POOR DIET, LITTLE EXERCISE, SMOKING: WESTERN WAYS THAT PROMOTE HEART DISEASE

Presbyphagia and dysphagia in old age

Although presbyphagia is a clinically relevant problem among elderly population, possibly leading to dysphagia in old age, it remains a still underestimated health condition. The present review analyzes swallowing related anatomical and functional changes during aging, both in healthy people and in those affected by dysphagia. First of all, dysphagia in old people must not be confused with presbyphagia. To distinguish these two different conditions, a correct definition of both should be considered. Subsequently, a comprehensive evaluation including instrumental analysis should be carried out. The aim of this narrative review is to analyze the current knowledge of this clinical condition an…

Verbal Fluency in Mild Alzheimer's Disease: Transcranial Direct Current Stimulation over the Dorsolateral Prefrontal Cortex

Background: Recent studies showed that in healthy controls and in aphasic patients, inhibitory trains of repetitive transcranial magnetic stimulation (rTMS) over the right prefrontal cortex can improve phonemic fluency performance, while anodal transcranial direct current stimulation (tDCS) over the left prefrontal cortex can improve performance in naming and semantic fluency tasks. Objective: This study aimed at investigating the effects of cathodal tDCS over the left or the right dorsolateral prefrontal cortex (DLPFC) on verbal fluency tasks (VFT) in patients with mild Alzheimer’s disease (AD). Methods: Forty mild AD patients participated in the study (mean age 73.17±5.61 years). All part…

ETHICS AND AGING: FOCUS ON LIVING WILL FOR PATIENTS WITH DEMENTIA

Today dementia certainly represents a public health priority with a huge global impact on wordwide population. However, clinical and social issues related to dementia have long been marginalized. The actual high prevalence of dementias requires also to face issues from a bioethical perspective, regarding how to deal with demented patient’s disposition. There are currently no specific guidelines on the national territory regarding whether to draw up a living will by a patient with dementia, neither about the informative role of physicians during the progressive story of the disease.

ATRIAL FIBRILLATION AND MILD COGNITIVE IMPAIRMENT: WHAT CORRELATION?

ATRIAL FIBRILLATION AND MILD COGNITIVE IMPAIRMENT: WHAT CORRELATION? Aim. Atrial fibrillation (AF), in addition to macroembolic complications, may also produce multiple cerebral ischemic areas due to microembolic phenomena and transient hypoperfusion, eventually leading to a progressive cognitive impairment and even to acclaimed vascular dementia. The aim of this study was to evaluate the prevalence of cognitive impairment in patients with AF. The reported results concern data obtained at the moment of recruitment. Methods. The authors studied 42 patients with a history of non valvular AF (paroxysmal, persistent, recurrent or permanent) and 40 homogenous controls in sinus rhythm without pre…

Adrenal cavernous hemangioma: which correct decision making process?

Introduction: Cavernous hemangioma of the adrenal gland is a rare benign tumor characterized by the presence of blood-fil- led, dilated vascular spaces. These adrenal masses are usually non-functioning and the patients have no symptoms so the diagnosis is incidental. Methods: We performed a systematic literature review for all articles published until April 2015. The initial search identified 98 publications. We considered some characteristics: the mean age of the patients at diagnosis was 59 years (range 19 - 84); there were approximately 1.7 times more female patients than male patients; mean diameter of the lesions was 10.3 cm (range 2 - 25). Surgical treatment was more often open with m…

AZITHROMYCIN IN AN OLDER WOMAN WITH DIABETIC GASTROPARESIS

Diabetic neuropathy is a common chronic complication of diabetes and cause of significant morbidity and mortality, because it may involve the autonomous and peripheral nervous systems. Autonomic diabetic neuropathy is a challenging chronic complication of long-standing diabetes manifested with hypotension, syncope, gastroparesis, diarrhea, constipation, bladder dysfunction, sexual dysfunction, cardiac arrest, and/or sudden death. We present a case of diabetic gastroparesis in an older woman. The patient was an 83-year-old woman with a 40-year history of type 2 diabetes who was admitted with hypoglycemia, malnutrition, persistent vomiting, and obstinate constipation. After several unsuccessf…

Febbre di origine sconosciuta (FUO): due casisitiche di una medesima divisione di medicina interna a confronto

Nutrition, physical activity, and other lifestyle factors in the prevention of cognitive decline and dementia

Multiple factors combined are currently recognized as contributors to cognitive decline. The main independent risk factor for cognitive impairment and dementia is advanced age followed by other determinants such as genetic, socioeconomic, and environmental factors, including nutrition and physical activity. In the next decades, a rise in dementia cases is expected due largely to the aging of the world population. There are no hitherto effective pharmaceutical therapies to treat age-associated cognitive impairment and dementia, which underscores the crucial role of prevention. A relationship among diet, physical activity, and other lifestyle factors with cognitive function has been intensive…

Combination of intensive cognitive rehabilitation and donepezil therapy in Alzheimer’s disease.