Body mass index as a predictor of all-cause mortality in nursing home residents during a 5-year follow-up.
Background: Body mass index (BMI) is considered a short-term mortality predictor, but a consensus has not been reached on its role and that of other nutritional parameters in predicting long-term mortality in nursing home residents. Objectives: To correlate BMI, Mini Nutritional Assessment scores, and serum albumin levels with the 5-year mortality rate in institutionalized elderly subjects. Methods: A total of 181 nursing home residents aged ≥70 years were included in a 5-year longitudinal study. Data were collected on all participants' nutritional, health, cognitive, and functional status by means of a comprehensive geriatric assessment. Data on the participants' vital status were obtained…
Vitamin D deficiency predicts cognitive decline in older men and women: The Pro.V.A. Study
Objective: To test the hypothesis that hypovitaminosis D is associated with a higher risk of cognitive decline over a 4.4-year follow-up in a large sample of older adults. Methods: This research was part of the Progetto Veneto Anziani (Pro.V.A.), an Italian populationbased cohort study of 1,927 elderly subjects. Serum 25-hydroxyvitamin D (25OHD) levels were measured at the baseline. Global cognitive function was measured with the Mini-Mental State Examination (MMSE); scores lower than 24 were indicative of cognitive dysfunction, and a decline of 3 or more points on the MMSE over the follow-up was considered as clinically significant. Analyses were adjusted for relevant confounders, includin…
Duration of breastfeeding as a risk factor for vertebral fractures
Abstract Purpose Among the risk factors for osteoporosis and fractures, gynecological history (fertile period, parity and breastfeeding) play an important part. Changes in calcium metabolism to enable an adequate mineral transfer to the milk have a prominent role in bone loss during breastfeeding. Data on the influence of breastfeeding in postmenopausal osteoporosis are inconsistent. The aim of the present study was to identify any association between duration of breastfeeding and vertebral fractures in postmenopausal women. Methods All patients underwent the following tests: bone mineral density measurements of the lumbar spine (L1–L4) and the total and femoral neck using dual-energy X-ray…
Factors influencing serum 25-hydroxivitamin D levels and other bone metabolism parameters in healthy older women
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
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…
Serum 25-hydroxyvitamin d and the onset of late-life depressive mood in older men and women: the Pro.V.A. study.
Depression is a debilitating chronic condition, and its diagnosis and treatment in elderly people are often challenging. Because depressive mood seems to follow a seasonal pattern, peaking in summer and winter (1), it has recently been suggested that, through its action on the hypothalamus (which is involved in mood regulation), vitamin D might account for the link between seasonal changes in photoperiod and seasonal mood swings (2). Acting as a neurosteroid hormone, vitamin D may regulate human and animal neurotransmission, neuroprotection, and neuroimmunomodulation (3), and nuclear vitamin D receptors have been located in the human cortex and hippocampus (4). Although an association betwe…
Behavioral and psychological effects of coronavirus disease-19 quarantine in patients with dementia
Background: In March 2020, the World Health Organization declared a global pandemic due to the novel coronavirus SARS-CoV-2 and several governments planned a national quarantine in order to control the virus spread. Acute psychological effects of quarantine in frail elderly subjects with special needs, such as patients with dementia, have been poorly investigated. The aim of this study was to assess modifications of neuropsychiatric symptoms during quarantine in patients with dementia and their caregivers. Methods: This is a sub-study of a multicenter nation-wide survey. A structured telephone interview was delivered to family caregivers of patients with diagnosis of Alzheimer disease (AD),…
Association between dietary folate intake and serum insulin-like growth factor-1 levels in healthy old women
Abstract Objective High serum levels of insulin-like growth factor-1 (IGF-1) seem to coincide with higher rates of some types of cancer and the risk of all-cause mortality in old people. Eating vegetables seems to reduce IGF-1 levels because they are rich in micronutrients such as vitamins. This study investigates the possible association between vitamin intake and IGF-1 levels in a representative group of healthy elderly women with Mediterranean dietary habits. Design This cross-sectional study included 124 healthy women with a mean age of 71.3 ± 4.2 years and a mean body mass index (BMI) of 27.37 ± 3.48 kg/m 2 attending a mild fitness program twice a week at public gyms in Padova. The mai…
Nutritional predictors of cognitive impairment severity in demented elderly patients: The key role of BMI
Introduction: The body mass index (BMI) is commonly used to assess nutritional status and the Mini Mental State Examination (MMSE) is a validated tool for assessing cognitive status in elderly people. Nutritional and cognitive aspects are closely related in dementia. Objectives: To establish whether BMI predicts cognitive decline in demented patients and whether an "alarm" BMI cut-off exists for declining MMSE scores. Subjects and methods: 82 elderly demented patients underwent clinical, bio-chemical and functional assessment. Design: Transversal study. Results: The mean BMI was 26.08±4.48 kg/m 2 and the mean MMSE 18.68±5.38. Patients with BMI>25 kg/m2 had significantly lower MMSE scores…
The Association Between Bone Mineral Density and Airflow Limitation in a Cohort of Fit Elderly Women
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 …
Effect of oral magnesium supplementation on physical performance in healthy elderly women involved in a weekly exercise program: A randomized controlled trial
Background: Magnesium deficiency is associated with poor physical performance, but no trials are available on how magnesium supplementation affects elderly people’s physical performance. Objective: The aim of our study was to investigate whether 12 wk of oral magnesium supplementation can improve physical performance in healthy elderly women. Design: In a parallel-group, randomized controlled trial, 139 healthy women (mean 6 SD age: 71.5 6 5.2 y) attending a mild fitness program were randomly allocated to a treatment group (300 mg Mg/d; n = 62) or a control group (no placebo or intervention; n = 77) by using a computer-generated randomization sequence, and researchers were blinded to their …
The Impact of COVID-19 Quarantine on Patients With Dementia and Family Caregivers: A Nation-Wide Survey
IntroductionPrevious studies showed that quarantine for pandemic diseases is associated with several psychological and medical effects. The consequences of quarantine for COVID-19 pandemic in patients with dementia are unknown. We investigated the clinical changes in patients with Alzheimer’s disease and other dementias, and evaluated caregivers’ distress during COVID-19 quarantine.MethodsThe study involved 87 Italian Dementia Centers. Patients with Alzheimer’s Disease (AD), Dementia with Lewy Bodies (DLB), Frontotemporal Dementia (FTD), and Vascular Dementia (VD) were eligible for the study. Family caregivers of patients with dementia were interviewed by phone in April 2020, 45 days after …
Validation of bioelectrical impedance analysis for estimating limb lean mass in free-living Caucasian elderly people
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…
Association Between Short Physical Performance Battery and Falls in Older People: The Progetto Veneto Anziani Study.
It is known that weakness in the lower limbs is associated with recurrent falls in old people. Among the tests routinely used to assess lower extremity strength, the Short Physical Performance Battery (SPPB) is one of those used most often, but its relationship with recurrent falls is poorly investigated. We aimed to determine if SPPB scores are related to recurrent falling in a sample of 2710 older-aged people, and to ascertain which test in the SPPB is most strongly associated with a higher rate of falls. In this cross-sectional study, we demonstrated that participants scoring 0-6 in the SPPB were more likely to be recurrent fallers than those scoring 10-12 (odds ratio [OR]=3.46, 95% conf…
Assessing appendicular skeletal muscle mass with bioelectrical impedance analysis in free-living Caucasian older adults
Background & aims: Aging is characterized by a loss of appendicular skeletal muscle mass (ASMM) leading to physical disability and death. Bioelectrical impedance analysis (BIA) is reliable in estimating ASMM but no prediction equations are available for elderly Caucasian subjects. The aim of the study was to develop and validate an equation derived from bioelectrical impedance analysis (BIA) to predict appendicular skeletal muscle mass (ASMM) in healthy Caucasian elderly subjects, taking dual X-ray absorptiometry (DXA) as the reference method, and comparing the reliability of the new equation with another BIA-based model developed by Kyle etal. (Kyle UG, Genton L, Hans D, Pichard C, 200…
Effect of weight loss on mortality in overweight and obese nursing home residents during a 5-year follow-up.
Background/Objectives:The objective of this study was to ascertain the effect of weight loss over the course of 1 year on 5-year mortality in old nursing home (NH) residents in different classes of body mass index (BMI).Subjects/Methods:A longitudinal study was conducted on 161 NH residents aged ≥70 years at the Istituto di Riposo per Anziani, Padova, Italy. Data were collected using a comprehensive geriatric assessment at baseline and at a 1-year follow-up visit. Mortality was recorded over a 5-year follow-up. We divided our sample into four groups using as cutoffs a BMI of 25 and a weight gain or loss of 5% at 1 year (BMI ≥25 and weight stable/gain, BMI ≥25 and weight loss, BMI<25 and …
Effect of Oral Beta-Hydroxy-Beta-Methylbutyrate (HMB) Supplementation on Physical Performance in Healthy Old Women Over 65 Years: An Open Label Randomized Controlled Trial
Although older people are particularly liable to sarcopenia, limited research is available on beta-hydroxy-beta-methylbutyrate (HMB) supplementation in this population, particularly in healthy subjects. In this parallel-group, randomized, controlled, open-label trial, we aimed to evaluate whether an oral supplement containing 1.5 g of calcium HMB for 8 weeks could improve physical performance and muscle strength parameters in a group of community-dwelling healthy older women. Eighty healthy women attending a twice-weekly mild fitness program were divided into two equal groups of 40, and 32 of the treated women and 33 control completed the study. We considered a change in the Short Physical …
Preventive effect of risedronate on bone loss and frailty fractures in elderly women treated with anastrozole for early breast cancer.
The aim of this study was to assess the effect of adjuvant anastrozole, alone or associated with risedronate, on BMD and bone fracture risk in women more than 70 years old with hormone receptor-positive early breast cancer (EBC). In a group of 51 elderly women (aged 76.4 ± 5.0 years) considered for adjuvant aromatase inhibitors for EBC, 24 patients with T-scores ≥ -2 and no prevalent fractures received anastrozole 1 mg/day (group A), and 27 patients with T-scores < -2, or with T-scores ≥ -2 and prevalent fractures (group B), received anastrozole (1 mg/day) plus risedronate (35 mg/week). Both groups received supplementation with 1 g calcium carbonate and 800 IU vitamin D per day. Differen…
Are the Recommended Dietary Allowances for Vitamins Appropriate for Elderly People?
Background: An adequate vitamin intake is essential for a good nutritional status, especially in older women, who are more sensitive to nutritional deficiencies. The American, European and Italian Recommended Dietary Allowances (RDAs) derive mainly from studies on adults, and it is not clear whether they also apply to elderly people. Comparing the RDAs with the actual vitamin intake of a group of healthy older women could help to clarify the real needs of elderly people. Objective: Our aim was to compare the American, European, and Italian RDAs with the actual vitamin intake of a group of healthy older women. Design: This was a cross-sectional study. Participants: The study included 286 hea…
Serum 25-hydroxyvitamin D and the incidence of peripheral artery disease in the elderly: The Pro.V.A study
Aim: This study was conducted to examine whether low serum levels of 25-hydroxyvitamin D (250HD) are associated with a higher risk of incident peripheral artery disease (PAD) in a representative group of elderly people. Methods: We followed 1568 community-dwelling elderly participants without PAD at the baseline among a sample of 2097 initially eligible over a mean of 4.4 years as part of the Progetto Veneto Anziani (Pro.V.A.) study. The baseline serum 250HD levels were categorized as <24, 25-49, 50-74, >75 nmol/L, and incident PAD was defined as an ankle-brachial index below 0.9. Results: At the baseline, there were no differences in known risk factors for PAD (BMI), waist circumfere…
Nutritional and global indexes of progression in dementia: a 12-month prospective study.
Background: To assess the influence of body mass index (BMI) on the progression of dementia. Methods: Sixty elderly outpatients with untreated dementia followed for 12 months. All patients underwent clinical, cognitive, functional, and nutritional assessment at the baseline and after 12 months. Patients were divided into 2 groups by baseline BMI (< or ≥25 kg/m2). Results: Participants with a baseline BMI ≥25 kg/m2 had significantly higher Mini-Mental State Examination (MMSE) scores (21 ± 5.1 vs 15.9 ± 5.5; P < .001), while clinical dementia rating (CDR) and multidimensional prognostic index (MPI) scores were similar in the 2 groups. After 12 months, the MMSE score decreased significan…