Search results for "FRAILTY"

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. …

A comparison of semiparametric approaches to evaluate composite endpoints in heart failure trials

2021

In heart failure trials efficacy is usually proven by a composite endpoint including cardiovascular death (CVD) and recurrent heart failure hospitalisations (HFH), evaluated with time-to-first-event analysis based on a Cox model. As a considerable fraction of events is ignored that way, recurrent event[for full text, please go to the a.m. URL]

Corrigendum: Effectiveness of interventions to prevent pre-frailty and frailty progression in older adults: a systematic review.

2018

ABSTRACT Objective: To summarize the best available evidence regarding the effectiveness of interventions for preventing frailty progression in older adults. Introduction: Frailty is an age-related state of decreased physiological reserves characterized by an increased risk of poor clinical outcomes. Evidence supporting the malleability of frailty, its prevention and treatment, has been presented. Inclusion criteria: The review considered studies on older adults aged 65 and over, explicitly identified as pre-frail or frail, who had been undergoing interventions focusing on the prevention of frailty progression. Participants selected on the basis of specific illness or with a terminal diagno…

Prevention of Functional Decline by Reframing the Role of Nursing Homes?

2017

Institutionalization is generally a consequence of functional decline driven by physical limitations, cognitive impairments, and/or loss of social supports. At this stage, intervention to reverse functional losses is often too late. To be more effective, geriatric medicine must evolve to intervene at an earlier stage of the disability process. Could nursing homes (NHs) transform from settings in which many residents dwell to settings in which the NH residents and those living in neighboring communities benefit from staff expertise to enhance quality of life and maintain or slow functional decline? A task force of clinical researchers met in Toulouse on December 2, 2015, to address some of t…

Pre-Frailty and Risk of Cardiovascular Disease in Elderly Men and Women The Pro.V.A. Study

2015

Background Frailty is an important risk factor for cardiovascular disease (CVD), but the impact of early, potentially reversible stages of frailty on CVD risk is unknown. Objectives This study sought to ascertain whether pre-frailty can predict the onset of CVD in a cohort of community-dwelling, not disabled, elderly people. Methods A sample of 1,567 participants age 65 to 96 years without frailty or disability at baseline was followed for 4.4 years. Pre-frailty was defined as the presence of 1 or 2 modified Fried criteria (unintentional weight loss, low physical activity level, weakness, exhaustion, and slow gait speed), and incident CVD as onset of coronary artery diseases, heart failure,…

The frail patient with heart disease: An emerging and challenging issue

2018

Frailty and cardiovascular disease (CVD) are two common conditions that may affect clinical outcomes in older people. Epidemiological studies suggest that CVD is one of the most important contributor to the development of frailty in the aged patient, and the latter can therefore be considered a potential CVD risk factor. Moreover, traditional CVD risk factors are also known to be important for developing frailty. This close relationship between CVD and frailty is due, in part, to the shared etiological factors, which include low-grade inflammation, cellular senescence, and endocrine dysregulation. Therefore, the early detection of frailty is important in the management of patients with CVD …