits and in some cases reluctance to accept changes. Message The SPRINTT nutrition intervention was feasible and allowed flexibility to the varying needs and cultural differences of this heterogeneous population of frail, older Europeans. It may serve as a model to educate and improve nutrition among community-dwelling older people at risk of mobility limitations. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-020-00438-4., Background The “Sarcopenia and Physical Frailty in Older People: Multicomponent Treatment Strategies” (SPRINTT) project sponsored a multi-center randomized controlled trial (RCT) with the objective to determine the effect of physical activity and nutrition intervention for prevention of mobility disability in community-dwelling frail older Europeans. We describe here the design and feasibility of the SPRINTT nutrition intervention, including techniques used by nutrition interventionists to identify those at risk of malnutrition and to carry out the nutrition intervention. Methods SPRINTT RCT recruited older adults (≥ 70 years) from 11 European countries. Eligible participants (n = 1517) had functional limitations measured with Short Physical Performance Battery (SPPB score 3–9) and low muscle mass as determined by DXA scans, but were able to walk 400 m without assistance within 15 min. Participants were followed up for up to 3 years. The nutrition intervention was carried out mainly by individual nutrition counseling. Nutrition goals included achieving a daily protein intake of 1.0–1.2 g/kg body weight, energy intake of 25–30 kcal/kg of body weight/day, and serum vitamin D concentration ≥ 75 mmol/L. Survey on the method strategies and feasibility of the nutrition intervention was sent to all nutrition interventionists of the 16 SPRINTT study sites. Results Nutrition interventionists from all study sites responded to the survey. All responders found that the SPRINTT nutrition intervention was feasible for the target population, and it was well received by the majority. The identification of participants at nutritional risk was accomplished by combining information from interviews, questionnaires, clinical and laboratory data. Although the nutrition intervention was mainly carried out using individual nutritional counselling, other assisting methods were used as appropriate. Conclusion The SPRINTT nutrition intervention was feasible and able to adapt flexibly to varying needs of this heterogeneous population. The procedures adopted to identify older adults at risk of malnutrition and to design the appropriate intervention may serve as a model to deliver nutrition intervention for community-dwelling older people with mobility limitations. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-020-00438-4.

Published
2021
Full Text
View/download PDF

11. Comorbidity status of deceased COVID-19 in-patients in Italy

Author

Vetrano, D. L., Tazzeo, C., Palmieri, L., Marengoni, A., Zucchelli, A., Lo Noce, C., Onder, G., Andrianou, X., Barbariol, P., Bella, A., Bellino, S., Benelli, E., Bertinato, L., Boros, S., Brambilla, G., Calcagnini, G., Canevelli, M., Castrucci, M. R., Censi, F., Ciervo, A., Colaizzo, E., D'Ancona, F., Del Manso, M., Di Benedetto, C., Donfrancesco, C., Fabiani, M., Facchiano, F., Filia, A., Floridia, M., Galati, F., Giuliano, M., Grisetti, T., Kodra, Y., Langer, M., Lega, I., Maiozzi, P., Malchiodi Albedi, F., Manno, V., Martini, M., Urdiales, A. M., Mattei, E., Meduri, C., Meli, P., Minelli, G., Nebuloni, M., Nistico, L., Nonis, M., Palmisano, L., Petrosillo, N., Pezzotti, P., Pricci, F., Punzo, O., Puro, V., Raparelli, V., Rezza, G., Riccardo, F., Rota, M. C., Salerno, P., Serra, D., Siddu, A., Stefanelli, P., Tamburo de Bella, M., Tiple, D., Unim, B., Vaianella, L., Vanacore, N., Vichi, M., Villani, E. R., Zona, A., and Brusaferro, S.

Subjects
Aging, medicine.medical_specialty, Short Communication, Disease, Type 2 diabetes, Comorbidity, Chronic disease, NO, 03 medical and health sciences, 0302 clinical medicine, COVID-19, Mortality, Multimorbidity, Risk Factors, Internal medicine, medicine, 80 and over, Diabetes Mellitus, Dementia, Humans, 030212 general & internal medicine, Stroke, Aged, Aged, 80 and over, COPD, business.industry, SARS-CoV-2, Atrial fibrillation, Italy, Diabetes Mellitus, Type 2, medicine.disease, 030228 respiratory system, Heart failure, Geriatrics and Gerontology, business, Type 2
Abstract

Background Most COVID-19-related deaths have occurred in older persons with comorbidities. Specific patterns of comorbidities related to COVID-19 deaths have not been investigated. Methods A random sample of 6085 individuals in Italy who died in-hospital with confirmed COVID-19 between February and December 2020 were included. Observed to expected (O/E) ratios of disease pairs were computed and logistic regression models were used to determine the association between disease pairs with O/E values ≥ 1.5. Results Six pairs of diseases exhibited O/E values ≥ 1.5 and statistically significant higher odds of co-occurrence in the crude and adjusted analyses: (1) ischemic heart disease and atrial fibrillation, (2) atrial fibrillation and heart failure, (3) atrial fibrillation and stroke, (4) heart failure and COPD, (5) stroke and dementia, and (6) type 2 diabetes and obesity. Conclusion In those deceased in-hospital due to COVID-19 in Italy, disease combinations defined by multiple cardio-respiratory, metabolic, and neuropsychiatric diseases occur more frequently than expected. This finding indicates a need to investigate the possible role of these clinical profiles in the chain of events that lead to death in individuals who have contracted SARS-CoV-2.

Published
2021

12. All-cause mortality and antipsychotic use among elderly persons with high baseline cardiovascular and cerebrovascular risk: a multi-center retrospective cohort study in Italy

Author

Sultana J., Giorgianni F., REA, FEDERICO, Lucenteforte E., Lombardi N., Mugelli A., Vannacci A., Liperoti R., Kirchmayer U., Vitale C., Chinellato A., Roberto G., Corrao G., Trifiro G., Agabiti N., Bartolini C., Bernabei R., Bettiol A., Bonassi S., Caputi A. P., Cascini S., Cipriani F., Davoli M., Fini M., Gini R., Lapi F., Onder G., Sorge C., Tari M., Vetrano D. L., Sultana, J, Giorgianni, F, Rea, F, Lucenteforte, E, Lombardi, N, Mugelli, A, Vannacci, A, Liperoti, R, Kirchmayer, U, Vitale, C, Chinellato, A, Roberto, G, Corrao, G, Trifiro, G, Agabiti, N, Bartolini, C, Bernabei, R, Bettiol, A, Bonassi, S, Caputi, A, Cascini, S, Cipriani, F, Davoli, M, Fini, M, Gini, R, Lapi, F, Onder, G, Sorge, C, Tari, M, and Vetrano, D

Subjects
Male, Pediatrics, medicine.medical_treatment, Toxicology, 030226 pharmacology & pharmacy, Cohort Studies, Antipsychotic, 0302 clinical medicine, Retrospective Studie, Risk Factors, Cardiovascular Disease, 80 and over, Antipsychotics, Medicine, Drug Interactions, Aged, 80 and over, Incidence, Incidence (epidemiology), General Medicine, Italy, Cardiovascular Diseases, 030220 oncology & carcinogenesis, Cerebrovascular Disorder, Female, cohort study, drug interactions, elderly, mortality, Antipsychotic Agents, Human, Cohort study, medicine.medical_specialty, 03 medical and health sciences, Elderly persons, Humans, Cerebrovascular risk, Proportional Hazards Models, Retrospective Studies, Aged, Pharmacology, drug interaction, urogenital system, business.industry, Proportional hazards model, Settore MED/09 - MEDICINA INTERNA, Retrospective cohort study, equipment and supplies, Cerebrovascular Disorders, Antipsychotic Agent, Proportional Hazards Model, Cohort Studie, business, All cause mortality
Abstract

Background: Little is known about the comparative risk of death with atypical or conventional antipsychotics (APs) among persons with cardiovascular or cerebrovascular disease (CCD). Research design and methods: A cohort study was conducted using five Italian claims databases. New atypical AP users with CCD aged ≥65 (reference) were matched to new conventional AP users. Mortality per 100 person-years (PYs) and hazard ratios (HR), estimated using Cox models, were reported. Incidence and risk of death were estimated for persons having drug–drug interactions. Outcome occurrence was evaluated 180 days after AP initiation. Results: Overall 24,711 and 27,051 elderly new conventional and atypical AP users were identified. The mortality rate was 51.3 and 38.5 deaths per 100 PYs for conventional and atypical AP users. Mortality risk was 1.33 (95%CI: 1.27–1.39) for conventional APs. There was no increased mortality risk with single drug–drug interactions (DDIs) vs. no DDI. AP users with ≥1 DDI had a 29% higher mortality risk compared to no DDI in the first 90 days of treatment (HR: 1.29 (95% CI: 1.00–1.67)). Conclusions: Conventional APs had a higher risk of death than atypical APs among elderly persons with CCD. Having ≥1 DDI was associated with an increased risk of death.

Published
2019
Full Text
View/download PDF

13. Sleep disturbances and the speed of multimorbidity development in old age : results from a longitudinal population-based study

Author

Sindi, S., Pérez, L. M., Vetrano, D. L., Triolo, F., Kåreholt, Ingemar, Sjöberg, L., Darin-Mattsson, A., Kivipelto, M., Inzitari, M., Calderón-Larrañaga, A., Sindi, S., Pérez, L. M., Vetrano, D. L., Triolo, F., Kåreholt, Ingemar, Sjöberg, L., Darin-Mattsson, A., Kivipelto, M., Inzitari, M., and Calderón-Larrañaga, A.

Abstract

Background: Sleep disturbances are prevalent among older adults and are associated with various individual diseases. The aim of this study was to investigate whether sleep disturbances are associated with the speed of multimorbidity development among older adults. Methods: Data were gathered from the Swedish National study of Aging and Care in Kungsholmen (SNAC-K), an ongoing population-based study of subjects aged 60+ (N = 3363). The study included a subsample (n = 1189) without multimorbidity at baseline (< 2 chronic diseases). Baseline sleep disturbances were derived from the Comprehensive Psychiatric Rating Scale and categorized as none, mild, and moderate–severe. The number of chronic conditions throughout the 9-year follow-up was obtained from clinical examinations. Linear mixed models were used to study the association between sleep disturbances and the speed of chronic disease accumulation, adjusting for sex, age, education, physical activity, smoking, alcohol consumption, depression, pain, and psychotropic drug use. We repeated the analyses including only cardiovascular, neuropsychiatric, or musculoskeletal diseases as the outcome. Results: Moderate–severe sleep disturbances were associated with a higher speed of chronic disease accumulation (ß/year = 0.142, p = 0.008), regardless of potential confounders. Significant positive associations were also found between moderate–severe sleep disturbances and neuropsychiatric (ß/year = 0.041, p = 0.016) and musculoskeletal (ß/year = 0.038, p = 0.025) disease accumulation, but not with cardiovascular diseases. Results remained stable when participants with baseline dementia, cognitive impairment, or depression were excluded. Conclusion: The finding that sleep disturbances are associated with faster chronic disease accumulation points towards the importance of early detection and treatment of sleep disturbances as a possible strategy to reduce chronic multimorbidity among older adults.

Published
2020
Full Text
View/download PDF

14. Safinamide as an adjunct therapy in older patients with Parkinson’s disease: a retrospective study

Author

Lo Monaco, Maria Rita, Petracca, Martina, Vetrano, D. L., Di Stasio, Enrico, Fusco, Domenico, Ricciardi, Diego, Laudisio, A., Zuccala', Giuseppe, Onder, Graziano, Bentivoglio, Anna Rita, Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Petracca M., Di Stasio E. (ORCID:0000-0003-1047-4261), Fusco D., Ricciardi D., Zuccala G. (ORCID:0000-0002-2567-2220), Onder G. (ORCID:0000-0003-3400-4491), Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Lo Monaco, Maria Rita, Petracca, Martina, Vetrano, D. L., Di Stasio, Enrico, Fusco, Domenico, Ricciardi, Diego, Laudisio, A., Zuccala', Giuseppe, Onder, Graziano, Bentivoglio, Anna Rita, Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Petracca M., Di Stasio E. (ORCID:0000-0003-1047-4261), Fusco D., Ricciardi D., Zuccala G. (ORCID:0000-0002-2567-2220), Onder G. (ORCID:0000-0003-3400-4491), and Bentivoglio A. R. (ORCID:0000-0002-9663-095X)

Abstract

Background: Safinamide, as a levodopa adjunct, is effective in reducing motor fluctuations in Parkinson’s disease (PD) patients; however, scarce evidence is available regarding its use in older PD patients. Aim: To evaluate the safety and tolerability of safinamide as an adjunct therapy in patients aged ≥ 60 years with advanced PD. Methods: A retrospective study including 203 PD patients admitted to a geriatric day hospital, who were evaluated following an extensive clinical protocol. Safinamide use was categorized as never used, ongoing, and withdrawn. Potential correlations of Safinamide withdrawal were investigated in stepwise backward logistic regression models. Results: A total of 44 out of 203 participants were current or former users of Safinamide. Overall, 14 (32%) patients discontinued due to treatment-emergent adverse events (TEAEs). Withdrawal was not associated with older age. Conclusions: Safinamide as an adjunct therapy in patients aged ≥ 60 years with advanced PD was found to be safe and well-tolerated in older patients. There were no specific demographic or clinical characteristics associated with suspension.

Published
2020

15. An International Perspective on Chronic Multimorbidity: Approaching the Elephant in the Room

Author

Vetrano, D. L., Calderon-Larranaga, A., Marengoni, A., Onder, Graziano, Bauer, J. M., Cesari, Matteo, Ferrucci, L., and Fratiglioni, L.

Subjects
Aging, Internationality, Portugal, Frailty, Settore MED/09 - MEDICINA INTERNA, Multimorbidity, Articles, Comorbidity, Guidelines, United States, chronic diseases, comorbidity, frailty, guidelines, multimorbidity, Geriatrics, The Journal of Gerontology: Medical Sciences, Medical, Chronic diseases, Chronic Disease, Practice Guidelines as Topic, Quality of Life, Humans, European Union, Societies, Delivery of Health Care, Societies, Medical, Aged
Abstract

Multimorbidity is a common and burdensome condition that may affect quality of life, increase medical needs, and make people live more years of life with disability. Negative outcomes related to multimorbidity occur beyond what we would expect from the summed effect of single conditions, as chronic diseases interact with each other, mutually enhancing their negative effects, and eventually leading to new clinical phenotypes. Moreover, multimorbidity mirrors an accelerated global susceptibility and a loss of resilience, which are both hallmarks of aging. Due to the complexity of its assessment and definition, and the lack of clear evidence steering its management, multimorbidity represents one of the main current challenges for clinicians, researchers, and policymakers. The authors of this article recently reflected on these issues during two twin international symposia at the 2016 European Union Geriatric Medicine Society (EUGMS) meeting in Lisbon, Portugal, and the 2016 Gerontological Society of America (GSA) meeting in New Orleans, USA. The present work summarizes the most relevant aspects related to multimorbidity, with the ultimate goal to identify knowledge gaps and suggest future directions to approach this condition.

Published
2018

16. All-cause mortality and antipsychotic use among elderly persons with high baseline cardiovascular and cerebrovascular risk: a multi-center retrospective cohort study in Italy

Author

Sultana, J, Giorgianni, F, Rea, F, Lucenteforte, E, Lombardi, N, Mugelli, A, Vannacci, A, Liperoti, R, Kirchmayer, U, Vitale, C, Chinellato, A, Roberto, G, Corrao, G, Trifiro, G, Agabiti, N, Bartolini, C, Bernabei, R, Bettiol, A, Bonassi, S, Caputi, A, Cascini, S, Cipriani, F, Davoli, M, Fini, M, Gini, R, Lapi, F, Onder, G, Sorge, C, Tari, M, Vetrano, D, Sultana J., Giorgianni F., REA, FEDERICO, Lucenteforte E., Lombardi N., Mugelli A., Vannacci A., Liperoti R., Kirchmayer U., Vitale C., Chinellato A., Roberto G., Corrao G., Trifiro G., Agabiti N., Bartolini C., Bernabei R., Bettiol A., Bonassi S., Caputi A. P., Cascini S., Cipriani F., Davoli M., Fini M., Gini R., Lapi F., Onder G., Sorge C., Tari M., Vetrano D. L., Sultana, J, Giorgianni, F, Rea, F, Lucenteforte, E, Lombardi, N, Mugelli, A, Vannacci, A, Liperoti, R, Kirchmayer, U, Vitale, C, Chinellato, A, Roberto, G, Corrao, G, Trifiro, G, Agabiti, N, Bartolini, C, Bernabei, R, Bettiol, A, Bonassi, S, Caputi, A, Cascini, S, Cipriani, F, Davoli, M, Fini, M, Gini, R, Lapi, F, Onder, G, Sorge, C, Tari, M, Vetrano, D, Sultana J., Giorgianni F., REA, FEDERICO, Lucenteforte E., Lombardi N., Mugelli A., Vannacci A., Liperoti R., Kirchmayer U., Vitale C., Chinellato A., Roberto G., Corrao G., Trifiro G., Agabiti N., Bartolini C., Bernabei R., Bettiol A., Bonassi S., Caputi A. P., Cascini S., Cipriani F., Davoli M., Fini M., Gini R., Lapi F., Onder G., Sorge C., Tari M., and Vetrano D. L.

Abstract

Background: Little is known about the comparative risk of death with atypical or conventional antipsychotics (APs) among persons with cardiovascular or cerebrovascular disease (CCD). Research design and methods: A cohort study was conducted using five Italian claims databases. New atypical AP users with CCD aged ≥65 (reference) were matched to new conventional AP users. Mortality per 100 person-years (PYs) and hazard ratios (HR), estimated using Cox models, were reported. Incidence and risk of death were estimated for persons having drug–drug interactions. Outcome occurrence was evaluated 180 days after AP initiation. Results: Overall 24,711 and 27,051 elderly new conventional and atypical AP users were identified. The mortality rate was 51.3 and 38.5 deaths per 100 PYs for conventional and atypical AP users. Mortality risk was 1.33 (95%CI: 1.27–1.39) for conventional APs. There was no increased mortality risk with single drug–drug interactions (DDIs) vs. no DDI. AP users with ≥1 DDI had a 29% higher mortality risk compared to no DDI in the first 90 days of treatment (HR: 1.29 (95% CI: 1.00–1.67)). Conclusions: Conventional APs had a higher risk of death than atypical APs among elderly persons with CCD. Having ≥1 DDI was associated with an increased risk of death.

Published
2019

17. All-cause mortality and antipsychotic use among elderly persons with high baseline cardiovascular and cerebrovascular risk: a multi-center retrospective cohort study in Italy

Author

Sultana, J., Giorgianni, F., Rea, F., Lucenteforte, E., Lombardi, N., Mugelli, A., Vannacci, A., Liperoti, Rosa, Kirchmayer, U., Vitale, C., Chinellato, A., Roberto, G., Corrao, G., Trifiro, G., Agabiti, N., Bartolini, C., Bernabei, Roberto, Bettiol, A., Bonassi, S., Caputi, A. P., Cascini, S., Cipriani, Fabrizio, Davoli, M., Fini, M., Gini, R., Lapi, F., Onder, Graziano, Sorge, C., Tari, M., Vetrano, D. L., Liperoti R. (ORCID:0000-0003-3740-1687), Bernabei R. (ORCID:0000-0002-9197-004X), Cipriani F., Onder G. (ORCID:0000-0003-3400-4491), Sultana, J., Giorgianni, F., Rea, F., Lucenteforte, E., Lombardi, N., Mugelli, A., Vannacci, A., Liperoti, Rosa, Kirchmayer, U., Vitale, C., Chinellato, A., Roberto, G., Corrao, G., Trifiro, G., Agabiti, N., Bartolini, C., Bernabei, Roberto, Bettiol, A., Bonassi, S., Caputi, A. P., Cascini, S., Cipriani, Fabrizio, Davoli, M., Fini, M., Gini, R., Lapi, F., Onder, Graziano, Sorge, C., Tari, M., Vetrano, D. L., Liperoti R. (ORCID:0000-0003-3740-1687), Bernabei R. (ORCID:0000-0002-9197-004X), Cipriani F., and Onder G. (ORCID:0000-0003-3400-4491)

Abstract

Background: Little is known about the comparative risk of death with atypical or conventional antipsychotics (APs) among persons with cardiovascular or cerebrovascular disease (CCD). Research design and methods: A cohort study was conducted using five Italian claims databases. New atypical AP users with CCD aged ≥65 (reference) were matched to new conventional AP users. Mortality per 100 person-years (PYs) and hazard ratios (HR), estimated using Cox models, were reported. Incidence and risk of death were estimated for persons having drug–drug interactions. Outcome occurrence was evaluated 180 days after AP initiation. Results: Overall 24,711 and 27,051 elderly new conventional and atypical AP users were identified. The mortality rate was 51.3 and 38.5 deaths per 100 PYs for conventional and atypical AP users. Mortality risk was 1.33 (95%CI: 1.27–1.39) for conventional APs. There was no increased mortality risk with single drug–drug interactions (DDIs) vs. no DDI. AP users with ≥1 DDI had a 29% higher mortality risk compared to no DDI in the first 90 days of treatment (HR: 1.29 (95% CI: 1.00–1.67)). Conclusions: Conventional APs had a higher risk of death than atypical APs among elderly persons with CCD. Having ≥1 DDI was associated with an increased risk of death.

Published
2019

18. NSAIDs utilization for musculoskeletal indications in elderly patients with cerebro/cardiovascular disease

Author

Roberto, G., Bartolini, C., Rea, Federico, Onder, G., Vitale, C., Trifirò, G., Kirchmayer, U., Chinellato, A., Lucenteforte, E., Corrao, G., Mugelli, A., Lapi, F., Gini, R., Agabiti, N., Bernabei, R., Bettiol, A., Bonassi, S., Caputi, A. P., Cascini, S., Davoli, M., Fini Storchi, Marco, Giorgianni, F., Lombardi, N., Rea, F., Sorge, C., Tari, M., Vannacci, A., Vetrano, D. L., Vitale, Claudia, Roberto, G, Bartolini, C, Rea, F, Onder, G, Vitale, C, Trifirò, G, Kirchmayer, U, Chinellato, A, Lucenteforte, E, Corrao, G, Mugelli, A, Lapi, F, Gini, R, On Behalf Of The Italian Group For Appropriate Drug Prescription In The Elderly (I-Grade): Agabiti, N, Bernabei, R, Bettiol, A, Bonassi, S, Caputi, A, Cascini, S, Davoli, M, Fini, M, Giorgianni, F, Lombardi, N, Sorge, C, Tari, M, Vannacci, A, and Vetrano, D

Subjects
Drug Utilization, medicine.medical_specialty, Diclofenac, Pharmacoepidemiology and Prescription, NSAIDs, Population, Psychological intervention, Cardiovascular risk Coxibs Diclofenac Drug utilization Elderly NSAIDs, Disease, 030204 cardiovascular system & hematology, Coxib, 03 medical and health sciences, 0302 clinical medicine, Elderly, Internal medicine, medicine, Coxibs, Drug utilization, Humans, Pharmacology (medical), Musculoskeletal Diseases, 030212 general & internal medicine, Medical prescription, education, Aged, Aged, 80 and over, Pharmacology, education.field_of_study, business.industry, Anti-Inflammatory Agents, Non-Steroidal, General Medicine, Cardiovascular risk, NSAID, Cardiovascular Diseases, Cohort, Female, business, Nimesulide, medicine.drug
Abstract

Objectives To describe NSAID utilization for musculoskeletal conditions in a large cohort of Italian elderly with cerebro/cardiovascular disease, a population in which NSAIDs should be generally avoided due to the prothrombotic potential. Methods Administrative data from five Italian geographic areas were analyzed. Patients aged ≥ 65 with a cerebro/cardiovascular event recorded between 2008 and 2011 (cohort entry) were selected. Prescription NSAIDs reimbursed for musculoskeletal conditions and dispensed during 1 year follow-up were retrieved to describe (i) prevalence of use, (ii) average amount of defined daily doses of NSAIDs claimed by users per day of follow-up, and (iii) distribution of the received daily dose (RDD) among patients with ≥ 2 dispensings. Among new users, i.e., patients without NSAID dispensings during 2 years before cohort entry, the first dispensed NSAID molecule was observed. Results Overall, 511,989 patients were selected. Across the five geographic areas, prevalence of use ranged from 48 to 21% and average consumption ranged between 30 and 67 DDD/1000 users/day. Around 10% of patients in the overall cohort had a RDD > 1. Nimesulide (9.6%) and diclofenac (7.5%) had the highest prevalence of use. The most consumed NSAIDs were nimesulide and coxibs with 10.6 and 7.5 DDD/1000 users/day, respectively. Among new users recruited in 2011, 30% had diclofenac or a coxibs as the first prescription. Conclusions NSAID use was common in the study cohort, particularly in central-southern areas. In contrast with current recommendations, coxibs and diclofenac were among the most prescribed active principles, even in new users. Interventions to promote appropriateness of use are warranted. Electronic supplementary material The online version of this article (10.1007/s00228-018-2411-y) contains supplementary material, which is available to authorized users.

Published
2018

22. Use of benzodiazepines and cognitive performance in primary care patients with first cognitive complaints

Author

Grande, G., Tramacere, I., Vetrano, D. L., Pomati, S., Mariani, C., Filippini, G., Grande, G., Tramacere, I., Vetrano, D. L., Pomati, S., Mariani, C., and Filippini, G.

Abstract

The aim of the present study is to investigate the impact of benzodiazepine use on cognitive performance in primary care patients with first cognitive complaints. The association between the exposition to benzodiazepines (short and long half-life) and cognitive performance, evaluated through the Mini Mental State Examination (MMSE), was tested through analysis of the covariance and logistic regression models. Within the 4,249 participants (mean age 77.0 +/- 8.2, 66.4% women), 732 (17%) were on benzodiazepines. When compared with non-users, short- and long-acting benzodiazepine users presented overlapping adjusted MMSE mean scores (respectively, mean MMSE score: 25.3, 95%CI 25.2-25.5; 25.4, 95%CI 25.1-25.7, and 25.9, 95%CI 25.3-26.4; p = 0.156). When tested according to the logistical regression model, after adjusting for potential confounders, no association was found between short and long acting benzodiazepine use and a MMSE < 24 (respectively, OR 0.9, 95%CI 0.7-1.2; OR 0.8, 95%CI 0.7-1.3) as compared with non-users. In conclusion, according to the results of our study, benzodiazepine use seems not to impact on cognitive performance- as assessed with the MMSE- of primary care patients referring to GPs for first cognitive complaints.

Published
2018
Full Text
View/download PDF

24. Multimorbidity and functional impairment-bidirectional interplay, synergistic effects and common pathways.

Author

Calderón‐Larrañaga, A., Vetrano, D. L., Ferrucci, L., Mercer, S. W., Marengoni, A., Onder, G., Eriksdotter, M., Fratiglioni, L., Calderón-Larrañaga, Amaia, Vetrano, Davide L, Ferrucci, Luigi, Mercer, Stewart W, Marengoni, Alessandra, Onder, Graziano, Eriksdotter, Maria, Fratiglioni, Laura, and Calderón-Larrañaga, A

Subjects
*MEDICAL needs assessment, *COMORBIDITY, *PSYCHOSOCIAL factors, *OLDER people, *BURDEN of care
Abstract

This review discusses the interplay between multimorbidity (i.e. co-occurrence of more than one chronic health condition in an individual) and functional impairment (i.e. limitations in mobility, strength or cognition that may eventually hamper a person's ability to perform everyday tasks). On the one hand, diseases belonging to common patterns of multimorbidity may interact, curtailing compensatory mechanisms and resulting in physical and cognitive decline. On the other hand, physical and cognitive impairment impact the severity and burden of multimorbidity, contributing to the establishment of a vicious circle. The circle may be further exacerbated by people's reduced ability to cope with treatment and care burden and physicians' fragmented view of health problems, which cause suboptimal use of health services and reduced quality of life and survival. Thus, the synergistic effects of medical diagnoses and functional status in adults, particularly older adults, emerge as central to assessing their health and care needs. Furthermore, common pathways seem to underlie multimorbidity, functional impairment and their interplay. For example, older age, obesity, involuntary weight loss and sedentarism can accelerate damage accumulation in organs and physiological systems by fostering inflammatory status. Inappropriate use or overuse of specific medications and drug-drug and drug-disease interactions also contribute to the bidirectional association between multimorbidity and functional impairment. Additionally, psychosocial factors such as low socioeconomic status and the direct or indirect effects of negative life events, weak social networks and an external locus of control may underlie the complex interactions between multimorbidity, functional decline and negative outcomes. Identifying modifiable risk factors and pathways common to multimorbidity and functional impairment could aid in the design of interventions to delay, prevent or alleviate age-related health deterioration; this review provides an overview of knowledge gaps and future directions. [ABSTRACT FROM AUTHOR]

Published
2019
Full Text
View/download PDF

25. Role of anticholinergic burden in primary care patients with first cognitive complaints

Author

Grande, G., Tramacere, I., Vetrano, D. L., Clerici, F., Pomati, S., Mariani, C., Filippini, G., Grande, G., Tramacere, I., Vetrano, D. L., Clerici, F., Pomati, S., Mariani, C., and Filippini, G.

Abstract

Background and purpose: Drugs with anticholinergic properties might have a negative impact on cognition, but findings are still conflicting. The association was evaluated between anticholinergic drugs and cognitive performance in primary care patients with first cognitive complaints. Methods: From April 2013 to March 2014, 353 general practitioners administered the Mini-Mental State Examination (MMSE) to patients presenting with first cognitive complaints. Drug history was collected and the anticholinergic cognitive burden (ACB) was scored and categorized as ACB 0, ACB 1 and ACB 2+. A mixed effect linear regression model was used to assess the association between ACB and MMSE score. Results: Of 4249 subjects entering the study (mean age 77 +/- 8.2 years, 66.4% women and mean years of schooling 8.9 +/- 4.5), 25.8% received at least one drug with anticholinergic action. According to multivariate analysis, and after adjustment for several confounders, subjects with ACB 2+ had a statistically significant lower MMSE score compared with those with ACB 0 (beta -0.63; 95% confidence interval -1.19; -0.07). Subjects with ACB 1 had a non-statistically significant lower MMSE score than those with ACB 0 (beta -0.11; 95% confidence interval -0.37; 0.15). Conclusions: Anticholinergic medication might affect cognitive function in people with first cognitive complaints. Alternatives should be taken into account when possible, balancing the benefits and harms of these medications.

Published
2017
Full Text
View/download PDF

26. Methodological issues in the observational studies conducted in older population: A narrative review

Author

Poscia, Andrea, Collamati, A., Milovanovic, Sonja, Vetrano, D. L., Liotta, G., Petitti, T., Di Pietro, Maria Luisa, Magnavita, Nicola, Ricciardi, Walter, Cherubini, A., Onder, Graziano, Poscia A. (ORCID:0000-0002-7616-3389), Milovanovic S., Di Pietro M. L. (ORCID:0000-0002-3893-8788), Magnavita N. (ORCID:0000-0002-0988-7344), Ricciardi W. (ORCID:0000-0002-5655-688X), Onder G. (ORCID:0000-0003-3400-4491), Poscia, Andrea, Collamati, A., Milovanovic, Sonja, Vetrano, D. L., Liotta, G., Petitti, T., Di Pietro, Maria Luisa, Magnavita, Nicola, Ricciardi, Walter, Cherubini, A., Onder, Graziano, Poscia A. (ORCID:0000-0002-7616-3389), Milovanovic S., Di Pietro M. L. (ORCID:0000-0002-3893-8788), Magnavita N. (ORCID:0000-0002-0988-7344), Ricciardi W. (ORCID:0000-0002-5655-688X), and Onder G. (ORCID:0000-0003-3400-4491)

Abstract

Introduction: Well-conducted observational studies may represent valuable tools for getting insight to disease etiology, detecting the effect of age-related changes, and providing an important perspective on health risk factors and disabilities in an aging population. Nevertheless, this kind of research poses several challenges for researchers. The main aim of this narrative review was to address the potential methodological issues in performing the observational studies in the elderly, the factors that influence their participation, and the possible solutions for overcoming the barriers to research in this population. Methods: Comprehensive search for the papers published in the period from January 1st 1980 until 31st July 2016 in English or Italian was conducted through MEDLINE, Scopus and Web of Science electronic databases. Findings from the included papers were finally summarized. Results: In cohort studies, the following barriers were addressed: sample size calculation, ascertainment of the target population, frequency of data collection, exposure determination, multi factorial loss to follow-up (drop-outs), cognitive impairment, definition of confounders, and ethical aspects. Case-control studies were reported to be prone to the issues like ascertainment of cases and controls, willingness to participate, data accuracy, recall bias, issues related to patients’ multi morbidity, and cognitive impairment. Conclusions: Important factors to consider in research in elderly people include: precise definition of the study population, well conducted recruitment process, engagement with family and home care staff, cognitive impairment assessment and the consequent relevant ethical and legal issues, relief of participant burden in order to minimize withdrawal, and engagement with the media.

Published
2017

30. Frailty, Physical Frailty, Sarcopenia: A New Conceptual Model

Author

Giuseppe Riva, Paolo Ajmone Marsan, Claudio Grassi, Bernabei, Roberto, Martone, Anna Maria, Vetrano, D. L., Calvani, Riccardo, Landi, Francesco, Marzetti, Emanuele, Bernabei R. (ORCID:0000-0002-9197-004X), Martone A. M., Calvani R. (ORCID:0000-0001-5472-2365), Landi F. (ORCID:0000-0002-3472-1389), Marzetti E. (ORCID:0000-0001-9567-6983), Giuseppe Riva, Paolo Ajmone Marsan, Claudio Grassi, Bernabei, Roberto, Martone, Anna Maria, Vetrano, D. L., Calvani, Riccardo, Landi, Francesco, Marzetti, Emanuele, Bernabei R. (ORCID:0000-0002-9197-004X), Martone A. M., Calvani R. (ORCID:0000-0001-5472-2365), Landi F. (ORCID:0000-0002-3472-1389), and Marzetti E. (ORCID:0000-0001-9567-6983)

Abstract

In the literature, different criteria have been validated to identify frail older subjects, which mainly refer to two conceptual models: the cumulative deficit approach proposed by Rockwood and the Physical Frailty (PF) phenotype proposed by Fried. Both models have received empirical validation. Nevertheless, the frailty phenotype is the most widely used and presents a characterized pathophysiologic background. The PF condition depicted by the frailty phenotype has shown to be predictive of major negative health-related outcomes, including mobility disability, disability for activities of daily living, institutionalization, and mortality. At the same time, it cannot be ignored that the PF phenotype presents substantial overlaps with sarcopenia, 'a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life and death'. In fact, many of the adverse outcomes of frailty are probably mediated by sarcopenia. Therefore, sarcopenia may be considered both as the biological substrate for the development of PF and the pathway through which the negative health outcomes of frailty ensue. Although PF encompasses only a part of the frailty spectrum, the identification of a definite biological basis (i.e., skeletal muscle decline) opens new venues for the development of interventions to slow or reverse the progression of this condition. Here, we present a novel conceptualisation of PF which will possibly promote significant advancements over the traditional approaches to this syndrome by enabling the precise operationalisation of the condition, a clear identification of the affected population and the rapid translation of findings to the clinical arena.

Published
2014

32. Metabolic syndrome and quality of life in the elderly: Age and gender differences

Author

Laudisio, A., Marzetti, Emanuele, Antonica, L., Pagano, Francesco Cosimo, Vetrano, D. L., Bernabei, Roberto, Zuccala', Giuseppe, Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F., Bernabei R. (ORCID:0000-0002-9197-004X), Zuccala G. (ORCID:0000-0002-2567-2220), Laudisio, A., Marzetti, Emanuele, Antonica, L., Pagano, Francesco Cosimo, Vetrano, D. L., Bernabei, Roberto, Zuccala', Giuseppe, Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F., Bernabei R. (ORCID:0000-0002-9197-004X), and Zuccala G. (ORCID:0000-0002-2567-2220)

Abstract

Purpose: The metabolic syndrome (MetS) is highly prevalent in Western older populations. MetS is an intriguing entity, because it includes potentially reversible risk factors. Some studies have suggested an inverse correlation between MetS and health-related quality of life (HRQoL), but data regarding older subjects are scanty and conflicting. The aim of this study was to assess the association between HRQoL and MetS in older, unselected community-dwelling subjects. Methods: We analyzed data of 356 subjects aged 75+ living in Tuscania (Italy). HRQoL was assessed using the Health Utilities Index, Mark 3. Diagnosis of MetS was defined according to the National Cholesterol Education Program's ATP-III criteria. Results: MetS was reported by 137 (38%) participants. According to linear regression analysis, MetS was associated with significantly better HRQoL in men (B = 0.19 95% CI = 0.06-0.32; p = 0.006), but not in women. Also, when the regression model was analyzed in men, MetS was associated with better HRQoL (B = 0.17, 95% CI = 0.01-0.32; p = 0.035) only among participants aged 80+. No significant associations were found in men between HRQoL and any of the single components of MetS. Conclusions: MetS is not associated with worse HRQoL among community-dwelling elderly; it is associated with significantly better HRQoL among the oldest men. © 2012 Springer-Verlag.

Published
2013

35. Laterality in Parkinson's disease may predict motor and visual imagery abilities.

Author

Lo Monaco MR, Laudisio A, Fusco D, Vetrano DL, Ricciardi D, Delle Donne V, Proietti F, Zuccalà G, and Silveri MC

Subjects
Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Functional Laterality physiology, Imagination physiology, Motor Activity physiology, Parkinson Disease physiopathology, Parkinson Disease rehabilitation, Visual Perception physiology
Abstract

Experimental evidence suggests that motor imagery (MI) engages the same neural substrates supporting actual motor activities and is likely impaired when such substrates are damaged, as in Parkinson's disease (PD). MI intuitively relies on visual imagery (VI), because mental simulations of physical movements depend on the visual retrieval of these movements. Although VI is generally considered a right hemispheric function, the hemispheric dominance of MI is still in dispute. Disparities in sidedness of motor disturbances are a distinctive feature of PD, and recent findings indicate that such disparities may similarly characterize cognition. Specifically, the deficits observed may depend upon which hemisphere is principally involved. Essentially, MI and VI are cognitive tasks subject to differential impairment and reflecting the prevalence of hemispheric impairment in PD. Motor imagery (assessed by the Vividness of Motor Imagery Questionnaire [VMIQ]) and VI (assessed by the Vividness of Visual Imagery Questionnaire [VVIQ] and Test of Visual Imagery Control [TVIC]) were examined in patients with asymmetric PD and in healthy elderly control subjects (HC group). VMIQ scores were similar in PD laterality subsets and the HC group, but VVIQ scores were significantly lower in both PD groups compared with the HC group. TVIC scores were significantly lower in the presence of left motor (right hemispheric) impairment and were predictive of left motor (right hemispheric) impairment. We suspect that MI is strongly reliant on VI and that language may mediate these two functions, to the extent that both are evoked through verbal stimuli. Working memory, both visual and verbal, is also involved in MI and VI tasks. Without due attention to laterality of symptoms, any training incorporating MI and VI may not deliver expected outcomes in the setting of asymmetric PD symptomatology.

Published
2018

36. Use of benzodiazepines and cognitive performance in primary care patients with first cognitive complaints.

Author

Grande G, Tramacere I, Vetrano DL, Pomati S, Mariani C, and Filippini G

Subjects
Aged, Benzodiazepines adverse effects, Cognition Disorders epidemiology, Cognition Disorders psychology, Dementia diagnosis, Dementia psychology, Female, Geriatric Assessment, Humans, Italy epidemiology, Male, Middle Aged, Neuropsychological Tests, Aged, 80 and over psychology, Benzodiazepines therapeutic use, Cognition drug effects, Cognition Disorders chemically induced, Cognition Disorders prevention & control, Dementia drug therapy, Primary Health Care
Abstract

ABSTRACTThe aim of the present study is to investigate the impact of benzodiazepine use on cognitive performance in primary care patients with first cognitive complaints. The association between the exposition to benzodiazepines (short and long half-life) and cognitive performance, evaluated through the Mini Mental State Examination (MMSE), was tested through analysis of the covariance and logistic regression models. Within the 4,249 participants (mean age 77.0 ± 8.2, 66.4% women), 732 (17%) were on benzodiazepines. When compared with non-users, short- and long-acting benzodiazepine users presented overlapping adjusted MMSE mean scores (respectively, mean MMSE score: 25.3, 95%CI 25.2-25.5; 25.4, 95%CI 25.1-25.7, and 25.9, 95%CI 25.3-26.4; p = 0.156). When tested according to the logistical regression model, after adjusting for potential confounders, no association was found between short and long acting benzodiazepine use and a MMSE < 24 (respectively, OR 0.9, 95%CI 0.7-1.2; OR 0.8, 95%CI 0.7-1.3) as compared with non-users. In conclusion, according to the results of our study, benzodiazepine use seems not to impact on cognitive performance- as assessed with the MMSE- of primary care patients referring to GPs for first cognitive complaints.

Published
2018
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results