showing 30 related works from this author
A Comparison of Objective Physical Performance Tests and Future Mortality in the Elderly People.
2017
Background: Physical performance is an important predictor of mortality, but little is known on the comparative prognostic utility of different objective physical performance tests in community-dwelling older adults. We compared the prognostic usefulness of several objective physical performance tests on mortality, adjusting our analyses for potential confounders. Methods: Among 3,099 older community-dwelling participants included in the Progetto Veneto Anziani study, 2,096 were followed for a mean of 4.4 years. Physical performance tests measured were Short Physical Performance Battery (SPPB), 4-meter gait speed, chair stands time, leg extension and flexion, handgrip strength, and 6-Minute…
Geriatric Insights on Elderly Women and Heart Disease
2017
Purpose of Review: The prevalence of heart diseases is growing in recent years and will further rise because of the increased longevity of elderly population, mainly reported for the female gender. Recent Findings: Several studies have demonstrated the presence of a large sex-specific variability on physiopathology, presentation, and overall prognosis of cardiovascular diseases (CVD). Women, in particular, tend to present heart diseases generally later than men, have a higher number of comorbidities, and report worse outcomes. Moreover, atypical symptomatology of heart diseases in older women constitutes a potential source of delay in the identification of such pathologies, influencing the …
Effects of acetyl-l-carnitine in diabetic neuropathy and other geriatric disorders
2018
A long history of diabetes mellitus and increasing age are associated with the onset of diabetic neuropathy, a painful and highly disabling complication with a prevalence peaking at 50% among elderly diabetic patients. Acetyl-l-carnitine (ALC) is a molecule derived from the acetylation of carnitine in the mitochondria that has an essential role in energy production. It has recently been proposed as a therapy to improve the symptoms of diabetic neuropathy. ALC is widely distributed in mammalian tissues, including the brain, blood–brain barrier, brain neurons, and astrocytes. Aside from its metabolic activity, ALC has demonstrated cytoprotective, antioxidant, and antiapoptotic effects in the …
Inflammation and sarcopenia: A systematic review and meta-analysis
2017
Inflammatory cytokines have been shown to prompt muscle wasting, ultimately stimulating protein catabolism and suppressing muscle synthesis. However, the possible association between inflammatory parameters and sarcopenia is poorly understood. We therefore aimed to summarize the current evidence about this topic with a meta-analysis of studies reporting serum inflammatory parameters in patients with sarcopenia vs. people without sarcopenia (controls). An electronic PubMed and Scopus search through to 09/01/2016 and meta-analysis of cross-sectional studies comparing serum levels of inflammatory cytokines between patients with sarcopenia and controls was made, calculating random-effects stand…
Serum Dehydroepiandrosterone Sulfate and Risk for Type 2 Diabetes in Older Men and Women: The Pro.V.A Study
2016
Objective: A large body of clinical data suggests the importance of endogenous sex hormones in the pathogenesis of diabetes, but very little is known about the possible relationship between dehydroepiandrosterone sulfate (DHEAS) and diabetes, particularly in the elderly. We aimed, therefore, to examine whether high serum levels of DHEAS have any protective effects on the incidence of type 2 diabetes and to elucidate the possible role of gender in a cohort of older subjects. Methods: We followed 1258 community-dwelling subjects aged ≥65 years without type 2 diabetes who belonged to the Progetto Veneto Anziani (Pro.V.A.) for 4.4±1.2 years. DHEAS were measured at baseline and categorized into …
Frailty Is Associated with an Increased Risk of Incident Type 2 Diabetes in the Elderly
2016
Objective To investigate whether frailty is associated with an increased risk of incident type 2 diabetes mellitus (T2DM) in a prospective cohort of community-dwelling older people. Design Longitudinal study, mean follow-up of 4.4 years. Setting Progetto Veneto Anziani (Pro.V.A.) study that involved older community-dwellers. Participants 1754 men and women older than 65 years without T2DM at baseline. Measurements Frailty status was defined according to Fried criteria and categorized as frailty (≥3 criteria), prefrailty (1-2 criteria), or no frailty (0 criterion). Incident T2DM was defined as fasting plasma glucose (FPG) ≥7.0 mmol/L, or glycosylated hemoglobin ≥6.5%, the use of glucose-lowe…
Factors influencing serum 25-hydroxivitamin D levels and other bone metabolism parameters in healthy older women
2016
Objective: Older women have frequently low serum 25-hydroxivitamin D (25[OH]D) concentrations, high parathormone (PTH) levels and low bone mineral density (BMD) values. Endogenous synthesis, dietary habits, sunlight exposure and fat-mass-mediated storage may influence 25(OH)D levels and bone metabolism, but the relevance of these factors in the elderly has yet to be fully elucidated. We aimed to investigate the influence of dietary vitamin D intake and fat mass on serum 25(OH)D levels and bone metabolism in older women. Design: Cross-sectional. Setting: Community. Participants: 218 fit older women attending a biweekly mild fitness program. Measurements: Dietary habits was investigated throu…
Hypovitaminosis D and fat mass in healthy older people
2016
Prospective studies have suggested that hypovitaminosis D can predict the onset of obesity, but they relied mainly on body mass index, which could be scarcely reliable in older people. We investigated whether baseline hypovitaminosis D could predict higher fat mass (FM) levels using dual-energy X-ray absorptiometry in a sample of 116 fit and healthy older subjects. Although no significant differences in FM estimates emerged between subjects with and without hypovitaminosis D at the baseline, abdominal FM was found significantly higher in the former group (with hypovitaminosis D at the baseline) than in the latter after 3 years of follow-up. Adjusted logistic regression analysis confirmed th…
Prevalence of sarcopenia and associated factors in the healthy older adults of the Peruvian Andes
2016
Aim To assess the prevalence of sarcopenia and associated factors in a population of older people living in a rural area of the Peruvian Andes. Materials and methods The study concerned 222 people aged ≥65 years. Sarcopenia was diagnosed on the basis of skeletal muscle mass, measured using bioimpedance analysis, and gait speed, measured with the 4-m walking test, as recommended by the International Working Group on sarcopenia. Self-reported physical activity, the Short Physical Performance Battery, and the Six-Minute Walking Test also contributed information on participants’ physical performance status. Disabilities were investigated by assessing participants’ self-reported difficulties in …
Serum dehydroepiandrosterone sulfate and osteoarthritis in older people: the Pro.V.A. study.
2016
Although osteoarthritis (OA) and low levels of dehydroepiandrosterone sulfate (DHEAS) are common in the elderly, no studies on human beings are available concerning the possible relationship between them. We aimed to examine the relationship between DHEAS levels and any presence of OA in a cohort of community-dwelling older subjects. This study was part of the Progetto Veneto Anziani (Pro.V.A.), an Italian population-based cohort study on people over 65 years old. In this cross-sectional work, we considered 2050 individuals with a mean age of 74.2 ± 7.1 years (818 M and 1232 F), and with a complete set of information on OA and DHEAS levels. OA was defined using a standardized algorithm inve…
Results of an Observational Cohort Study of Hyperuricemia as a Predictor of Poor Physical Performance in the Elderly
2017
Objective: Hyperuricemia is frequent in older people and associated with several medical conditions. The relationship between hyperuricemia and physical performance is limited. We aimed to investigate the association between hyperuricemia and physical performance over a 4.4-year followup in the elderly. Methods: A total of 1,904 community-dwelling older participants were followed for a mean of 4.4 years. Hyperuricemia at baseline was defined using serum uric acid concentrations ≥6 and ≥7 mg/dl for women and men, respectively. Objective physical performance tests measured included the Short Physical Performance Battery (SPPB), 4-meter gait speed, chair-stands time, leg extension and flexion,…
Low Hemoglobin Levels and the Onset of Cognitive Impairment in Older People: The PRO.V.A. Study
2016
Low hemoglobin (Hb) levels are attracting interest as a risk factor for cognitive impairment, but with contrasting evidence emerging from the current literature. The aim of our work was to investigate the relationship between baseline serum Hb levels and the incidence of cognitive impairment in older people over a follow-up of 4.4 years. Our study considered a sample of 1227 elderly subjects cognitively intact at baseline, enrolled under the Progetto Veneto Anziani (Pro.V.A.) among 3099 screened subjects. For all participants, we measured serum Hb levels on blood samples; incident cognitive impairment was defined as a Mini Mental State Examination (MMSE) score <24 and confirmed by geriat…
Hypovitaminosis D predicts the onset of orthostatic hypotension in older adults
2016
A number of small cross sectional studies have demonstrated that hypovitaminosis D (represented by low 25 hydroxyvitamin D (25OHD) levels) is associated with orthostatic hypotension (OH). We investigated if hypovitaminosis D is associated with the onset of OH in older adults over a follow-up of 4.4 years. 25OHD was categorized using sex-specific quartiles; OH was defined as a drop of ≤20 mm Hg in systolic or ≤10 mm Hg in diastolic blood pressure <3 minutes of standing. Among 1308 elderly without OH at baseline, using an adjusted logistic regression analysis and taking those with higher baseline serum 25OHD as reference, there was a significant increase in the onset of OH in those with lo…
The Association Between Bone Mineral Density and Airflow Limitation in a Cohort of Fit Elderly Women
2016
Purpose: As studies examining the association between bone mineral density (BMD) and airflow limitation (AL) have produced conflicting results, the current one set out to analyze if and to what degree there are any correlations between these variables in a population of fit elderly women. Methods: One hundred and twenty-one non-smoking, fit and healthy women (age ≥ 65 years) underwent anthropometric assessment, laboratory testing (serum 25-hydroxy vitamin D, parathormone, and cytokine levels), pulmonary function testing (PFT), and dual-energy X-ray absorptiometry to evaluate BMD values of the lumbar and femoral regions. Results: A significant positive association was found between FEV1/FVC …
Orthostatic Changes in Blood Pressure and Cognitive Status in the Elderly: The Progetto Veneto Anziani Study.
2016
We studied a cohort of 1408 older subjects to explore whether postural changes in blood pressure (BP; defined as orthostatic hypo- or hypertension) can predict the onset of cognitive deterioration. Orthostatic hypotension was defined as a drop of 20 mm Hg in systolic or 10 mm Hg in diastolic BP and orthostatic hypertension as a rise of 20 mm Hg in systolic BP. Orthostatic BP values were grouped into quintiles for secondary analyses. Two cognitive assessments were considered: (1) cognitive impairment, that is, Mini-Mental State Examination scores ≤24/30, and (2) cognitive decline (CD), that is, a 3-point decrease in Mini-Mental State Examination score from the baseline to the follow-up. At t…
What physical performance measures predict incident cognitive decline among intact older adults? A 4.4 year follow up study
2016
Reductions in physical performance, cognitive impairment (CI) and decline (CD), are common in older age, but few prospective cohort studies have considered the relationship between these domains. In this study we investigated whether reduced physical performance and low handgrip/lower limbs strength, could predict a higher incidence of CI/CD during a 4-year follow-up among a cohort of elderly individuals. From 3099 older community-dwelling individuals initially enrolled in the Progetto Veneto Anziani (PRO.V.A.) study, 1249 participants without CI at the baseline were included (mean age 72.2 years, 59.5% females). Physical performance measures included the Short Physical Performance Battery …
Hyperuricemia protects against low bone mineral density, osteoporosis and fractures: a systematic review and meta-analysis
2016
Background: Serum uric acid (SUA) accounts for about 50% of extracellular antioxidant activity, suggesting that hyperuricemia may have a protective role in diseases characterized by high levels of oxidative stress, such as osteoporosis. We aimed to meta-analyse data regarding bone mineral density (BMD), osteoporosis and fractures in people with higher SUA vs. lower SUA concentrations. Materials and methods: Two investigators conducted a literature search using PubMed and Scopus, without language restrictions. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were used for BMD; risk ratios (RRs) and adjusted odds ratios (ORs) for cross-sectional data. Most possible adju…
Low Hemoglobin Levels and Risk of Developing Depression in the Elderly: Results From the Prospective PRO.V.A. Study.
2016
OBJECTIVE Low hemoglobin negatively affects health in the elderly, but research about the association with risk for depression is limited. We investigated the association between baseline hemoglobin concentrations and incident depression in a cohort of nondepressed elderly individuals. METHODS As part of the Northern Italian Progetto Veneto Anziani (PRO.V.A.) study, randomly drawn, community-dwelling subjects aged ≥ 65 years underwent prospective clinical and laboratory assessments between October 1995 and December 2002. The association between baseline hemoglobin and depression was assessed with adjusted Cox regression analyses. Baseline serum hemoglobin concentrations were further categor…
Changes in Frailty Status and Risk of Depression: Results From the Progetto Veneto Anziani Longitudinal Study.
2017
Objective To evaluate whether prefrailty was associated with the risk of developing depression and if longitudinal changes in frailty status corresponded to changes in incident depression during follow up. Methods A population-based, prospective cohort study was conducted for 4.4 years in two separate geographic areas near the city of Padua in the Veneto Region of Northern Italy. In 891 nondepressed, nonfrail, community-dwelling Italian subjects aged ≥ 65 (46.6% men) belonging to the Progetto Veneto Anziani study, depression was defined according to the Geriatric Depression Scale and was confirmed by geriatricians skilled in psychogeriatric medicine. Prefrailty was defined by the presence o…
Nutritional status, physical performance and disability in the elderly of the Peruvian Andes
2016
Background: Although nutritional status plays an important part in the physical performance and disability of older people, this relationship has been little studied in developing countries. Aims: A study on the effects of nutritional status on the physical performance and functional status of elderly people living in rural areas of the Peruvian Andes. Methods: The study concerned 222 people aged ≥65 years living in a rural area of the Peruvian Andes. The Mini-Nutritional Assessment (MNA) was used to classify participants as malnourished (MNA <= 17), at risk of malnutrition (MNA 18-23), or well-nourished (MNA>= 24). The short physical performance battery (SPPB) and six-minute walking …
Magnesium Status in Alzheimer's Disease: A Systematic Review
2016
The interest in poor magnesium (Mg) status as risk factor for Alzheimer's disease (AD) is increasing due to its antioxidant and neuroprotective properties. A systematic PubMed literature search of studies investigating Mg status was undertaken comparing AD to healthy controls (HCs) or patients with medical illness (medical controls [MCs]). Standardized mean differences (SMDs) ± 95% confidence intervals (CIs) were calculated for all outcomes. Of 192 potentially eligible studies, 13 were included (559 patients with AD, 381 HCs, and 126 MCs). Compared to HCs, patients with AD had significantly lower Mg in cerebrospinal fluid (2 studies; SMD = -0.35; P =.02) and in hair (2 studies; SMD = -0.75;…
Nephrolithiasis, bone mineral density, osteoporosis, and fractures: a systematic review and comparative meta-analysis
2016
Summary: Our meta-analysis demonstrates that people with nephrolithiasis have decreased bone mineral density, an increased odds of osteoporosis, and potentially an elevated risk of fractures. Introduction: People with nephrolithiasis might be at risk of reduced bone mineral density (BMD) and fractures, but the data is equivocal. We conducted a meta-analysis to investigate if patients with nephrolithiasis have worse bone health outcomes (BMD), osteoporosis, and fractures versus healthy controls (HCs). Methods: Two investigators searched major databases for articles reporting BMD (expressed as g/cm2 or a T- or Z-score), osteoporosis or fractures in a sample of people with nephrolithiasis, and…
Validation of bioelectrical impedance analysis for estimating limb lean mass in free-living Caucasian elderly people
2017
Background & aims Aging is characterized by a loss of limb lean mass (LLM) that can lead to physical disability and death. Regional bioelectrical impedance analysis (BIA) may be a reliable method for estimating LLM, but no prediction equations are available for elderly Caucasian subjects. The aim of this study was to develop and validate a BIA-based equation for predicting LLM in healthy elderly Caucasians, taking dual X-ray absorptiometry (DXA) as the reference method. Methods Using a cross-sectional design, 244 free-living healthy Caucasian subjects (117 men, 179 women) over 60 years of age were enrolled. LLM was measured with DXA (LLMDXA), and the resistance (Rz) and reactance (Xc) o…
Low vitamin D levels increase the risk of type 2 diabetes in older adults: A systematic review and meta-analysis
2017
Low serum levels of 25 hydroxyvitamin D (25OHD) (hypovitaminosis D) is common in older adults and associated with several negative outcomes. The association between hypovitaminosis D and diabetes in older adults is equivocal, however. We conducted a meta-analysis investigating if hypovitaminosis D is associated with diabetes in prospective studies among older participants. Two investigators systematically searched major electronic databases, from inception until 10/07/2016. The cumulative incidence of diabetes among groups was estimated according to baseline serum 25OHD levels. Random effect models were used to assess the association between hypovitaminosis D and diabetes at follow-up. From…
Marital status and frailty in older people: Gender differences in the Progetto Veneto Anziani longitudinal study
2016
Objectives: Marital status has been associated with disability and mortality, but its potential role as a factor influencing frailty has yet to be thoroughly investigated. The analysis of gender-related differences in the relationship between marital status and frailty is another interesting matter that remains to be fully elucidated. The aim of our study was to examine the association between marital status and the incidence of frailty in a cohort of older men and women over a 4.4-year follow-up. Materials and Methods: A sample of 1887 subjects older than 65 years, enrolled under the Progetto Veneto Anziani (Pro.V.A.) and with no evidence of frailty at baseline, were grouped by marital sta…
Factors Influencing Transitions Between Frailty States in Elderly Adults: The Progetto Veneto Anziani Longitudinal Study.
2017
Objectives: To investigate frailty state transitions in a cohort of older Italian adults to identify factors exacerbating or improving frailty conditions. Design: Population-based longitudinal study with mean follow-up of 4.4 years. Setting: Community. Participants: Individuals enrolled in the Progetto Veneto Anziani (Pro.V.A.) (N = 2,925; n = 1,179 male, n = 1,746 female; mean age 74.4 ± 7.3). Measurements: Frailty was identified at baseline and follow-up based on the presence of at least three Fried criteria; prefrailty was defined as the presence of one or two Fried criteria. Anthropometric, socioeconomic, and clinical characteristics were assessed at baseline in a personal interview and…
Poor Physical Performance Predicts Future Onset of Depression in Elderly People: Progetto Veneto Anziani Longitudinal Study.
2016
Abstract Background. Reduced physical performance is predictive of deleterious outcomes in older adults. Data considering objective physical performance and incident depression are sparse. Objective. The objective of this study was to investigate during a 4-year study whether objective physical performance can predict incident depression among older adults who do not have depression at the baseline. Design. This was a longitudinal study. Methods. From 3,099 older people initially enrolled in the Progetto Veneto Anziani study, 970 participants without depression at the baseline were included (mean age = 72.5 years; 54.6% women). Physical performance measures included the Short Physical Perfo…
Italian guidelines on management of persons with multimorbidity and polypharmacy
2022
AbstractMultimorbidity and polypharmacy are emerging health priorities and the care of persons with these conditions is complex and challenging. The aim of the present guidelines is to develop recommendations for the clinical management of persons with multimorbidity and/or polypharmacy and to provide evidence-based guidance to improve their quality of care. The recommendations have been produced in keeping with the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Overall, 14 recommendations were issued, focusing on 4 thematic areas: (1.) General Principles; (2.) target population for an individualized approach to care; (3.) individualized care of patients with mul…
Imaging of sarcopenia.
2016
Sarcopenia is currently considered a geriatric syndrome increasing in older people. The consequences of sarcopenia – in terms of impaired mobility, limited self-sufficiency and disability – have been amply demonstrated, increasing the need to develop methods to identify muscle mass loss as early as possible. Although sarcopenia involves a reduction in both muscle mass and function, loss of muscle mass remains the essential criterion for diagnosing this condition in daily practice. Computed tomography and magnetic resonance imaging represent the gold standard for studying body composition, and can identify quantitative and qualitative changes in muscle mass. These techniques are costly, time…
Pain increases the risk of developing frailty in older adults with osteoarthritis
2016
OBJECTIVE.: While osteoarthritis (OA)-related pain increases the risk of physical inactivity, disability, and falls, less is known about whether pain increases the risk of frailty. We investigated if people with OA reporting pain are more likely to develop frailty than people with OA without pain. DESIGN.: Population-based prospective cohort study with a follow-up of 4.4 years. SETTING.: Community. SUBJECTS.: The subjects were 1,775 older men and women with osteoarthritis, enrolled in the Progetto Veneto Anziani. METHODS.: Pain was ascertained according to medical records, symptoms/signs, and use of analgesics. Participants were considered frail if they met three out of five criteria of Fri…