Rehabilitation Clinical Institute Villa Delle Querce Nemi

Rome, Italy

Rehabilitation Clinical Institute Villa Delle Querce Nemi

Rome, Italy
SEARCH FILTERS
Time filter
Source Type

Donini L.M.,University of Rome La Sapienza | Scardella P.,Ist. Naz. Promozione Salute Popolazioni Migranti Il Contrasto Malat. Poverta | Piombo L.,Ist. Naz. Promozione Salute Popolazioni Migranti Il Contrasto Malat. Poverta | Neri B.,Rehabilitation Clinical Institute Villa Delle Querce Nemi | And 9 more authors.
Journal of Nutrition, Health and Aging | Year: 2013

Malnutrition occurs frequently in the frailest groups of the population, especially in people who are on a low income and elderly subjects, overall if they are institutionalized. The aim of this study was to assess the prevalence of malnutrition in a sample of elderly people living in different settings and to identify the determinants of malnutrition. Methods: A total of 718 subjects, 472 females (F) and 246 males (M), were recruited from nursing homes or were free living in three different regions in Italy. Nutritional status, depression, social, functional and cognitive status, were evaluated. Results: According to the Mini Nutritional Assessment (MNA), a high prevalence of malnutrition was found out in both genders: 26% of F and 16.3% of M were classified as being malnourished (MNA<17); 40.9% of F and 35% of M were at risk of malnutrition (MNA 17-23,5). The prevalence of malnutrition was significantly higher in NH subjects in both sexes. Moreover, a relationship was shown between malnutrition and inability to shop, prepare and cook meals because of a low income, distance from markets or supermarkets as well as impossibility to drive the car or to use public transportation. This study confirms the necessity to routinely perform nutritional status evaluation in elderly subjects, to carry out training courses for health workers (doctors, nurses, psychologists, dietitians), to implement nutritional education of the geriatric population, to develop tools and guidelines for health workers and caregivers, to identify and reduce clinical, functional, social or economic risk factors for malnutrition. © 2013 Serdi and Springer-Verlag France.


Donini L.M.,University of Rome La Sapienza | Donini L.M.,Rehabilitation Clinical Institute Villa Delle Querce Nemi | Poggiogalle E.,University of Rome La Sapienza | Morrone A.,Italian National Institute for Health | And 7 more authors.
Journal of Nutrition, Health and Aging | Year: 2013

Malnutrition occurs frequently in the elderly with important clinical and functional consequences. Moreover, the treatment of malnutrition in the elderly may be effective if clinical and nutritional interventions are performed in the early stages. Therefore the early identification of the risk of malnutrition using validated and handy tools plays a pivotal role in terms of clinical outcome. Mini Nutritional Assessment (MNA) was validated for this purpose since many years but it is still ongoing the debate over whether the use of different items in certain clinical conditions can be effective without affecting the validity of the nutritional status evaluation. The aim of this study was to assess the agreement between different versions of MNA in the evaluation of nutritional risk in elderly subjects. Methods: 522 subjects, 345 women and 177 men, were recruited from nursing homes or were free living in three different regions in Italy. All subjects underwent a multidimensional geriatric evaluation, addressed especially to nutritional status. We compared three different versions of MNA: the "original" version; a "proportional" MNA (MNA-P) in which the total MNA score was replaced by the ratio between the maximum score that each subject could obtain without including the body mass index (BMI) and the total original MNA score; and a third version in which calf circumference (CC) and mid-upper arm circumference (MAC) were used instead of BMI. Results: According to the original MNA, a high prevalence of malnutrition was found out in both genders (26% of women and 16.3% of men); both the versions of MNA, in which BMI was not considered, showed a good predictive value compared to original MNA. In particular, the MNA-P. showed an overall efficiency equal to 89,1% with specificity and positive predictive value respectively equal to 97.5% and 95.2%. MNA-CC-MAC showed even better results in terms of overall efficiency (91.4%), sensitivity (81.1%), specificity (97.1%), positive and negative predictive values (94.2% and 94.4%, respectively). Conclusion: The different versions of MNA gave similar results in the classifications of subjects and in comparison with nutritional and biochemical parameters. Moreover MNA versions that did not considered BMI seem to be more effective in singling out subjects with risk factors related to malnutrition (disability, reduced strength and calf circumference, anaemia). © 2013 Serdi and Springer-Verlag France.


Donini L.M.,University of Rome La Sapienza | De Felice M.R.,Rehabilitation Clinical Institute Villa Delle Querce Nemi | Savina C.,Rehabilitation Clinical Institute Villa Delle Querce Nemi | Coletti C.,Rehabilitation Clinical Institute Villa Delle Querce Nemi | And 5 more authors.
Journal of Nutrition, Health and Aging | Year: 2011

In elderly subjects, past researches have already underlined the role of nutritional status as a basic factor able to influence the prognosis either in acute wards or in rehabilitation and long-term care settings. aim of the study is that of retrospectively verify, through a multivariate analysis, the factors able to condition mortality in long-term care, paying particular attention to the nutritional status. Methods: the survey included 513 patients aged more than 65 years admitted to a long-term care unit during a three years period. exitus within the first three months of hospitalization was considered the outcome variable, while baseline functional, cognitive, clinical and nutritional status were considered the independent variables eventually related to mortality. Results: the univariate analysis found that some variables were significantly correlated with the outcome: comorbidity, aDL, cognitive status, pressure sores, albumin, transferrin, cRP, mucoprotein, cholesterol, cholinesterase, MaMc and Mna. the predictive value of the block model of the logistic regression analysis was 77.9% (specificity = 85.3%, sensitivity = 63.9%). With the forward stepwise analysis only Mna, cholinesterase, cRP and mucoprotein were considered in the final model. in this case the predictive value of the model was 79.3% (specificity = 84.6%, sensitivity = 69.46%).


Donini L.M.,University of Rome La Sapienza | Donini L.M.,Rehabilitation Clinical Institute Villa delle Querce Nemi | Neri B.,University of Rome La Sapienza | De Chiara S.,University of Rome La Sapienza | And 2 more authors.
PLoS ONE | Year: 2013

Introduction: Malnutrition is a clinical condition due to the imbalance among needs, intake and use of nutrients, leading to the increase of morbidity and mortality, and to the impairment of quality of life. Even in industrialized countries undernutrition is becoming an alarming phenomenon, especially involving elderly institutionalized subjects. A multicentric study called PIMAI (Project Iatrogenic MAlnutrition in Italy), was carried out in Italy over 2005. The aims of this study were to determine the prevalence of malnutrition in hospitals and in nursing care homes (NH), to assess the level of nutritional attention and to measure the perceived quality in food and nutritional care. This paper represents a preliminary analysis of data collected in a NH included in the PIMAI project. Materials and methods: A total of 100 subjects (29 males and 71 females, aged 80.2±10 years), were recruited from January to June 2005 at the Clinical Rehabilitation Institute "Villa delle Querce" in Nemi (Rome), among patients in the NH facility. All the participants underwent a multidimensional geriatric evaluation (considering nutritional, clinical, functional and cognitive parameters), and a survey on "perceived quality" of nutritional care. Results and discussion: According to nutritional status defined by the Mini Nutritional Assessment®, data analysis showed a high prevalence of malnutrition (36%) especially related to advanced age, chewing, cognitive and functional impairments. Patients seemed to consider nutrition to be important for their health; on the other hand, they were not thoroughly satisfied with the quality of food. Particularly, it was observed scarce attention to nutritional status from medical and nursing staff. Conclusions: Our study confirms the need to pay greater attention to nutritional status in elderly institutionalized subjects. Medical and nursing teams need to be aware of the importance to perform an evaluation of nutritional status in these subset of subjects. © 2013 Donini et al.

Loading Rehabilitation Clinical Institute Villa Delle Querce Nemi collaborators
Loading Rehabilitation Clinical Institute Villa Delle Querce Nemi collaborators