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• The sensibility of the method in diagnosis of sarcopenia was 100%. • ROC analysis showed high accuracy of the method (AUC resulted 0.9). • This method is useful in elderly patients with functional or cognitive impairment. Sarcopenia is a geriatric syndrome related to loss of muscle mass and function, leading to disability, frailty and higher mortality. According to European Working Group on Sarcopenia in Older People (EWGSOP) the diagnosis of sarcopenia requires the assessment of muscle mass, muscle force and function, that is time-consuming and not easily at hand in everyday clinical practice. We propose the B-mode ultrasound measurement of muscle thickness as a quick screening test to assess the presence of sarcopenia. A cross-sectional study was realized, 119 patients (average age 82 years, 50.4% females) from the Department of Internal Medicine of the University Hospital of Siena (Italy) were enrolled. The diagnosis of sarcopenia was assessed according to EWGSOP criteria. Rectus femoris muscle (RFM) thickness (in cm) was measured by ultrasound B-mode scanning. Sensibility and specificity of the test was evaluated and Receiver Operating Analysis (ROC) was performed to assess the accuracy of the test. Average RFM thickness was 0.78 ± 0.26, significantly lower in sarcopenic patients (0.55 ± 0.2 vs. 0.9 ± 0.3; Mann-Whitney; p < 0.001) and females (0.7 ± 0.3 vs 0.86 ± 0.3; Mann-Whitney; p < 0.001). The cut-off point of 0.7 cm for females and 0.9 cm for males was established as a threshold to assess the presence of sarcopenia by ultrasound. Sensibility of ultrasound measurement of RFM thickness was 100%, specificity 64%, positive predictive value (PPV) 64.3% and negative predictive value (NPV) 100%. ROC analysis was performed in order to quantify how accurately RFM thickness can discriminate between sarcopenia and non-sarcopenia state. AUC for all patients was 0.9 and after a comparative analysis for gender higher values for males (0.94 vs. 0.92) were observed. We suggest a screening test for sarcopenia based on the ultrasound measurement of RFM thickness, as a not invasive and easy to perform method even in elderly patients with functional or cognitive impairment. [ABSTRACT FROM AUTHOR]

Objective: To evaluate mortality for Parkinson's disease (PD) in Italy during a long time period (1980-2015) and to discuss the role of possible general and specific influencing factors.Methods: Based on mortality data provided by the Italian National Institute of Statistics, sex- and age-specific crude mortality rates were computed, for the whole country and for its main geographical sub-areas. Rates were standardized using both direct (annual mortality rates AMRs) and indirect (standardized mortality rates SMRs) methods. SMRs were used to evaluate geographical differences, whereas AMRs and joinpoint linear regression analysis to study mortality trends.Results: Considering the entire period, highest mortality rates were observed in males (AMR/100,000: 9.0 in males, 5.25 in females), in North-West and Central Italy (SMR > 100). Overall PD mortality decreased from mid-eighties onwards and then rapidly reversed the trend in the period 1998-2002, rising up to a maximum in 2015, with some differences according to sex and geographical areas.Conclusions: Several factors may have contributed to the rapid inversion of decreasing trend in mortality observed in the last part of XX century. Possible explanations of this rising trend are related to the increasing burden of PD (especially in males and in certain Italian regions), caused by different factors as population aging, physiological prevalence rise due to incidence exceeding mortality, and growing exposure to environmental or occupational risk factors. In addition, the accuracy of death certificate compilation could account for geographical differences and for the temporal trend. The role of levodopa and recently introduced dopaminergic drugs is also discussed. [ABSTRACT FROM AUTHOR]