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Abbiategrasso, Italy

Frisardi V.,Istituto Geriatrico Camillo Golgi
Journal of Alzheimer's Disease | Year: 2014

Metabolic syndrome (MetS) has been found to be a risk factor for dementia, mild cognitive impairment, and its associated states. However, a definitive conclusion cannot be drawn from the available data. Discrepancies between the results are due to several factors, e.g., study design, heterogeneity of the population enrolled, reliability and sensitivity of detection tools for cognitive changes, cut-offs and criteria used to diagnose MetS, the outcome measures considered, MetS duration before the onset of cognitive decline, and also the analytical approach performed. Recently, a systematic review and meta-analysis including 19,522 subjects aged 59-85 years from 13 longitudinal population-based studies has been conducted to examine the association between MetS and longitudinal changes in cognitive functions. While a marginal significant association was found in the younger old group, this relationship was not observed in older group (>70 years). It is not yet clear how age can influence this relationship. Apart from methodological issues, other biological factors are likely involved in this direction reversal. © 2014 - IOS Press and the authors. All rights reserved.

Colombo M.,Istituto Geriatrico Camillo Golgi | Cottino M.,Istituto Geriatrico Camillo Golgi | Ferrari D.,Istituto Geriatrico Camillo Golgi | Procino G.,Istituto Geriatrico Camillo Golgi | And 4 more authors.
Giornale di Gerontologia | Year: 2010

Objective. To measure the impact of depressive symptoms on functional and clinical parameters at admission in a rehabilitative geriatric ward. Method. We studied 434 elderly subjects, aged 78.7 ± 8.9 years (72% females). We measured at admission and at discharge: depressive symptoms by Geriatric Depression Scale (5 items GDS); functional status by Barthel Index and Tinetti tests; clinical status by CIRS severity and comorbidity scores; cognitive functions by Mini Mental State Examination, and pain level by a score from 0 (no pain) to 10 (highest pain level). Descriptive and inferential analyses were performed through the statistical package SPSS. Results. At admission, 34% of GDS were ≤ 1 (normal) and 15,5% ≥ 4 (severe symptomatology); respective results at discharge were 58.8 and 8.8%. Discharge GDS negatively correlated with % gain related to rehabilitative potential, and with clinical improvements in severity and comorbidity, and respective efficiencies. GDS differences (admission versus discharge) correlated to differences (admission versus discharge) in: clinical severity and its efficiency, Tinetti tests (both balance and gait), MMSE and pain level. GDS modifications (admission versus discharge) correlated through multiple regression with modifications (admission versus discharge) in Tinetti gait scores and in pain level. Conclusions. Our results underscore the high prevalence of depressive symptoms among elderly patients admitted to a rehabilitative geriatric ward. They also confirm the influence of depressive symptoms on functional and clinical outcomes of rehabilitative stay, as well as on its efficiency. Improvements of depressive symptoms is associated with improvements in several important markers of frailty, and with better efficiency of the rehabilitative process.

Colombo M.,Istituto Geriatrico Camillo Golgi | Procino G.,Istituto Geriatrico Camillo Golgi | Cottino M.,Istituto Geriatrico Camillo Golgi | Previdere G.,Istituto Geriatrico Camillo Golgi | And 5 more authors.
Giornale di Gerontologia | Year: 2012

Objectives. To investigate: A) social outcome, B) functional status, C) to compare functional levels of persons discharged/institutionalized/endowed of personal assistant, and D) to verify the representativeness of such sample of patients discharged by rehabilitative geriatric wards. Materials and methods. 99 subjects agreed to receive a phone interview 2 months after discharge, through a questionnaire including an adapted version of Barthel Index. Results. A) Social outcome: 89 subject (92,7%) were discharged home, 6 (6,3%) institutionalized in nursing homes, 1 died while in the ward and 3 were lost to follow-up; 27 (28,4%) had personal assistance. B) Average Barthel Index total score was 78,1 (± 24,2), most people performed well in basic activities of daily living. C) Functional status did not differ by discharge destination. Barthel Index score of subjects having personal assistance were slightly lower than those without it: 61,4 ± 26,3 vs. 85 ± 20; p = 0,000. D) Barthel Index score for patients discharged from specialist rehabilitative wards was the highest (84,1 ± 23,5) followed by geriatric rehabilitation (76 ± 21,6), general rehabilitation (71,7 ± 39). Barthel Index scores 2 months after discharge were slightly lower than at discharge in the same subjects (84,4 ± 19,5: p = 0,43). Conclusions. Our results may be useful in terms of: 1) continuity of care within a network; 2) new inter-professional assessment tools; 3) education in clinical gerontology.

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