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Lombardi G, Pancani S, Bagnoli S, Vannetti F, Nacmias B, Sorbi S, Cecchi F, Macchi C. Understanding the interplay between APO E polymorphism and cognition in the Italian oldest old: results from the "Mugello study". Neurol Sci 2024; 45:539-546. [PMID: 37710144 DOI: 10.1007/s10072-023-07073-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/09/2023] [Indexed: 09/16/2023]
Abstract
INTRODUCTION Recent data suggest that the deleterious effect on general health and cognition of ε4 allele of Apolipoprotein E (ApoE) observed in the elderly population, may attenuate in extreme aging. This study aimed to describe the ApoE genotype distribution and its relationship with cognition in a group of nonagenarians living in the Mugello area, Italy. MATERIAL AND METHODS Cognition was evaluated using the Mini-Mental-State-Examination (MMSE). DNA was extracted from blood samples to determine ApoE genotyping. Participants were classified into three ApoE groups (ε2, ε3, ε4). Logistic and linear regression models were created, to assess the relationship between ApoE genotype group and dementia diagnosis and cognitive performance, respectively. RESULTS 169 subjects were included. ApoE ε3 was the most prevalent genotype (76.3%). Dementia prevalence was 26.6% and it was not associated with the presence of ApoE ε4. Participants of ε4 group were significantly more likely to have lower cognitive performances than ε2 and ε3, independently of a dementia diagnosis. DISCUSSION Results support that ApoE genotype no longer plays a role in the health condition of the oldest old, however, an interaction is detectable between ApoE polymorphism and cognitive performances at this extreme age.
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Affiliation(s)
- Gemma Lombardi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Via Di Scandicci 269, 50143, Florence, Italy
| | - Silvia Pancani
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Via Di Scandicci 269, 50143, Florence, Italy.
| | - Silvia Bagnoli
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Via Di Scandicci 269, 50143, Florence, Italy
| | - Federica Vannetti
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Via Di Scandicci 269, 50143, Florence, Italy
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Via Di Scandicci 269, 50143, Florence, Italy
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Via Di Scandicci 269, 50143, Florence, Italy
| | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Via Di Scandicci 269, 50143, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Via Di Scandicci 269, 50143, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
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Lombardi G, Baccini M, Gualerzi A, Pancani S, Campagnini S, Doronzio S, Longo D, Maselli A, Cherubini G, Piazzini M, Ciapetti T, Polito C, Pinna S, De Santis C, Bedoni M, Macchi C, Ramat S, Cecchi F. Comparing the effects of augmented virtual reality treadmill training versus conventional treadmill training in patients with stage II-III Parkinson's disease: the VIRTREAD-PD randomized controlled trial protocol. Front Neurol 2024; 15:1338609. [PMID: 38327625 PMCID: PMC10847255 DOI: 10.3389/fneur.2024.1338609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/09/2024] [Indexed: 02/09/2024] Open
Abstract
Background Intensive treadmill training (TT) has been documented to improve gait parameters and functional independence in Parkinson's Disease (PD), but the optimal intervention protocol and the criteria for tailoring the intervention to patients' performances are lacking. TT may be integrated with augmented virtual reality (AVR), however, evidence of the effectiveness of this combined treatment is still limited. Moreover, prognostic biomarkers of rehabilitation, potentially useful to customize the treatment, are currently missing. The primary aim of this study is to compare the effects on gait performances of TT + AVR versus TT alone in II-III stage PD patients with gait disturbance. Secondary aims are to assess the effects on balance, gait parameters and other motor and non-motor symptoms, and patient's satisfaction and adherence to the treatment. As an exploratory aim, the study attempts to identify biomarkers of neuroplasticity detecting changes in Neurofilament Light Chain concentration T0-T1 and to identify prognostic biomarkers associated to blood-derived Extracellular Vesicles. Methods Single-center, randomized controlled single-blind trial comparing TT + AVR vs. TT in II-III stage PD patients with gait disturbances. Assessment will be performed at baseline (T0), end of training (T1), 3 (T2) and 6 months (T3, phone interview) from T1. The primary outcome is difference in gait performance assessed with the Tinetti Performance-Oriented Mobility Assessment gait scale at T1. Secondary outcomes are differences in gait performance at T2, in balance and spatial-temporal gait parameters at T1 and T2, patients' satisfaction and adherence. Changes in falls, functional mobility, functional autonomy, cognition, mood, and quality of life will be also assessed at different timepoints. The G*Power software was used to estimate a sample size of 20 subjects per group (power 0.95, α < 0.05), raised to 24 per group to compensate for potential drop-outs. Both interventions will be customized and progressive, based on the participant's performance, according to a predefined protocol. Conclusion This study will provide data on the possible superiority of AVR-associated TT over conventional TT in improving gait and other motor and non-motor symptoms in persons with PD and gait disturbances. Results of the exploratory analysis could add information in the field of biomarker research in PD rehabilitation.
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Affiliation(s)
- Gemma Lombardi
- Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
| | - Marco Baccini
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
| | | | - Silvia Pancani
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
| | | | - Stefano Doronzio
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Diego Longo
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Alessandro Maselli
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
- Department of Technical-Health Professions, Rehabilitation, and Prevention, Campostaggia Hospital, Poggibonsi (SI), USL Toscana Sudest, Italy
| | - Giulio Cherubini
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | | | | | - Samuele Pinna
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Chiara De Santis
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marzia Bedoni
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Silvia Ramat
- Parkinson Unit, Department of NeuroMuscular-Skeletal and Sensorial Organs, AOU Careggi, Florence, Italy
| | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Binazzi B, Provini F, Pancani S, Grippo A, Vannetti F, Pasquini G, Frandi R, Turcan N, Razzolini L, Cecchi F, Lova RM, Macchi C. Sleep profile in a population of community-dwelling nonagenarians: data from the Mugello study. Psychogeriatrics 2023; 23:487-493. [PMID: 36967638 DOI: 10.1111/psyg.12959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 02/13/2023] [Accepted: 03/07/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Very few studies have investigated sleep characteristics in the oldest-old individuals (aged ≥85 years) and data collected often rely on self-reported information. This study had three aims: (i) to objectively assess, using a wearable device, the sleep characteristics of a large community of oldest-old subjects; (ii) to assess differences in sleep parameters between self-reported 'good sleepers' and 'bad sleepers'; (iii) to assess whether there was a relationship between sleep parameters and cognitive status in this community-dwelling population. METHODS There were 178 subjects (74.2% women, median age 92 years) included in the 'Mugello study', who wore an armband 24 h/day for at least two consecutive nights to estimate sleep parameters. The perceived sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), the cognitive status through the Mini-Mental State Examination. Continuous variables were compared between men/women, and good/bad sleepers with the independent t-test or Mann-Whitney U-test, according to data distribution. Chi-square test was used for categorical/dichotomous variables. An ordinal logistic regression model was used to study the possible association between sleep parameters and cognitive function. RESULTS Participants spent in bed nearly 9 h, with a total sleep time of 7 h, a sleep onset latency of 17 min, and a sleep efficiency of 83%. Sleep onset latency was significantly associated with different cognitive levels when age and education level were considered. No significant difference in sleep parameters estimated using the SenseWear armband were found between poor (n = 136, 76.4%) and good sleepers (n = 42, 23.6%), identified according to the PSQI. CONCLUSIONS In this study, actigraphic measurements revealed that subjects with a cognitive decline were more prone to increased sleep onset latency. Sleep quality assessed using the PSQI was not coherent with actigraphic measurements in this sample, supporting the need for objective measures when investigating sleep quality in the oldest-old population.
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Affiliation(s)
| | - Federica Provini
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | | | | | | | | | - Nona Turcan
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | | | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Poulsen W, Christensen K, Dalgård C. Dietary patterns and survival to 100 + years: an empty systematic review of cohort and case–control studies. Arch Public Health 2022; 80:161. [PMID: 35768834 PMCID: PMC9241213 DOI: 10.1186/s13690-022-00914-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/10/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Centenarians are used as a model of healthy ageing and longevity. Diet is a factor known to affect mortality in middle aged adults and elderly. However, it is unknown whether diet has an impact on survival to 100 + years. The aims of this systematic review were to summarize the evidence on (i) the association between dietary patterns in late adult life and survival to 100 + years and (ii) the common characteristics across dietary patterns that are shown to be positively associated with survival to 100 + years.
Methods
We performed a systematic literature search in MEDLINE and EMBASE, and a hand search at four longevity projects homepages up to 4 June 2021. We searched for cohort and case–control studies investigating the association between dietary patterns and all-cause mortality among individuals aged ≥ 65 years at enrolment regardless of their health status and residence. Studies were excluded if follow-up was performed too soon to allow the population or a subgroup of it to have become 100 + years of age.
Results
Of 3,685 identified records 108 reports were retrieved and full text screened. No studies met our inclusion criteria, thus the review process resulted in no eligible studies found. Hence, no risk of bias assessment and no synthesis of data was performed.
Conclusions
No studies have investigated dietary patterns in late adult life in relation to survival to 100 + years of age. We have observed that as of June 2021 published cohort studies exist investigating all-cause mortality risk from different dietary patterns among the oldest old, but follow-up has been performed before the cohort could have reached 100 years of age. However, cohorts do exist where data on dietary habits in adult life has been collected decades ago and where follow-up in 2022 will allow the participants to have become 100 + years old.
Registration
The review protocol is published at University of Southern Denmark’s Research Portal (Poulsen et al. Dietary Patterns and Survival to 100 + Years: Protocol for a Systematic Review of cohort and case–control studies University of Southern Denmark's Research Portal: University of Southern Denmark, 2021) available at https://portal.findresearcher.sdu.dk/en/publications/kostm%C3%B8nstre-og-overlevelse-til-100-%C3%A5r-protokol-for-en-systematisk. We have specified aim (i) of our research question in this report compared to the protocol, by adding “late” to “adult life”.
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Serum TSH and Daily Physical Activity in a Cohort of Nonagenarians: Results from the Mugello Study. J Funct Morphol Kinesiol 2022; 7:jfmk7030056. [PMID: 35997372 PMCID: PMC9396985 DOI: 10.3390/jfmk7030056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The current literature does not furnish clear data concerning the relationship between thyroid function, sedentary time and daily physical activity (PA) in older adults with euthyroid condition. The aim of this study was to investigate the association of serum Thyrotropin-Stimulating Hormone (TSH), free Triiodothyronine (fT3) and free Thyroxine (fT4) with sedentary time and PA in a cohort of nonagenarians. METHODS A total of 108 nonagenarians (92.8 ± 3.2 years), participating in the Mugello Study, and with complete data on thyroid function, sedentary time, PA and sleeping (objectively collected through a multisensory device), were considered for the analysis. RESULTS Mainly, TSH negatively correlated with time spent lying down, and positively correlated with METs. fT4 levels were negatively associated with mean daily metabolic equivalents (METs) and with low-intensity PA practice (LIPAT), and positively associated with lying down and sleeping time. Similar results have been shown in the female sample. Mainly, participants with high-normal (third tertile) versus low-normal TSH (first tertile) had higher moderate-intensity PA (MIPAT) (p = 0.03). In the female sample, first TSH tertile had higher METs (p = 0.010), LIPAT (p = 0.02), MIPAT (p = 0.01) and lower time lying down (p = 0.04) than third TSH tertile. CONCLUSION High-normal serum TSH and low-normal fT4 are associated with higher levels and intensity of daily PA, together with higher MIPAT continuity, in the oldest-old.
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Szklarzewska S, Vande Walle J, De Breucker S, Schoevaerdts D. A comparison of clinical characteristics between old and oldest-old patients hospitalised for SARS-COV2. Acta Clin Belg 2022; 78:192-199. [PMID: 35894148 DOI: 10.1080/17843286.2022.2102115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
OBJECTIVES Oldest-old patients may have an unusual SARS-COV2 presentation that can jeopardise diagnosis and management. The aim of this study was to compare the clinical characteristics and outcomes of oldest-old (≥85 years) and old patients (75-85 years) admitted with COVID-19 to Belgian hospitals during the first wave of the pandemic. METHODS We conducted a multicentre, retrospective, observational study in ten Belgian hospitals. We reviewed the electronic clinical records of patients ≥75 years hospitalised with COVID-19 from March to June 2020. RESULTS A total of 986 patients were placed on the register (old group: n = 507; oldest-old group: n = 479). Before hospitalisation, the oldest-old (OO) group presented with more geriatric syndromes including comorbidities, frailty, falls, cognitive impairment, and incontinence. At admission, the OO group presented with less cough, less headache, and less fever but significantly more delirium than old (O) group. Members of the OO group were admitted less frequently to intensive care units (ICUs). A geriatrician was consulted to help in the decision-making process more often for the OO group. The global mortality of the cohort was 47%, with no difference between the two groups. Patients in the OO group were more often institutionalised after hospitalisation and less often referred for rehabilitation. CONCLUSIONS The OO patients presented with more geriatric syndromes that make them vulnerable to dependence and institutionalisation after a hospital stay, without having a higher mortality rate than O patients. Geriatrician expertise is necessary in the management of frail older patients.
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Affiliation(s)
- Sylwia Szklarzewska
- Department of Geriatric Medicine, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Justine Vande Walle
- Department of Geriatric Medicine, CHU UCL Namur Hospital, Godinne site, Université Catholique de Louvain, Brussels, Belgium
| | - Sandra De Breucker
- Department of Geriatric Medicine, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Didier Schoevaerdts
- Department of Geriatric Medicine, CHU UCL Namur Hospital, Godinne site, Université Catholique de Louvain, Brussels, Belgium
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Assessing Relationships between Physically Demanding Work and Late-Life Disability in Italian Nonagenarian Women Living in a Rural Area. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148880. [PMID: 35886729 PMCID: PMC9319548 DOI: 10.3390/ijerph19148880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/11/2022] [Accepted: 07/20/2022] [Indexed: 02/04/2023]
Abstract
As more and more persons live into their 90s and beyond, investigating causes of disability in the oldest-old population is relevant for public health implications to plan preventive strategies and rehabilitation interventions. A negative association between physically demanding work and midlife physical function has been shown, but there is a paucity of longitudinal studies investigating possible work-related long-term effects in the oldest old. This study investigates the relationship between physically demanding work exposure and late-life physical performances, disability, general health status, and quality of life in a sample of women aged 90 years and over inside the Mugello Study. Sociodemographic data, cognitive and functional status, lifestyle, medical history, drug use, and work history were collected from 236 participants. Farmers had a lower percentage of individuals with preserved independence in basic activities of daily living compared to other occupations. However, in the multivariate analysis, only a higher cognitive function remained associated with functional independence. While confirming the well-known association between cognitive and functional decline in very old age, our results do not support the hypothesis that the negative effects of physical work exposure observed in midlife are relevant to predict disability in nonagenarian women.
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Pancani S, Lombardi G, Sofi F, Gori AM, Boni R, Castagnoli C, Paperini A, Pasquini G, Vannetti F, Molino Lova R, Macchi C, Cecchi F. Predictors of Mortality in 433 Nonagenarians Inside the Mugello Study: A 10 Years Follow-Up Study. J Aging Health 2022; 34:1071-1080. [PMID: 35499248 DOI: 10.1177/08982643221091653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE to identify the predictors of mortality in a cohort of nonagenarians inside the "Mugello study" after 10 years follow-up. METHODS Information on sociodemographic data, cognitive and functional status, lifestyle, medical history, and drug use was collected from 433 non-selected participants aged 90-99 years, living in the Mugello area (Italy). Participants were followed over 10 years and their dates of death were retrieved from the municipal registers. Cox regression analysis was used to determine significant potential prognostic factors. RESULTS The mortality rate was 96.5%. Cox proportional hazards analysis showed that a lower cognitive status was significantly associated with higher mortality as well as a poorer functional status, a higher comorbidity, and a higher number of drugs consumption. DISCUSSION Impaired cognitive function, loss of functional independence, higher comorbidity, and higher drugs intake were the stronger predictors of mortality.
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Affiliation(s)
| | | | - Francesco Sofi
- 9360IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.,Department of Experimental and Clinical Medicine, 9300University of Florence, Florence, Italy
| | - Anna Maria Gori
- Department of Experimental and Clinical Medicine, 9300University of Florence, Florence, Italy.,Atherothrombotic Unit, Careggi University Hospital, Florence, Italy
| | - Roberta Boni
- 9360IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | | | | | | | | | | | - Claudio Macchi
- 9360IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.,Department of Experimental and Clinical Medicine, 9300University of Florence, Florence, Italy
| | - Francesca Cecchi
- 9360IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.,Department of Experimental and Clinical Medicine, 9300University of Florence, Florence, Italy
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Pancani S, Lombardi G, Sofi F, Gori AM, Boni R, Castagnoli C, Paperini A, Pasquini G, Vannetti F, Lova RM, Macchi C, Cecchi F. 12-month survival in nonagenarians inside the Mugello study: on the way to live a century. BMC Geriatr 2022; 22:194. [PMID: 35279074 PMCID: PMC8918304 DOI: 10.1186/s12877-022-02908-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/07/2022] [Indexed: 11/24/2022] Open
Abstract
Background Life expectancy has increased over the last century and a growing number of people is reaching age 90 years and over. However, data on nonagenarians’ health trends are scarce due to difficulties in investigating this specific population. This study aims to identify risk factors for one-year mortality in nonagenarians using data collected within the “Mugello Study”. Methods Complete information on sociodemographic data, cognitive and functional status, lifestyle, medical history, and drug use was collected from 433 nonagenarians, as well as information about survival after 1 year from the interview. Results The sample included 314 women (72.5%) and 119 men (27.5%) with a median age of 92 years (range 90-99 years). The mortality rate was 20.3% (88 deaths). After adjustment for age and sex, a significantly higher risk of dying within 12 months was observed in individuals with more severe cognitive impairment (HR = 5.011, p < 0.001), more severe disability in basic activities of daily living (HR = 4.193, p < 0.001), sedentary lifestyle (HR = 3.367, p < 0.001), higher number of drugs assumed (HR = 1.118, p = 0.031), and kidney dysfunction (HR = 2.609, p = 0.004). When all the variables were included in the analysis, only older age (HR = 1.079, p = 0.048), lower cognitive function (HR = 2.859, p = 0.015), sedentary lifestyle (HR = 2.030, p = 0.026), and kidney dysfunction (HR = 2.322, p = 0.018) remained significantly associated with reduced survival. Conclusions Data from the Mugello study support the hypothesis that survival at 12 months in nonagenarians is not a stochastic process and that older age, reduced cognitive function, sedentary lifestyle, and the presence of kidney dysfunction are associated with mortality. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02908-9.
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Iacovelli C, Germanotta M, Coraci D, Mosca R, Vincenzi MT, Gilardi A, Padua L, Aprile I. Back Pain in Adolescents: Characteristics, Quality of Life, and Drug Self-Management: A Cross-Sectional Study of 1301 Italian Students. Pediatr Emerg Care 2021; 37:e716-e718. [PMID: 31389902 DOI: 10.1097/pec.0000000000001876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Back pain is one of the major problems for the public health system in the western world. The purposes of this study were to assess back pain in a large cohort of adolescents; to evaluate the prevalence, intensity, and features; and obtain information about drug management of this symptom. METHODS One thousand four hundred seventy-one healthy students aged 14 to 19 years were enrolled in the study. The subjects underwent a face-to-face interview using an ad hoc questionnaire, the Numeric Rating Scale, the Neuropathic Pain Symptom Inventory, and the Short-Form 36 questionnaire. RESULTS Sixty-eight percent of adolescents reported moderate to severe pain, with a higher prevalence of moderate/severe pain in female. The intensity of pain was higher (P < 0.001) in females than in men. A correlation was found between pain and quality of life. Considering the adolescents with severe pain, 21.6% requested a doctor's opinion, and 18% used analgesics (63.2% of them without a doctor's prescription), with a frequency of about 2 times per month. CONCLUSIONS We found that the prevalence of back pain in adolescents is very high, with the consequences on quality of life, and it becomes frequently a self-managed symptom. This should encourage research on the causes of pain in order to limit the risk factors underlying the pain development and obtain a good prevention strategy.
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Affiliation(s)
| | | | - Daniele Coraci
- Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS
| | - Rita Mosca
- From the IRCCS Fondazione Don Carlo Gnocchi, Milan
| | | | | | | | - Irene Aprile
- From the IRCCS Fondazione Don Carlo Gnocchi, Milan
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Lombardi G, Paganelli R, Abate M, Ireland A, Molino-Lova R, Sorbi S, Macchi C, Pellegrino R, Di Iorio A, Cecchi F. Leukocyte-derived ratios are associated with late-life any type dementia: a cross-sectional analysis of the Mugello study. GeroScience 2021; 43:2785-2793. [PMID: 34674153 PMCID: PMC8529862 DOI: 10.1007/s11357-021-00474-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/11/2021] [Indexed: 11/01/2022] Open
Abstract
Immunosenescence, vascular aging, and brain aging, all characterized by elevated levels of inflammatory markers, are thought to share a common pathogenetic pathway: inflamm-aging. Retrospective cross-sectional analysis was conducted using data from the Mugello study (Tuscany, Italy), a representative Italian cohort of free-living nonagenarians. to assess the association between specific peripheral inflammation markers derived from white blood cell counts, and the diagnosis of dementia. All the variables of interest were reported for 411 subjects (110 males and 301 females) out of 475 enrolled in the study. Anamnestic dementia diagnosis was obtained from clinical certificate and confirmed by a General Practitioner, whereas leukocyte ratios were directly calculated from white blood cell counts. Body mass index and comorbidities were considered potential confounders. Diagnosis of any type dementia was certified in 73 cases (17.8%). Subjects affected by dementia were older, more frequently reported a previous stroke, had lower body mass index, and lower Mini-Mental-State-Examination score. Moreover, they had a higher lymphocyte count and lymphocyte-to-monocyte ratio compared to the non-demented nonagenarians. We found that higher levels of lymphocyte counts are cross-sectionally associated with a clinical diagnosis of dementia. Furthermore, lymphocyte-to-monocyte ratio is directly associated with any type of dementia, independently of age, sex, lymphocyte count, and comorbidities. Lymphocyte-to-monocyte ratio may be considered a marker of immunological changes in the brain of dementia patients; moreover, it is low-cost, and easily available, thus enabling comparisons among different studies and populations, although the timeline and the extent of lymphocyte-to-monocyte ratio role in dementia development must be further investigated.
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Affiliation(s)
- Gemma Lombardi
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269, 50143, Florence, Italy.,Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Roberto Paganelli
- Department of Medicine and Science of Aging, Laboratory of Clinical Epidemiology and Aging, University Centre of Sports Medicine, University "G. d'Annunzio, Viale Abruzzo 322, Chieti, Italy.,Institute of Clinical Immunotherapy and Advanced Biological Treatments, YDA, Pescara, Italy
| | - Michele Abate
- Department of Medicine and Science of Aging, Laboratory of Clinical Epidemiology and Aging, University Centre of Sports Medicine, University "G. d'Annunzio, Viale Abruzzo 322, Chieti, Italy
| | - Alex Ireland
- Department of Life Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, M1 5GD, UK
| | - Raffaele Molino-Lova
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269, 50143, Florence, Italy
| | - Sandro Sorbi
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269, 50143, Florence, Italy.,Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269, 50143, Florence, Italy.,Department of Experimental and Clinical Medicine, Università Di Firenze, Largo Brambilla 3, 50100, Florence, Italy
| | - Raffaello Pellegrino
- Department of Medicine and Science of Aging, Laboratory of Clinical Epidemiology and Aging, University Centre of Sports Medicine, University "G. d'Annunzio, Viale Abruzzo 322, Chieti, Italy
| | - Angelo Di Iorio
- Department of Medicine and Science of Aging, Laboratory of Clinical Epidemiology and Aging, University Centre of Sports Medicine, University "G. d'Annunzio, Viale Abruzzo 322, Chieti, Italy.
| | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269, 50143, Florence, Italy.,Department of Experimental and Clinical Medicine, Università Di Firenze, Largo Brambilla 3, 50100, Florence, Italy
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12
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Hakiki B, Pancani S, Portaccio E, Molino-Lova R, Sofi F, Macchi C, Cecchi F. Impact of occupational complexity on cognitive decline in the oldest-old. Aging Ment Health 2021; 25:1630-1635. [PMID: 32252551 DOI: 10.1080/13607863.2020.1746739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The theory of "Cognitive Reserve" assumes that premorbid factors such as high educational and occupational attainment may enable a better way of coping with brain damage. It has been suggested that more stimulating lifestyles, including more complex work environments, may provide a buffer against cognitive decline in later life. This study aimed to investigate the association between occupational history and cognitive decline in a large cohort of Italian oldest-old. METHODS 392 individuals (266 women/126 men, mean age 93 ± 3 years) enrolled in the "Mugello study" provided information about their work history. Jobs were classified in nine categories, according to the level of expertise required to perform them, as suggested by the Italian National Institute for Statistics (ISTAT). In addition, socio-demographic characteristics, comorbidities, level of independence, depression, and cognitive status were assessed. The presence of dementia was established based on cognitive status and independence in performing four selected instrumental activities of daily living (ability to manage telephone, transportation, medications, and budget). RESULTS Neither work complexity (p = 0.995) nor work duration (p = 0.701) showed a significant effect on the likelihood of presenting a lower cognitive profile or developing dementia (p = 0.385 and p = 0.096, for work complexity and work duration, respectively). CONCLUSION In the observed sample of oldest-old individuals, cognitive decline did not seem to be influenced by cognitive reserve as assessed through the evaluation of cognitive status and level of independence. It is conceivable that in this population, the decline of the brain reserve has a preponderant role in the definition of the cognitive profile.
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Affiliation(s)
- Bahia Hakiki
- Don Carlo Gnocchi Foundation, IRCSS, Florence, Italy
| | | | - Emilio Portaccio
- SOC Neurologia, Ospedale San Giovanni di Dio, AUSL Toscana Centro, Florence, Italy
| | | | - Francesco Sofi
- Don Carlo Gnocchi Foundation, IRCSS, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Clinical Nutrition Unit, Careggi University Hospital, Florence, Italy
| | - Claudio Macchi
- Don Carlo Gnocchi Foundation, IRCSS, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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13
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Di Cesare F, Tenori L, Meoni G, Gori AM, Marcucci R, Giusti B, Molino-Lova R, Macchi C, Pancani S, Luchinat C, Saccenti E. Lipid and metabolite correlation networks specific to clinical and biochemical covariate show differences associated with sexual dimorphism in a cohort of nonagenarians. GeroScience 2021; 44:1109-1128. [PMID: 34324142 PMCID: PMC9135919 DOI: 10.1007/s11357-021-00404-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/13/2021] [Indexed: 12/26/2022] Open
Abstract
This study defines and estimates the metabolite-lipidic component association networks constructed from an array of 20 metabolites and 114 lipids identified and quantified via NMR spectroscopy in the serum of a cohort of 355 Italian nonagenarians and ultra-nonagenarian. Metabolite-lipid association networks were built for men and women and related to an array of 101 clinical and biochemical parameters, including the presence of diseases, bio-humoral parameters, familiarity diseases, drugs treatments, and risk factors. Different connectivity patterns were observed in lipids, branched chains amino acids, alanine, and ketone bodies, suggesting their association with the sex-related and sex-clinical condition-related intrinsic metabolic changes. Furthermore, our results demonstrate, using a holistic system biology approach, that the characterization of metabolic structures and their dynamic inter-connections is a promising tool to shed light on the dimorphic pathophysiological mechanisms of aging at the molecular level.
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Affiliation(s)
- Francesca Di Cesare
- Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Italy
| | - Leonardo Tenori
- Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Italy.,Department of Chemistry "Ugo Schiff", University of Florence, Sesto Fiorentino, Italy
| | | | - Anna Maria Gori
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Atherothrombotic Unit, Careggi University Hospital, Florence, Italy
| | - Rossella Marcucci
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Atherothrombotic Unit, Careggi University Hospital, Florence, Italy
| | - Betti Giusti
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Atherothrombotic Unit, Careggi University Hospital, Florence, Italy
| | | | - Claudio Macchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | | | - Claudio Luchinat
- Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Italy.,Department of Chemistry "Ugo Schiff", University of Florence, Sesto Fiorentino, Italy.,Consorzio Interuniversitario Risonanze Magnetiche di Metallo Proteine (CIRMMP), Sesto Fiorentino, Italy
| | - Edoardo Saccenti
- Laboratory of Systems and Synthetic Biology, Wageningen University & Research, Wageningen, the Netherlands.
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14
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Thyroid hormone signaling is associated with physical performance, muscle mass, and strength in a cohort of oldest-old: results from the Mugello study. GeroScience 2020; 43:1053-1064. [PMID: 33219914 PMCID: PMC8110652 DOI: 10.1007/s11357-020-00302-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 11/16/2020] [Indexed: 12/23/2022] Open
Abstract
Thyroid hormones (THs) play a crucial role in the homeostasis of muscle function, such as myogenesis and energy metabolism, suggesting that the thyroid may be also involved in the entropic processes of muscle aging. The aim of the present study is to evaluate the effect of TH signaling on physical performance, muscle mass, and strength in a cohort of community-dwelling oldest-old subjects (> 90 years). The study population was selected in a rural area of central Italy (Mugello, Tuscany), and the design was cross-sectional. Four hundred seventy-five subjects (130 males and 345 females) were enrolled, representing about 65% of all the nonagenarians living in the Mugello area. After adjusting for multiple confounding factors (sex, age, diabetes, and levothyroxine administration), the lowest quartile of FT3/FT4 ratio distribution showed lower physical performance compared to the other quartiles (β ± SE: − 0.49 ± 0.12; p < 0.001), whereas the highest quartile of FT3/FT4 ratio was associated with higher skeletal muscle index (β ± SE: 1.11 ± 0.42; p = 0.009). In addition, the lowest quartile of FT4 showed a statistically significant higher handgrip strength (β ± SE: 1.78 ± 0.68; p = 0.009) compared to all other quartiles. This study demonstrates that nonagenarians with higher FT3/FT4 ratios had better preserved muscle function, therefore successfully overcoming the imbalance of homeostatic and entropic processes involved in muscle aging. However, we could not establish a cause-effect relationship due to the cross-sectional design of the study.
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15
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Dinu M, Colombini B, Pagliai G, Vannetti F, Pasquini G, Molino Lova R, Cecchi F, Sorbi S, Sofi F, Macchi C. BMI, functional and cognitive status in a cohort of nonagenarians: results from the Mugello study. Eur Geriatr Med 2020; 12:379-386. [PMID: 33085046 PMCID: PMC7990833 DOI: 10.1007/s41999-020-00417-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/07/2020] [Indexed: 11/21/2022]
Abstract
Aim Our aim was to investigate the association of body mass index (BMI) with functional and cognitive status in a group of nonagenarians. Findings By grouping the participants according to BMI categories, overweight and obese participants showed lower functional capability, higher risk of falling but better Mini-Mental State Examination (MMSE) performance than participants with normal weight or underweight. Message This cross-sectional survey supports the hypothesis that adiposity could affect the cognitive state of people reaching the old age. Purpose The study of the relationship between body weight and health in old age has attracted increasing interest. The aim of the present study is to investigate the association of body mass index (BMI) with functional and cognitive status in a group of nonagenarians. Methods We analyzed 475 participants (348 women, 127 men; median age 92 years) from the Mugello study. Participants were evaluated through laboratory, instrumental examinations and questionnaires. Results By grouping the participants according to BMI categories, a better perception of health and nutritional status and a lower prevalence of sarcopenia (p < 0.05) were observed in participants with overweight and obesity compared to participants with normal weight or underweight. Concerning functional and cognitive measures, overweight and obese participants showed significantly worse performance on short physical performance battery and timed up and go tests and better performance on the mini-mental state examination (MMSE). As regards the other tests performed, no statistically significant differences were observed. In a multivariate logistic regression analysis adjusted for possible confounding factors, participants with BMI ≥ 30 kg/m2 showed lower probability to achieve poor performance on the MMSE (OR 0.42; 95% CI 0.19–0.94; p = 0.035). Conclusion Our results support the hypothesis that in nonagenarians, a higher BMI is associated with better cognitive ability. Further studies are needed to explore the mechanisms underlying this association.
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Affiliation(s)
- Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy.
| | - Barbara Colombini
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Giuditta Pagliai
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | | | - Guido Pasquini
- Don Carlo Gnocchi Foundation Florence, Onlus IRCCS, Florence, Italy
| | | | - Francesca Cecchi
- Don Carlo Gnocchi Foundation Florence, Onlus IRCCS, Florence, Italy
| | - Sandro Sorbi
- Don Carlo Gnocchi Foundation Florence, Onlus IRCCS, Florence, Italy
| | - Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy.,Don Carlo Gnocchi Foundation Florence, Onlus IRCCS, Florence, Italy
| | - Claudio Macchi
- Don Carlo Gnocchi Foundation Florence, Onlus IRCCS, Florence, Italy
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16
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Chrzastek Z, Guligowska A, Piglowska M, Soltysik B, Kostka T. Association between sucrose and fiber intake and symptoms of depression in older people. Nutr Neurosci 2020; 25:886-897. [PMID: 32945734 DOI: 10.1080/1028415x.2020.1819106] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objectives: This study aimed to analyze the relationship between sucrose and fiber intake and symptoms of depression in older people.Material and Methods: The research group consisted of 813 community-dwelling subjects (221 males and 592 females, median age 75). The symptoms of depression were assessed using the Geriatric Depression Scale (GDS). Participants were divided into two subgroups according to the GDS scale. Group A: 0-5 points - no symptoms of depression (612, M:167, W:445), and group B: 6-15 points - with symptoms of depression (201, M:54, W:147). The level of nutrient consumption was assessed with a 24 h Recall Questionnaire and the software 'Dieta 5.0'.Results: In males, consumption of sucrose (A: 30 g (18.1-53.3), B: 62.8 g (43.2-92.6)) (median (25%-75% quartile) and % of energy from sucrose (A: 7.3% (4.8-11.9), B: 13.5% (7.8-18.6)) were significantly higher in the group with symptoms of depression. Kilocalories per 1 g of fiber intake ratios were higher in depressive groups of both males (A: 89.1 kcal/g (68.1-109), B: 103.9 kcal/g (86.1-134.1)) and females (A: 78.6 kcal/g (62.1-99.9), B: 93 kcal/g (67.1-118.3)). Females without symptoms of depression consumed significantly more fiber (17.2 g (12.9-23.1)) than females with symptoms of depression (16.1 g (11.3-20)).Conclusions: This analysis shows increased kilocalories per 1 g of fiber intake in patients with symptoms of depression. In males, symptoms of depression were connected with higher consumption of sucrose and higher % of energy intake from sucrose. In females, greater fiber consumption was related to less frequent symptoms of depression.
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Affiliation(s)
- Zuzanna Chrzastek
- Department of Geriatrics Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Agnieszka Guligowska
- Department of Geriatrics Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Malgorzata Piglowska
- Department of Geriatrics Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Bartlomiej Soltysik
- Department of Geriatrics Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Tomasz Kostka
- Department of Geriatrics Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
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17
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Strozza C, Pasqualetti P, Egidi V, Loreti C, Vannetti F, Macchi C, Padua L. Health profiles and socioeconomic characteristics of nonagenarians residing in Mugello, a rural area in Tuscany (Italy). BMC Geriatr 2020; 20:289. [PMID: 32799807 PMCID: PMC7429096 DOI: 10.1186/s12877-020-01689-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 08/03/2020] [Indexed: 01/14/2023] Open
Abstract
Background Health, as defined by the WHO, is a multidimensional concept that includes different aspects. Interest in the health conditions of the oldest-old has increased as a consequence of the phenomenon of population aging. This study investigates whether (1) it is possible to identify health profiles among the oldest-old, taking into account physical, emotional and psychological information about health, and (2) there are demographic and socioeconomic differences among the health profiles. Methods Latent Class Analysis with covariates was applied to the Mugello Study data to identify health profiles among the 504 nonagenarians residing in the Mugello district (Tuscany, Italy) and to evaluate the association between socioeconomic characteristics and the health profiles resulting from the analysis. Results This study highlights four groups labeled according to the posterior probability of determining a certain health characteristic: “healthy”, “physically healthy with cognitive impairment”, “unhealthy”, and “severely unhealthy”. Some demographic and socioeconomic characteristics were found to be associated with the final groups: older nonagenarians are more likely to be in worse health conditions; men are in general healthier than women; more educated individuals are less likely to be in extremely poor health conditions, while the lowest-educated are more likely to be cognitively impaired; and office or intellectual workers are less likely to be in poor health conditions than are farmers. Conclusions Considering multiple dimensions of health to determine health profiles among the oldest-old could help to better evaluate their care needs according to their health status.
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Affiliation(s)
- Cosmo Strozza
- Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, J.B. Winsløws Vej 9B, 2nd floor, 5000, Odense C, Denmark. .,Department of Statistical Sciences, Sapienza University of Rome, Viale Regina Elena 295, 00161, Rome, Italy.
| | - Patrizio Pasqualetti
- Fatebenefratelli Foundation for Health Research and Education, Via della Lungaretta 177, 00153, Rome, Italy
| | - Viviana Egidi
- Department of Statistical Sciences, Sapienza University of Rome, Viale Regina Elena 295, 00161, Rome, Italy
| | - Claudia Loreti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00136, Rome, Italy
| | - Federica Vannetti
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269, 50143, Florence, Italy
| | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269, 50143, Florence, Italy
| | | | - Luca Padua
- Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy.,UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00136, Rome, Italy
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18
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Laudisio A, Giovannini S, Finamore P, Loreti C, Vannetti F, Coraci D, Incalzi RA, Zuccal G, Macchi C, Padua L. Muscle strength is related to mental and physical quality of life in the oldest old. Arch Gerontol Geriatr 2020; 89:104109. [PMID: 32460125 DOI: 10.1016/j.archger.2020.104109] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/05/2020] [Accepted: 05/10/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE OF THE STUDY Quality of life represents the principal outcome of health interventions for the oldest old. However, little is known about the determinants of quality of life in this population stratum. We evaluated the association between health-related quality of life (HRQoL) and handgrip strength in a cohort of 331 participants aged 90+ with a living in the Mugello area (Tuscany, Italy). DESIGN AND METHODS HRQoL was assessed using the Medical Outcomes Study Short Form 12 (SF12), considering the Physical Composite Score (PCS) and the Mental Composite Score (MCS) of the SF-12. Muscle strength was tested by hand grip dynamometry. RESULTS The median MCS was 46.9, while the median PCS was 43.0. According to logistic regression, muscle strength was associated with increased probability of better PCS (OR = 1.05; 95 % CI = 1.01-1.10, P = .042), and better MCS (OR = 1.05; 95 % CI = 1.01-1.10, P = .036), after adjusting. IMPLICATION Muscle strength is associated with both physical and mental HRQoL among nonagenarians. Further studies are needed to explore the subsystems involved in this association, and whether improving muscle performance might improve global mental and physical quality of life in the most advanced age.
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Affiliation(s)
- Alice Laudisio
- Unit of Geriatrics, Department of Medicine, Campus Bio-Medico di Roma University, Rome, Italy
| | - Silvia Giovannini
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - Panaiotis Finamore
- Unit of Geriatrics, Department of Medicine, Campus Bio-Medico di Roma University, Rome, Italy
| | - Claudia Loreti
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Daniele Coraci
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore di Roma, Rome, Italy
| | | | - Giuseppe Zuccal
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore di Roma, Rome, Italy
| | | | - Luca Padua
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore di Roma, Rome, Italy
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19
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Laudisio A, Giovannini S, Finamore P, Navarini L, Margiotta DPE, Vannetti F, Macchi C, Coraci D, Imbimbo I, Molino-Lova R, Loreti C, Antonelli Incalzi R, Zuccalà G, Padua L. Metabolic syndrome is associated with better quality of sleep in the oldest old: results from the "Mugello Study". Diabetol Metab Syndr 2020; 12:46. [PMID: 32742311 PMCID: PMC7386243 DOI: 10.1186/s13098-020-00554-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 05/15/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND AIMS Reduced sleep quality is common in advanced age. Poor sleep quality is associated with adverse outcomes, chiefly cardiovascular, in young and middle-aged subjects, possibly because of its association with metabolic syndrome (MetS). However, the correlates of sleep quality in oldest populations are unknown. We evaluated the association of sleep quality with MetS in a cohort of subjects aged 90+. METHODS AND RESULTS We analysed data of 343 subjects aged 90+ living in the Mugello area (Tuscany, Italy). Quality of sleep was assessed using the Pittsburgh Sleep Quality Assessment Index (PSQI). Good quality of sleep was defined by a PSQI score < 5. MetS was diagnosed according to the National Cholesterol Education Program's ATP-III criteria; 83 (24%) participants reported good quality of sleep. MetS was diagnosed in 110 (24%) participants. In linear and logistic models, MetS was inversely associated with PSQI score ((B = - 1.04; 95% CI - 2.06 to - .03; P = .044), with increased probability of good sleep quality (OR = 2.52; 95% CI 1.26-5.02; P = .009), and with a PSQI below the median (OR = 2.11; 95% CI 1.11-3.40, P = .022), after adjusting. None of the single components of MetS were associated with PSQI (all P values > .050). However, an increasing number of MetS components was associated with increasing probability of good quality of sleep (P for trend = .002), and of PSQI below the median (P for trend = .007). Generalized Additive Model analysis documented no smoothing function suggestive of nonlinear association between PSQI and MetS. CONCLUSION Our results confirm a high prevalence of poor sleep quality in oldest age; however, in these subjects, MetS seems to be associated with better sleep quality. Additional larger, dedicated studies are required to confirm our results, and, if so, to identify the subsystems involved and the potential therapeutic implications of such an association.
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Affiliation(s)
- Alice Laudisio
- Unit of Geriatrics, Department of Medicine, Campus Bio-Medico di Roma University, Rome, Italy
| | - Silvia Giovannini
- Department of Geriatrics, Neurosciences and Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Panaiotis Finamore
- Unit of Geriatrics, Department of Medicine, Campus Bio-Medico di Roma University, Rome, Italy
| | - Luca Navarini
- Unit of Allergology, Immunology and Rheumatology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | | | | | | | - Daniele Coraci
- Department of Geriatrics, Neurosciences and Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | | | - Claudia Loreti
- Department of Geriatrics, Neurosciences and Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Giuseppe Zuccalà
- Department of Geriatrics, Neurosciences and Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Padua
- Department of Geriatrics, Neurosciences and Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
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20
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Cecchi F, Pancani S, Molino-Lova R, Castagnoli C, Paperini A, Boni R, Gori G, Macchi C. Independent Functioning in Nonagenarians Living in a Rural Italian Community: The Mugello Study. J Appl Gerontol 2019; 39:259-268. [PMID: 31232132 DOI: 10.1177/0733464819858575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Nonagenarians are a fast-growing population deserving specific research. We explored the prevalence and characteristics of functionally independent nonagenarians from a rural community-dwelling Italian population. Data were collected in the Mugello Study; 475 persons aged ≥90 years (median age, 92) underwent a home-based clinical and functional assessment, including psychosocial, clinical, functional, and lifestyle history and status and physical and instrumental examinations. Sixty-eight (15%) persons reported no need for help in basic and instrumental daily living activities. Among variables significantly associated with independent functionality after age- and gender-adjusted cross-sectional analysis, lower body mass index (BMI; p = .034) and depressive symptoms (p = .028), higher current physical activity (p < .001), better cognitive status (p = .033), and lower medication intake (p = .048) were associated with reporting no disability in the logistic regression analysis. Disability was mainly associated with current lifestyle-related potentially modifiable factors. Thus, lifestyle-oriented multidimensional interventions, should be developed and evaluated for their potential effects on functionality, even in the oldest old.
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Affiliation(s)
- F Cecchi
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - S Pancani
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | | | - C Castagnoli
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - A Paperini
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - R Boni
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - G Gori
- Humanitas Association, Florence, Italy
| | - C Macchi
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Italy
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Association of Body Fat With Health-Related Quality of Life and Depression in Nonagenarians: The Mugello Study. J Am Med Dir Assoc 2019; 20:564-568. [PMID: 30852165 DOI: 10.1016/j.jamda.2019.01.128] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/07/2019] [Accepted: 01/13/2019] [Indexed: 01/14/2023]
Abstract
OBJECTIVES The association of body fat with health status and depression in the oldest old is still debated. The aim of this cross-sectional study is to investigate the association of body fat with health-related quality of life and depression in a sample of nonagenarians. DESIGN Data are from the Mugello study, a community-based project conducted in Italian older adults aged 90 years. SETTING AND PARTICIPANTS Total body fat was assessed by body impedance assessment. Participants were divided into 3 groups according to gender-specific tertiles of body fat percentage (BF%). Self-perceived mental and physical health status were assessed by the Mental Component Summary (MCS) and the Physical Component Summary (PCS) subscales derived from the 12-item Short Form Health Survey. Lower scores of MCS and PCS indicated poorer mental health and physical health status, respectively. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale, and a score ≥5 was used to identify participants with depression. RESULTS The mean age of 251 study participants was 92.5 years, and 173 (68.9%) were women. Participants were included in the low (n = 83), medium (n = 83), and high (n = 85) BF% groups. In the whole sample, mean scores at PCS progressively declined with the increasing BF% group (P = .004). This association was stronger in women, although no significant interaction was observed between the gender and BF% group (P = .63). No significant association between BF% and MCS was documented. Medium and high BF% were associated with a significantly higher probability of depression as compared with low BF% [odds ratio (OR) 2.15, 95% confidence interval (CI) 1.04-4.44, and OR 2.15, 95% CI 1.06-4.34, respectively]. This association was stronger in women, although no significant interaction was observed between gender and BF% group (P = .70). CONCLUSIONS AND IMPLICATIONS High BF% is significantly positively associated with poor health-related quality of life and depression, underpinning the clinical relevance to test BF% in older adults. These associations appear to be stronger in women than in men, highlighting the need to investigate deep inside this gender discrepancy.
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Wang H, Hai S, Liu Y, Liu Y, Dong B. Skeletal Muscle Mass as a Mortality Predictor among Nonagenarians and Centenarians: A Prospective Cohort Study. Sci Rep 2019; 9:2420. [PMID: 30787413 PMCID: PMC6382937 DOI: 10.1038/s41598-019-38893-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 12/04/2018] [Indexed: 02/05/2023] Open
Abstract
This study aimed to evaluate the association between skeletal muscle mass and long-term all-cause mortality among nonagenarians and centenarians in China. We used data from the Project of Longevity and Aging in Dujiangyan (PLAD). A total of 738 community-dwelling people aged ≥ 90 years (mean age of 93.5 ± 3.2 years) were analyzed in this study. The appendicular skeletal muscle mass (ASM) was estimated using a previously validated anthropometric equation. The information on the survival status was requested from the local government registries during the 4 year follow-up period following the baseline investigation. The mean muscle mass index (SMI) was 6.11 ± 0.53 kg/m2 in men and 4.00 ± 0.63 kg/m2 in women, respectively. Low muscle mass was associated with a higher risk of death (hazard ratio [HR] 1.54; (95% confidence interval [CI]:1.10–2.16) in women; however, no significant association was found in men. Disability in activities of daily living (ADL) (HR = 1.73; 95% CI: 1.13–2.63) in men and women and cognitive impairment (HR = 1.49; 95% CI: 1.05–2.13) in men were also associated with increased all-cause mortality. In conclusion, low muscle mass were predictors of long-term mortality in nonagenarian and centenarian women.
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Affiliation(s)
- Hui Wang
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China.,Center of Gerontology and Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Shan Hai
- Center of Gerontology and Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Yixin Liu
- Center of Gerontology and Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Ying Liu
- Center of Gerontology and Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Birong Dong
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China.
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CLOCK gene polymorphisms and quality of aging in a cohort of nonagenarians - The MUGELLO Study. Sci Rep 2019; 9:1472. [PMID: 30728411 PMCID: PMC6365537 DOI: 10.1038/s41598-018-37992-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 11/23/2018] [Indexed: 02/01/2023] Open
Abstract
A total of 356 elderly subjects [257F; 88–106 years] were genotyped for three polymorphisms of the CLOCK gene by TaqMan real-time PCR approach, in order to find associations with quality of aging. Subjects homozygous for the minor allele of rs1801260 were less frequently overweight (p = 0.046), had higher fasting glucose levels (p = 0.037), better scores at the Clock Drawing Test (CDT) (p = 0.047) and worse scores at the Geriatric Depression Scale (p = 0.032). Subjects homozygous for the minor allele of rs11932595 showed higher fasting glucose levels (p = 0.044) and better scores at CDT (p = 0.030). Conversely, subjects homozygous for the minor allele of rs4580704 showed higher triglyceride (p = 0.012), and LDL-cholesterol levels (p = 0.44), and a greater adherence to the Mediterranean diet (MD) (p = 0.044). In addition, AAC, AAG, GGC and AGC (rs1801260–rs11932595–rs4580704) haplotypes were analyzed: AAG was associated with higher risk of overweight (p = 0.008), hypertriglyceridemia (p = 0.040) and hypercholesterolemia (p = 0.036); GGC with lower risk of hyperglycemia (p = 0.022), better sleep pattern (p = 0.001) and with better score at mini-mental state examination (p = 0.010); AGC with lower risk of depression (p = 0.026) and AAC with lower adherence to the MD (p = 0.028). Therefore, CLOCK gene polymorphisms let us hypothesize an involvement in the quality of aging in a cohort of nonagenarians.
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Pancani S, Sofi F, Cecchi F, Macchi C. HDL Cholesterol Is Independently Associated with Cognitive Function in Males But Not in Females within a Cohort of Nonagenarians: The MUGELLO Study. J Nutr Health Aging 2019; 23:552-557. [PMID: 31233077 DOI: 10.1007/s12603-019-1203-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To investigate the possible relationship between lipid profile and cognitive functions in a cohort of nonagenarians enrolled within the Mugello Study, an epidemiological study aimed at investigating both clinically relevant geriatric items and various health issues. DESIGN Cross-sectional survey. SETTING This study focused on oldest old community-dwelling participants. PARTICIPANTS Three hundred twenty-five nonagenarians (218 F, median age: 92 years). MEASUREMENTS Participants were evaluated through laboratory, instrumental examinations and questionnaires concerning lifestyle, dietary habits and cognitive status. RESULTS Females are older, with a lower level of education, live more prevalently on their own and have higher values for total cholesterol and high-density lipoprotein cholesterol (HDL) compared to males. With regard to functional and cognitive measures females report a significantly lower skill level in the physical activity performance, with a level of independence that is better for both basic and instrumental activities. In order to investigate whether there was an association between lipid variables and cognitive function as measured by the Mini-Mental State Examination a multiple regression analysis was performed with adjustments for confounding variables based on gender. In males, HDL cholesterol showed a significant relationship with Mini-Mental State Examination after a complete adjustment with years of education, physical activity performance and daily living activities (β = 0.174; p=0.037). In females HDL cholesterol showed a significant association only in the model adjusted for age and body mass index, losing its associations as soon as the cohabitation state and the depression status entered the model. CONCLUSION Our results support the hypothesis that HDL cholesterol is significantly linked to cognitive functions, especially in males of a cohort of very old people.
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Affiliation(s)
- S Pancani
- Silvia Pancani, PhD, IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci, 269, 50143, Florence, Italy, E-mail address:
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Molino Lova R, Vassalle C, Masini E, Del Ry S, Cabiati M, Pasquini G, Macchi C. Relationship between inflammatory parameters and cardiovascular and lifestyle factors in the Mugello study oldest old. Biomark Med 2018; 12:1115-1124. [PMID: 30203672 DOI: 10.2217/bmm-2017-0441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM To explore possible inter-relationships of various biomarkers of inflammation and lifestyle and other cardiovascular risk factors (age, gender, smoking history, hypertension, Type 2 diabetes, dyslipidemia, alteration of circadian rhythms, body mass index, calf circumference, thigh circumference, abdominal circumference) in the Mugello study oldest old. METHODS In 399 noninstitutionalized nonagenarians (291 women), whole blood cells, mean platelet volume, C-reactive protein, uric acid, gamma-glutamyl transferase were assessed. RESULTS Aging resulted as the only independent determinant for uric acid (<0.05), and abdominal circumference for C-reactive protein. Female gender (<0.01), and thigh circumference (<0.05) remained as determinants for mean platelet volume, age (<0.01), and male gender (<0.01) for gamma-glutamyl transferase, and Type 2 diabetes (≤0.01) and alteration of circadian rhythms (<0.05) for whole blood cells. CONCLUSION Several inflammatory parameters remain associated with adverse lifestyle and cardiovascular risk factors even among nonagenarians.
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Affiliation(s)
| | | | | | - Silvia Del Ry
- Italian National Research Council, Istituto di Fisiologia Clinica, Pisa, Italy
| | - Manuela Cabiati
- Italian National Research Council, Istituto di Fisiologia Clinica, Pisa, Italy
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Gender effect on well-being of the oldest old: a survey of nonagenarians living in Tuscany: the Mugello study. Neurol Sci 2018; 39:509-517. [PMID: 29313171 DOI: 10.1007/s10072-017-3223-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 12/08/2017] [Indexed: 10/18/2022]
Abstract
The population of industrialized nations is progressively aging, with Italy having one of the most elderly populations in the world. Natural aging may be associated with physical and cognitive impairments, often straining public resources. The present study aims to investigate the influence of gender on wellness of the nonagenarians. We evaluated quality of life among nonagenarians living in the Mugello area, an Italian location with a large population of individuals > 90 years, using the Health Survey Scoring SF-12. The 15-item Geriatric Depression Scale and Basic and Instrumental Activity of Daily Living scales were also assessed. The Mini-Mental State Examination was used to evaluate the cognitive status. In the current survey, women outnumbered men 2.7:1 confirming their higher longevity. However, on the basis of SF-12 scores, nonagenarian women felt worse than men, both physically (mean: women = 41.8 vs men = 44.4, p = 0.004) and mentally (mean: women = 46.7 vs men =48.5, p = 0.034), and their depression rates were higher: considering a General Depression Scale score ≥ 5 as a possible depression status; 37.5% of men reported depression vs. 48.5% of women (p = 0.021). Significant differences were observed also in daily activities, both basic (median: woman = 3 vs men = 5, p < 0.001) and instrumental (median woman = 1 vs me = 3, p < 0.001). Despite prior reports showing that women perform better than men in aging, our study confirms data reported in most national and European surveys: women live longer than men, but with poorer quality of life. The current study confirms the phenomenon known as the "male-female health-survival paradox."
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Cesari F, Sofi F, Molino Lova R, Vannetti F, Pasquini G, Cecchi F, Marcucci R, Gori AM, Macchi C. Aging process, adherence to Mediterranean diet and nutritional status in a large cohort of nonagenarians: Effects on endothelial progenitor cells. Nutr Metab Cardiovasc Dis 2018; 28:84-90. [PMID: 29167060 DOI: 10.1016/j.numecd.2017.09.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/09/2017] [Accepted: 09/11/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIM Adherence to the Mediterranean Diet (MD) has been associated with a longer and better life. The aim of this study was to examine the effects of adherence to the MD, and of nutritional habits on endothelial progenitor (EPCs) and circulating progenitor (CPCs) cells in a cohort of nonagenarians enrolled within the Mugello Study, an epidemiological study aimed at investigating both clinically relevant geriatric items and various health issues, including those related to nutritional status. METHODS AND RESULTS Four hundred twenty-one nonagenarians (306 F, 115 M, mean age: 93.1 ± 3.2 years) were evaluated. Adherence to MD was assessed through the Mediterranean Diet Score. Elderly subjects who were in the fourth quartile of the Mediterranean diet score showed significantly higher EPCs than subjects grouped into the other three quartiles. After adjustment for confounders, elderly subjects who were in the highest quartile of adherence to the MD score reported to have EPCs' levels significantly higher than those who reported lower values of adherence to the MD. Furthermore, by analyzing different food categories, it was reported that daily consumption of olive oil and a higher consumption of fruit and vegetables showed higher CPCs CD34+ and EPCs CD34+/KDR+ than subjects with not daily or lower consumption. CONCLUSION Our results support the hypothesis that the adherence to MD, as well as a daily consumption of olive oil and fruit and vegetables, characteristics of MD, may protect against the development of endothelial dysfunction through increasing EPCs and CPCs in older age.
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Affiliation(s)
- F Cesari
- Central Laboratory, Careggi University Hospital, Florence, Italy
| | - F Sofi
- Department of Experimental and Clinical Medicine, University of Florence, Italy; Clinical Nutrition Unit, Careggi University Hospital, Florence, Italy; Don Carlo Gnocchi Foundation, Onlus IRCCS, Florence, Italy.
| | - R Molino Lova
- Don Carlo Gnocchi Foundation, Onlus IRCCS, Florence, Italy
| | - F Vannetti
- Don Carlo Gnocchi Foundation, Onlus IRCCS, Florence, Italy
| | - G Pasquini
- Don Carlo Gnocchi Foundation, Onlus IRCCS, Florence, Italy
| | - F Cecchi
- Don Carlo Gnocchi Foundation, Onlus IRCCS, Florence, Italy
| | - R Marcucci
- Department of Experimental and Clinical Medicine, University of Florence, Italy; Unit of Atherothrombotic Diseases, Careggi University Hospital, Florence, Italy
| | - A M Gori
- Department of Experimental and Clinical Medicine, University of Florence, Italy; Unit of Atherothrombotic Diseases, Careggi University Hospital, Florence, Italy
| | - C Macchi
- Department of Experimental and Clinical Medicine, University of Florence, Italy; Don Carlo Gnocchi Foundation, Onlus IRCCS, Florence, Italy
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Pagliai G, Sofi F, Vannetti F, Caiani S, Pasquini G, Molino Lova R, Cecchi F, Sorbi S, Macchi C. Mediterranean Diet, Food Consumption and Risk of Late-Life Depression: The Mugello Study. J Nutr Health Aging 2018; 22:569-574. [PMID: 29717755 DOI: 10.1007/s12603-018-1019-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To investigate eating habits and adherence to Mediterranean Diet (MD) in relation to the risk of depression in a cohort of nonagenarians enrolled within the Mugello Study, an epidemiological study aimed at investigating both clinically relevant geriatric items and various health issues, including those related to nutritional status. DESIGN Cross-sectional study. SETTING Homes and nursing homes in the Mugello area, Florence, Italy. PARTICIPANTS Subjects aged 90-99 years [N=388 (271F; 117M) mean age: 92.7±3.1]. MEASUREMENTS All subjects were evaluated through questionnaires and instrumental examinations. Adherence to MD was assessed through the Mediterranean Diet Score. A shorter version of the Geriatric Depression Scale (GDS) was used to detect the possible presence of depressive symptoms. In addition, cognitive and functional status was assessed using the Mini-Mental State Examination, the Clock Drawing Test, as well as the Basic and Instrumental Activities of Daily Living test. RESULTS Depressed subjects (DS) (GDS score≥5, 43.8%) were older, females and widows, than non-depressed subjects (NDS). DS reported a slightly but not statistically significant lower MD score than NDS (33.9±3.9 vs. 34.6±3.3, p=0.149). Subjects who reported to consume a greater amount of olive oil and fruit were associated with a lower risk of depression (OR=0.35, 95%CI=0.20-0.59, p<0.001 and OR=0.46, 95%CI=0.26-0.84, p=0.011, respectively) after adjustment for many possible confounders. Similar results were obtained for women, while no statistically significant differences emerged for men. CONCLUSION Our results support the hypothesis that a diet rich in olive oil and fruit, characteristics of MD, may protect against the development of depressive symptoms in older age.
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Affiliation(s)
- G Pagliai
- Giuditta Pagliai, Department of Experimental and Clinical Medicine, University of Florence, Italy, Largo Brambilla 3, 50134, Florence, Italy, Phone: 0557947510,
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Adherence to Mediterranean diet and nutritional status in a sample of nonagenarians. Exp Gerontol 2017; 103:57-62. [PMID: 29274395 DOI: 10.1016/j.exger.2017.12.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 12/18/2017] [Accepted: 12/19/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The aim is to describe the adherence to Mediterranean diet in a sample of nonagenarians and to analyse its cross-sectional association with anthropometric and bioelectrical parameters. DESIGN A cross-sectional design was employed in this study. The adherence to the Mediterranean diet was measured through the Mediterranean Diet Score (MedDietScore). SETTING AND PARTICIPANTS A representative sample of nonagenarian residents in the eight municipalities belonging to Mugello (Florence, Italy). MEASUREMENTS The tools used to investigate the nutritional status and the body composition were: weight; ulna length to estimate the height; body mass index (BMI); mid-upper arm circumference (MUAC); calf circumference (CC); waist circumference (WC); hip circumference (HC); and specific bioelectrical impedance vector analysis (BIVAsp). RESULTS All the measurements were carried out for 298 nonagenarians (70.8% of whom were females). The mean value of MedDietScore was 34.3±3.6. The MedDietScore was significantly correlated with CC (r=0.127), specific resistance (Rsp, r=0.152), and specific impedance (Zsp, r=0.153) in the whole sample, as well as with height (r=-0.222), Rsp (r=0.282), and Zsp (r=0.282) in males. In the whole sample, Rsp and Zsp mean values significantly increased by quartiles of MedDietScore; these results were confirmed by vector analysis. CONCLUSIONS The high level of adherence to Mediterranean diet could contribute to explaining the longevity of our sample. Studying the influence of dietary lifestyle in nonagenarians in depth could help to promote healthy ageing.
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Cecchi F, Pancani S, Vannetti F, Boni R, Castagnoli C, Paperini A, Pasquini G, Sofi F, Molino-Lova R, Macchi C. Hemoglobin concentration is associated with self-reported disability and reduced physical performance in a community dwelling population of nonagenarians: the Mugello Study. Intern Emerg Med 2017; 12:1167-1173. [PMID: 29071662 PMCID: PMC5691100 DOI: 10.1007/s11739-017-1762-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 10/14/2017] [Indexed: 02/06/2023]
Abstract
People aged 90 and older represent a fast-growing population segment who deserve specific attention and research. Aging is associated with a progressive decrease in hemoglobin concentration, which predicts adverse outcome, such as mortality, morbidity, frailty and disability. Whether this association is independent from increased prevalence of comorbidity, causing both anemia and reduced physical function is yet under debate. The aim of this study is to explore the relationship between hemoglobin concentration and self-reported disability and reduced physical performance in a community dwelling population of nonagenarians. Data presented were collected in the framework of the Mugello Study, a clinical epidemiologic survey of nonagenarians living in the Mugello area (Tuscany, Italy). 251 persons (177 women, age 93.2 ± 3.3 years; 74 men, age 92.2 ± 2.5 years) underwent a blood draw. Along with hemoglobin concentration, self-reported disability (basic and instrumental activities of daily living), physical performance (Short Physical Performance Battery), self-reported physical activity and muscular strength (handgrip measurement) were assessed. Covariates, inherent sociodemographic and health indicators and comorbidities were also included in the analysis. This study confirms that anemia is very common in the oldest old, with a significantly higher prevalence in males (50% in men vs 24% in women). Multiple linear regression analysis, including all the comorbid conditions as confounding factors, shows that hemoglobin concentration is independently associated with handgrip strength, self-reported physical activity and disability in dressing, and taking a shower/bath. In conclusion, results from this study confirm that in the oldest old, low hemoglobin concentration is strongly associated with self-reported disability and decline of physical performance independent of comorbidity.
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Affiliation(s)
- Francesca Cecchi
- Don Carlo Gnocchi Foundation, IRCSS, Via di Scandicci, 269, 50143, Florence, Italy
| | - Silvia Pancani
- Don Carlo Gnocchi Foundation, IRCSS, Via di Scandicci, 269, 50143, Florence, Italy.
| | - Federica Vannetti
- Don Carlo Gnocchi Foundation, IRCSS, Via di Scandicci, 269, 50143, Florence, Italy
| | - Roberta Boni
- Don Carlo Gnocchi Foundation, IRCSS, Via di Scandicci, 269, 50143, Florence, Italy
| | - Chiara Castagnoli
- Don Carlo Gnocchi Foundation, IRCSS, Via di Scandicci, 269, 50143, Florence, Italy
| | - Anita Paperini
- Don Carlo Gnocchi Foundation, IRCSS, Via di Scandicci, 269, 50143, Florence, Italy
| | - Guido Pasquini
- Don Carlo Gnocchi Foundation, IRCSS, Via di Scandicci, 269, 50143, Florence, Italy
| | - Francesco Sofi
- Don Carlo Gnocchi Foundation, IRCSS, Via di Scandicci, 269, 50143, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Raffaele Molino-Lova
- Don Carlo Gnocchi Foundation, IRCSS, Via di Scandicci, 269, 50143, Florence, Italy
| | - Claudio Macchi
- Don Carlo Gnocchi Foundation, IRCSS, Via di Scandicci, 269, 50143, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Martin FPJ, Montoliu I, Kussmann M. Metabonomics of ageing – Towards understanding metabolism of a long and healthy life. Mech Ageing Dev 2017; 165:171-179. [DOI: 10.1016/j.mad.2016.12.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 12/21/2016] [Indexed: 12/18/2022]
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Molino-Lova R, Sofi F, Pasquini G, Vannetti F, Del Ry S, Vassalle C, Clerici M, Sorbi S, Macchi C. Higher uric acid serum levels are associated with better muscle function in the oldest old: Results from the Mugello Study. Eur J Intern Med 2017; 41:39-43. [PMID: 28342714 DOI: 10.1016/j.ejim.2017.03.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 03/17/2017] [Accepted: 03/18/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Sarcopenia is the progressive loss of muscle mass and strength that occurs with advancing age and plays a pivotal role in the causal pathway leading to frailty, disability and, eventually, to death among older persons. As oxidative damage of muscle proteins has been shown to be a relevant contributory factor, in this study we hypothesized that uric acid (UA), a powerful endogenous antioxidant, might exert a protective effect on muscle function in the oldest old and we tested our hypothesis in a group of nonagenarians who participated in the Mugello Study. METHODS 239 subjects, 73 men and 166 women, mean age 92.8years±SD 3.1, underwent the assessment of UA serum level and isometric handgrip strength, a widely used clinical measure of sarcopenia. RESULTS Mean UA serum level was 5.69mg/dL±SD 1.70 and mean handgrip strength was 15.0kg±SD 6.9. After adjusting for relevant confounders, higher UA serum levels remained independent positive predictors of isometric handgrip strength (β 1.24±SE(β) 0.43, p=0.005). CONCLUSION Our results show that higher UA serum levels are associated with better muscle function in the oldest old and, accordingly, might slow down the progression of sarcopenia.
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Affiliation(s)
- R Molino-Lova
- IRCCS Don Gnocchi Foundation, Via di Scandicci 269, 50143 Florence, Italy
| | - F Sofi
- IRCCS Don Gnocchi Foundation, Via di Scandicci 269, 50143 Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 3, 50134 Florence, Italy.
| | - G Pasquini
- IRCCS Don Gnocchi Foundation, Via di Scandicci 269, 50143 Florence, Italy
| | - F Vannetti
- IRCCS Don Gnocchi Foundation, Via di Scandicci 269, 50143 Florence, Italy
| | - S Del Ry
- Institute of Clinical Physiology, CNR, Via Giuseppe Moruzzi 1, 56124 Pisa, Italy
| | - C Vassalle
- Gabriele Monasterio Tuscany Foundation, CNR, Via Giuseppe Moruzzi 1, 56124 Pisa, Italy
| | - M Clerici
- IRCCS Don Gnocchi Foundation, Via Alfonso Capecelatro 66, 20148 Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Via Fratelli Cervi 93, 20090, Segrate, Milan, Italy
| | - S Sorbi
- IRCCS Don Gnocchi Foundation, Via di Scandicci 269, 50143 Florence, Italy; Dept. Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Largo Brambilla, 3, 50134 Florence, Italy
| | - C Macchi
- IRCCS Don Gnocchi Foundation, Via di Scandicci 269, 50143 Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 3, 50134 Florence, Italy
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Comment on "Cut-off points to identify sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP) definition". Clin Nutr 2016; 35:1568-1569. [PMID: 27449539 DOI: 10.1016/j.clnu.2016.06.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 06/23/2016] [Indexed: 11/22/2022]
Abstract
Bahat and colleagues presented cut-off values for muscle mass and strength and calf circumference for correct application, in Turkish population, of European Working Group on Sarcopenia in Older People criteria. The work is important to assess this condition on the basis of population-specific data. Ageing care represents a target of modern medicine and sarcopenia, consequence of it, can worse the quality of life. Assessing this, considering population characteristics, as authors described, is very functional in medical practice. We would suggest consideration of people older than 90 years as different elderly subclass and application of technological tools to monitor muscular performance.
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Bonaccorsi G, Santomauro F, Lorini C, Indiani L, Pellegrino E, Pasquini G, Molino-Lova R, Epifani F, Macchi C. Risk of malnutrition in a sample of nonagenarians: Specific versus classic bioelectrical impedance vector analysis. Nutrition 2016; 32:368-74. [PMID: 26724959 DOI: 10.1016/j.nut.2015.09.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 07/07/2015] [Accepted: 09/21/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The aims were to describe the body composition and the risk of malnutrition in a sample of nonagenarians and to identify what bioelectrical impedance vector analysis (BIVA) approach (classic or specific) is more correlated with either the risk of malnutrition or various anthropometric parameters. METHODS In the Mugello area (Italy), a representative sample of nonagenarians was enrolled in a survey aimed at investigating various health issues, including those related to nutritional status. The nutritional status was investigated using body mass index (BMI), mid-upper arm circumference (MUAC), calf circumference (CC), Malnutrition Universal Screening Tool (MUST), and BIVA. Two different approaches were used for the BIVA data analysis: the classic method and the specific method. RESULTS All measurements were obtained from 321 nonagenarians (65.7% of the enrolled sample; 92 men and 229 women); 74.8% of the subjects were at low risk of malnutrition according to MUST, 62.5% exhibited CC values higher than 31 cm, and 86.8% exhibited MUAC values higher than 22 cm. The bioelectrical parameters varied with nutritional status, independent of the nutritional indicator used; the parameters also varied based on sex and BIVA approach. The bioelectrical parameters obtained by the specific BIVA approach were more strongly correlated with MUST score, MUAC, and CC values compared with the parameters calculated using the classic approach. CONCLUSIONS Our study produced findings relevant to particular aspects of population aging. Above all, the specific BIVA was more effective at assessing nutritional status based on both anthropometric parameters and the risk of malnutrition.
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Affiliation(s)
- Guglielmo Bonaccorsi
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | | | - Chiara Lorini
- Department of Health Science, University of Florence, Florence, Italy.
| | - Laura Indiani
- School of Specialization in Hygiene and Preventive Medicine, University of Florence, Florence, Italy
| | - Elettra Pellegrino
- School of Specialization in Hygiene and Preventive Medicine, University of Florence, Florence, Italy
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