Search results for "Frail"

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…

Ramucirumab in elderly patients with hepatocellular carcinoma and elevated alpha-fetoprotein after sorafenib in REACH and REACH-2.

2020

Background & Aims: Limited data on treatment of elderly patients with hepatocellular carcinoma (HCC) increase the unmet need. REACH and REACH-2 were global phase III studies of ramucirumab in patients with HCC after prior sorafenib, where patients with alpha-fetoprotein (AFP) ≥400 ng/mL showed an overall ssurvival (OS) benefit for ramucirumab. These post-hoc analyses examined efficacy and safety of ramucirumab in patients with HCC and baseline AFP ≥ 400 ng/mL by three prespecified age subgroups (<65, ≥65 to <75 and ≥75 years). Methods: Individual patient data were pooled from REACH (baseline AFP ≥400 ng/mL) and REACH-2. Kaplan-Meier and Cox proportional hazards regression methods …

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…