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1. Progress toward standardized diagnosis of vascular cognitive impairment: Guidelines from the Vascular Impairment of Cognition Classification Consensus Study

Author

Taragano, F.E., Kril, J., Cavalieri, M., Jellinger, K.A., Kovacs, G.G., Engelborghs, S., Lafosse, C., Bertolucci, P.H., Brucki, S., Caramelli, P., de Toledo Ferraz Alves, T.C., Bocti, C., Fulop, T., Hogan, D.B., Hsiung, G.R., Kirk, A., Leach, L., Robillard, A., Sahlas, D.J., Guo, Q., Tian, J., Hokkanen, L., Jokinen, H., Benisty, S., Deramecourt, V., Hauw, J., Lenoir, H., Tsatali, M., Tsolaki, M., Sundar, U., Coen, R.F., Korczyn, A.D., Altieri, M., Baldereschi, M., Caltagirone, C., Caravaglios, G., Di Carlo, A., Di Piero, V., Gainotti, G., Galluzzi, S., Logroscino, G., Mecocci, P., Moretti, D.V., Padovani, A., Fukui, T., Ihara, M., Mizuno, T., Kim, S.Y., Akinyemi, R., Baiyewu, O., Ogunniyi, A., Szczudlik, A., Bastos-Leite, A.J., Firmino, H., Massano, J., Verdelho, A., Kruglov, L.S., Ikram, M.K., Kandiah, N., Arana, E., Barroso-Ribal, J., Calatayud, T., Cruz-Jentoft, A.J., López-Pousa, S., Martinez-Lage, P., Mataro, M., Börjesson-Hanson, A., Englund, E., Laukka, E.J., Qiu, C., Viitanen, M., Biessels, G.J., de Leeuw, F.-E., den Heijer, T., Exalto, L.G., Kappelle, L.J., Prins, N.D., Richard, E., Schmand, B., van den Berg, E., van der Flier, W.M., Bilgic, B., Allan, L.M., Archer, J., Attems, J., Bayer, A., Blackburn, D., Brayne, C., Bullock, R., Connelly, P.J., Farrant, A., Fish, M., Harkness, K., Ince, P.G., Langhorne, P., Mann, J., Matthews, F.E., Mayer, P., Pendlebury, S.T., Perneczky, R., Peters, R., Smithard, D., Stephan, B.C., Swartz, J.E., Todd, S., Werring, D.J., Wijayasiri, S.N., Wilcock, G., Zamboni, G., Au, R., Borson, S., Bozoki, A., Browndyke, J.N., Corrada, M.M., Crane, P.K., Diniz, B.S., Etcher, L., Fillit, H., Greenberg, S.M., Grinberg, L.T., Hurt, S.W., Lamar, M., Mielke, M., Ott, B.R., Perry, G., Powers, W.J., Ramos-Estebanez, C., Reed, B., Roberts, R.O., Romero, J.R., Saykin, A.J., Seshadri, S., Silbert, L., Stern, Y., Zarow, C., Skrobot, Olivia A., Black, Sandra E., Chen, Christopher, DeCarli, Charles, Erkinjuntti, Timo, Ford, Gary A., Kalaria, Rajesh N., O'Brien, John, Pantoni, Leonardo, Pasquier, Florence, Roman, Gustavo C., Wallin, Anders, Sachdev, Perminder, Skoog, Ingmar, Ben-Shlomo, Yoav, Passmore, Anthony P., Love, Seth, and Kehoe, Patrick G.

Published
2018
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2. Additive Role of a Potentially Reversible Cognitive Frailty Model and Inflammatory State on the Risk of Disability: The Italian Longitudinal Study on Aging

Author

Scafato, E., Farchi, G., Galluzzo, L., Gandin, C., Capurso, A., Panza, F., Solfrizzi, V., Lepore, V., Livrea, P., Motta, L., Carnazzo, G., Motta, M., Bentivegna, P., Bonaiuto, S., Cruciani, G., Postacchini, D., Inzitari, D., Amaducci, L., Di Carlo, A., Baldereschi, M., Gandolfo, C., Conti, M., Canal, N., Franceschi, M., Scarlato, G., Candelise, L., Scapini, E., Rengo, F., Abete, P., Cacciatore, F., Enzi, G., Battistin, L., Sergi, G., Crepaldi, G., Maggi, S., Minicucci, N., Noale, M., Grigoletto, F., Perissinotto, E., Carbonin, P., Solfrizzi, Vincenzo, Scafato, Emanuele, Lozupone, Madia, Seripa, Davide, Giannini, Michele, Sardone, Rodolfo, Bonfiglio, Caterina, Abbrescia, Daniela I., Galluzzo, Lucia, Gandin, Claudia, Baldereschi, Marzia, Di Carlo, Antonio, Inzitari, Domenico, Daniele, Antonio, Sabbà, Carlo, Logroscino, Giancarlo, and Panza, Francesco

Published
2017
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3. The Vascular Impairment of Cognition Classification Consensus Study

Author

Taragano, F.E., Kril, J., Cavalieri, M., Jellinger, K.A., Kovacs, G.G., Engelborghs, S., Lafosse, C., Bertolucci, P.H., Brucki, S., Caramelli, P., de Toledo Ferraz Alves, T.C., Bocti, C., Fulop, T., Hogan, D.B., Hsiung, G.R., Kirk, A., Leach, L., Robillard, A., Sahlas, D.J., Guo, Q., Tian, J., Hokkanen, L., Jokinen, H., Benisty, S., Deramecourt, V., Hauw, J., Lenoir, H., Tsatali, M., Tsolaki, M., Sundar, U., Coen, R.F., Korczyn, A.D., Altieri, M., Baldereschi, M., Caltagirone, C., Caravaglios, G., Di Carlo, A., DI Piero, V., Gainotti, G., Galluzzi, S., Logroscino, G., Mecocci, P., Moretti, D.V., Padovani, A., Fukui, T., Ihara, M., Mizuno, T., Kim, S.Y., Akinyemi, R., Baiyewu, O., Ogunniyi, A., Szczudlik, A., Bastos-Leite, A.J., Firmino, H., Massano, J., Verdelho, A., Kruglov, L.S., Ikram, M.K., Kandiah, N., Arana, E., Barroso-Ribal, J., Calatayud, T., Cruz-Jentoft, A.J., López-Pousa, S., Martinez-Lage, P., Mataro, M., Börjesson-Hanson, A., Englund, E., Laukka, E.J., Qiu, C., Viitanen, M., Biessels, G.J., de Leeuw, F.-E., den Heijer, T., Exalto, L.G., Kappelle, L.J., Prins, N.D., Richard, E., Schmand, B., van den Berg, E., van der Flier, W.M., Bilgic, B., Allan, L.M., Archer, J., Attems, J., Bayer, A., Blackburn, D., Brayne, C., Bullock, R., Connelly, P.J., Farrant, A., Fish, M., Harkness, K., Ince, P.G., Langhorne, P., Mann, J., Matthews, F.E., Mayer, P., Pendlebury, S.T., Perneczky, R., Peters, R., Smithard, D., Stephan, B.C., Swartz, J.E., Todd, S., Werring, D.J., Wijayasiri, S.N., Wilcock, G., Zamboni, G., Au, R., Borson, S., Bozoki, A., Browndyke, J.N., Corrada, M.M., Crane, P.K., Diniz, B.S., Etcher, L., Fillit, H., Greenberg, S.M., Grinberg, L.T., Hurt, S.W., Lamar, M., Mielke, M., Ott, B.R., Perry, G., Powers, W.J., Ramos-Estebanez, C., Reed, B., Roberts, R.O., Romero, J.R., Saykin, A.J., Seshadri, S., Silbert, L., Stern, Y., Zarow, C., Skrobot, Olivia A., O'Brien, John, Black, Sandra, Chen, Christopher, DeCarli, Charles, Erkinjuntti, Timo, Ford, Gary A., Kalaria, Rajesh N., Pantoni, Leonardo, Pasquier, Florence, Roman, Gustavo C., Wallin, Anders, Sachdev, Perminder, Skoog, Ingmar, Ben-Shlomo, Yoav, Passmore, Anthony P., Love, Seth, and Kehoe, Patrick G.

Published
2017
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5. Associations between cardiac arrhythmia, incident disability in activities of daily living and physical performance: The ilsa study

Author

Noale, M., Veronese, N., Smith, L., Ungar, A., Fumagalli, S., Maggi, S., Scafato, E., Farchi, G., Galluzzo, L., Gandin, C., Capurso, A., Panza, F., Solfrizzi, V., Lepore, V., Livrea, P., Motta, L., Car-Nazzo, G., Motta, M., Bentivegna, P., Bonaiuto, S., Cruciani, G., Postacchini, D., Inzitari, D., Amaducci, L., Di Carlo, A., Baldereschi, M., Gandolfo, C., Conti, M., Canal, N., Franceschi, M., Scarlato, G., Candelise, L., Scapini, E., Rengo, F., Abete, P., Cacciatore, F., Enzi, G., Battistin, L., Sergi, G., Crepaldi, G., Minicuci, N., Grigoletto, F., Perissinotto, E., Carbonin, P., Noale, M., Veronese, N., Smith, L., Ungar, A., Fumagalli, S., Maggi, S., Scafato, E., Farchi, G., Galluzzo, L., Gandin, C., Capurso, A., Panza, F., Solfrizzi, V., Lepore, V., Livrea, P., Motta, L., Car-Nazzo, G., Motta, M., Bentivegna, P., Bonaiuto, S., Cruciani, G., Postacchini, D., Inzitari, D., Amaducci, L., Di Carlo, A., Baldereschi, M., Gandolfo, C., Conti, M., Canal, N., Franceschi, M., Scarlato, G., Candelise, L., Scapini, E., Rengo, F., Abete, P., Cacciatore, F., Enzi, G., Battistin, L., Sergi, G., Crepaldi, G., Minicuci, N., Grigoletto, F., Perissinotto, E., and Carbonin, P.

Subjects
Disability, Physical activity, Atrial fibrillation, Cardiac arrhythmia, not known, Physical performance
Abstract

Background Cardiac arrhythmias are common conditions in older people. Unfortunately, there is limited literature on associations between cardiac arrhythmias and physical performance or disability. We therefore aimed to prospectively investigate associations between cardiac arrhythmias and changes in disability and physical performance during 8 years of follow-up, using data from the Italian Longitudinal Study on Aging (ILSA). Methods Cardiac arrhythmias diagnosis was posed through a screening phase, confirmed by a physician. The onset of disability in activities of daily living (ADL) and the changes in several physical performance tests during follow-up were considered as outcomes. Fully-adjusted and propensity-score Cox Proportional Hazard models and mixed models were used for exploring associations between cardiac arrhythmia and the outcomes of interest. Results The prevalence of cardiac arrhythmia at baseline was 23.3%. People reporting cardiac arrhythmia at the baseline were significantly older, more frequently male, smokers and reported a higher presence of all medical conditions investigated (hypertension, heart failure, angina, myocardial infarction, diabetes, stroke), but no difference in dementia, Parkinsonism, cognitive or mood disorder. Cardiac arrhythmia at baseline was significantly associated with the incidence of disability in ADL (HR = 1.23; 95%: CI: 1.01-1.50; P = 0.0478 in propensity score analyses; HR = 1.28; 95% CI: 1.01-1.61; P = 0.0401 in fully adjusted models). Cardiac arrhythmia at baseline was also associated with a significant worsening in balance test (P = 0.0436). Conclusions The presence of cardiac arrhythmia at baseline was associated with a significant higher risk of disability and of worsening in some physical performance tests, particularly those relating to balance. Screening and frequently assessing physical performance in older people affected by cardiac arrhythmia can be important to prevent a loss of physical performance, with further, potential, complications of medical management. © 2020 JGC All rights reserved

Published
2020

9. Progress toward standardized diagnosis of vascular cognitive impairment

Author

Skrobot, Olivia A., Black, Sandra E., Chen, Christopher, DeCarli, Charles, Erkinjuntti, Timo, Ford, Gary A., Kalaria, Rajesh N., O'Brien, John, Pantoni, Leonardo, Pasquier, Florence, Roman, Gustavo C., Wallin, Anders, Sachdev, Perminder, Skoog, Ingmar, Ben-Shlomo, Yoav, Passmore, Anthony P., Love, Seth, Kehoe, Patrick G., Taragano, F.E., Kril, J., Cavalieri, M., Jellinger, K.A., Kovacs, G.G., Engelborghs, S., Lafosse, C., Bertolucci, P.H., Brucki, S., Caramelli, P., de Toledo Ferraz Alves, T.C., Bocti, C., Fulop, T., Hogan, D.B., Hsiung, G.R., Kirk, A., Leach, L., Robillard, A., Sahlas, D.J., Guo, Q., Tian, J., Hokkanen, L., Jokinen, H., Benisty, S., Deramecourt, V., Hauw, J., Lenoir, H., Tsatali, M., Tsolaki, M., Sundar, U., Coen, R.F., Korczyn, A.D., Altieri, M., Baldereschi, M., Caltagirone, C., Caravaglios, G., Di Carlo, A., Di Piero, V., Gainotti, G., Galluzzi, S., Logroscino, G., Mecocci, P., Moretti, D.V., Padovani, A., Fukui, T., Ihara, M., Mizuno, T., Kim, S.Y., Akinyemi, R., Baiyewu, O., Ogunniyi, A., Szczudlik, A., Bastos-Leite, A.J., Firmino, H., Massano, J., Verdelho, A., Kruglov, L.S., Ikram, M.K., Kandiah, N., Arana, E., Barroso-Ribal, J., Calatayud, T., Cruz-Jentoft, A.J., López-Pousa, S., Martinez-Lage, P., Mataro, M., Börjesson-Hanson, A., Englund, E., Laukka, E.J., Qiu, C., Viitanen, M., Biessels, G.J., de Leeuw, F.-E., den Heijer, T., Exalto, L.G., Kappelle, L.J., Prins, N.D., Richard, E., Schmand, B., van den Berg, E., van der Flier, W.M., Bilgic, B., Allan, L.M., Archer, J., Attems, J., Bayer, A., Blackburn, D., Brayne, C., Bullock, R., Connelly, P.J., Farrant, A., Fish, M., Harkness, K., Ince, P.G., Langhorne, Peter, Mann, J., Matthews, F.E., Mayer, P., Pendlebury, S.T., Perneczky, R., Peters, R., Smithard, D., Stephan, B.C., Swartz, J.E., Todd, S., Werring, D.J., Wijayasiri, S.N., Wilcock, G., Zamboni, G., Au, R., Borson, S., Bozoki, A., Browndyke, J.N., Corrada, M.M., Crane, P.K., Diniz, B.S., Etcher, L., Fillit, H., Greenberg, S.M., Grinberg, L.T., Hurt, S.W., Lamar, M., Mielke, M., Ott, B.R., Perry, G., Powers, W.J., Ramos-Estebanez, C., Reed, B., Roberts, R.O., Romero, J.R., Saykin, A.J., Seshadri, S., Silbert, L., Stern, Y., Zarow, C., Epidemiology, Neurology, General Practice, VICCCS Grp, Clinicum, Neurologian yksikkö, Department of Neurosciences, University of Helsinki, Department of Physics, HUS Neurocenter, Amsterdam Neuroscience - Neurodegeneration, APH - Personalized Medicine, and APH - Methodology

Subjects
0301 basic medicine, Neurology, Delphi Technique, Epidemiology, Delphi method, Delphi, Vascular dementia, 3124 Neurology and psychiatry, 0302 clinical medicine, SMALL VESSEL DISEASE, Neuropsychological assessment, Stroke, medicine.diagnostic_test, Health Policy, Neuropsychology, CLINICAL-CRITERIA, Brain, Cognition, 3. Good health, ALZHEIMERS-DISEASE, Settore MED/26 - NEUROLOGIA, Psychiatry and Mental health, Vascular cognitive impairment, NINDS-AIREN, ACUTE STROKE, STROKE, Clinical psychology, medicine.medical_specialty, Clinical Neurology, MINI-MENTAL-STATE, Guidelines, ATROPHY, 03 medical and health sciences, Cellular and Molecular Neuroscience, WHITE-MATTER CHANGES, Developmental Neuroscience, Vascular, medicine, Journal Article, Dementia, Humans, Intensive care medicine, business.industry, Dementia, Vascular, 3112 Neurosciences, medicine.disease, Criteria, 030104 developmental biology, consensus, Consensus, Neurology (clinical), Geriatrics and Gerontology, Psychiatry and Mental Health, CEREBRAL-BLOOD-FLOW, Human medicine, business, 030217 neurology & neurosurgery
Abstract

Hanna Jokinen tutkimusryhmän jäsenenä (VICCCS Grp) Introduction: Progress in understanding and management of vascular cognitive impairment (VCI) has been hampered by lack of consensus on diagnosis, reflecting the use of multiple different assessment protocols. A large multinational group of clinicians and researchers participated in a two-phase Vascular Impairment of Cognition Classification Consensus Study (VICCCS) to agree on principles (VICCCS-1) and protocols (VICCCS-2) for diagnosis of VCI. We present VICCCS-2. Methods: We used VICCCS-1 principles and published diagnostic guidelines as points of reference for an online Delphi survey aimed at achieving consensus on clinical diagnosis of VCI. Results: Six survey rounds comprising 65-79 participants agreed guidelines for diagnosis of VICCCS-revised mild and major forms of VCI and endorsed the National Institute of Neurological Disorders-Canadian Stroke Network neuropsychological assessment protocols and recommendations for imaging. Discussion: The VICCCS-2 suggests standardized use of the National Institute of Neurological Disorders-Canadian Stroke Network recommendations on neuropsychological and imaging assessment for diagnosis of VCI so as to promote research collaboration. (C) 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Published
2018
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19. Daily Function as Predictor of Dementia in Cognitive Impairment, No Dementia (CIND) and Mild Cognitive Impairment (MCI): An 8-Year Follow-Up in the ILSA Study

Author

Di Carlo, Antonio, Baldereschi, Marzia, Lamassa, Maria, Bovis, Francesca, Inzitari, Marco, Solfrizzi, Vincenzo, Panza, Francesco, Galluzzo, Lucia, Scafato, Emanuele, Inzitari, Domenico, Malara, Alba, Scafato, E., Farchi, G., Galluzzo, L., Gandin, C., Capurso, A., Panza, F., Solfrizzi, V., Lepore, V., Livrea, P., Motta, L., Carnazzo, G., Motta, M., Bentivegna, P., Bonaiuto, S., Cruciani, G., Fini, F., Vesprini, A., Postacchini, D., Inzitari, D., Amaducci, L., Di Carlo, A., Baldereschi, M., Ghetti, A., Vergassola, R., Gandolfo, C., Conti, M., Canal, N., Franceschi, M., Scarlato, G., Candelise, L., Scarpini, E., Rengo, F., Abete, P., Cacciatore, F., Covelluzzi, F., Enzi, G., Battistin, L., Sergi, G., Crepaldi, G., Bressan, M., Bortolan, G., Maggi, S., Minicuci, N., Noale, M., Grigoletto, F., Perissinotto, E., Carbonin, P., Di Carlo, Antonio, Baldereschi, Marzia, Lamassa, Maria, Bovis, Francesca, Inzitari, Marco, Solfrizzi, Vincenzo, Panza, Francesco, Galluzzo, Lucia, Scafato, E., Inzitari, Domenico, Malara, Alba, Farchi, G., Galluzzo, L., Gandin, C., Capurso, A., Panza, F., Solfrizzi, V., Lepore, V., Livrea, P., Motta, L., Carnazzo, G., Motta, M., Bentivegna, P., Bonaiuto, S., Cruciani, G., Fini, F., Vesprini, A., Postacchini, D., Inzitari, D., Amaducci, L., Di Carlo, A., Baldereschi, M., Ghetti, A., Vergassola, R., Gandolfo, C., Conti, M., Canal, N., Franceschi, M., Scarlato, G., Candelise, L., Scarpini, E., Rengo, F., Abete, P., Cacciatore, F., Covelluzzi, F., Enzi, G., Battistin, L., Sergi, G., Crepaldi, G., Bressan, M., Bortolan, G., Maggi, S., Minicuci, N., Noale, M., Grigoletto, F., Perissinotto, E., and Carbonin, P.

Subjects
Male, Gerontology, Longitudinal study, Time Factors, Activities of daily living, Psychological intervention, Neuropsychological Tests, Community Health Planning, Cohort Studies, 03 medical and health sciences, Motor performance, Longitudinal studie, 0302 clinical medicine, Predictive Value of Tests, Activities of Daily Living, mental disorders, 80 and over, medicine, Instrumental activities of daily living, Humans, Dementia, Cognitive Dysfunction, 030212 general & internal medicine, Mild cognitive impairment (MCI), Longitudinal studies, Mild cognitive impairment, Age Factors, Aged, Aged, 80 and over, Disease Progression, Female, Italy, Mental Status and Dementia Tests, Proportional Hazards Models, Cognitive impairment, Proportional hazards model, General Neuroscience, Incidence (epidemiology), General Medicine, medicine.disease, Clinical Psychology, Psychiatry and Mental Health, Geriatrics and Gerontology, Psychology, human activities, 030217 neurology & neurosurgery
Abstract

ACKGROUND: Preclinical cognitive changes may predict an increased risk of dementia, allowing selection of subgroups as possible targets for preventive or therapeutic interventions. OBJECTIVE: To evaluate the predictive effect of daily functioning and motor performance (MP) on the progression to dementia in normal cognition, cognitive impairment, no dementia (CIND), and mild cognitive impairment (MCI). METHODS: The Italian Longitudinal Study on Aging is a large population-based survey on age-related diseases of the cardiovascular and nervous systems. After the baseline assessment, to detect prevalent cases of cognitive impairment and dementia, participants were re-examined at 4-year and 8-year follow-ups. Functional independence was evaluated using the Index of Activities of Daily Living (ADL) and the Instrumental Activities of Daily Living (IADL) Scale. A six-test battery was used to assess MP. RESULTS: Overall, 2,386 individuals were included, for a total of 16,545 person-years. Eight-year incidence of dementia (per 1,000 person-years) was 12.69 in total sample, 9.86 in subjects with normal cognition at baseline, 22.99 in CIND, and 21.43 in MCI. Progression to dementia was significantly higher with increasing baseline ADL and IADL impairment, and with a worse MP. In Cox regression analyses controlled for demographics and major age-related conditions, increased IADL impairment was the stronger predictor of progression to dementia (p

Published
2016

20. Hippocampal atrophy in people with memory deficits: results from the population-based IPREA study

Author

Ferrarini L, van Lew B, Reiber JH, Gandin C, Galluzzo L, Scafato E, FrisoniGB, Milles J, Pievani M, IPREA Working Group: Scafato E, Farchi G, Giampaoli S, Mariotti S, Ghirini S, Martire S, Di Pasquale L, Maggi S, Crepaldi G, Enzi G, Gallina P, Inzitari D, Baldereschi M, Di Carlo A, Frisoni GB, Galluzzi S, Gandolfo C, Conti M, Postacchini D, Cruciani G, Giuli C, Capurso A, Solfrizzi V, Panza F, Rengo F, ABETE, PASQUALE, Motta M, Negrini R, Forti P, Tabanelli P, Cocchi A, Zuccal G, Cacciatore F, Calabrese C, Sica G, Estraneo A, Foundation SM, Consoli D, Naso F, Torcasio G, Valentia V, Mecocci P, Rinaldi P, Serafini V, Senin U., Ferrarini, L, van Lew, B, Reiber, Jh, Gandin, C, Galluzzo, L, Scafato, E, Frisonigb, Milles, J, Pievani, M, IPREA Working Group: Scafato, E, Farchi, G, Giampaoli, S, Mariotti, S, Ghirini, S, Martire, S, Di Pasquale, L, Maggi, S, Crepaldi, G, Enzi, G, Gallina, P, Inzitari, D, Baldereschi, M, Di Carlo, A, Frisoni, Gb, Galluzzi, S, Gandolfo, C, Conti, M, Postacchini, D, Cruciani, G, Giuli, C, Capurso, A, Solfrizzi, V, Panza, F, Rengo, F, Abete, Pasquale, Motta, M, Negrini, R, Forti, P, Tabanelli, P, Cocchi, A, Zuccal, G, Cacciatore, F, Calabrese, C, Sica, G, Estraneo, A, Foundation, Sm, Consoli, D, Naso, F, Torcasio, G, Valentia, V, Mecocci, P, Rinaldi, P, Serafini, V, and Senin, U.

Subjects
medicine.medical_specialty, education.field_of_study, business.industry, Population, Not Otherwise Specified, Hippocampus, Audiology, Hippocampal formation, medicine.disease, population-based, memory, Psychiatry and Mental health, Clinical Psychology, Atrophy, hippocampal atrophy, medicine, Dementia, Memory impairment, Geriatrics and Gerontology, Alzheimer's disease, business, education, Gerontology, MRI
Abstract

Background:Clinical studies have shown that hippocampal atrophy is present before dementia in people with memory deficits and can predict dementia development. The question remains whether this association holds in the general population. This is of interest for the possible use of hippocampal atrophy to screen population for preventive interventions. The aim of this study was to assess hippocampal volume and shape abnormalities in elderly adults with memory deficits in a cross-sectional population-based study.Methods:We included individuals participating in the Italian Project on the Epidemiology of Alzheimer Disease (IPREA) study: 75 cognitively normal individuals (HC), 31 individuals with memory deficits (MEM), and 31 individuals with memory deficits not otherwise specified (MEMnos). Hippocampal volumes and shape were extracted through manual tracing and the growing and adaptive meshes (GAMEs) shape-modeling algorithm. We investigated between-group differences in hippocampal volume and shape, and correlations with memory deficits.Results:In MEM participants, hippocampal volumes were significantly smaller than in HC and were mildly associated with worse memory scores. Memory-associated shape changes mapped to the anterior hippocampus. Shape-based analysis detected no significant difference between MEM and HC, while MEMnos showed shape changes in the posterior hippocampus compared with HC and MEM groups.Conclusions:These findings support the discriminant validity of hippocampal volumetry as a biomarker of memory impairment in the general population. The detection of shape changes in MEMnos but not in MEM participants suggests that shape-based biomarkers might lack sensitivity to detect Alzheimer's-like pathology in the general population.

Published
2014

21. Prevalence of diabetes and depressive symptomatology and their effect on mortality risk in elderly Italians: The Italian Longitudinal Study on Aging

Author

Limongi F, Noale M, Crepaldi G, Maggi S, ILSA Working Group: Scafato E, Farchi G, Galluzzo L, Gandin C, Capurso A, Panza F, Solfrizzi V, Lepore V, Livrea P, Motta L, Carnazzo G, Motta M, Bentivegna P, Bonaiuto S, Cruciani G, Postacchini D, Inzitari D, Amaducci L, Di Carlo A, Baldereschi M, Gandolfo C, Conti M, Canal N, Franceschi M, Scarlato G, Candelise L, Scapini E, Rengo F, ABETE, PASQUALE, Cacciatore F, Enzi G, Battistin L, Sergi G, Minicuci N, Grigoletto F, Perissinotto E, Carbonin P., Limongi, F, Noale, M, Crepaldi, G, Maggi, S, ILSA Working Group: Scafato, E, Farchi, G, Galluzzo, L, Gandin, C, Capurso, A, Panza, F, Solfrizzi, V, Lepore, V, Livrea, P, Motta, L, Carnazzo, G, Motta, M, Bentivegna, P, Bonaiuto, S, Cruciani, G, Postacchini, D, Inzitari, D, Amaducci, L, Di Carlo, A, Baldereschi, M, Gandolfo, C, Conti, M, Canal, N, Franceschi, M, Scarlato, G, Candelise, L, Scapini, E, Rengo, F, Abete, Pasquale, Cacciatore, F, Enzi, G, Battistin, L, Sergi, G, Minicuci, N, Grigoletto, F, Perissinotto, E, and Carbonin, P.

Published
2014

23. Physical disability and depressive symptomatology in an elderly population: a complex relationship. The Italian Longitudinal Study on Aging (ILSA)

Author

DALLE CARBONARE LD, Maggi, S, Noale, M, Giannini, S, Rozzini, R, LO CASCIO, V, Crepaldi, G, AND ILSA WORKING GROUP CREPALDI, G, Minicuci, N, Grigoletto, F, Perissinotto, E, Inzitari, D, DI CARLO, A, Baldereschi, M, Scafato, E, Farchi, G, Galluzzo, L, Gandin, C, Capurso, A, Panza, F, Solfrizzi, V, Lepore, V, Livrea, P, Motta, L, Carnazzo, G, Motta, M, Bentivegna, P, Bonaiuto, S, Cruciani, G, Postacchini, D, Gandolfo, Carlo, Conti, M, Canal, N, Franceschi, M, Candelise, L, Scapini, E, Rengo, F, Abete, P, Cacciatore, F, Enzi, G, Battistin, L, Sergi, G, and Carbonin, P.

Published
2009

25. Stroke in an elderly population: incidence and impact on survival and daily function. The Italian Longitudinal Study on Aging

Author

Carlo, A. D., Baldereschi, M., Gandolfo, Carlo, Candelise, L., Ghetti, A., Maggi, S., Scafato, E., Carbonin, P., Amaducci, L., Inzitari, D., and I. L. S.

Subjects
Male, Aging, Incidence, Age Factors, Cohort Studies, Stroke, Survival Rate, Sex Factors, Italy, Socioeconomic Factors, Activities of Daily Living, physiology, Activities of Daily Living, Age Factors, Aged, Aged, 80 and over, Aging, physiology, Cohort Studies, Female, Follow-Up Studies, Humans, Incidence, Italy, epidemiology, Longitudinal Studies, Male, Sex Factors, Socioeconomic Factors, Stroke, complications/epidemiology/physiopathology, Survival Rate, 80 and over, Humans, Female, epidemiology, Longitudinal Studies, complications/epidemiology/physiopathology, Aged, Follow-Up Studies
Published
2003

28. Gender differences in the incidence of AD and vascular dementia:The EURODEM Studies. EURODEM Incidence Research Group

Author

Andersen, K, Launer, L J, Dewey, M E, Letenneur, L, Ott, A, Copeland, J R, Dartigues, J F, Kragh-Sorensen, P, Baldereschi, M, Brayne, C, Lobo, A, Martinez-Lage, J M, Stijnen, T, and Hofman, A

Subjects
Aged, 80 and over, Europe, Male, Risk, Cross-Sectional Studies, Sex Factors, Alzheimer Disease, Dementia, Vascular, Incidence, Humans, Female, Aged, Follow-Up Studies
Abstract

To study the difference in risk for dementing diseases between men and women.

Published
1999

32. Metabolic syndrome and the risk of vascular dementia: the Italian Longitudinal Study on Ageing.

Author

Solfrizzi V, Scafato E, Capurso C, D'Introno A, Colacicco AM, Frisardi V, Vendemiale G, Baldereschi M, Crepaldi G, Di Carlo A, Galluzzo L, Gandin C, Inzitari D, Maggi S, Capurso A, Panza F, Italian Longitudinal Study on Ageing Working Group, Solfrizzi, Vincenzo, Scafato, Emanuele, and Capurso, Cristiano

Abstract

Objective: The authors investigated the relationship of metabolic syndrome (MetS) and its individual components with incident dementia in a prospective population-based study with a 3.5-year follow-up.Methods: A total of 2097 participants from a sample of 5632 subjects (65-84 years old) from the Italian Longitudinal Study on Ageing were evaluated. MetS was defined according to the Third Adults Treatment Panel of the National Cholesterol Education Program criteria. Dementia, Alzheimer disease (AD) and vascular dementia (VaD) were classified using current published criteria.Results: MetS subjects (N=918) compared with those without MetS (N=1179) had an increased risk for VaD (1.63% vs 0.85%, adjusted hazard ratio (HR) 3.71, 95% CI 1.40 to 9.83). After excluding 338 subjects with baseline undernutrition, MetS subjects compared with those without MetS had an elevated risk of VaD (adjusted HR, 3.82; 95% CI 1.32 to 11.06). Moreover, those with MetS and high inflammation had a still further higher risk of VaD (multivariate adjusted HR, 9.55; 95% CI 1.17 to 78.17) compared with those without MetS and high inflammation. On the other hand, those with MetS and low inflammation compared with those without MetS and low inflammation did not exhibit a significant increased risk of VaD (adjusted HR, 3.31, 95% CI 0.91 to 12.14). Finally, a synergistic MetS effect versus its individual component effects was verified on the risk of VaD.Conclusion: In our population, MetS subjects had an elevated risk of VaD that increased after excluding patients with baseline undernutrition and selecting MetS subjects with high inflammation. [ABSTRACT FROM AUTHOR]

Published
2010
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33. Education and Risk for Alzheimer's Disease: Sex Makes a Difference EURODEM Pooled Analyses.

Author

Letenneur, L., Launer, J., Andersen, K., Dewey, M. E., Ott, A., Copeland, J. R. M., Dartigues, J-F., Kragh-Sorensen, P., Baldereschi, M., Brayne, C., Lobo, A., Martinez-Lage, J. M., Stijnen, T., and Hofman, A.

Subjects
ALZHEIMER'S disease risk factors, DEMENTIA risk factors, GENDER differences (Sociology), DISEASES in women, HUNTINGTON disease, STATISTICAL sampling
Abstract

The hypotesis that a low educational level increases the risk for Alzhelmer's disease remains controversial. The authors studied the asociation of years of schooling with the risk for incident Dementla cases were identifled in a two-stage procedure that included a detailed diagnostic assessment of screen-postive subjects. Dementia and Alzheimer's disease were diagnosed by international research criteris. Educational level was categorized by years of schooling as low (≤7), middle (8–11), or high (>12). Relative risks (95% confidence intervals)were estimatted by using Poission regression, Adjusting for age, sex, study canter, smoking status, and self-reported myocadial infraction and storke. There were 493 (328) incident cases of dementia (Alzheimer's disease) and 28, 061 (27, 839) person-years of follow-up. Compared with women with a high level of education, those with low and middle levels of education had 4.3 (95%confidence Interval: 1.5, 11.9) and 2.6 (95% confidence interval: 1.0, 7.1) times increased risks, respectively, for Alzheimer's disease for women only raises the possibllity that unmeasured conlounding explains the previously reported increased risk for Alzhemer's disease for persons with low levels of education, Am J Epidemiol 2000; 151: 1064-71 [ABSTRACT FROM PUBLISHER]

Published
2009

34. Impaired attention predicts motor performance decline in older community-dwellers with normal baseline mobility: results from the Italian Longitudinal Study on Aging (ILSA).

Author

Inzitari M, Baldereschi M, Di Carlo A, Di Bari M, Marchionni N, Scafato E, Farchi G, Inzitari D, ILSA Working Group, Inzitari, Marco, Baldereschi, Marzia, Di Carlo, Antonio, Di Bari, Mauro, Marchionni, Niccolò, Scafato, Emanuele, Farchi, Gino, and Inzitari, Domenico

Abstract

Background: Cognitive decline, particularly when executive functions are compromised, may worsen motor performance (MP) decline in the elderly population. We investigated whether a global test, a memory test, and an attention test predicted MP decline in older community-dwellers with normal baseline MP participating in the Italian Longitudinal Study on Aging (ILSA).Methods: One thousand fifty-two ILSA participants (71.2 +/- 4.8 years old, mean +/- standard deviation [SD], 67% men), with normal baseline MP were reassessed after 3 years using the same MP battery. Participants whose MP score reduction from baseline to follow-up was > 75 percentile were considered to be MP decliners. Global cognition, memory, and attention were assessed using the Mini-Mental State Examination (MMSE), the Babcock Story Recall Test (BSRT), and the Digit Cancellation Test (DCT), respectively. The baseline score on each test was examined as a potential predictor of decline in global MP or in single motor tasks.Results: Baseline scores on the three cognitive tests were worse among the 166 MP decliners, compared with nondecliners. Participants in the lowest quartile of DCT had a > 2-fold higher adjusted risk of declining than did participants in the highest quartile (odds ratio = 2.47, 95% confidence interval, 1.29-4.74). Conversely, MMSE and BSRT scores no longer predicted MP decline after adjustment. Impaired attention strongly predicted the decline in attention-demanding tasks (tandem walking), but also affected routine tasks (walking).Conclusions: Impairment in a test measuring attention predicts MP decline among older community-dwellers with normal baseline MP. This finding is consistent with the hypothesis that attentional and executive dysfunction is a major determinant of mobility disability in elderly persons. [ABSTRACT FROM AUTHOR]

Published
2007
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36. Behavioral and psychological symptoms in Alzheimer's disease: frequency and relationship with duration and severity of the disease.

Author

Piccininni M, Di Carlo A, Baldereschi M, Zaccara G, and Inzitari D

Abstract

The occurrence of behavioral and psychological symptoms of dementia (BPSD) is currently recognized as an important aspect of Alzheimer's disease (AD). We evaluated the frequency and severity of BPSD with the Neuropsychiatric Inventory across the various degrees and phases of the disease in 50 consecutive AD outpatients. Apathy, aberrant motor activity, dysphoria and anxiety were the symptoms most frequently reported by the caregivers, ranging in the whole study sample from 46 to 74%. A clear trend towards increasing frequency with the severity of disease was found for delusions, hallucinations and aberrant motor activity. A major effect of the duration of the disease was found in the probability of developing hallucinations and aberrant motor activity. Apart from hallucinations, all BPSD were present starting from a mild degree of dementia. A better understanding of the global spectrum of BPSD in AD is warranted in order to improve the allocation of health resources toward the treatment of dementia. [ABSTRACT FROM AUTHOR]

Published
2005
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37. Depressive symptoms and development of coronary heart disease events: the Italian longitudinal study on aging.

Author

Marzari C, Maggi S, Manzato E, Destro C, Noale M, Bianchi D, Minicuci N, Farchi G, Baldereschi M, Di Carlo A, Crepaldi G, Italian Longitudinal Study on Aging Working Group, Marzari, Chiara, Maggi, Stefania, Manzato, Enzo, Destro, Carla, Noale, Marianna, Bianchi, Daniele, Minicuci, Nadia, and Farchi, Gino

Abstract

Background: Studies on the association between depressive symptomatology (DS) and cardiovascular events and mortality in elderly persons have yielded contradictory findings. To address this issue, the authors assessed DS and an extensive array of sociodemographic, behavioral, and biological variables in the largest population-based sample of older Italians ever studied and analyzed their association with coronary heart disease (CHD) morbidity and total number of deaths.Methods: This prospective, community-based cohort study included a sample of 5632 Italians, 65 years and older, who were recruited from the demographic registries of eight municipalities in Italy. Depressive symptomatology was assessed using the Geriatric Depression Scale, and a score > or =10 was used to indicate the presence of DS. All traditional cardiovascular disease risk factors were assessed at baseline, through questionnaires, blood tests, and physical examinations. The outcomes were CHD fatal and nonfatal events and total number of deaths. The association of the predictive variables with the outcomes was assessed using different Cox models.Results: Baseline DS was associated with a higher incidence of fatal and nonfatal CHD events (hazard ratio [HR], 1.66; 95% confidence interval [CI], 1.06-2.60) and with cardiovascular mortality in men (HR, 2.49; 95% CI, 1.60-3.87) and with total mortality in men (HR, 2.02; 95% CI, 1.58-2.58) and women (HR, 1.43; 95% CI, 1.04-1.95) at the 4-year follow-up assessment. This association was observed after adjusting for a vast array of potential confounding variables, including major chronic conditions.Conclusions: Depressive symptomatology confers an increased risk for CHD in men and for total mortality in men and women but is not explained by health behaviors, social isolation, or biological or clinical determinants. [ABSTRACT FROM AUTHOR]

Published
2005
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38. Sex differences in the clinical presentation, resource use, and 3-month outcome of acute stroke in Europe: data from a multicenter multinational hospital-based registry.

Author

Di Carlo A, Lamassa M, Baldereschi M, Pracucci G, Basile AM, Wolfe CDA, Giroud M, Rudd A, Ghetti A, Inzitari D, European BIOMED Study of Stroke Care Group, Di Carlo, Antonio, Lamassa, Maria, Baldereschi, Marzia, Pracucci, Giovanni, Basile, Anna Maria, Wolfe, Charles D A, Giroud, Maurice, Rudd, Anthony, and Ghetti, Augusto

Published
2003
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39. Dementia and Disability: Impact on Mortality.

Author

Noale, M., Maggi, S., Minicuci, N., Marzari, C., Destro, C., Farchi, G., Scafato, E., Baldereschi, M., Di Carlo, A., and Crepaldi, G.

Subjects
DEMENTIA, NEUROBEHAVIORAL disorders, DISEASES in older people, MORTALITY, DISABILITIES, PEOPLE with disabilities
Abstract

Dementia is known to be associated with excess mortality. Physical disability, as a marker of dementia severity, is often considered the last step on the way from disease to death. The objective of this study was to investigate the direct effect of dementia on mortality in a population-based study, carried out in Italy, with a sample of 5,632 individuals aged 65-84 years. At 4-year follow-up, 998 participants had died. The independent predictors of death were: age (75-84 years; HR 2.63, CI = 2.11-3.27), male sex (HR 1.45, CI = 1.22-1.74), coronary heart disease (HR 1.61, CI = 1.34-1.94), moderate and severe instrumental activities of daily living disability (HR 1.98, CI = 1.30-3.03 and HR 3.26, CI = 2.09-5.09, respectively), diabetes in subjects with a survival time greater than 23 months (HR 0.68, CI = 0.43-1.08) and dementia (HR 2.07, CI = 1.62-2.66). These data provide evidence that dementia per se, independently from physical disability, is a strong predictor of death in the elderly. [ABSTRACT FROM AUTHOR]

Published
2003
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40. High plasma insulin and lipids profile in older individuals: the Italian longitudinal study on aging.

Author

Maggi, Stefania, Minicuci, Nadia, Harris, Tamara, Motta, Luciano, Baldereschi, Marzia, Di Carlo, Antonio, Inzitari, Domenico, Crepaldi, Gaetano, Maggi, S, Minicuci, N, Harris, T, Motta, L, Baldereschi, M, Di Carlo, A, Inzitari, D, and Crepaldi, G

Subjects
DIABETES in old age, DISEASES in older people, DISEASE risk factors
Abstract

Background: The inverse relationship of insulin level to high-density lipoprotein (HDL)-cholesterol and its positive association with hypertriglyceridemia has been demonstrated in several studies; however, the relationship of insulin to low-density lipoprotein (LDL)-cholesterol in elderly persons is not clear. This study investigates the relationships of fasting plasma insulin and selected metabolic and biological risk factors in an aged population.Methods: The present study is based on a cross-sectional analysis of the data collected at baseline of the Italian Longitudinal Study on Aging in 1992 on a random sample of 5632 Italians aged 65-84 years. Analyses were performed to compare the distribution of risk factors, such as blood level of lipids, creatinine, albumin, fibrinogen, apolipoprotein A-1 and B, blood pressure, and body mass index (BMI), by quartiles of insulin, in both diabetic and nondiabetic participants.Results: Significantly higher levels of triglycerides and BMI and lower levels of HDL-cholesterol were found in the upper quartile of insulin among nondiabetic individuals. In men, we also found significantly higher levels of systolic and diastolic blood pressure. The same trend for these variables, although not significant for HDL-cholesterol and blood pressure, was seen in diabetic men. In diabetic women, total and LDL-cholesterol were significantly lower in the highest insulin quartile (p <.001), while no significant differences were seen in nondiabetic women or in men. We also found higher levels of white blood cells in the highest insulin quartile of diabetic women.Conclusions: These results, apparently in disagreement with earlier reports on the clustering of cardiovascular disease risk factors in hyperinsulinemic individuals, could be due to the high frequency of chronic inflammation and the high prevalence of urinary infections in older diabetic women. [ABSTRACT FROM AUTHOR]

Published
2001
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43. Education and the risk of physical disability and mortality among men and women aged 65 to 84: the Italian Longitudinal Study on Aging.

Author

Amaducci, L, Maggi, S, Langlois, J, Minicuci, N, Baldereschi, M, Di Carlo, A, and Grigoletto, F

Abstract

Background: Most studies report that people with higher education enjoy better health and longer life. Although it is well known that most risk factors are more common among individuals with a lower level of education, the underlying mechanism of this association is not fully understood. The objective of this study was to assess the association between education, disability, and mortality.Methods: We analyzed data on 1,817 men and 1,643 women, aged 65-84 years, to assess the association of educational level with physical disability and mortality adjusting for age, sex, smoking habit, occupation, and major chronic conditions.Results: The association between educational level and disability was characterized by a dose-response effect, with the relative odds significantly decreased by about 30%, 60%, and 79% in those with 4 or 5, 6 to 8, and more than 8 years of education, compared to those with 3 or less years of education. Death rates were lower among persons with 4 or more years of education compared to those with less education. However, after adjusting for disability status, education was no longer associated with mortality (RR=0.97, CI=0.65-1.43).Conclusions: The strong association of low education with disability found in this study may explain the inverse association with mortality reported in previous studies. Disability, indeed, seems to be the mediator between education and mortality and might be due to the higher severity level of diseases, leading to death, in the lower educated group. [ABSTRACT FROM AUTHOR]

Published
1998
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48. Marital and cohabitation status as predictors of mortality: a 10-year follow-up of an Italian elderly cohort.

Author

Scafato E, Galluzzo L, Gandin C, Ghirini S, Baldereschi M, Capurso A, Maggi S, Farchi G, and ILSA Working Group

Abstract

The relationship between mortality and marital status has long been recognized, but only a small number of investigations consider also the association with cohabitation status. Moreover, age and gender differences have not been sufficiently clarified. In addition, little is known on this matter about the Italian elderly population. The aim of this study is to examine differentials in survival with respect to marital status and cohabitation status in order to evaluate their possible predictive value on mortality of an Italian elderly cohort. This paper employs data from the Italian Longitudinal Study on Aging (ILSA), an extensive epidemiologic project on subjects aged 65-84 years. Of the 5376 individuals followed-up from 1992 to 2002, 1977 died, and 1492 were lost during follow-up period. The baseline interview was administered to 84% of the 5376 individuals and 65% of them underwent biological and instrumental examination. Relative risks of mortality for marital (married vs. non-married) and cohabitation (not living alone vs. living alone) categories are estimated through hazard ratios (HR), obtained by means of the Cox proportional hazards regression model, adjusting for age and several other potentially confounding variables. Non-married men (HR=1.25; 95% CI: 1.03-1.52) and those living alone (HR=1.42; 95% CI: 1.05-1.92) show a statistically significant increased mortality risk compared to their married or cohabiting counterparts. After age-adjustment, women's survival is influenced neither by marital status nor by cohabitation status. None of the other covariates significantly alters the observed differences in mortality, in either gender. Neither marital nor cohabitation status are independent predictors of mortality among Italian women 65+, while among men living alone is a predictor of mortality even stronger than not being married. These results suggest that Italian men benefit more than women from the protective effect of living with someone. [ABSTRACT FROM AUTHOR]

Published
2008
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49. Reversible Cognitive Frailty, Dementia, and All-Cause Mortality The Italian Longitudinal Study on Aging

Author

Vincenzo Solfrizzi, Emanuele Scafato, Davide Seripa, Madia Lozupone, Bruno P. Imbimbo, Angela D'Amato, Rosanna Tortelli, Andrea Schilardi, Lucia Galluzzo, Claudia Gandin, Marzia Baldereschi, Antonio Di Carlo, Domenico Inzitari, Antonio Daniele, Carlo Sabbà, Giancarlo Logroscino, Francesco Panza, Gino Farchi, Antonio Capurso, Vito Lepore, Paolo Livrea, Luciano Motta, Giuseppe Carnazzo, Massimo Motta, Prospera Bentivegna, Salvatore Bonaiuto, Guido Cruciani, Demetrio Postacchini, Luigi Amaducci, Carlo Gandolfo, Massimo Conti, Nicola Canal, Massimo Franceschi, Guglielmo Scarlato, Livia Candelise, Elio Scapini, Franco Rengo, Pasquale Abete, Francesco Cacciatore, Giuliano Enzi, Leontino Battistin, Giuseppe Sergi, Gaetano Crepaldi, Stefania Maggi, Nadia Minicuci, Marianna Noale, Francesco Grigoletto, Egle Perissinotto, Pierugo Carbonin, Solfrizzi, V, Scafato, E, Seripa, D, Lozupone, M, Imbimbo, Bp, D'Amato, A, Tortelli, R, Schilardi, A, Galluzzo, L, Gandin, C, Baldereschi, M, Di Carlo, A, Inzitari, D, Daniele, A, Sabbà, C, Logroscino, G, Panza, F, Farchi, G, Capurso, A, Lepore, V, Livrea, P, Motta, L, Carnazzo, G, Motta, M, Bentivegna, P, Bonaiuto, S, Cruciani, G, Postacchini, D, Amaducci, L, Gandolfo, C, Conti, M, Canal, N, Franceschi, M, Scarlato, G, Candelise, L, Scapini, E, Rengo, F, Abete, Pasquale, Cacciatore, F, Enzi, G, Battistin, L, Sergi, G, Crepaldi, G, Maggi, S, Minicuci, N, Noale, M, Grigoletto, F, Perissinotto, E, and Carbonin, P.

Subjects
Gerontology, Male, Aging, Population, Alzheimer disease, Frailty, cognitive aging, dementia, mortality, vascular dementia, Aged, Aged, 80 and over, Dementia, Female, Humans, Italy, Longitudinal Studies, Mortality, Proportional Hazards Models, Cause of Death, Cognitive Dysfunction, 03 medical and health sciences, 0302 clinical medicine, medicine, 80 and over, 030212 general & internal medicine, Risk factor, Cognitive decline, education, Vascular dementia, General Nursing, education.field_of_study, Mini–Mental State Examination, medicine.diagnostic_test, business.industry, Health Policy, General Medicine, Nursing (all)2901 Nursing (miscellaneous), Medicine (all), medicine.disease, Multiinfarct dementia, Settore MED/26 - NEUROLOGIA, Geriatrics and Gerontology, Alzheimer's disease, business, 030217 neurology & neurosurgery
Abstract

Objectives Cognitive frailty, a condition describing the simultaneous presence of physical frailty and mild cognitive impairment, has been recently defined by an international consensus group. We estimated the predictive role of a “reversible” cognitive frailty model on incident dementia, its subtypes, and all-cause mortality in nondemented older individuals. We verified if vascular risk factors or depressive symptoms could modify this predictive role. Design Longitudinal population-based study with 3.5- and 7-year of median follow-up. Setting Eight Italian municipalities included in the Italian Longitudinal Study on Aging. Participants In 2150 older individuals from the Italian Longitudinal Study on Aging, we operationalized reversible cognitive frailty with the presence of physical frailty and pre-mild cognitive impairment subjective cognitive decline, diagnosed with a self-report measure based on item 14 of the Geriatric Depression Scale. Measurements Incidence of dementia, its subtypes, and all-cause mortality. Results Over a 3.5-year follow-up, participants with reversible cognitive frailty showed an increased risk of overall dementia [hazard ratio (HR) 2.30, 95% confidence interval (CI) 1.02–5.18], particularly vascular dementia (VaD), and all-cause mortality (HR 1.74, 95% CI 1.07–2.83). Over a 7-year follow-up, participants with reversible cognitive frailty showed an increased risk of overall dementia (HR 2.12, 95% CI 1.12–4.03), particularly VaD, and all-cause mortality (HR 1.39, 95% CI 1.03–2.00). Vascular risk factors and depressive symptoms did not have any effect modifier on the relationship between reversible cognitive frailty and incident dementia and all-cause mortality. Conclusions A model of reversible cognitive frailty was a short- and long-term predictor of all-cause mortality and overall dementia, particularly VaD. The absence of vascular risk factors and depressive symptoms did not modify the predictive role of reversible cognitive frailty on these outcomes.

Published
2017

50. Additive Role of a Potentially Reversible Cognitive Frailty Model and Inflammatory State on the Risk of Disability: The Italian Longitudinal Study on Aging

Author

Marianna Noale, Ljanka Motta, F. Rengo, Massimo Conti, Massimo Motta, E. Scafato, Domenico Inzitari, Guglielmo Scarlato, Antonio Capurso, M. Baldereschi, Egle Perissinotto, V. Solfrizzi, P. Carbonin, C. Gandin, Marilisa Franceschi, Vito Lepore, Emanuele Scafato, Daniela Isabel Abbrescia, Prospera Bentivegna, E. Scapini, Giancarlo Logroscino, Nicola Canal, Davide Seripa, Paolo Livrea, Giuliano Enzi, Francesco Panza, Vincenzo Solfrizzi, Leontino Battistin, G. Carnazzo, Francesco Grigoletto, Gaetano Crepaldi, Stefania Maggi, S. Bonaiuto, L. Galluzzo, Lucia Galluzzo, Pasquale Abete, Antonio Daniele, Rodolfo Sardone, Antonio Di Carlo, Caterina Bonfiglio, F. Panza, Marzia Baldereschi, N. Minicucci, D. Inzitari, Giuseppe Sergi, Livia Candelise, Guido Cruciani, Carlo Sabbà, Michele Giannini, A. Di Carlo, Claudia Gandin, Carlo Gandolfo, Gino Farchi, Madia Lozupone, Francesco Cacciatore, D. Postacchini, Luigi Amaducci, Solfrizzi, V, Scafato, E, Lozupone, M, Seripa, D, Giannini, M, Sardone, R, Bonfiglio, C, Abbrescia DI Galluzzo, L, Gandin, C, Baldereschi, M, Di Carlo, A, Inzitari, D, Daniele, A, Sabbà, C, Logroscino, G, Panza, F, Farchi, G, Galluzzo, L, Capurso, A, Lepore, V, Livrea, P, Motta, L, Carnazzo G., Motta M, Bentivegna, P, Bonaiuto, S, Cruciani, G, Postacchini, D, Amaducci, L, Gandolfo, C, Conti, M, Canal, N, Franceschi, M, Scarlato, G, Candelise, L, Scapini, E, Rengo, F, Abete, Pasquale, Cacciatore, F, Enzi, G, Battistin, L, Sergi, G, Crepaldi, G, Maggi, S, Minicucci, N, Noale, M, Grigoletto, F, Perissinotto, E, and Carbonin, P.

Subjects
Male, Risk, Gerontology, lifestyle, Aging, Longitudinal study, Alzheimer disease, cognitive aging, disablement process, Frailty, inflammation, Geriatrics and Gerontology, Psychiatry and Mental Health, Frail Elderly, Population, Comorbidity, Aged, Aged, 80 and over, Cognitive Dysfunction, Disabled Persons, Female, Follow-Up Studies, Humans, Inflammation, Italy, Longitudinal Studies, Prevalence, behavioral disciplines and activities, 03 medical and health sciences, 0302 clinical medicine, 030502 gerontology, mental disorders, 80 and over, medicine, Dementia, Cognitive decline, education, education.field_of_study, Incidence (epidemiology), medicine.disease, Confidence interval, Psychiatry and Mental health, Settore MED/26 - NEUROLOGIA, Alzheimer's disease, 0305 other medical science, Risk assessment, Psychology, human activities, 030217 neurology & neurosurgery
Abstract

Objective Cognitive frailty is a condition recently defined by operationalized criteria describing the simultaneous presence of physical frailty and mild cognitive impairment (MCI). Two subtypes for this clinical construct have been proposed: "potentially reversible" cognitive frailty (physical frailty plus MCI) and "reversible" cognitive frailty (physical frailty plus pre-MCI subjective cognitive decline). Here the prevalence of a potentially reversible cognitive frailty model was estimated. It was also evaluated if introducing a diagnosis of MCI in older subjects with physical frailty could have an additive role on the risk of dementia, disability, and all-cause mortality in comparison with frailty state or MCI condition alone, with analyses separately performed for inflammatory state. Methods In 2,373 individuals from the population-based Italian Longitudinal Study on Aging with a 3.5-year-follow-up, we operationally categorized older individuals without dementia into four groups: non-frail/non-MCI, non-frail/MCI, frail/non-MCI, and frail/MCI. Results The prevalence of potentially reversible cognitive frailty was 1%, increasing with age and more represented in women than in men, and all groups were associated with significant increased incident rate ratios of dementia, disability, and mortality. A significant difference in rates of disability has been found between the MCI and non-MCI groups (contrasts of adjusted predictions: 0.461; 95% confidence interval: 0.187–0.735) in frail individuals with high inflammatory states (fibrinogen >339 mg/dL). Conclusion In older individuals without dementia and with elevated inflammation, a potentially reversible cognitive frailty model could have a significant additional predictive effect on the risk of disability than the single conditions of frailty or MCI.

Published
2017

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