Search results for " Frailty"

Frailty Scales for Prognosis Assessment of Older Adult Patients after Acute Myocardial Infarction

2021

We aimed to compare the prognostic value of two different measures, the Fried’s Frailty Scale (FFS) and the Clinical Frailty Scale (CFS), following myocardial infarction (MI). We included 150 patients ≥ 70 years admitted from AMI. Frailty was evaluated on the day before discharge. The primary endpoint was number of days alive and out of hospital (DAOH) during the first 800 days. Secondary endpoints were mortality and a composite of mortality and reinfarction. Frailty was diagnosed in 58% and 34% of patients using the FFS and CFS scales, respectively. During the first 800 days 34 deaths and 137 admissions occurred. The number of DAOH decreased significantly with increasing scores of both FFS…

Should we use gait speed in COPD, FEV 1 in frailty and dyspnoea in both?

2016

Frailty is a progressive physiological decline in multiple organ systems marked by loss of function, loss of physiological reserve and increased vulnerability to disease [1]. Biological (inflammation and loss of hormones), clinical ( e.g. sarcopenia and osteoporosis) and social factors are involved in frailty onset, evolution and prognosis [2, 3]. Links between frailty, dyspnoea and chronic respiratory diseases represent a novel and practical approach

Multidimensional frailty and quality of life: data from the English Longitudinal Study of Ageing

2022

Abstract Purpose Frailty has been found to be associated with poor quality of life (QoL) in older people, but data available are limited to cross-sectional studies. We therefore aimed to assess the association between multidimensional frailty, determined by Multidimensional Prognostic Index (MPI), with mortality and good QoL expectancy (GQoLE) in a large representative sample of older adults, over 10 years of follow-up. Methods In the English Longitudinal Study of Ageing, using the data from 2004–2005 and 2014–2015, MPI was calculated using a weighted score of domains of comprehensive geriatric assessment, i.e., number of difficulties in activities of daily living (ADL) and instrumental ADL…

Bioimpedance: a new approach for studying longevity

2017

Centenarians are the best model to study successful ageing. Unfortunately, they are rare and do not have an aged-matched control population to compare their exceptional characteristics with non-longevous people. Considering the complexity of molecular studies, the opportunity to analyse the centenarian phenotype with anthropometry could be an easy and no invasive interesting solution to identify peculiar measurable variables. In addition to the classic measurements, the bioelectrical impedance could be considered. This method permits to analyse the body composition, in terms of fat free mass and fat mass. Ageing is related to reduced fat free mass and increased body fat. The reduction of th…

BPCO E OSTEOPOROSI

2013

COPD and osteoporosis are frequently associated because they have common risk factors, including age, smoking habits and reduced physical activity. COPD is also characterized by systemic inflammation, malnutrition (up to cachexia), hypovitaminosis D, and the use of local and systemic corticosteroids, all of which could cause deterioration in bone quality with a consequent increase in fragility fractures. These fractures may further impair mobility and increase disability and mortality. The vertebral and rib fractures can directly further affect lung function and promote exacerbations. As a result, the assessment of fracture risk in patients with COPD is of vital importance from the earliest…

GLUCOSE CONTROL IN THE OLDER PATIENT: FROM INTENSIVE CONTROL TO EFFECTIVE AND SAFE CONTROL

2009

IL PAZIENTE ANZIANO CON FRATTURA DI FEMORE: VALUTAZIONE E SUPPORTO NUTRIZIONALE

2013

Osteoporosis in the elderly population is a major health problem worldwide, because it is associated with fragility fractures with consequent financial burden for health systems. Europe and North America are the regions where half of all hip fractures among elderly people occurred today, with Scandinavian countries reporting the highest incidence worldwide. Undernutrition, particularly protein malnutrition, is frequent in elderly with osteoporotic hip fracture, although, the role of dietary protein intake in osteoporosis remains controversial. Poor nutritional status is associated with higher comorbidity indices, mortality and readmissions in patients with femoral fracture. Another crucial …

PROTEIN SUPPLEMENTATION IN FRAIL OLDER PERSONS: OFTEN NECESSARY BUT NOT ALWAYS SUFFICIENT

2012

TERAPIA DELLA SARCOPENIA

2014

La sarcopenia e la cachessia sono i disordini muscolari più comune negli adulti. La principale differenza tra le due condizioni è che, a livello istologico, la sarcopenia rappresenta una condizione età correlata che si accompagna a neurodegenerazione, mentre la cachessia è una malattia infiammatoria del muscolo, che è associata a perdita di tessuto adiposo e ad anoressia. E’ stato dimostrato che entrambe le condizioni, nonostante le differenze nella etiologia e fisiopatologia, rispondono positivamente a trattamenti che aumentano la massa e la forza muscolare. Il gold standard attuale della terapia della sarcopenia è l'esercizio fisico. Inoltre, esistono una serie di farmaci che sono disponi…

Marginal hazard ratio estimates in joint frailty models for heart failure trials

2019

Abstract This work is motivated by clinical trials in chronic heart failure disease, where treatment has effects both on morbidity (assessed as recurrent non‐fatal hospitalisations) and on mortality (assessed as cardiovascular death, CV death). Recently, a joint frailty proportional hazards model has been proposed for these kind of efficacy outcomes to account for a potential association between the risk rates for hospital admissions and CV death. However, more often clinical trial results are presented by treatment effect estimates that have been derived from marginal proportional hazards models, that is, a Cox model for mortality and an Andersen–Gill model for recurrent hospitalisations. …