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49 results on '"Gareri P."'

4. Atrial fibrillation and COVID-19 in older patients: how disability contributes to shape the risk profile. An analysis of the GeroCovid registry

Author

Fumagalli, Stefano, Trevisan, Caterina, Del Signore, Susanna, Pelagalli, Giulia, Fumagalli, Carlo, Herbst, Andrea, Volpato, Stefano, Gareri, Pietro, Mossello, Enrico, Malara, Alba, Monzani, Fabio, Okoye, Chukwuma, Coin, Alessandra, Bellelli, Giuseppe, Zia, Gianluca, Ungar, Andrea, Ranhoff, Anette Hylen, and Antonelli Incalzi, Raffaele

Published
2022
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5. Promoting and Building Long-Term Care Health Research Networks: GeroCovid Observational and Gerocovid Vax Initiatives

Author

Abbatecola, A, Incalzi, R, Bellelli, G, Borselli, G, Cafariello, C, Coin, A, Del Signore, S, Fumagalli, S, Gareri, P, Malara, A, Mossello, E, Monzani, F, Noale, M, Okoye, C, Onder, G, Trevisan, C, Volpato, S, Zia, G, Abbatecola A. M., Incalzi R. A., Bellelli G., Borselli G., Cafariello C., Coin A., Del Signore S., Fumagalli S., Gareri P., Malara A., Mossello E., Monzani F., Noale M., Okoye C., Onder G., Trevisan C., Volpato S., Zia G., Abbatecola, A, Incalzi, R, Bellelli, G, Borselli, G, Cafariello, C, Coin, A, Del Signore, S, Fumagalli, S, Gareri, P, Malara, A, Mossello, E, Monzani, F, Noale, M, Okoye, C, Onder, G, Trevisan, C, Volpato, S, Zia, G, Abbatecola A. M., Incalzi R. A., Bellelli G., Borselli G., Cafariello C., Coin A., Del Signore S., Fumagalli S., Gareri P., Malara A., Mossello E., Monzani F., Noale M., Okoye C., Onder G., Trevisan C., Volpato S., and Zia G.

Published
2023

6. Clinical presentation and prognosis of COVID-19 in older adults with hypothyroidism: data from the GeroCovid observational study

Author

Bagala, V, Sala, A, Trevisan, C, Okoye, C, Incalzi, R, Monzani, F, Volpato, S, Antognoli, R, Antonietti, M, Bandini, G, Bellelli, G, Benvenuti, E, Bergamin, M, Bertolotti, M, Biagini, C, Bianchetti, A, Bianchi, A, Bianchi, M, Bignamini, S, Blandini, D, Boffelli, S, Bugada, M, Calsolaro, V, Calvani, D, Carpagnano, E, Carrieri, B, Castaldo, V, Cavarape, A, Cazzulani, I, Celesti, C, Ceolin, C, Ceresini, M, Cherubini, A, Chizzoli, A, Ciarrocchi, E, Cicciomessere, P, Coin, A, Corsi, A, Custodero, C, D'Agostino, F, D'Errico, M, De Iorio, A, De Marchi, A, Desideri, G, Di Matteo, E, Espinosa, E, Esposito, L, Fazio, C, Filippini, C, Fiore, L, Fontana, C, Forte, L, Montorzi, R, Fumagalli, C, Fumagalli, S, Gareri, P, Giordano, A, Giuliani, E, Greco, A, Herbst, A, Ielo, G, La Marca, A, Porta, U, Lazzari, I, Lelli, D, Longobucco, Y, Lucchini, F, Lucente, D, Maestri, L, Maggio, M, Mainqua, P, Marengoni, A, Martin, B, Massa, V, Mazza, L, Mazzoccoli, C, Mossello, E, Morellini, F, Mussi, C, Orio, G, Paglia, A, Pelagalli, G, Pelizzoni, L, Picci, A, Ranhoff, A, Remelli, F, Resta, O, Riccardi, A, Rinaldi, D, Rozzini, R, Sabba, C, Sacco, L, Santoliquido, M, Savino, M, Scarso, F, Sergi, G, Serviddio, G, Sidoli, C, Solfrizzi, V, Soli, B, Tafaro, L, Tedde, A, Testa, G, Tinti, M, Tonarelli, F, Tonon, E, Vitali, A, Zoccarato, F, Zotti, S, Bagala V., Sala A., Trevisan C., Okoye C., Incalzi R. A., Monzani F., Volpato S., Antognoli R., Antonietti M. P., Bandini G., Bellelli G., Benvenuti E., Bergamin M., Bertolotti M., Biagini C. A., Bianchetti A., Bianchi A., Bianchi M., Bignamini S., Blandini D., Boffelli S., Bugada M., Calsolaro V., Calvani D., Carpagnano E., Carrieri B., Castaldo V., Cavarape A., Cazzulani I., Celesti C., Ceolin C., Ceresini M. G., Cherubini A., Chizzoli A., Ciarrocchi E., Cicciomessere P., Coin A., Corsi A., Custodero C., D'Agostino F., D'Errico M. M., De Iorio A., De Marchi A., Desideri G., Di Matteo E., Espinosa E., Esposito L., Fazio C., Filippini C., Fiore L., Fontana C., Forte L., Montorzi R. F., Fumagalli C., Fumagalli S., Gareri P., Giordano A., Giuliani E., Greco A., Herbst A., Ielo G., La Marca A., Porta U., Lazzari I., Lelli D., Longobucco Y., Lucchini F., Lucente D., Maestri L., Maggio M., Mainqua P., Marengoni A., Martin B., Massa V., Mazza L., Mazzoccoli C., Mossello E., Morellini F., Mussi C., Orio G., Paglia A., Pelagalli G., Pelizzoni L., Picci A., Ranhoff A. H., Remelli F., Resta O., Riccardi A., Rinaldi D., Rozzini R., Sabba C., Sacco L., Santoliquido M., Savino M., Scarso F., Sergi G., Serviddio G., Sidoli C., Solfrizzi V., Soli B., Tafaro L., Tedde A., Testa G. D., Tinti M. G., Tonarelli F., Tonon E., Vitali A., Zoccarato F., Zotti S., Bagala, V, Sala, A, Trevisan, C, Okoye, C, Incalzi, R, Monzani, F, Volpato, S, Antognoli, R, Antonietti, M, Bandini, G, Bellelli, G, Benvenuti, E, Bergamin, M, Bertolotti, M, Biagini, C, Bianchetti, A, Bianchi, A, Bianchi, M, Bignamini, S, Blandini, D, Boffelli, S, Bugada, M, Calsolaro, V, Calvani, D, Carpagnano, E, Carrieri, B, Castaldo, V, Cavarape, A, Cazzulani, I, Celesti, C, Ceolin, C, Ceresini, M, Cherubini, A, Chizzoli, A, Ciarrocchi, E, Cicciomessere, P, Coin, A, Corsi, A, Custodero, C, D'Agostino, F, D'Errico, M, De Iorio, A, De Marchi, A, Desideri, G, Di Matteo, E, Espinosa, E, Esposito, L, Fazio, C, Filippini, C, Fiore, L, Fontana, C, Forte, L, Montorzi, R, Fumagalli, C, Fumagalli, S, Gareri, P, Giordano, A, Giuliani, E, Greco, A, Herbst, A, Ielo, G, La Marca, A, Porta, U, Lazzari, I, Lelli, D, Longobucco, Y, Lucchini, F, Lucente, D, Maestri, L, Maggio, M, Mainqua, P, Marengoni, A, Martin, B, Massa, V, Mazza, L, Mazzoccoli, C, Mossello, E, Morellini, F, Mussi, C, Orio, G, Paglia, A, Pelagalli, G, Pelizzoni, L, Picci, A, Ranhoff, A, Remelli, F, Resta, O, Riccardi, A, Rinaldi, D, Rozzini, R, Sabba, C, Sacco, L, Santoliquido, M, Savino, M, Scarso, F, Sergi, G, Serviddio, G, Sidoli, C, Solfrizzi, V, Soli, B, Tafaro, L, Tedde, A, Testa, G, Tinti, M, Tonarelli, F, Tonon, E, Vitali, A, Zoccarato, F, Zotti, S, Bagala V., Sala A., Trevisan C., Okoye C., Incalzi R. A., Monzani F., Volpato S., Antognoli R., Antonietti M. P., Bandini G., Bellelli G., Benvenuti E., Bergamin M., Bertolotti M., Biagini C. A., Bianchetti A., Bianchi A., Bianchi M., Bignamini S., Blandini D., Boffelli S., Bugada M., Calsolaro V., Calvani D., Carpagnano E., Carrieri B., Castaldo V., Cavarape A., Cazzulani I., Celesti C., Ceolin C., Ceresini M. G., Cherubini A., Chizzoli A., Ciarrocchi E., Cicciomessere P., Coin A., Corsi A., Custodero C., D'Agostino F., D'Errico M. M., De Iorio A., De Marchi A., Desideri G., Di Matteo E., Espinosa E., Esposito L., Fazio C., Filippini C., Fiore L., Fontana C., Forte L., Montorzi R. F., Fumagalli C., Fumagalli S., Gareri P., Giordano A., Giuliani E., Greco A., Herbst A., Ielo G., La Marca A., Porta U., Lazzari I., Lelli D., Longobucco Y., Lucchini F., Lucente D., Maestri L., Maggio M., Mainqua P., Marengoni A., Martin B., Massa V., Mazza L., Mazzoccoli C., Mossello E., Morellini F., Mussi C., Orio G., Paglia A., Pelagalli G., Pelizzoni L., Picci A., Ranhoff A. H., Remelli F., Resta O., Riccardi A., Rinaldi D., Rozzini R., Sabba C., Sacco L., Santoliquido M., Savino M., Scarso F., Sergi G., Serviddio G., Sidoli C., Solfrizzi V., Soli B., Tafaro L., Tedde A., Testa G. D., Tinti M. G., Tonarelli F., Tonon E., Vitali A., Zoccarato F., and Zotti S.

Abstract

Background: The prevalence of hypothyroidism among older patients hospitalized for COVID-19 and its association with mortality is unclear. This study aims to investigate the prevalence of hypothyroidism in older COVID-19 inpatients and verify if this comorbidity is associated with a specific pattern of onset symptoms and a worse prognosis. Methods: COVID-19 inpatients aged ≥ 60 years, participating in the GeroCovid acute wards cohort, were included. The history of hypothyroidism was derived from medical records and the use of thyroid hormones. Sociodemographic data, comorbidities, symptoms/signs at the disease onset and inflammatory markers at ward admission were compared between people with vs without history of hypothyroidism. The association between hypothyroidism and in-hospital mortality was tested through Cox regression. Results: Of the 1245 patients included, 8.5% had a history of hypothyroidism. These patients were more likely to present arterial hypertension and obesity compared with those without an history of hypothyroidism. Concerning COVID-19 clinical presentation, patients with hypothyroidism had less frequently low oxygen saturation and anorexia but reported muscle pain and loss of smell more commonly than those without hypothyroidism. Among the inflammatory markers, patients with hypothyroidism had higher lymphocytes values. At Cox regression, hypothyroidism was associated with reduced in-hospital mortality only in the univariable model (HR = 0.66, 95% CI 0.45–0.96, p = 0.03); conversely, no significant result were observed after adjusting for potential confounders (HR = 0.69, 95% CI 0.47–1.03, p = 0.07). Conclusions: Hypothyroidism does not seem to substantially influence the prognosis of COVID-19 in older people, although it may be associated with peculiar clinical and biochemical features at the disease onset.

Published
2023

7. Clinical profile of trazodone users in a multisetting older population: data from the Italian GeroCovid Observational study

Author

Coin, A, Noale, M, Gareri, P, Trevisan, C, Bellio, A, Fini, F, Abbatecola, A, Del Signore, S, Malara, A, Mossello, E, Fumagalli, S, Volpato, S, Monzani, F, Bellelli, G, Zia, G, Incalzi, R, Andrieri, D, Antognoli, R, Antonietti, M, Bagalà, V, Bandini, G, Bazzano, S, Bellotti, F, Benvenuti, E, Bergamin, M, Bertolotti, M, Biagini, C, Bianchetti, A, Bianchi, A, Bianchi, M, Bianchi, P, Biasin, F, Bignamini, S, Blandini, D, Boffelli, S, Bontempi, C, Bordignon, A, Bracchitta, L, Bugada, M, Cafariello, C, Caleri, V, Calsolaro, V, Calvani, D, Campagna, F, Capasso, A, Capurso, S, Carino, S, Carpagnano, E, Carrieri, B, Castaldo, V, Castelli, M, Castellino, M, Cavarape, A, Cazzulani, I, Celesti, C, Ceolin, C, Ceresini, M, Ceretti, A, Cherubini, A, Chizzoli, A, Ciarrocchi, E, Cicciomessere, P, Colombo, M, Corsi, A, Crispino, A, Cucunato, R, Custodero, C, D’Agostino, F, D’Errico, M, D’Amico, F, De Iorio, A, De Marchi, A, Dell’Armi, A, Delmonte, M, Desideri, G, Devita, M, Di Matteo, E, Espinosa, E, Esposito, L, Fazio, C, Ferro, C, Filippini, C, Fiore, L, Fiorillo, S, Fontana, C, Forte, L, Montorzi, R, Fumagalli, C, Gasbarri, P, Giordano, A, Giuliani, E, Granata, R, Coin A., Noale M., Gareri P., Trevisan C., Bellio A., Fini F., Abbatecola A. M., Del Signore S., Malara A., Mossello E., Fumagalli S., Volpato S., Monzani F., Bellelli G., Zia G., Incalzi R. A., Andrieri D., Antognoli R., Antonietti M. P., Bagalà V., Bandini G., Bazzano S., Bellotti F., Benvenuti E., Bergamin M., Bertolotti M., Biagini C. A., Bianchetti A., Bianchi A., Bianchi M., Bianchi P., Biasin F., Bignamini S., Blandini D., Boffelli S., Bontempi C., Bordignon A., Bracchitta L. M., Bugada M., Cafariello C., Caleri V., Calsolaro V., Calvani D., Campagna F. A., Capasso A., Capurso S., Carino S., Carpagnano E., Carrieri B., Castaldo V., Castelli M., Castellino M., Cavarape A., Cazzulani I., Celesti C., Ceolin C., Ceresini M. G., Ceretti A., Cherubini A., Chizzoli A., Ciarrocchi E., Cicciomessere P., Colombo M., Corsi A., Crispino A., Cucunato R., Custodero C., D’Agostino F., D’Errico M. M., D’Amico F., De Iorio A., De Marchi A., Dell’Armi A., Delmonte M., Desideri G., Devita M., Di Matteo E., Espinosa E., Esposito L., Fazio C., Ferro C., Filippini C., Fiore L., Fiorillo S., Fontana C., Forte L., Montorzi R. F., Fumagalli C., Gasbarri P. P., Giordano A., Giuliani E., Granata R., Coin, A, Noale, M, Gareri, P, Trevisan, C, Bellio, A, Fini, F, Abbatecola, A, Del Signore, S, Malara, A, Mossello, E, Fumagalli, S, Volpato, S, Monzani, F, Bellelli, G, Zia, G, Incalzi, R, Andrieri, D, Antognoli, R, Antonietti, M, Bagalà, V, Bandini, G, Bazzano, S, Bellotti, F, Benvenuti, E, Bergamin, M, Bertolotti, M, Biagini, C, Bianchetti, A, Bianchi, A, Bianchi, M, Bianchi, P, Biasin, F, Bignamini, S, Blandini, D, Boffelli, S, Bontempi, C, Bordignon, A, Bracchitta, L, Bugada, M, Cafariello, C, Caleri, V, Calsolaro, V, Calvani, D, Campagna, F, Capasso, A, Capurso, S, Carino, S, Carpagnano, E, Carrieri, B, Castaldo, V, Castelli, M, Castellino, M, Cavarape, A, Cazzulani, I, Celesti, C, Ceolin, C, Ceresini, M, Ceretti, A, Cherubini, A, Chizzoli, A, Ciarrocchi, E, Cicciomessere, P, Colombo, M, Corsi, A, Crispino, A, Cucunato, R, Custodero, C, D’Agostino, F, D’Errico, M, D’Amico, F, De Iorio, A, De Marchi, A, Dell’Armi, A, Delmonte, M, Desideri, G, Devita, M, Di Matteo, E, Espinosa, E, Esposito, L, Fazio, C, Ferro, C, Filippini, C, Fiore, L, Fiorillo, S, Fontana, C, Forte, L, Montorzi, R, Fumagalli, C, Gasbarri, P, Giordano, A, Giuliani, E, Granata, R, Coin A., Noale M., Gareri P., Trevisan C., Bellio A., Fini F., Abbatecola A. M., Del Signore S., Malara A., Mossello E., Fumagalli S., Volpato S., Monzani F., Bellelli G., Zia G., Incalzi R. A., Andrieri D., Antognoli R., Antonietti M. P., Bagalà V., Bandini G., Bazzano S., Bellotti F., Benvenuti E., Bergamin M., Bertolotti M., Biagini C. A., Bianchetti A., Bianchi A., Bianchi M., Bianchi P., Biasin F., Bignamini S., Blandini D., Boffelli S., Bontempi C., Bordignon A., Bracchitta L. M., Bugada M., Cafariello C., Caleri V., Calsolaro V., Calvani D., Campagna F. A., Capasso A., Capurso S., Carino S., Carpagnano E., Carrieri B., Castaldo V., Castelli M., Castellino M., Cavarape A., Cazzulani I., Celesti C., Ceolin C., Ceresini M. G., Ceretti A., Cherubini A., Chizzoli A., Ciarrocchi E., Cicciomessere P., Colombo M., Corsi A., Crispino A., Cucunato R., Custodero C., D’Agostino F., D’Errico M. M., D’Amico F., De Iorio A., De Marchi A., Dell’Armi A., Delmonte M., Desideri G., Devita M., Di Matteo E., Espinosa E., Esposito L., Fazio C., Ferro C., Filippini C., Fiore L., Fiorillo S., Fontana C., Forte L., Montorzi R. F., Fumagalli C., Gasbarri P. P., Giordano A., Giuliani E., and Granata R.

Abstract

Background and objectives: Depression is highly prevalent in older adults, especially in those with dementia. Trazodone, an antidepressant, has shown to be effective in older patients with moderate anxiolytic and hypnotic activity; and a common off-label use is rising for managing behavioral and psychological symptoms of dementia (BPSD). The aim of the study is to comparatively assess the clinical profiles of older patients treated with trazodone or other antidepressants. Methods: This cross-sectional study involved adults aged ≥ 60 years at risk of or affected with COVID-19 enrolled in the GeroCovid Observational study from acute wards, geriatric and dementia-specific outpatient clinics, as well as long-term care facilities (LTCF). Participants were grouped according to the use of trazodone, other antidepressants, or no antidepressant use. Results: Of the 3396 study participants (mean age 80.6 ± 9.1 years; 57.1% females), 10.8% used trazodone and 8.5% others antidepressants. Individuals treated with trazodone were older, more functionally dependent, and had a higher prevalence of dementia and BPSD than those using other antidepressants or no antidepressant use. Logistic regression analyses found that the presence of BPSD was associated with trazodone use (odds ratio (OR) 28.4, 95% confidence interval (CI) 18-44.7 for the outcome trazodone vs no antidepressants use, among participants without depression; OR 2.17, 95% CI 1.05-4.49 for the outcome trazodone vs no antidepressants use, among participants with depression). A cluster analysis of trazodone use identified three clusters: cluster 1 included mainly women, living at home with assistance, multimorbidity, dementia, BPSD, and depression; cluster 2 included mainly institutionalized women, with disabilities, depression, and dementia; cluster 3 included mostly men, often living at home unassisted, with better mobility performance, fewer chronic diseases, dementia, BPSD, and depression. Discussion: The use of trazodo

Published
2023

8. Prevalence and features of delirium in older patients admitted to rehabilitation facilities

Author

Sidoli, Chiara, Zambon, Antonella, Tassistro, Elena, Rossi, Emanuela, Mossello, Enrico, Inzitari, Marco, Cherubini, Antonio, Marengoni, Alessandra, Morandi, Alessandro, Bellelli, Giuseppe, Tarasconi, A, Sella, M, Paternò, G, Faggian, G, Lucarelli, C, De Grazia, N, Alberto, C, Porcella, L, Nardiello, I, Chimenti, E, Zeni, M, Romairone, E, Minaglia, C, Ceccotti, C, Guerra, G, Mantovani, G, Monacelli, F, Candiani, T, Santolini, F, Rosso, M, Bono, V, Sibilla, S, Dal Santo, P, Ceci, M, Barone, P, Schirinzi, T, Formenti, A, Nastasi, G, Isaia, G, Gonella, D, Battuello, A, Casson, S, Calvani, D, Boni, F, Ciaccio, A, Rosa, R, Sanna, G, Manfredini, S, Cortese, L, Rizzo, M, Prestano, R, Greco, A, Lauriola, M, Gelosa, G, Piras, V, Arena, M, Cosenza, D, Bellomo, A, Lamontagna, M, Gabbani, L, Lambertucci, L, Perego, S, Parati, G, Basile, G, Gallina, V, Pilone, G, Giudice, C, Pietrogrande, L, Mosca, M, Corazzin, I, Rossi, P, Nunziata, V, D’Amico, F, Grippa, A, Giardini, S, Barucci, R, Cossu, A, Fiorin, L, Distefano, M, Lunardelli, M, Brunori, M, Ruffini, I, Abraham, E, Varutti, A, Fabbro, E, Catalano, A, Martino, G, Leotta, D, Marchet, A, Dell’Aquila, G, Scrimieri, A, Davoli, M, Casella, M, Cartei, A, Polidori, G, Brischetto, D, Motta, S, Saponara, R, Perrone, P, Russo, G, Del, D, Car, C, Pirina, T, Franzoni, S, Cotroneo, A, Ghiggia, F, Volpi, G, Menichetti, C, Bo, M, Panico, A, Calogero, P, Corvalli, G, Mauri, M, Lupia, E, Manfredini, R, Fabbian, F, March, A, Pedrotti, M, Veronesi, M, Strocchi, E, Borghi, C, Bianchetti, A, Crucitti, A, Difrancesco, V, Fontana, G, Geriatria, A, Bonanni, L, Barbone, F, Serrati, C, Ballardini, G, Simoncelli, M, Ceschia, G, Scarpa, C, Brugiolo, R, Fusco, S, Ciarambino, T, Biagini, C, Tonon, E, Porta, M, Venuti, D, Delsette, M, Poeta, M, Barbagallo, G, Trovato, G, Delitala, A, Arosio, P, Reggiani, F, Zuliani, G, Ortolani, B, Mussio, E, Girardi, A, Coin, A, Ruotolo, G, Castagna, A, Masina, M, Cimino, R, Pinciaroli, A, Tripodi, G, Cassadonte, F, Vatrano, M, Scaglione, L, Fogliacco, P, Muzzuilini, C, Romano, F, Padovani, A, Rozzini, L, Cagnin, A, Fragiacomo, F, Desideri, G, Liberatore, E, Bruni, A, Orsitto, G, Franco, M, Bonfrate, L, Bonetto, M, Pizio, N, Magnani, G, Cecchetti, G, Longo, A, Bubba, V, Marinan, L, Cotelli, M, Turla, M, Sessa, M, Abruzzi, L, Castoldi, G, Lovetere, D, Musacchio, C, Novello, M, Cavarape, A, Bini, A, Leonardi, A, Seneci, F, Grimaldi, W, Fimognari, F, Bambar, V, Saitta, A, Corica, F, Braga, M, Servi, Null, Ettorre, E, Camellini Bellelli, C G, Annoni, G, Marengoni, A, Crescenzo, A, Noro, G, Turco, R, Ponzetto, M, Giuseppe, L, Mazzei, B, Maiuri, G, Costaggiu, D, Damato, R, Formilan, M, Patrizia, G, Santuar, L, Gallucci, M, Paragona, M, Bini, P, Modica, D, Abati, C, Clerici, M, Barbera, I, Nigroimperiale, F, Manni, A, Votino, C, Castiglioni, C, Di, M, Degl’Innocenti, M, Moscatelli, G, Guerini, S, Casini, C, Dini, D, Denotariis, S, Bonometti, F, Paolillo, C, Riccardi, A, Tiozzo, A, Samysalamafahmy, A, Dibari, M, Vanni, S, Scarpa, A, Zara, D, Ranieri, P, Alessandro, M, Di, F, Pezzoni, D, Platto, C, D’Ambrosio, V, Ivaldi, C, Milia, P, Desalvo, F, Solaro, C, Strazzacappa, M, Cazzadori, M, Grasso, M, Troisi, E, Guerini, V, Bernardini, B, Corsini, C, Boffelli, S, Filippi, A, Delpin, K, Faraci, B, Bertoletti, E, Vannucci, M, Crippa, P, Malighetti, A, Caltagirone, C, Disant, S, Bettini, D, Maltese, F, Abruzzese, G, Cosimo, D, Azzini, M, Colombo, M, Procino, G, Fascendini, S, Barocco, F, Del, P, Mazzone, A, Cottino, M, Vezzadini, G, Avanzi, S, Brambilla, C, Orini, S, Sgrilli, F, Mello, A, Lombardi Muti, L E, Dijk, B, Fenu, S, Pes, C, Gareri, P, Passamonte, M, Rigo, R, Locusta, L, Caser, L, Rosso, G, Cesarini, S, Cozzi, R, Santini, C, Carbone, P, Cazzaniga, I, Lovati, R, Cantoni, A, Ranzani, P, Barra, D, Pompilio, G, Dimori, S, Cernesi, S, Riccò, C, Piazzolla, F, Capittini, E, Rota, C, Gottardi, F, Merla, L, Barelli, A, Millul, A, De, G, Morrone, G, Bigolari, M, Macchi, M, Zambon, F, Pizzorni, C, Dicasaleto, G, Menculini, G, Marcacci, M, Catanese, G, Sprini, D, Dicasalet, T, Bocci, M, Borga, S, Caironi, P, Cat, C, Cingolani, E, Avalli, L, Greco, G, Citerio, G, Gandini, L, Cornara, G, Lerda, R, Brazzi, L, Simeone, F, Caciorgna, M, Alampi, D, Francesconi, S, Beck, E, Antonini, B, Vettoretto, K, Meggiolaro, M, Garofalo, E, Notaro, S, Varutti, R, Bassi, F, Mistraletti, G, Marino, A, Rona, R, Rondelli, E, Riva, I, Cortegiani, A, Pistidda, L, D’Andrea, R, Querci, L, Gnesin, P, Todeschini, M, Lugano, M, Castelli, G, Ortolani, M, Cotoia, A, Maggiore, S, Ditizio, L, Graziani, R, Testa, I, Ferretti, E, Castioni, C, Lombardi, F, Caserta, R, Pasqua, M, Simoncini, S, Baccarini, F, Rispoli, M, Grossi, F, Cancelliere, L, Carnelli, M, Puccini, F, Biancofiore, G, Siniscalchi, A, Laici, C, Mossello, E, Torrini, M, Pasetti, G, Palmese, S, Oggioni, R, Mangani, V, Pini, S, Martelli, M, Rigo, E, Zuccalà, F, Cherri, A, Spina, R, Calamai, I, Petrucci, N, Caicedo, A, Ferri, F, Gritti, P, Brienza, N, Fonnesu, R, Dessena, M, Fullin, G, Saggioro, D, Sidoli, Chiara, Zambon, Antonella, Tassistro, Elena, Rossi, Emanuela, Mossello, Enrico, Inzitari, Marco, Cherubini, Antonio, Marengoni, Alessandra, Morandi, Alessandro, Bellelli, Giuseppe, A Tarasconi, M Sella, G Paternò, G Faggian, C Lucarelli, N De Grazia, C Alberto, L Porcella, I Nardiello, E Chimenti, M Zeni, E Romairone, C Minaglia, C Ceccotti, G Guerra, G Mantovani, F Monacelli, C Minaglia, T Candiani, F Santolini, C Minaglia, M Rosso, V Bono, S Sibilla, P Dal Santo, M Ceci, P Barone, T Schirinzi, A Formenti, G Nastasi, G Isaia, D Gonella, A Battuello, S Casson, D Calvani, F Boni, A Ciaccio, R Rosa, G Sanna, S Manfredini, L Cortese, M Rizzo, R Prestano, A Greco, M Lauriola, G Gelosa, V Piras, M Arena, D Cosenza, A Bellomo, M LaMontagna, L Gabbani, L Lambertucci, S Perego, G Parati, G Basile, V Gallina, G Pilone, C Giudice, L Pietrogrande, M Mosca, I Corazzin, P Rossi, V Nunziata, F D’Amico, A Grippa, S Giardini, R Barucci, A Cossu, L Fiorin, M Arena , M Distefano, M Lunardelli, M Brunori, I Ruffini, E Abraham, A Varutti, E Fabbro, A Catalano, G Martino, D Leotta, A Marchet, G Dell’Aquila, A Scrimieri, M Davoli, M Casella, A Cartei, G Polidori, G Basile, D Brischetto, S Motta, R Saponara, P Perrone, G Russo, D Del, C Car, T Pirina, S Franzoni, A Cotroneo, F Ghiggia, G Volpi, C Menichetti, M Bo, A Panico, P Calogero, G Corvalli, M Mauri, E Lupia, R Manfredini, F Fabbian, A March, M Pedrotti, M Veronesi, E Strocchi, C Borghi, A Bianchetti, A Crucitti, V DiFrancesco, G Fontana, A Geriatria, L Bonanni, F Barbone, C Serrati, G Ballardini, M Simoncelli, G Ceschia, C Scarpa, R Brugiolo, S Fusco, T Ciarambino, C Biagini, E Tonon, M Porta , D Venuti, M DelSette, M Poeta, G Barbagallo, G Trovato, A Delitala, P Arosio, F Reggiani, G Zuliani, B Ortolani, E Mussio, A Girardi, A Coin, G Ruotolo, A Castagna, M Masina, R Cimino, A Pinciaroli, G Tripodi, F Cassadonte, M Vatrano, L Scaglione, P Fogliacco, C Muzzuilini, F Romano, A Padovani, L Rozzini, A Cagnin, F Fragiacomo, G Desideri, E Liberatore, A Bruni, G Orsitto, M Franco, L Bonfrate, M Bonetto, N Pizio, G Magnani, G Cecchetti, A Longo, V Bubba, L Marinan, M Cotelli, M Turla, M Brunori, M Sessa, L Abruzzi, G Castoldi, D LoVetere, C Musacchio, M Novello, A Cavarape, A Bini, A Leonardi, F Seneci, W Grimaldi, F Seneci, F Fimognari, V Bambar, A Saitta, F Corica, M Braga, Servi, E Ettorre , C G Camellini Bellelli, G Annoni, A Marengoni, A Bruni, A Crescenzo, G Noro, R Turco, M Ponzetto, L Giuseppe, B Mazzei, G Maiuri, D Costaggiu, R Damato, E Fabbro, M Formilan, G Patrizia, L Santuar , M Gallucci, C Minaglia, M Paragona, P Bini, D Modica, C Abati, M Clerici, I Barbera, F NigroImperiale, A Manni, C Votino, C Castiglioni, M Di, M Degl’Innocenti, G Moscatelli, S Guerini, C Casini, D Dini, S DeNotariis, F Bonometti, C Paolillo, A Riccardi, A Tiozzo, A SamySalamaFahmy, A Riccardi, C Paolillo, M DiBari, S Vanni, A Scarpa, D Zara, P Ranieri, M Alessandro, P Calogero, G Corvalli, F Di, D Pezzoni, C Platto, V D’Ambrosio, C Ivaldi, P Milia, F DeSalvo, C Solaro, M Strazzacappa, M Bo, A Panico, M Cazzadori, M Bonetto, M Grasso, E Troisi, G Magnani, G Cecchetti, V Guerini, B Bernardini, C Corsini, S Boffelli, A Filippi, K Delpin, B Faraci, E Bertoletti, M Vannucci, P Crippa, A Malighetti, C Caltagirone, S DiSant, D Bettini, F Maltese, M Formilan, G Abruzzese, C Minaglia, D Cosimo, M Azzini, M Cazzadori, M Colombo, G Procino, S Fascendini, F Barocco, P Del, F D’Amico, A Grippa , A Mazzone, M Cottino, G Vezzadini, S Avanzi, C Brambilla, S Orini, F Sgrilli, A Mello, L E Lombardi Muti, B Dijk , S Fenu, C Pes, P Gareri, A Castagna, M Passamonte, R Rigo, L Locusta, L Caser, G Rosso, S Cesarini, R Cozzi, C Santini, P Carbone, I Cazzaniga, R Lovati, A Cantoni, P Ranzani, D Barra, G Pompilio, S Dimori, S Cernesi, C Riccò, F Piazzolla, E Capittini, C Rota, F Gottardi, L Merla, A Barelli, A Millul , G De, G Morrone, M Bigolari, C Minaglia, M Macchi, F Zambon, F D’Amico, F D’Amico, C Pizzorni, G DiCasaleto, G Menculini, M Marcacci, G Catanese, D Sprini, T DiCasalet, M Bocci, S Borga, P Caironi, C Cat, E Cingolani, L Avalli, G Greco, G Citerio, L Gandini, G Cornara, R Lerda, L Brazzi, F Simeone, M Caciorgna, D Alampi, S Francesconi, E Beck, B Antonini, K Vettoretto, M Meggiolaro, E Garofalo, A Bruni, S Notaro, R Varutti, F Bassi, G Mistraletti, A Marino, R Rona, E Rondelli, I Riva, A Cortegiani, L Pistidda, R D’Andrea, L Querci, P Gnesin, M Todeschini, M Lugano, G Castelli, M Ortolani, A Cotoia, S Maggiore, L DiTizio, R Graziani, I Testa, E Ferretti, C Castioni, F Lombardi, R Caserta, M Pasqua, S Simoncini, F Baccarini, M Rispoli, F Grossi, L Cancelliere, M Carnelli, F Puccini, G Biancofiore, A Siniscalchi, C Laici, E Mossello, M Torrini, G Pasetti, S Palmese, R Oggioni, V Mangani, S Pini, M Martelli, E Rigo, F Zuccalà , A Cherri, R Spina, I Calamai, N Petrucci, A Caicedo, F Ferri, P Gritti, N Brienza, R Fonnesu, M Dessena, G Fullin & D Saggioro, VU University medical center, Sidoli, C, Zambon, A, Tassistro, E, Rossi, E, Mossello, E, Inzitari, M, Cherubini, A, Marengoni, A, Morandi, A, Bellelli, G, Tarasconi, A, Sella, M, Paterno, G, Faggian, G, Lucarelli, C, De Grazia, N, Alberto, C, Porcella, L, Nardiello, I, Chimenti, E, Zeni, M, Romairone, E, Minaglia, C, Ceccotti, C, Guerra, G, Mantovani, G, Monacelli, F, Candiani, T, Santolini, F, Rosso, M, Bono, V, Sibilla, S, Dal Santo, P, Ceci, M, Barone, P, Schirinzi, T, Formenti, A, Nastasi, G, Isaia, G, Gonella, D, Battuello, A, Casson, S, Calvani, D, Boni, F, Ciaccio, A, Rosa, R, Sanna, G, Manfredini, S, Cortese, L, Rizzo, M, Prestano, R, Greco, A, Lauriola, M, Gelosa, G, Piras, V, Arena, M, Cosenza, D, Bellomo, A, Lamontagna, M, Gabbani, L, Lambertucci, L, Perego, S, Parati, G, Basile, G, Gallina, V, Pilone, G, Giudice, C, Pietrogrande, L, Mosca, M, Corazzin, I, Rossi, P, Nunziata, V, D'Amico, F, Grippa, A, Giardini, S, Barucci, R, Cossu, A, Fiorin, L, Distefano, M, Lunardelli, M, Brunori, M, Ruffini, I, Abraham, E, Varutti, A, Fabbro, E, Catalano, A, Martino, G, Leotta, D, Marchet, A, Dell'Aquila, G, Scrimieri, A, Davoli, M, Casella, M, Cartei, A, Polidori, G, Brischetto, D, Motta, S, Saponara, R, Perrone, P, Russo, G, Del, D, Car, C, Pirina, T, Franzoni, S, Cotroneo, A, Ghiggia, F, Volpi, G, Menichetti, C, Bo, M, Panico, A, Calogero, P, Corvalli, G, Mauri, M, Lupia, E, Manfredini, R, Fabbian, F, March, A, Pedrotti, M, Veronesi, M, Strocchi, E, Borghi, C, Bianchetti, A, Crucitti, A, Difrancesco, V, Fontana, G, Geriatria, A, Bonanni, L, Barbone, F, Serrati, C, Ballardini, G, Simoncelli, M, Ceschia, G, Scarpa, C, Brugiolo, R, Fusco, S, Ciarambino, T, Biagini, C, Tonon, E, Porta, M, Venuti, D, Delsette, M, Poeta, M, Barbagallo, G, Trovato, G, Delitala, A, Arosio, P, Reggiani, F, Zuliani, G, Ortolani, B, Mussio, E, Girardi, A, Coin, A, Ruotolo, G, Castagna, A, Masina, M, Cimino, R, Pinciaroli, A, Tripodi, G, Cassadonte, F, Vatrano, M, Scaglione, L, Fogliacco, P, Muzzuilini, C, Romano, F, Padovani, A, Rozzini, L, Cagnin, A, Fragiacomo, F, Desideri, G, Liberatore, E, Bruni, A, Orsitto, G, Franco, M, Bonfrate, L, Bonetto, M, Pizio, N, Magnani, G, Cecchetti, G, Longo, A, Bubba, V, Marinan, L, Cotelli, M, Turla, M, Sessa, M, Abruzzi, L, Castoldi, G, Lovetere, D, Musacchio, C, Novello, M, Cavarape, A, Bini, A, Leonardi, A, Seneci, F, Grimaldi, W, Fimognari, F, Bambar, V, Saitta, A, Corica, F, Braga, M, Servi, Ettorre, E, Camellini Bellelli, C, Annoni, G, Crescenzo, A, Noro, G, Turco, R, Ponzetto, M, Giuseppe, L, Mazzei, B, Maiuri, G, Costaggiu, D, Damato, R, Formilan, M, Patrizia, G, Santuar, L, Gallucci, M, Paragona, M, Bini, P, Modica, D, Abati, C, Clerici, M, Barbera, I, Nigroimperiale, F, Manni, A, Votino, C, Castiglioni, C, Di, M, Degl'Innocenti, M, Moscatelli, G, Guerini, S, Casini, C, Dini, D, Denotariis, S, Bonometti, F, Paolillo, C, Riccardi, A, Tiozzo, A, Samysalamafahmy, A, Dibari, M, Vanni, S, Scarpa, A, Zara, D, Ranieri, P, Alessandro, M, Di, F, Pezzoni, D, Platto, C, D'Ambrosio, V, Ivaldi, C, Milia, P, Desalvo, F, Solaro, C, Strazzacappa, M, Cazzadori, M, Grasso, M, Troisi, E, Guerini, V, Bernardini, B, Corsini, C, Boffelli, S, Filippi, A, Delpin, K, Faraci, B, Bertoletti, E, Vannucci, M, Crippa, P, Malighetti, A, Caltagirone, C, Disant, S, Bettini, D, Maltese, F, Abruzzese, G, Cosimo, D, Azzini, M, Colombo, M, Procino, G, Fascendini, S, Barocco, F, Del, P, Mazzone, A, Cottino, M, Vezzadini, G, Avanzi, S, Brambilla, C, Orini, S, Sgrilli, F, Mello, A, Lombardi Muti, L, Dijk, B, Fenu, S, Pes, C, Gareri, P, Passamonte, M, Rigo, R, Locusta, L, Caser, L, Rosso, G, Cesarini, S, Cozzi, R, Santini, C, Carbone, P, Cazzaniga, I, Lovati, R, Cantoni, A, Ranzani, P, Barra, D, Pompilio, G, Dimori, S, Cernesi, S, Ricco, C, Piazzolla, F, Capittini, E, Rota, C, Gottardi, F, Merla, L, Barelli, A, Millul, A, De, G, Morrone, G, Bigolari, M, Macchi, M, Zambon, F, Pizzorni, C, Dicasaleto, G, Menculini, G, Marcacci, M, Catanese, G, Sprini, D, Dicasalet, T, Bocci, M, Borga, S, Caironi, P, Cat, C, Cingolani, E, Avalli, L, Greco, G, Citerio, G, Gandini, L, Cornara, G, Lerda, R, Brazzi, L, Simeone, F, Caciorgna, M, Alampi, D, Francesconi, S, Beck, E, Antonini, B, Vettoretto, K, Meggiolaro, M, Garofalo, E, Notaro, S, Varutti, R, Bassi, F, Mistraletti, G, Marino, A, Rona, R, Rondelli, E, Riva, I, Cortegiani, A, Pistidda, L, D'Andrea, R, Querci, L, Gnesin, P, Todeschini, M, Lugano, M, Castelli, G, Ortolani, M, Cotoia, A, Maggiore, S, Ditizio, L, Graziani, R, Testa, I, Ferretti, E, Castioni, C, Lombardi, F, Caserta, R, Pasqua, M, Simoncini, S, Baccarini, F, Rispoli, M, Grossi, F, Cancelliere, L, Carnelli, M, Puccini, F, Biancofiore, G, Siniscalchi, A, Laici, C, Torrini, M, Pasetti, G, Palmese, S, Oggioni, R, Mangani, V, Pini, S, Martelli, M, Rigo, E, Zuccala, F, Cherri, A, Spina, R, Calamai, I, Petrucci, N, Caicedo, A, Ferri, F, Gritti, P, Brienza, N, Fonnesu, R, Dessena, M, Fullin, G, and Saggioro, D

Subjects
Aging, Disability, Rehabilitation, Delirium, Dementia, Physical restraint, Cross-Sectional Studies, Activities of Daily Living, mental disorders, Prevalence, Humans, Geriatrics and Gerontology, Aged
Abstract

Background: Delirium is thought to be common across various settings of care; however, still little research has been conducted in rehabilitation. Aim: We investigated the prevalence of delirium, its features and motor subtypes in older patients admitted to rehabilitation facilities during the three editions of the “Delirium Day project”. Methods: We conducted a cross-sectional study in which 1237 older patients (age ≥ 65 years old) admitted to 50 Italian rehabilitation wards during the three editions of the “Delirium Day project” (2015 to 2017) were included. Delirium was evaluated through the 4AT and its motor subtype with the Delirium Motor Subtype Scale. Results: Delirium was detected in 226 patients (18%), and the most recurrent motor subtype was mixed (37%), followed by hypoactive (26%), hyperactive (21%) and non-motor one (16%). In a multivariate Poisson regression model with robust variance, factors associated with delirium were: disability in basic (PR 1.48, 95%CI: 1.17–1.9, p value 0.001) and instrumental activities of daily living (PR 1.58, 95%CI: 1.08–2.32, p value 0.018), dementia (PR 2.10, 95%CI: 1.62–2.73, p value < 0.0001), typical antipsychotics (PR 1.47, 95%CI: 1.10–1.95, p value 0.008), antidepressants other than selective serotonin reuptake inhibitors (PR 1.3, 95%CI: 1.02–1.66, p value 0.035), and physical restraints (PR 2.37, 95%CI: 1.68–3.36, p value < 0.0001). Conclusion: This multicenter study reports that 2 out 10 patients admitted to rehabilitations had delirium on the index day. Mixed delirium was the most prevalent subtype. Delirium was associated with unmodifiable (dementia, disability) and modifiable (physical restraints, medications) factors. Identification of these factors should prompt specific interventions aimed to prevent or mitigate delirium.

Published
2022
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9. Clinical profile of trazodone users in a multisetting older population: data from the Italian GeroCovid Observational study

Author

Coin A., Noale M., Gareri P., Trevisan C., Bellio A., Fini F., Abbatecola A. M., Del Signore S., Malara A., Mossello E., Fumagalli S., Volpato S., Monzani F., Bellelli G., Zia G., Incalzi R. A., Andrieri D., Antognoli R., Antonietti M. P., Bagalà V., Bandini G., Bazzano S., Bellotti F., Benvenuti E., Bergamin M., Bertolotti M., Biagini C. A., Bianchetti A., Bianchi A., Bianchi M., Bianchi P., Biasin F., Bignamini S., Blandini D., Boffelli S., Bontempi C., Bordignon A., Bracchitta L. M., Bugada M., Cafariello C., Caleri V., Calsolaro V., Calvani D., Campagna F. A., Capasso A., Capurso S., Carino S., Carpagnano E., Carrieri B., Castaldo V., Castelli M., Castellino M., Cavarape A., Cazzulani I., Celesti C., Ceolin C., Ceresini M. G., Ceretti A., Cherubini A., Chizzoli A., Ciarrocchi E., Cicciomessere P., Colombo M., Corsi A., Crispino A., Cucunato R., Custodero C., D’Agostino F., D’Errico M. M., D’Amico F., De Iorio A., De Marchi A., Dell’Armi A., Delmonte M., Desideri G., Devita M., Di Matteo E., Espinosa E., Esposito L., Fazio C., Ferro C., Filippini C., Fiore L., Fiorillo S., Fontana C., Forte L., Montorzi R. F., Fumagalli C., Gasbarri P. P., Giordano A., Giuliani E., Granata R., Coin, A, Noale, M, Gareri, P, Trevisan, C, Bellio, A, Fini, F, Abbatecola, A, Del Signore, S, Malara, A, Mossello, E, Fumagalli, S, Volpato, S, Monzani, F, Bellelli, G, Zia, G, Incalzi, R, Andrieri, D, Antognoli, R, Antonietti, M, Bagalà, V, Bandini, G, Bazzano, S, Bellotti, F, Benvenuti, E, Bergamin, M, Bertolotti, M, Biagini, C, Bianchetti, A, Bianchi, A, Bianchi, M, Bianchi, P, Biasin, F, Bignamini, S, Blandini, D, Boffelli, S, Bontempi, C, Bordignon, A, Bracchitta, L, Bugada, M, Cafariello, C, Caleri, V, Calsolaro, V, Calvani, D, Campagna, F, Capasso, A, Capurso, S, Carino, S, Carpagnano, E, Carrieri, B, Castaldo, V, Castelli, M, Castellino, M, Cavarape, A, Cazzulani, I, Celesti, C, Ceolin, C, Ceresini, M, Ceretti, A, Cherubini, A, Chizzoli, A, Ciarrocchi, E, Cicciomessere, P, Colombo, M, Corsi, A, Crispino, A, Cucunato, R, Custodero, C, D’Agostino, F, D’Errico, M, D’Amico, F, De Iorio, A, De Marchi, A, Dell’Armi, A, Delmonte, M, Desideri, G, Devita, M, Di Matteo, E, Espinosa, E, Esposito, L, Fazio, C, Ferro, C, Filippini, C, Fiore, L, Fiorillo, S, Fontana, C, Forte, L, Montorzi, R, Fumagalli, C, Gasbarri, P, Giordano, A, Giuliani, E, and Granata, R

Subjects
BPSD, Profile, Clinical characteristic, Depression, Trazodone, Dementia
Abstract

Background and objectives: Depression is highly prevalent in older adults, especially in those with dementia. Trazodone, an antidepressant, has shown to be effective in older patients with moderate anxiolytic and hypnotic activity; and a common off-label use is rising for managing behavioral and psychological symptoms of dementia (BPSD). The aim of the study is to comparatively assess the clinical profiles of older patients treated with trazodone or other antidepressants. Methods: This cross-sectional study involved adults aged ≥ 60 years at risk of or affected with COVID-19 enrolled in the GeroCovid Observational study from acute wards, geriatric and dementia-specific outpatient clinics, as well as long-term care facilities (LTCF). Participants were grouped according to the use of trazodone, other antidepressants, or no antidepressant use. Results: Of the 3396 study participants (mean age 80.6 ± 9.1 years; 57.1% females), 10.8% used trazodone and 8.5% others antidepressants. Individuals treated with trazodone were older, more functionally dependent, and had a higher prevalence of dementia and BPSD than those using other antidepressants or no antidepressant use. Logistic regression analyses found that the presence of BPSD was associated with trazodone use (odds ratio (OR) 28.4, 95% confidence interval (CI) 18-44.7 for the outcome trazodone vs no antidepressants use, among participants without depression; OR 2.17, 95% CI 1.05-4.49 for the outcome trazodone vs no antidepressants use, among participants with depression). A cluster analysis of trazodone use identified three clusters: cluster 1 included mainly women, living at home with assistance, multimorbidity, dementia, BPSD, and depression; cluster 2 included mainly institutionalized women, with disabilities, depression, and dementia; cluster 3 included mostly men, often living at home unassisted, with better mobility performance, fewer chronic diseases, dementia, BPSD, and depression. Discussion: The use of trazodone was highly prevalent in functionally dependent and comorbid older adults admitted to LTCF or living at home. Clinical conditions associated with its prescription included depression as well as BPSD.

Published
2023

10. Prevalence and features of delirium in older patients admitted to rehabilitation facilities: a multicenter study

Author

Sidoli, C, Zambon, A, Tassistro, E, Rossi, E, Mossello, E, Inzitari, M, Cherubini, A, Marengoni, A, Morandi, A, Bellelli, G, Tarasconi, A, Sella, M, Paterno, G, Faggian, G, Lucarelli, C, De Grazia, N, Alberto, C, Porcella, L, Nardiello, I, Chimenti, E, Zeni, M, Romairone, E, Minaglia, C, Ceccotti, C, Guerra, G, Mantovani, G, Monacelli, F, Candiani, T, Santolini, F, Rosso, M, Bono, V, Sibilla, S, Dal Santo, P, Ceci, M, Barone, P, Schirinzi, T, Formenti, A, Nastasi, G, Isaia, G, Gonella, D, Battuello, A, Casson, S, Calvani, D, Boni, F, Ciaccio, A, Rosa, R, Sanna, G, Manfredini, S, Cortese, L, Rizzo, M, Prestano, R, Greco, A, Lauriola, M, Gelosa, G, Piras, V, Arena, M, Cosenza, D, Bellomo, A, Lamontagna, M, Gabbani, L, Lambertucci, L, Perego, S, Parati, G, Basile, G, Gallina, V, Pilone, G, Giudice, C, Pietrogrande, L, Mosca, M, Corazzin, I, Rossi, P, Nunziata, V, D'Amico, F, Grippa, A, Giardini, S, Barucci, R, Cossu, A, Fiorin, L, Distefano, M, Lunardelli, M, Brunori, M, Ruffini, I, Abraham, E, Varutti, A, Fabbro, E, Catalano, A, Martino, G, Leotta, D, Marchet, A, Dell'Aquila, G, Scrimieri, A, Davoli, M, Casella, M, Cartei, A, Polidori, G, Brischetto, D, Motta, S, Saponara, R, Perrone, P, Russo, G, Del, D, Car, C, Pirina, T, Franzoni, S, Cotroneo, A, Ghiggia, F, Volpi, G, Menichetti, C, Bo, M, Panico, A, Calogero, P, Corvalli, G, Mauri, M, Lupia, E, Manfredini, R, Fabbian, F, March, A, Pedrotti, M, Veronesi, M, Strocchi, E, Borghi, C, Bianchetti, A, Crucitti, A, Difrancesco, V, Fontana, G, Geriatria, A, Bonanni, L, Barbone, F, Serrati, C, Ballardini, G, Simoncelli, M, Ceschia, G, Scarpa, C, Brugiolo, R, Fusco, S, Ciarambino, T, Biagini, C, Tonon, E, Porta, M, Venuti, D, Delsette, M, Poeta, M, Barbagallo, G, Trovato, G, Delitala, A, Arosio, P, Reggiani, F, Zuliani, G, Ortolani, B, Mussio, E, Girardi, A, Coin, A, Ruotolo, G, Castagna, A, Masina, M, Cimino, R, Pinciaroli, A, Tripodi, G, Cassadonte, F, Vatrano, M, Scaglione, L, Fogliacco, P, Muzzuilini, C, Romano, F, Padovani, A, Rozzini, L, Cagnin, A, Fragiacomo, F, Desideri, G, Liberatore, E, Bruni, A, Orsitto, G, Franco, M, Bonfrate, L, Bonetto, M, Pizio, N, Magnani, G, Cecchetti, G, Longo, A, Bubba, V, Marinan, L, Cotelli, M, Turla, M, Sessa, M, Abruzzi, L, Castoldi, G, Lovetere, D, Musacchio, C, Novello, M, Cavarape, A, Bini, A, Leonardi, A, Seneci, F, Grimaldi, W, Fimognari, F, Bambar, V, Saitta, A, Corica, F, Braga, M, Servi, Ettorre, E, Camellini Bellelli, C, Annoni, G, Crescenzo, A, Noro, G, Turco, R, Ponzetto, M, Giuseppe, L, Mazzei, B, Maiuri, G, Costaggiu, D, Damato, R, Formilan, M, Patrizia, G, Santuar, L, Gallucci, M, Paragona, M, Bini, P, Modica, D, Abati, C, Clerici, M, Barbera, I, Nigroimperiale, F, Manni, A, Votino, C, Castiglioni, C, Di, M, Degl'Innocenti, M, Moscatelli, G, Guerini, S, Casini, C, Dini, D, Denotariis, S, Bonometti, F, Paolillo, C, Riccardi, A, Tiozzo, A, Samysalamafahmy, A, Dibari, M, Vanni, S, Scarpa, A, Zara, D, Ranieri, P, Alessandro, M, Di, F, Pezzoni, D, Platto, C, D'Ambrosio, V, Ivaldi, C, Milia, P, Desalvo, F, Solaro, C, Strazzacappa, M, Cazzadori, M, Grasso, M, Troisi, E, Guerini, V, Bernardini, B, Corsini, C, Boffelli, S, Filippi, A, Delpin, K, Faraci, B, Bertoletti, E, Vannucci, M, Crippa, P, Malighetti, A, Caltagirone, C, Disant, S, Bettini, D, Maltese, F, Abruzzese, G, Cosimo, D, Azzini, M, Colombo, M, Procino, G, Fascendini, S, Barocco, F, Del, P, Mazzone, A, Cottino, M, Vezzadini, G, Avanzi, S, Brambilla, C, Orini, S, Sgrilli, F, Mello, A, Lombardi Muti, L, Dijk, B, Fenu, S, Pes, C, Gareri, P, Passamonte, M, Rigo, R, Locusta, L, Caser, L, Rosso, G, Cesarini, S, Cozzi, R, Santini, C, Carbone, P, Cazzaniga, I, Lovati, R, Cantoni, A, Ranzani, P, Barra, D, Pompilio, G, Dimori, S, Cernesi, S, Ricco, C, Piazzolla, F, Capittini, E, Rota, C, Gottardi, F, Merla, L, Barelli, A, Millul, A, De, G, Morrone, G, Bigolari, M, Macchi, M, Zambon, F, Pizzorni, C, Dicasaleto, G, Menculini, G, Marcacci, M, Catanese, G, Sprini, D, Dicasalet, T, Bocci, M, Borga, S, Caironi, P, Cat, C, Cingolani, E, Avalli, L, Greco, G, Citerio, G, Gandini, L, Cornara, G, Lerda, R, Brazzi, L, Simeone, F, Caciorgna, M, Alampi, D, Francesconi, S, Beck, E, Antonini, B, Vettoretto, K, Meggiolaro, M, Garofalo, E, Notaro, S, Varutti, R, Bassi, F, Mistraletti, G, Marino, A, Rona, R, Rondelli, E, Riva, I, Cortegiani, A, Pistidda, L, D'Andrea, R, Querci, L, Gnesin, P, Todeschini, M, Lugano, M, Castelli, G, Ortolani, M, Cotoia, A, Maggiore, S, Ditizio, L, Graziani, R, Testa, I, Ferretti, E, Castioni, C, Lombardi, F, Caserta, R, Pasqua, M, Simoncini, S, Baccarini, F, Rispoli, M, Grossi, F, Cancelliere, L, Carnelli, M, Puccini, F, Biancofiore, G, Siniscalchi, A, Laici, C, Torrini, M, Pasetti, G, Palmese, S, Oggioni, R, Mangani, V, Pini, S, Martelli, M, Rigo, E, Zuccala, F, Cherri, A, Spina, R, Calamai, I, Petrucci, N, Caicedo, A, Ferri, F, Gritti, P, Brienza, N, Fonnesu, R, Dessena, M, Fullin, G, Saggioro, D, Sidoli C., Zambon A., Tassistro E., Rossi E., Mossello E., Inzitari M., Cherubini A., Marengoni A., Morandi A., Bellelli G., Tarasconi A., Sella M., Paterno G., Faggian G., Lucarelli C., De Grazia N., Alberto C., Porcella L., Nardiello I., Chimenti E., Zeni M., Romairone E., Minaglia C., Ceccotti C., Guerra G., Mantovani G., Monacelli F., Candiani T., Santolini F., Rosso M., Bono V., Sibilla S., Dal Santo P., Ceci M., Barone P., Schirinzi T., Formenti A., Nastasi G., Isaia G., Gonella D., Battuello A., Casson S., Calvani D., Boni F., Ciaccio A., Rosa R., Sanna G., Manfredini S., Cortese L., Rizzo M., Prestano R., Greco A., Lauriola M., Gelosa G., Piras V., Arena M., Cosenza D., Bellomo A., LaMontagna M., Gabbani L., Lambertucci L., Perego S., Parati G., Basile G., Gallina V., Pilone G., Giudice C., Pietrogrande L., Mosca M., Corazzin I., Rossi P., Nunziata V., D'Amico F., Grippa A., Giardini S., Barucci R., Cossu A., Fiorin L., Distefano M., Lunardelli M., Brunori M., Ruffini I., Abraham E., Varutti A., Fabbro E., Catalano A., Martino G., Leotta D., Marchet A., Dell'Aquila G., Scrimieri A., Davoli M., Casella M., Cartei A., Polidori G., Brischetto D., Motta S., Saponara R., Perrone P., Russo G., Del D., Car C., Pirina T., Franzoni S., Cotroneo A., Ghiggia F., Volpi G., Menichetti C., Bo M., Panico A., Calogero P., Corvalli G., Mauri M., Lupia E., Manfredini R., Fabbian F., March A., Pedrotti M., Veronesi M., Strocchi E., Borghi C., Bianchetti A., Crucitti A., DiFrancesco V., Fontana G., Geriatria A., Bonanni L., Barbone F., Serrati C., Ballardini G., Simoncelli M., Ceschia G., Scarpa C., Brugiolo R., Fusco S., Ciarambino T., Biagini C., Tonon E., Porta M., Venuti D., DelSette M., Poeta M., Barbagallo G., Trovato G., Delitala A., Arosio P., Reggiani F., Zuliani G., Ortolani B., Mussio E., Girardi A., Coin A., Ruotolo G., Castagna A., Masina M., Cimino R., Pinciaroli A., Tripodi G., Cassadonte F., Vatrano M., Scaglione L., Fogliacco P., Muzzuilini C., Romano F., Padovani A., Rozzini L., Cagnin A., Fragiacomo F., Desideri G., Liberatore E., Bruni A., Orsitto G., Franco M., Bonfrate L., Bonetto M., Pizio N., Magnani G., Cecchetti G., Longo A., Bubba V., Marinan L., Cotelli M., Turla M., Sessa M., Abruzzi L., Castoldi G., LoVetere D., Musacchio C., Novello M., Cavarape A., Bini A., Leonardi A., Seneci F., Grimaldi W., Fimognari F., Bambar V., Saitta A., Corica F., Braga M., Ettorre E., Camellini Bellelli C. G., Annoni G., Crescenzo A., Noro G., Turco R., Ponzetto M., Giuseppe L., Mazzei B., Maiuri G., Costaggiu D., Damato R., Formilan M., Patrizia G., Santuar L., Gallucci M., Paragona M., Bini P., Modica D., Abati C., Clerici M., Barbera I., NigroImperiale F., Manni A., Votino C., Castiglioni C., Di M., Degl'Innocenti M., Moscatelli G., Guerini S., Casini C., Dini D., DeNotariis S., Bonometti F., Paolillo C., Riccardi A., Tiozzo A., SamySalamaFahmy A., DiBari M., Vanni S., Scarpa A., Zara D., Ranieri P., Alessandro M., Di F., Pezzoni D., Platto C., D'Ambrosio V., Ivaldi C., Milia P., DeSalvo F., Solaro C., Strazzacappa M., Cazzadori M., Grasso M., Troisi E., Guerini V., Bernardini B., Corsini C., Boffelli S., Filippi A., Delpin K., Faraci B., Bertoletti E., Vannucci M., Crippa P., Malighetti A., Caltagirone C., DiSant S., Bettini D., Maltese F., Abruzzese G., Cosimo D., Azzini M., Colombo M., Procino G., Fascendini S., Barocco F., Del P., Mazzone A., Cottino M., Vezzadini G., Avanzi S., Brambilla C., Orini S., Sgrilli F., Mello A., Lombardi Muti L. E., Dijk B., Fenu S., Pes C., Gareri P., Passamonte M., Rigo R., Locusta L., Caser L., Rosso G., Cesarini S., Cozzi R., Santini C., Carbone P., Cazzaniga I., Lovati R., Cantoni A., Ranzani P., Barra D., Pompilio G., Dimori S., Cernesi S., Ricco C., Piazzolla F., Capittini E., Rota C., Gottardi F., Merla L., Barelli A., Millul A., De G., Morrone G., Bigolari M., Macchi M., Zambon F., Pizzorni C., DiCasaleto G., Menculini G., Marcacci M., Catanese G., Sprini D., DiCasalet T., Bocci M., Borga S., Caironi P., Cat C., Cingolani E., Avalli L., Greco G., Citerio G., Gandini L., Cornara G., Lerda R., Brazzi L., Simeone F., Caciorgna M., Alampi D., Francesconi S., Beck E., Antonini B., Vettoretto K., Meggiolaro M., Garofalo E., Notaro S., Varutti R., Bassi F., Mistraletti G., Marino A., Rona R., Rondelli E., Riva I., Cortegiani A., Pistidda L., D'Andrea R., Querci L., Gnesin P., Todeschini M., Lugano M., Castelli G., Ortolani M., Cotoia A., Maggiore S., DiTizio L., Graziani R., Testa I., Ferretti E., Castioni C., Lombardi F., Caserta R., Pasqua M., Simoncini S., Baccarini F., Rispoli M., Grossi F., Cancelliere L., Carnelli M., Puccini F., Biancofiore G., Siniscalchi A., Laici C., Torrini M., Pasetti G., Palmese S., Oggioni R., Mangani V., Pini S., Martelli M., Rigo E., Zuccala F., Cherri A., Spina R., Calamai I., Petrucci N., Caicedo A., Ferri F., Gritti P., Brienza N., Fonnesu R., Dessena M., Fullin G., Saggioro D., Sidoli, C, Zambon, A, Tassistro, E, Rossi, E, Mossello, E, Inzitari, M, Cherubini, A, Marengoni, A, Morandi, A, Bellelli, G, Tarasconi, A, Sella, M, Paterno, G, Faggian, G, Lucarelli, C, De Grazia, N, Alberto, C, Porcella, L, Nardiello, I, Chimenti, E, Zeni, M, Romairone, E, Minaglia, C, Ceccotti, C, Guerra, G, Mantovani, G, Monacelli, F, Candiani, T, Santolini, F, Rosso, M, Bono, V, Sibilla, S, Dal Santo, P, Ceci, M, Barone, P, Schirinzi, T, Formenti, A, Nastasi, G, Isaia, G, Gonella, D, Battuello, A, Casson, S, Calvani, D, Boni, F, Ciaccio, A, Rosa, R, Sanna, G, Manfredini, S, Cortese, L, Rizzo, M, Prestano, R, Greco, A, Lauriola, M, Gelosa, G, Piras, V, Arena, M, Cosenza, D, Bellomo, A, Lamontagna, M, Gabbani, L, Lambertucci, L, Perego, S, Parati, G, Basile, G, Gallina, V, Pilone, G, Giudice, C, Pietrogrande, L, Mosca, M, Corazzin, I, Rossi, P, Nunziata, V, D'Amico, F, Grippa, A, Giardini, S, Barucci, R, Cossu, A, Fiorin, L, Distefano, M, Lunardelli, M, Brunori, M, Ruffini, I, Abraham, E, Varutti, A, Fabbro, E, Catalano, A, Martino, G, Leotta, D, Marchet, A, Dell'Aquila, G, Scrimieri, A, Davoli, M, Casella, M, Cartei, A, Polidori, G, Brischetto, D, Motta, S, Saponara, R, Perrone, P, Russo, G, Del, D, Car, C, Pirina, T, Franzoni, S, Cotroneo, A, Ghiggia, F, Volpi, G, Menichetti, C, Bo, M, Panico, A, Calogero, P, Corvalli, G, Mauri, M, Lupia, E, Manfredini, R, Fabbian, F, March, A, Pedrotti, M, Veronesi, M, Strocchi, E, Borghi, C, Bianchetti, A, Crucitti, A, Difrancesco, V, Fontana, G, Geriatria, A, Bonanni, L, Barbone, F, Serrati, C, Ballardini, G, Simoncelli, M, Ceschia, G, Scarpa, C, Brugiolo, R, Fusco, S, Ciarambino, T, Biagini, C, Tonon, E, Porta, M, Venuti, D, Delsette, M, Poeta, M, Barbagallo, G, Trovato, G, Delitala, A, Arosio, P, Reggiani, F, Zuliani, G, Ortolani, B, Mussio, E, Girardi, A, Coin, A, Ruotolo, G, Castagna, A, Masina, M, Cimino, R, Pinciaroli, A, Tripodi, G, Cassadonte, F, Vatrano, M, Scaglione, L, Fogliacco, P, Muzzuilini, C, Romano, F, Padovani, A, Rozzini, L, Cagnin, A, Fragiacomo, F, Desideri, G, Liberatore, E, Bruni, A, Orsitto, G, Franco, M, Bonfrate, L, Bonetto, M, Pizio, N, Magnani, G, Cecchetti, G, Longo, A, Bubba, V, Marinan, L, Cotelli, M, Turla, M, Sessa, M, Abruzzi, L, Castoldi, G, Lovetere, D, Musacchio, C, Novello, M, Cavarape, A, Bini, A, Leonardi, A, Seneci, F, Grimaldi, W, Fimognari, F, Bambar, V, Saitta, A, Corica, F, Braga, M, Servi, Ettorre, E, Camellini Bellelli, C, Annoni, G, Crescenzo, A, Noro, G, Turco, R, Ponzetto, M, Giuseppe, L, Mazzei, B, Maiuri, G, Costaggiu, D, Damato, R, Formilan, M, Patrizia, G, Santuar, L, Gallucci, M, Paragona, M, Bini, P, Modica, D, Abati, C, Clerici, M, Barbera, I, Nigroimperiale, F, Manni, A, Votino, C, Castiglioni, C, Di, M, Degl'Innocenti, M, Moscatelli, G, Guerini, S, Casini, C, Dini, D, Denotariis, S, Bonometti, F, Paolillo, C, Riccardi, A, Tiozzo, A, Samysalamafahmy, A, Dibari, M, Vanni, S, Scarpa, A, Zara, D, Ranieri, P, Alessandro, M, Di, F, Pezzoni, D, Platto, C, D'Ambrosio, V, Ivaldi, C, Milia, P, Desalvo, F, Solaro, C, Strazzacappa, M, Cazzadori, M, Grasso, M, Troisi, E, Guerini, V, Bernardini, B, Corsini, C, Boffelli, S, Filippi, A, Delpin, K, Faraci, B, Bertoletti, E, Vannucci, M, Crippa, P, Malighetti, A, Caltagirone, C, Disant, S, Bettini, D, Maltese, F, Abruzzese, G, Cosimo, D, Azzini, M, Colombo, M, Procino, G, Fascendini, S, Barocco, F, Del, P, Mazzone, A, Cottino, M, Vezzadini, G, Avanzi, S, Brambilla, C, Orini, S, Sgrilli, F, Mello, A, Lombardi Muti, L, Dijk, B, Fenu, S, Pes, C, Gareri, P, Passamonte, M, Rigo, R, Locusta, L, Caser, L, Rosso, G, Cesarini, S, Cozzi, R, Santini, C, Carbone, P, Cazzaniga, I, Lovati, R, Cantoni, A, Ranzani, P, Barra, D, Pompilio, G, Dimori, S, Cernesi, S, Ricco, C, Piazzolla, F, Capittini, E, Rota, C, Gottardi, F, Merla, L, Barelli, A, Millul, A, De, G, Morrone, G, Bigolari, M, Macchi, M, Zambon, F, Pizzorni, C, Dicasaleto, G, Menculini, G, Marcacci, M, Catanese, G, Sprini, D, Dicasalet, T, Bocci, M, Borga, S, Caironi, P, Cat, C, Cingolani, E, Avalli, L, Greco, G, Citerio, G, Gandini, L, Cornara, G, Lerda, R, Brazzi, L, Simeone, F, Caciorgna, M, Alampi, D, Francesconi, S, Beck, E, Antonini, B, Vettoretto, K, Meggiolaro, M, Garofalo, E, Notaro, S, Varutti, R, Bassi, F, Mistraletti, G, Marino, A, Rona, R, Rondelli, E, Riva, I, Cortegiani, A, Pistidda, L, D'Andrea, R, Querci, L, Gnesin, P, Todeschini, M, Lugano, M, Castelli, G, Ortolani, M, Cotoia, A, Maggiore, S, Ditizio, L, Graziani, R, Testa, I, Ferretti, E, Castioni, C, Lombardi, F, Caserta, R, Pasqua, M, Simoncini, S, Baccarini, F, Rispoli, M, Grossi, F, Cancelliere, L, Carnelli, M, Puccini, F, Biancofiore, G, Siniscalchi, A, Laici, C, Torrini, M, Pasetti, G, Palmese, S, Oggioni, R, Mangani, V, Pini, S, Martelli, M, Rigo, E, Zuccala, F, Cherri, A, Spina, R, Calamai, I, Petrucci, N, Caicedo, A, Ferri, F, Gritti, P, Brienza, N, Fonnesu, R, Dessena, M, Fullin, G, Saggioro, D, Sidoli C., Zambon A., Tassistro E., Rossi E., Mossello E., Inzitari M., Cherubini A., Marengoni A., Morandi A., Bellelli G., Tarasconi A., Sella M., Paterno G., Faggian G., Lucarelli C., De Grazia N., Alberto C., Porcella L., Nardiello I., Chimenti E., Zeni M., Romairone E., Minaglia C., Ceccotti C., Guerra G., Mantovani G., Monacelli F., Candiani T., Santolini F., Rosso M., Bono V., Sibilla S., Dal Santo P., Ceci M., Barone P., Schirinzi T., Formenti A., Nastasi G., Isaia G., Gonella D., Battuello A., Casson S., Calvani D., Boni F., Ciaccio A., Rosa R., Sanna G., Manfredini S., Cortese L., Rizzo M., Prestano R., Greco A., Lauriola M., Gelosa G., Piras V., Arena M., Cosenza D., Bellomo A., LaMontagna M., Gabbani L., Lambertucci L., Perego S., Parati G., Basile G., Gallina V., Pilone G., Giudice C., Pietrogrande L., Mosca M., Corazzin I., Rossi P., Nunziata V., D'Amico F., Grippa A., Giardini S., Barucci R., Cossu A., Fiorin L., Distefano M., Lunardelli M., Brunori M., Ruffini I., Abraham E., Varutti A., Fabbro E., Catalano A., Martino G., Leotta D., Marchet A., Dell'Aquila G., Scrimieri A., Davoli M., Casella M., Cartei A., Polidori G., Brischetto D., Motta S., Saponara R., Perrone P., Russo G., Del D., Car C., Pirina T., Franzoni S., Cotroneo A., Ghiggia F., Volpi G., Menichetti C., Bo M., Panico A., Calogero P., Corvalli G., Mauri M., Lupia E., Manfredini R., Fabbian F., March A., Pedrotti M., Veronesi M., Strocchi E., Borghi C., Bianchetti A., Crucitti A., DiFrancesco V., Fontana G., Geriatria A., Bonanni L., Barbone F., Serrati C., Ballardini G., Simoncelli M., Ceschia G., Scarpa C., Brugiolo R., Fusco S., Ciarambino T., Biagini C., Tonon E., Porta M., Venuti D., DelSette M., Poeta M., Barbagallo G., Trovato G., Delitala A., Arosio P., Reggiani F., Zuliani G., Ortolani B., Mussio E., Girardi A., Coin A., Ruotolo G., Castagna A., Masina M., Cimino R., Pinciaroli A., Tripodi G., Cassadonte F., Vatrano M., Scaglione L., Fogliacco P., Muzzuilini C., Romano F., Padovani A., Rozzini L., Cagnin A., Fragiacomo F., Desideri G., Liberatore E., Bruni A., Orsitto G., Franco M., Bonfrate L., Bonetto M., Pizio N., Magnani G., Cecchetti G., Longo A., Bubba V., Marinan L., Cotelli M., Turla M., Sessa M., Abruzzi L., Castoldi G., LoVetere D., Musacchio C., Novello M., Cavarape A., Bini A., Leonardi A., Seneci F., Grimaldi W., Fimognari F., Bambar V., Saitta A., Corica F., Braga M., Ettorre E., Camellini Bellelli C. G., Annoni G., Crescenzo A., Noro G., Turco R., Ponzetto M., Giuseppe L., Mazzei B., Maiuri G., Costaggiu D., Damato R., Formilan M., Patrizia G., Santuar L., Gallucci M., Paragona M., Bini P., Modica D., Abati C., Clerici M., Barbera I., NigroImperiale F., Manni A., Votino C., Castiglioni C., Di M., Degl'Innocenti M., Moscatelli G., Guerini S., Casini C., Dini D., DeNotariis S., Bonometti F., Paolillo C., Riccardi A., Tiozzo A., SamySalamaFahmy A., DiBari M., Vanni S., Scarpa A., Zara D., Ranieri P., Alessandro M., Di F., Pezzoni D., Platto C., D'Ambrosio V., Ivaldi C., Milia P., DeSalvo F., Solaro C., Strazzacappa M., Cazzadori M., Grasso M., Troisi E., Guerini V., Bernardini B., Corsini C., Boffelli S., Filippi A., Delpin K., Faraci B., Bertoletti E., Vannucci M., Crippa P., Malighetti A., Caltagirone C., DiSant S., Bettini D., Maltese F., Abruzzese G., Cosimo D., Azzini M., Colombo M., Procino G., Fascendini S., Barocco F., Del P., Mazzone A., Cottino M., Vezzadini G., Avanzi S., Brambilla C., Orini S., Sgrilli F., Mello A., Lombardi Muti L. E., Dijk B., Fenu S., Pes C., Gareri P., Passamonte M., Rigo R., Locusta L., Caser L., Rosso G., Cesarini S., Cozzi R., Santini C., Carbone P., Cazzaniga I., Lovati R., Cantoni A., Ranzani P., Barra D., Pompilio G., Dimori S., Cernesi S., Ricco C., Piazzolla F., Capittini E., Rota C., Gottardi F., Merla L., Barelli A., Millul A., De G., Morrone G., Bigolari M., Macchi M., Zambon F., Pizzorni C., DiCasaleto G., Menculini G., Marcacci M., Catanese G., Sprini D., DiCasalet T., Bocci M., Borga S., Caironi P., Cat C., Cingolani E., Avalli L., Greco G., Citerio G., Gandini L., Cornara G., Lerda R., Brazzi L., Simeone F., Caciorgna M., Alampi D., Francesconi S., Beck E., Antonini B., Vettoretto K., Meggiolaro M., Garofalo E., Notaro S., Varutti R., Bassi F., Mistraletti G., Marino A., Rona R., Rondelli E., Riva I., Cortegiani A., Pistidda L., D'Andrea R., Querci L., Gnesin P., Todeschini M., Lugano M., Castelli G., Ortolani M., Cotoia A., Maggiore S., DiTizio L., Graziani R., Testa I., Ferretti E., Castioni C., Lombardi F., Caserta R., Pasqua M., Simoncini S., Baccarini F., Rispoli M., Grossi F., Cancelliere L., Carnelli M., Puccini F., Biancofiore G., Siniscalchi A., Laici C., Torrini M., Pasetti G., Palmese S., Oggioni R., Mangani V., Pini S., Martelli M., Rigo E., Zuccala F., Cherri A., Spina R., Calamai I., Petrucci N., Caicedo A., Ferri F., Gritti P., Brienza N., Fonnesu R., Dessena M., Fullin G., and Saggioro D.

Abstract

Background: Delirium is thought to be common across various settings of care; however, still little research has been conducted in rehabilitation. Aim: We investigated the prevalence of delirium, its features and motor subtypes in older patients admitted to rehabilitation facilities during the three editions of the “Delirium Day project”. Methods: We conducted a cross-sectional study in which 1237 older patients (age ≥ 65 years old) admitted to 50 Italian rehabilitation wards during the three editions of the “Delirium Day project” (2015 to 2017) were included. Delirium was evaluated through the 4AT and its motor subtype with the Delirium Motor Subtype Scale. Results: Delirium was detected in 226 patients (18%), and the most recurrent motor subtype was mixed (37%), followed by hypoactive (26%), hyperactive (21%) and non-motor one (16%). In a multivariate Poisson regression model with robust variance, factors associated with delirium were: disability in basic (PR 1.48, 95%CI: 1.17–1.9, p value 0.001) and instrumental activities of daily living (PR 1.58, 95%CI: 1.08–2.32, p value 0.018), dementia (PR 2.10, 95%CI: 1.62–2.73, p value < 0.0001), typical antipsychotics (PR 1.47, 95%CI: 1.10–1.95, p value 0.008), antidepressants other than selective serotonin reuptake inhibitors (PR 1.3, 95%CI: 1.02–1.66, p value 0.035), and physical restraints (PR 2.37, 95%CI: 1.68–3.36, p value < 0.0001). Conclusion: This multicenter study reports that 2 out 10 patients admitted to rehabilitations had delirium on the index day. Mixed delirium was the most prevalent subtype. Delirium was associated with unmodifiable (dementia, disability) and modifiable (physical restraints, medications) factors. Identification of these factors should prompt specific interventions aimed to prevent or mitigate delirium.

Published
2022

11. Disentangling the impact of COVID-19 infection on clinical outcomes and preventive strategies in older persons: An Italian perspective

Author

Abbatecola, A, Antonelli Incalzi, R, Malara, A, Palmieri, A, Di Lonardo, A, Borselli, G, Russo, M, Noale, M, Fumagalli, S, Gareri, P, Mossello, E, Trevisan, C, Volpato, S, Monzani, F, Coin, A, Bellelli, G, Okoye, C, Del Signore, S, Zia, G, Bottoni, E, Cafariello, C, Onder, G, Abbatecola A. M., Antonelli Incalzi R., Malara A., Palmieri A., Di Lonardo A., Borselli G., Russo M., Noale M., Fumagalli S., Gareri P., Mossello E., Trevisan C., Volpato S., Monzani F., Coin A., Bellelli G., Okoye C., Del Signore S., Zia G., Bottoni E., Cafariello C., Onder G., Abbatecola, A, Antonelli Incalzi, R, Malara, A, Palmieri, A, Di Lonardo, A, Borselli, G, Russo, M, Noale, M, Fumagalli, S, Gareri, P, Mossello, E, Trevisan, C, Volpato, S, Monzani, F, Coin, A, Bellelli, G, Okoye, C, Del Signore, S, Zia, G, Bottoni, E, Cafariello, C, Onder, G, Abbatecola A. M., Antonelli Incalzi R., Malara A., Palmieri A., Di Lonardo A., Borselli G., Russo M., Noale M., Fumagalli S., Gareri P., Mossello E., Trevisan C., Volpato S., Monzani F., Coin A., Bellelli G., Okoye C., Del Signore S., Zia G., Bottoni E., Cafariello C., and Onder G.

Abstract

Italy was one of the first western countries to embrace the first wave of COVID-19 and undergo detrimental outcomes in older adults in different clinical settings, especially in those with comorbidity and frailty. In addition, older nursing home (NH) residents had significantly higher mortality rates most likely due to the increased susceptibility of infection due to combined physical vulnerability and risks linked to the NH living environment itself. Different reports throughout Italy have rapidly highlighted selected outcomes related to COVID-19 in older patients being treated in acute and long-term care (LTC) settings. However, the majority of these studies are single center studies. Thus, it remains fundamental to collect large data from prospective based-population studies in order to identify preventive and therapeutic COVID-19 risk/protective factors correlated with COVID-19 health status outcomes. In this commentary paper, we will discuss different Italian reports according to clinical settings and highlight the importance of GeroCovid Observational and GeroCovid Vax, two large population based prospective studies in Italy.

Published
2022

12. Atrial fibrillation and COVID-19 in older patients: how disability contributes to shape the risk profile. An analysis of the GeroCovid registry

Author

Fumagalli, S, Trevisan, C, Del Signore, S, Pelagalli, G, Fumagalli, C, Herbst, A, Volpato, S, Gareri, P, Mossello, E, Malara, A, Monzani, F, Okoye, C, Coin, A, Bellelli, G, Zia, G, Ungar, A, Ranhoff, A, Antonelli Incalzi, R, Fumagalli S., Trevisan C., Del Signore S., Pelagalli G., Fumagalli C., Herbst A., Volpato S., Gareri P., Mossello E., Malara A., Monzani F., Okoye C., Coin A., Bellelli G., Zia G., Ungar A., Ranhoff A. H., Antonelli Incalzi R., Fumagalli, S, Trevisan, C, Del Signore, S, Pelagalli, G, Fumagalli, C, Herbst, A, Volpato, S, Gareri, P, Mossello, E, Malara, A, Monzani, F, Okoye, C, Coin, A, Bellelli, G, Zia, G, Ungar, A, Ranhoff, A, Antonelli Incalzi, R, Fumagalli S., Trevisan C., Del Signore S., Pelagalli G., Fumagalli C., Herbst A., Volpato S., Gareri P., Mossello E., Malara A., Monzani F., Okoye C., Coin A., Bellelli G., Zia G., Ungar A., Ranhoff A. H., and Antonelli Incalzi R.

Abstract

Background and aims: Atrial fibrillation (AF) is often complicated by disabling conditions in the elderly. COVID-19 has high mortality in older people. This study aimed at evaluating the relationship of pre-infection AF with characteristics and survival of older COVID-19 patients. Methods: We retrospectively analyzed inpatients aged ≥ 60 years enrolled in GeroCovid Observational, a multicenter registry endorsed by the Italian and the Norwegian Societies of Gerontology and Geriatrics. Pre-COVID-19 sociodemographic, functional, and medical data were systematically collected, as well as in-hospital mortality. Results: Between March and June 2020, 808 COVID-19 subjects were enrolled (age 79 ± 9 years; men 51.7%). The prevalence of AF was 21.8%. AF patients were older (82 ± 8 vs. 77 ± 9 years, p < 0.001), had a higher CHA2DS2-VASc score (4.1 ± 1.5 vs. 3.2 ± 1.5, p < 0.001) and were more likely to present almost all comorbidities. At multivariable analysis, advanced age, white blood cell count, the presence of heart and peripheral artery diseases were significantly associated with the presence of AF. In-hospital mortality was higher in AF patients (36.9 vs. 27.5%; OR = 1.55, 95% CI = 1.09–2.20; p = 0.015). A decision tree analysis showed that, in AF subjects, preserved functional status at admission was the most important factor associated with survival. In patients without AF, baseline COVID-19 severity was the most relevant variable related to clinical prognosis. Conclusions: AF is frequent in older patients with COVID-19, in whom it associates with clinical complexity and high mortality. Pre-infection disability shapes the prognosis of this extremely vulnerable segment of hospitalized subjects. Clinical trial registration: GeroCovid Observational was registered at www.clinicaltrials.gov (NCT04379440).

Published
2022

13. Monitoring COVID-19 vaccine use in Italian long term care centers: The GeroCovid VAX study

Author

Abbatecola, A, Incalzi, R, Malara, A, Palmieri, A, Di Lonardo, A, Fedeli, G, Stefanelli, P, Borselli, G, Russo, M, Noale, M, Fumagalli, S, Gareri, P, Mossello, E, Trevisan, C, Volpato, S, Monzani, F, Coin, A, Bellelli, G, Okoye, C, Del Signore, S, Zia, G, Bottoni, E, Cafariello, C, Onder, G, Abbatecola A. M., Incalzi R. A., Malara A., Palmieri A., Di Lonardo A., Fedeli G., Stefanelli P., Borselli G., Russo M., Noale M., Fumagalli S., Gareri P., Mossello E., Trevisan C., Volpato S., Monzani F., Coin A., Bellelli G., Okoye C., Del Signore S., Zia G., Bottoni E., Cafariello C., Onder G., Abbatecola, A, Incalzi, R, Malara, A, Palmieri, A, Di Lonardo, A, Fedeli, G, Stefanelli, P, Borselli, G, Russo, M, Noale, M, Fumagalli, S, Gareri, P, Mossello, E, Trevisan, C, Volpato, S, Monzani, F, Coin, A, Bellelli, G, Okoye, C, Del Signore, S, Zia, G, Bottoni, E, Cafariello, C, Onder, G, Abbatecola A. M., Incalzi R. A., Malara A., Palmieri A., Di Lonardo A., Fedeli G., Stefanelli P., Borselli G., Russo M., Noale M., Fumagalli S., Gareri P., Mossello E., Trevisan C., Volpato S., Monzani F., Coin A., Bellelli G., Okoye C., Del Signore S., Zia G., Bottoni E., Cafariello C., and Onder G.

Abstract

The COVID-19 pandemic has changed routine care practice for older persons, especially in those with frailty living in long term care (LTC) facilities. Due to the high mortality rates of Nursing home (NH) residents during the first wave of the COVID-19 pandemic, priority for COVID-19 vaccinations was given to this vulnerable population. However, the safety and efficacy of such vaccines in older frail elders remains questionable due to the fact that initial randomized clinical trials (RCTs) for such vaccines did not include this population. This type of discrimination in patient participation in RCTs continues and has been recognized in the literature. Nevertheless, in the context of a worldwide emergency, COVID-19 vaccination in older persons living in LTC facilities may provide a solid basis to protect against negative outcomes, such as COVID-19 infection and death. In this report, we present the protocol of the GeroCovid Vax study, an Italian study that began in February 2021 which is aimed at investigating the safety and efficacy of the anti-SARS-CoV-2 vaccinations in older persons living in LTCs. This protocol specially aims to continuously and closely monitor events related to- and following- the anti-SARS-CoV-2 vaccination in elderly living in LTC facilities. In this report, we will provide information related to the study protocol and describe baseline characteristics of the sample.

Published
2022

14. Frailty, psychological well-being, and social isolation in older adults with cognitive impairment during the SARS-CoV-2 pandemic: data from the GeroCovid initiative

Author

Terziotti, C, Ceolin, C, Devita, M, Raffaelli, C, Antenucci, S, Bazzano, S, Capasso, A, Castellino, M, Signore, S, Lubian, F, Maiotti, M, Monacelli, F, Mormile, M, Sgarito, C, Vella, F, Sergi, G, Gareri, P, Trevisan, C, Bellio, A, Fini, F, Malara, A, Mossello, E, Fumagalli, S, Volpato, S, Monzani, F, Bellelli, G, Zia, G, Incalzi, R, Coin, A, Terziotti, Camilla, Ceolin, Chiara, Devita, Maria, Raffaelli, Cecilia, Antenucci, Sara, Bazzano, Salvatore, Capasso, Andrea, Castellino, Manuela, Signore, Stefania Del, Lubian, Francesca, Maiotti, Mariangela, Monacelli, Fiammetta, Mormile, Maria Teresa, Sgarito, Claudia, Vella, Filomena, Sergi, Giuseppe, Gareri, Pietro, Trevisan, Caterina, Bellio, Andrea, Fini, Filippo, Malara, Alba, Mossello, Enrico, Fumagalli, Stefano, Volpato, Stefano, Monzani, Fabio, Bellelli, Giuseppe, Zia, Gianluca, Incalzi, Raffaele Antonelli, Coin, Alessandra, Terziotti, C, Ceolin, C, Devita, M, Raffaelli, C, Antenucci, S, Bazzano, S, Capasso, A, Castellino, M, Signore, S, Lubian, F, Maiotti, M, Monacelli, F, Mormile, M, Sgarito, C, Vella, F, Sergi, G, Gareri, P, Trevisan, C, Bellio, A, Fini, F, Malara, A, Mossello, E, Fumagalli, S, Volpato, S, Monzani, F, Bellelli, G, Zia, G, Incalzi, R, Coin, A, Terziotti, Camilla, Ceolin, Chiara, Devita, Maria, Raffaelli, Cecilia, Antenucci, Sara, Bazzano, Salvatore, Capasso, Andrea, Castellino, Manuela, Signore, Stefania Del, Lubian, Francesca, Maiotti, Mariangela, Monacelli, Fiammetta, Mormile, Maria Teresa, Sgarito, Claudia, Vella, Filomena, Sergi, Giuseppe, Gareri, Pietro, Trevisan, Caterina, Bellio, Andrea, Fini, Filippo, Malara, Alba, Mossello, Enrico, Fumagalli, Stefano, Volpato, Stefano, Monzani, Fabio, Bellelli, Giuseppe, Zia, Gianluca, Incalzi, Raffaele Antonelli, and Coin, Alessandra

Abstract

Background: The containment measures linked to the COVID-19 pandemic negatively affected the phyco-physical well-being of the population, especially older adults with neurocognitive disorders (NCDs). This study aims to evaluate whether the frailty of NCD patients was associated with different changes in multiple health domains, in particular in relation to loneliness and social isolation, pre- and post-lockdown. Materials and Methods: Patients were recruited from 10 Italian Centers for Cognitive Disorders and Dementia. Data were collected in the pre-pandemic period (T0), during the pandemic lockdown (T1), and 6–9 months post-lockdown (T2). The UCLA Loneliness Scale-3, Activities of Daily Living (ADL), Instrumental ADL (IADL), Mini-Mental State Examination, and Neuropsychiatric Inventory (NPI) were administered. Caregivers' burden was also tested. Patients were categorized as non-frail, pre-frail, and frail according to the Fatigue, Resistance, Ambulation, Illness, and Loss of Weight scale. Results: The sample included 165 subjects (61.9% women, mean age 79.5 ± 4.9 years). In the whole sample, the ADL, IADL, and NPI scores significantly declined between T0 and T2. There were no significative variations in functional and cognitive domains between the frail groups. During lockdown we recorded higher Depression Anxiety Stress Scales and Perceived Stress Scale scores in frail people. In multivariable logistic regression, frailty was associated with an increase in social isolation, and a loss of IADL. Conclusions: We observed a global deterioration in functional and neuro-psychiatric domains irrespective of the degree of frailty. Frailty was associated with the worsening of social isolation during lockdown. Frail patients and their caregivers seemed to experience more anxiety and stress disorders during SARS-CoV-2 pandemic.

Published
2023

15. Efficacy of COVID-19 control measures on post-vaccination outbreak in Italian Long Term Care Facilities: implications for policies

Author

Malara, A, Noale, M, Trevisan, C, Abbatecola, A, Borselli, G, Cafariello, C, Gareri, P, Fumagalli, S, Mossello, E, Volpato, S, Monzani, F, Coin, A, Okoye, C, Bellelli, G, Del Signore, S, Zia, G, Antonelli Incalzi, R, Palmieri, A, Fedele, G, Onder, G, Malara, A, Noale, M, Trevisan, C, Abbatecola, A, Borselli, G, Cafariello, C, Gareri, P, Fumagalli, S, Mossello, E, Volpato, S, Monzani, F, Coin, A, Okoye, C, Bellelli, G, Del Signore, S, Zia, G, Antonelli Incalzi, R, Palmieri, A, Fedele, G, and Onder, G

Abstract

Background: Numerous individual and organizational factors can influence the spread of SARS-CoV-2 infection in Long Term Care Facilities (LTCFs). A range of outbreak control measures are still implemented in most facilities involving administrations, staff, residents and their families. This study aims to evaluate which measure could influence the transmission of SARS-CoV-2 infection among residents during the period March 2021-June 2022. Methods: We enrolled 3,272 residents aged ≥60 years. The outbreak control measures adopted to prevent or manage the infection included entry regulations, contact-regulating procedures, and virological surveillance of residents and staff. The association between LTCFs' and participants' characteristics with new cases of COVID-19 infections was analyzed using multilevel logistic regression models. Results: In 33.8% of the facilities 261 cases of SARS-CoV-2 infection were reported. Among participant characteristics, gender and age were not associated with SARS-CoV-2 infection, while having received the vaccine booster dose was protective against infection [Odds Ratio (OR) = 0.34, 95% Confidence Interval (CI) 0.12–0.99, p = 0.048]. In addition, the implementation of protected areas for family visits was associated with a significant reduction of the probability of infections (OR = 0.18, 95% CI 0.03–0.98, p = 0.047). Overall, about 66% of the variability in the probability of SARS-CoV-2 infection during the observational period may be due to facility structure characteristics and 34% to the participant characteristics. Conclusions: These data showed that vaccination booster doses and family visit restriction-control are still needed to make the LTCFs safer against SARS-CoV-2 infection.

Published
2023

16. Health trajectories in older patients hospitalized for COVID-19: Results from the GeroCovid multicenter study

Author

Trevisan, C., Tonarelli, F., Zucchelli, A., Parrotta, I., Calvani, Riccardo, Malara, A., Monzani, F., Gareri, P., Zia, G., Antonelli Incalzi, R., Calvani R. (ORCID:0000-0001-5472-2365), Trevisan, C., Tonarelli, F., Zucchelli, A., Parrotta, I., Calvani, Riccardo, Malara, A., Monzani, F., Gareri, P., Zia, G., Antonelli Incalzi, R., and Calvani R. (ORCID:0000-0001-5472-2365)

Abstract

Background: COVID-19 has disproportionately affected older adults. Yet, healthcare trajectories experienced by older persons hospitalized for COVID-19 have not been investigated. This study aimed at estimating the probabilities of transitions between severity states in older adults admitted in COVID-19 acute wards and at identifying the factors associated with such dynamics. Methods: COVID-19 patients aged ≥60 years hospitalized between March and December 2020 were involved in the multicentre GeroCovid project–acute wards substudy. Sociodemographic and health data were obtained from medical records. Clinical states during hospitalization were categorized on a seven-category scale, ranging from hospital discharge to death. Based on the transitions between these states, first, we defined patients’ clinical course as positive (only improvements), negative (only worsening), or fluctuating (both improvements and worsening). Second, we focused on the single transitions between clinical states and estimated their probability (through multistage Markov modeling) and associated factors (with proportional intensity models). Results: Of the 1024 included patients (mean age 78.1 years, 51.1% women), 637 (62.2%) had a positive, 66 (6.4%) had a fluctuating, and 321 (31.3%) had a negative clinical course. Patients with a fluctuating clinical course were younger, had better mobility and cognitive levels, fewer diseases, but a higher prevalence of cardiovascular disease and obesity. Considering the single transitions, the probability that older COVID-19 patients experienced clinical changes was higher within a 10-day timeframe, especially for milder clinical states. Older age, male sex, lower mobility level, multimorbidity, and hospitalization during the COVID-19 first wave (compared with the second one) were associated with an increased probability of progressing towards worse clinical states or with a lower recovery. Conclusion: COVID-19 in older inpatients has a complex and dynam

Published
2023

17. Covid-19 as a paradigmatic model of the heterogeneous disease presentation in older people: data from the GeroCovid Observational study

Author

Trevisan, C, Remelli, F, Fumagalli, S, Mossello, E, Okoye, C, Bellelli, G, Coin, A, Malara, A, Gareri, P, Monzani, F, Del Signore, S, Zia, G, Antonelli Incalzi, R, Volpato, S, Trevisan, Caterina, Remelli, Francesca, Fumagalli, Stefano, Mossello, Enrico, Okoye, Chukwuma, Bellelli, Giuseppe, Coin, Alessandra, Malara, Alba, Gareri, Pietro, Monzani, Fabio, Del Signore, Susanna, Zia, Gianluca, Antonelli Incalzi, Raffaele, Volpato, Stefano, Trevisan, C, Remelli, F, Fumagalli, S, Mossello, E, Okoye, C, Bellelli, G, Coin, A, Malara, A, Gareri, P, Monzani, F, Del Signore, S, Zia, G, Antonelli Incalzi, R, Volpato, S, Trevisan, Caterina, Remelli, Francesca, Fumagalli, Stefano, Mossello, Enrico, Okoye, Chukwuma, Bellelli, Giuseppe, Coin, Alessandra, Malara, Alba, Gareri, Pietro, Monzani, Fabio, Del Signore, Susanna, Zia, Gianluca, Antonelli Incalzi, Raffaele, and Volpato, Stefano

Abstract

COVID-19 may have a heterogeneous onset, especially in older age. However, whether and how COVID-19 signs and symptoms may present and aggregate together according to sociodemographic and health factors is unclear, as well as their prognostic value. This study included 981 COVID-19 inpatients who participated in the GeroCovid Observational study. Signs/symptoms at disease onset, sociodemographic, health, cognitive status, and mobility were systematically recorded. Clusters of signs/symptoms were identified through agglomerative hierarchical clustering. The associations of single signs/symptoms and symptom clusters with longer hospitalization (≥16 days) and in-hospital mortality were explored through logistic and Cox regressions. The signs/symptoms most reported in our sample (age 78.3 ± 9.39 years; 49.4% women) were fever (62.5%), cough (45.5%), and dyspnea (62.7%). Atypical symptoms were reported by up to one-third of patients, and delirium by 9.1%. Atypical symptoms were more frequent with advancing age and with lower pre-COVID-19 cognitive and mobility levels. Older men more likely reported respiratory symptoms than women. Dyspnea (hazard ratio [HR] = 1.47, 95% confidence interval [CI]: 1.02-2.12), tachypnea (HR = 1.53, 95% CI: 1.14-2.07), low oxygen saturation (HR = 1.95, 95% CI: 1.32-2.88) and delirium (HR = 1.60, 95% CI: 1.13-2.28) were associated with higher in-hospital mortality. Four symptom clusters were identified. Compared with the mild respiratory symptoms cluster, the severe clinical impairment cluster was associated with higher mortality (HR = 2.57, 95% CI: 1.58-4.18). The severe clinical impairment and aspecific symptoms clusters were associated with longer hospitalization (odds ratio [OR] = 2.38, 95% CI: 1.56-3.63, and OR = 1.75, 95% CI: 1.08-2.83, respectively). Multiple health aspects influence COVID-19 clinical presentation. A symptom clusters approach may help predict adverse health outcomes in older patients. In addition to respiratory symptoms

Published
2022

18. COVID-19 Signs and Symptom Clusters in Long-Term Care Facility Residents: Data from the GeroCovid Observational Study

Author

Malara, A, Noale, M, Abbatecola, A, Borselli, G, Cafariello, C, Fumagalli, S, Gareri, P, Mossello, E, Trevisan, C, Volpato, S, Monzani, F, Coin, A, Bellelli, G, Okoye, C, Del Signore, S, Zia, G, Incalzi, R, Malara, Alba, Noale, Marianna, Abbatecola, Angela Marie, Borselli, Gilda, Cafariello, Carmine, Fumagalli, Stefano, Gareri, Pietro, Mossello, Enrico, Trevisan, Caterina, Volpato, Stefano, Monzani, Fabio, Coin, Alessandra, Bellelli, Giuseppe, Okoye, Chukwuma, Del Signore, Stefania, Zia, Gianluca, Incalzi, Raffaele Antonelli, Malara, A, Noale, M, Abbatecola, A, Borselli, G, Cafariello, C, Fumagalli, S, Gareri, P, Mossello, E, Trevisan, C, Volpato, S, Monzani, F, Coin, A, Bellelli, G, Okoye, C, Del Signore, S, Zia, G, Incalzi, R, Malara, Alba, Noale, Marianna, Abbatecola, Angela Marie, Borselli, Gilda, Cafariello, Carmine, Fumagalli, Stefano, Gareri, Pietro, Mossello, Enrico, Trevisan, Caterina, Volpato, Stefano, Monzani, Fabio, Coin, Alessandra, Bellelli, Giuseppe, Okoye, Chukwuma, Del Signore, Stefania, Zia, Gianluca, and Incalzi, Raffaele Antonelli

Abstract

Background: Long-term care facility (LTCF) residents often present asymptomatic or paucisymptomatic features of SARS-CoV-2 infection. We aimed at investigating signs/symptoms, including their clustering on SARS-CoV-2 infection and mortality rates associated with SARS-CoV-2 infection in LTCF residents. Methods: This is a cohort study of 586 aged ≥ 60 year-old residents at risk of or affected with COVID-19 enrolled in the GeroCovid LTCF network. COVID-19 signs/symptom clusters were identified using cluster analysis. Cluster analyses associated with SARS-CoV-2 infection and mortality were evaluated using logistic regression and Cox proportional hazard models. Results: Cluster 1 symptoms (delirium, fever, low-grade fever, diarrhea, anorexia, cough, increased respiratory rate, sudden deterioration in health conditions, dyspnea, oxygen saturation, and weakness) affected 39.6% of residents and were associated with PCR swab positivity (OR = 7.21, 95%CI 4.78–10.80; p < 0.001). Cluster 1 symptoms were present in deceased COVID-19 residents. Cluster 2 (increased blood pressure, sphincter incontinence) and cluster 3 (new-onset cognitive impairment) affected 20% and 19.8% of residents, respectively. Cluster 3 symptoms were associated with increased mortality (HR = 5.41, 95%CI 1.56–18.8; p = 0.008), while those of Cluster 2 were not associated with mortality (HR = 0.82, 95%CI 0.26–2.56; p = 730). Conclusions: Our study highlights that delirium, fever, and low-grade fever, alone or in clusters should be considered in identifying and predicting the prognosis of SARS-CoV-2 infection in older LTCF patients.

Published
2022

19. Computed tomography findings and prognosis in older COVID-19 patients

Author

Okoye, C, Finamore, P, Bellelli, G, Coin, A, Del Signore, S, Fumagalli, S, Gareri, P, Malara, A, Mossello, E, Trevisan, C, Volpato, S, Zia, G, Monzani, F, Incalzi, R, Okoye, Chukwuma, Finamore, Panaiotis, Bellelli, Giuseppe, Coin, Alessandra, Del Signore, Susanna, Fumagalli, Stefano, Gareri, Pietro, Malara, Alba, Mossello, Enrico, Trevisan, Caterina, Volpato, Stefano, Zia, Gianluca, Monzani, Fabio, Incalzi, Raffaele Antonelli, Okoye, C, Finamore, P, Bellelli, G, Coin, A, Del Signore, S, Fumagalli, S, Gareri, P, Malara, A, Mossello, E, Trevisan, C, Volpato, S, Zia, G, Monzani, F, Incalzi, R, Okoye, Chukwuma, Finamore, Panaiotis, Bellelli, Giuseppe, Coin, Alessandra, Del Signore, Susanna, Fumagalli, Stefano, Gareri, Pietro, Malara, Alba, Mossello, Enrico, Trevisan, Caterina, Volpato, Stefano, Zia, Gianluca, Monzani, Fabio, and Incalzi, Raffaele Antonelli

Abstract

Background: In older and multimorbid patients, chronic conditions may affect the prognostic validity of computed tomography (CT) findings in COVID-19. This study aims at assessing to which extent CT findings have prognostic implications in COVID-19 older patients. Methods: Hospitalized COVID-19 patients aged 60 years or more enrolled in the multicenter, observational and longitudinal GeroCovid study who underwent chest CT were included. Patients were stratified by tertiles of age and pneumonia severity to compare CT findings. Hierarchical clustering based on CT findings was performed to identify CT-related classificatory constructs, if any. The hazard ratio (HR) of mortality was calculated for individual CT findings and for clusters, after adjusting for potential confounders. Results: 380 hospitalized COVID-19 patients, with a mean age of 78 (SD:9) years, underwent chest CT scan. Ground glass opacity (GGO), consolidation, and pleural effusion were the three most common CT findings, with GGO prevalence decreasing from younger to older patients and pleural effusion increasing. More severe the pneumonia more prevalent were GGO, consolidation and pleural effusion. HR of mortality was 1.94 (95%CI 1.24–3.06) for pleural effusion and 13 (95%CI 6.41–27) for cluster with a low prevalence of GGO and a high prevalence of pleural effusion (“LH”), respectively. Out of the three CT based clusters, “LH” was the only independent predictor in the multivariable model. Conclusions: Pleural effusion qualifies as a distinctive prognostic marker in older COVID-19 patients. Research is needed to verify whether pleural effusion reflects COVID-19 severity or a coexisting chronic condition making the patient at special risk of death. Trial registration: ClinicalTrials.gov: NCT04379440

Published
2022

20. Clinical Features of SARS-CoV-2 Infection in Italian Long-Term Care Facilities: GeroCovid LTCFs Observational Study

Author

Malara, A, Noale, M, Abbatecola, A, Borselli, G, Cafariello, C, Fumagalli, S, Gareri, P, Mossello, E, Trevisan, C, Volpato, S, Monzani, F, Coin, A, Bellelli, G, Okoye, C, Del Signore, S, Zia, G, Antonelli Incalzi, R, Malara, Alba, Noale, Marianna, Abbatecola, Angela Marie, Borselli, Gilda, Cafariello, Carmine, Fumagalli, Stefano, Gareri, Pietro, Mossello, Enrico, Trevisan, Caterina, Volpato, Stefano, Monzani, Fabio, Coin, Alessandra, Bellelli, Giuseppe, Okoye, Chukwuma, Del Signore, Susanna, Zia, Gianluca, Antonelli Incalzi, Raffaele, Malara, A, Noale, M, Abbatecola, A, Borselli, G, Cafariello, C, Fumagalli, S, Gareri, P, Mossello, E, Trevisan, C, Volpato, S, Monzani, F, Coin, A, Bellelli, G, Okoye, C, Del Signore, S, Zia, G, Antonelli Incalzi, R, Malara, Alba, Noale, Marianna, Abbatecola, Angela Marie, Borselli, Gilda, Cafariello, Carmine, Fumagalli, Stefano, Gareri, Pietro, Mossello, Enrico, Trevisan, Caterina, Volpato, Stefano, Monzani, Fabio, Coin, Alessandra, Bellelli, Giuseppe, Okoye, Chukwuma, Del Signore, Susanna, Zia, Gianluca, and Antonelli Incalzi, Raffaele

Published
2022

21. Management of Older Outpatients during the COVID-19 Pandemic: The GeroCovid Ambulatory Study

Author

Gareri, P, Fumagalli, S, Malara, A, Mossello, E, Trevisan, C, Volpato, S, Coin, A, Calsolaro, V, Bellelli, G, Del Signore, S, Zia, G, Ranhoff, A, Incalzi, R, Gareri, Pietro, Fumagalli, Stefano, Malara, Alba, Mossello, Enrico, Trevisan, Caterina, Volpato, Stefano, Coin, Alessandra, Calsolaro, Valeria, Bellelli, Giuseppe, Del Signore, Susanna, Zia, Gianluca, Ranhoff, Anette Hylen, Incalzi, Raffaele Antonelli, Gareri, P, Fumagalli, S, Malara, A, Mossello, E, Trevisan, C, Volpato, S, Coin, A, Calsolaro, V, Bellelli, G, Del Signore, S, Zia, G, Ranhoff, A, Incalzi, R, Gareri, Pietro, Fumagalli, Stefano, Malara, Alba, Mossello, Enrico, Trevisan, Caterina, Volpato, Stefano, Coin, Alessandra, Calsolaro, Valeria, Bellelli, Giuseppe, Del Signore, Susanna, Zia, Gianluca, Ranhoff, Anette Hylen, and Incalzi, Raffaele Antonelli

Abstract

Objectives: The GeroCovid Study is a multi-setting, multinational, and multi-scope registry that includes the GeroCovid home and outpatients' care cohort. The present study aims to evaluate whether outpatient and home care services with remote monitoring and consultation could mitigate the impact of the COVID-19 pandemic on mental and affective status, perceived well-being, and personal capabilities of outpatients and home care patients with cognitive disorders. Methods: Prospectively recorded patients in an electronic web registry provided by BlueCompanion Ltd. Up to October 31, 2020, the sample included 90 patients receiving regular care from the Center for Cognitive Disorders and Dementia in Catanzaro Lido, Italy. It was made of 52 ambulatory outpatients and 38 home care patients, mean age 83.3 +/- 7.54 years. Participants underwent a multidimensional assessment at baseline (T0) and after 90 days (T1). For each patient, we administered the Mini-Mental State Examination (MMSE) for cognitive functions, the Activities of Daily Living (ADL) and Instrumental ADL (IADL) scales for functional capabilities, the Cumulative Illness Rating Scale (CIRS) for comorbidities and their impact on patients' health, the 5-items Geriatric Depression Scale (GDS) for mood, and the Euro Quality of Life (EuroQoL) for perceived quality of life. Contacts with both ambulatory and home care patients were managed in person or via telephone, preferably through video calls (WhatsApp or FaceTime). Results: Contacts with patients were kept at T0 through telephone. At T1, visits were made in person for over 95% out of the cases. The ADL, IADL, CIRS, GDS, MMSE, and EuroQoL changed slightly between T0 and T1. Most of the patients were clinically stable over time on the majority of the scales explored, but behavioral changes were found in 24.4% of patients and anxiety and insomnia in 17.7% of patients. Conclusion: Our study suggests that contacts through telephone and video consultations are likely a

Published
2022

22. COVID-19 and atrial fibrillation in older patients. Does oral anticoagulant therapy provide a survival benefit? An insight from the GeroCovid Registry

Author

Fumagalli, S, Trevisan, C, Del Signore, S, Pelagalli, G, Volpato, S, Gareri, P, Mossello, E, Malara, A, Monzani, F, Coin, A, Bellelli, G, Zia, G, Antonelli Incalzi, R, Fumagalli, Stefano, Trevisan, Caterina, Del Signore, Susanna, Pelagalli, Giulia, Volpato, Stefano, Gareri, Pietro, Mossello, Enrico, Malara, Alba, Monzani, Fabio, Coin, Alessandra, Bellelli, Giuseppe, Zia, Gianluca, Antonelli Incalzi, Raffaele, Fumagalli, S, Trevisan, C, Del Signore, S, Pelagalli, G, Volpato, S, Gareri, P, Mossello, E, Malara, A, Monzani, F, Coin, A, Bellelli, G, Zia, G, Antonelli Incalzi, R, Fumagalli, Stefano, Trevisan, Caterina, Del Signore, Susanna, Pelagalli, Giulia, Volpato, Stefano, Gareri, Pietro, Mossello, Enrico, Malara, Alba, Monzani, Fabio, Coin, Alessandra, Bellelli, Giuseppe, Zia, Gianluca, and Antonelli Incalzi, Raffaele

Abstract

Introduction. Atrial fibrillation (AF), the most frequent arrhythmia of older patients, associates with serious thrombo-embolic complications and high mortality. COVID-19 severely affects aged subjects, determining an important prothrombotic status. Aim of this study was to evaluate mortality-related factors in older AF patients with COVID-19. Methods. Between March and June 2020, we enrolled >=60 years in-hospital COVID-19 patients (N=806) in GeroCovid, a multicenter observational study promoted by the Italian Society of Gerontology and Geriatric Medicine. Results. The prevalence of AF was 21.8%. In-hospital mortality was higher in the AF group (36.9 vs. 27.5%, p=0.015). At admission, 51.7%, 10.2% and 38.1% of AF cases were taking, respectively, oral anticoagulants (OACs), antiplatelet agents and no antithrombotic therapy. During hospitalization, 51% patients switched to low-molecular weight heparins. AF patients who survived were younger (81±8 vs. 84±7 years; p=0.002) and had a lower CHA2DS2-VASc score (3.9±1.6 vs. 4.4±1.3; p=0.02) than those who died. OACs use before (63.1% vs. 32.3%; p<0.001) and during hospitalization (34.0% vs. 12.7%; p=0.002) was higher among survivors. At multivariable analysis, lower age, higher self-sufficiency, less severe initial COVID-19 presentation, and the use of Vitamin K antagonists (OR=0.16, 95%CI: 0.03-0.84) or DOACs (OR=0.22, 95%CI: 0.08-0.56) at admission, or the persistence of OAC during hospitalization (OR=0.05, 95%CI: 0.01-0.24), were associated with a lower chance of in-hospital death. Conclusions. AF is a prevalent and severe condition in older COVID-19 patients. Advanced age, dependency and relevant clinical manifestations of disease characterized a worse prognosis. Pre-admission and in-hospital anticoagulant therapy were positively associated with survival.

Published
2022

23. The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017

Author

Zucchelli, A, Manzoni, F, Morandi, A, Di Santo, S, Rossi, E, Valsecchi, Mg, Inzitari, M, Cherubini, A, Bo, M, Mossello, E, Marengoni, A, Bellelli, G, Tarasconi, A, Sella, M, Auriemma, S, Paternò, G, Faggian, G, Lucarelli, C, De Grazia, N, Alberto, C, Margola, A, Porcella, L, Nardiello, I, Chimenti, E, Zeni, M, Giani, A, Famularo, S, Romairone, E, Minaglia, C, Ceccotti, C, Guerra, G, Mantovani, G, Monacelli, F, Candiani, T, Ballestrero, A, Santolini, F, Rosso, M, Bono, V, Sibilla, S, Dal Santo, P, Ceci, M, Barone, P, Schirinzi, T, Formenti, A, Nastasi, G, Isaia, G, Gonella, D, Battuello, A, Casson, S, Calvani, D, Boni, F, Ciaccio, A, Rosa, R, Sanna, G, Manfredini, S, Cortese, L, Rizzo, M, Prestano, R, Greco, A, Lauriola, M, Gelosa, G, Piras, V, Arena, M, Cosenza, D, Bellomo, A, Lamontagna, M, Gabbani, L, Lambertucci, L, Perego, S, Parati, G, Basile, G, Gallina, V, Pilone, G, Giudice, C, De, F, Pietrogrande, L, De, B, Mosca, M, Corazzin, I, Rossi, P, Nunziata, V, D'Amico, F, Grippa, A, Giardini, S, Barucci, R, Cossu, A, Fiorin, L, Distefano, M, Lunardelli, M, Brunori, M, Ruffini, I, Abraham, E, Varutti, A, Fabbro, E, Catalano, A, Martino, G, Leotta, D, Marchet, A, Dell'Aquila, G, Scrimieri, A, Davoli, M, Casella, M, Cartei, A, Polidori, G, Brischetto, D, Motta, S, Saponara, R, Perrone, P, Russo, G, Del, D, Car, C, Pirina, T, Franzoni, S, Cotroneo, A, Ghiggia, F, Volpi, G, Menichetti, C, Panico, A, Calogero, P, Corvalli, G, Mauri, M, Lupia, E, Manfredini, R, Fabbian, F, March, A, Pedrotti, M, Veronesi, M, Strocchi, E, Bianchetti, A, Crucitti, A, Di Francesco, V, Fontana, G, Bonanni, L, Barbone, F, Serrati, C, Ballardini, G, Simoncelli, M, Ceschia, G, Scarpa, C, Brugiolo, R, Fusco, S, Ciarambino, T, Biagini, C, Tonon, E, Porta, M, Venuti, D, Delsette, M, Poeta, M, Barbagallo, G, Trovato, G, Delitala, A, Arosio, P, Reggiani, F, Zuliani, G, Ortolani, B, Mussio, E, Girardi, A, Coin, A, Ruotolo, G, Castagna, A, Masina, M, Cimino, R, Pinciaroli, A, Tripodi, G, Cannistrà, U, Cassadonte, F, Vatrano, M, Scaglione, L, Fogliacco, P, Muzzuilini, C, Romano, F, Padovani, A, Rozzini, L, Cagnin, A, Fragiacomo, F, Desideri, G, Liberatore, E, Bruni, A, Orsitto, G, Franco, M, Bonfrate, L, Bonetto, M, Pizio, N, Magnani, G, Cecchetti, G, Longo, A, Bubba, V, Marinan, L, Cotelli, M, Turla, M, Sessa, M, Abruzzi, L, Castoldi, G, Lovetere, D, Musacchio, C, Novello, M, Cavarape, A, Bini, A, Leonardi, A, Seneci, F, Grimaldi, W, Fimognari, F, Bambara, V, Saitta, A, Corica, F, Braga, M, Ettorre, E, Camellini, C, Crescenzo, A, Noro, G, Turco, R, Ponzetto, M, Giuseppe, L, Mazzei, B, Maiuri, G, Costaggiu, D, Damato, R, Formilan, M, Patrizia, G, Santuari, L, Gallucci, M, Paragona, M, Bini, P, Modica, D, Abati, C, Clerici, M, Barbera, I, Nigroimperiale, F, Manni, A, Votino, C, Castiglioni, C, Di, M, Degl'Innocenti, M, Moscatelli, G, Guerini, S, Casini, C, Dini, D, D'Imporzano, E, Denotariis, S, Bonometti, F, Paolillo, C, Riccardi, A, Tiozzo, A, Samy Salama Fahmy, A, Dibari, M, Vanni, S, Scarpa, A, Zara, D, Ranieri, P, Pezzoni, D, Gentile, S, Platto, C, D'Ambrosio, V, Faraci, B, Brambilla, C, Ivaldi, C, Milia, P, Desalvo, F, Solaro, C, Strazzacappa, M, Cazzadori, M, Confente, S, Grasso, M, Troisi, E, Guerini, V, Bernardini, B, C Boffelli S, Corsini, Filippi, A, Delpin, K, Bertoletti, E, Vannucci, M, Tesi, F, Crippa, P, Malighetti, A, Caltagirone, C, Disant, S, Bettini, D, Maltese, F, Abruzzese, G, Cosimo, D, Azzini, M, Colombo, M, Procino, G, Fascendini, S, Barocco, F, Del, P, Mazzone, A, Riva, E, Dell'Acqua, D, Cottino, M, Vezzadini, G, Avanzi, S, Orini, S, Sgrilli, F, Mello, A, Lombardi, L, Muti, E, Dijk, B, Fenu, S, Pes, C, Gareri, P, Passamonte, M, Rigo, R, Locusta, L, Caser, L, Rosso, G, Cesarini, S, Cozzi, R, Santini, C, Carbone, P, Cazzaniga, I, Lovati, R, Cantoni, A, Ranzani, P, Barra, D, Pompilio, G, Dimori, S, Cernesi, S, Riccò, C, Piazzolla, F, Capittini, E, Rota, C, Gottardi, F, Merla, L, A Millul A, Barelli, De, G, Morrone, G, Bigolari, M, Macchi, M, Zambon, F, Pizzorni, C, Dicasaleto, G, Menculini, G, Marcacci, M, Catanese, G, Sprini, D, Dicasalet, T, Bocci, M, Borga, S, Caironi, P, Cat, C, Cingolani, E, Avalli, L, Greco, G, Citerio, G, Gandini, L, Cornara, G, Lerda, R, Brazzi, L, Simeone, F, Caciorgna, M, Alampi, D, Francesconi, S, Beck, E, Antonini, B, Vettoretto, K, Meggiolaro, M, Garofalo, E, Notaro, S, Varutti, R, Bassi, F, Mistraletti, G, Marino, A, Rona, R, Rondelli, E, Riva, I, Scapigliati, A, Cortegiani, A, Vitale, F, Pistidda, L, D'Andrea, R, Querci, L, Gnesin, P, Todeschini, M, Lugano, M, Castelli, G, Ortolani, M, Cotoia, A, Maggiore, S, Ditizio, L, Graziani, R, Testa, I, Ferretti, E, Castioni, C, Lombardi, F, Caserta, R, Pasqua, M, Simoncini, S, Baccarini, F, Rispoli, M, Grossi, F, Cancelliere, L, Carnelli, M, Puccini, F, Biancofiore, G, Siniscalchi, A, Laici, C, Torrini, M, Pasetti, G, Palmese, S, Oggioni, R, Mangani, V, Pini, S, Martelli, M, Rigo, E, Zuccalà, F, Cherri, A, Spina, R, Calamai, I, Petrucci, N, Caicedo, A, Ferri, F, Gritti, P, Brienza, N, Fonnesu, R, Dessena, M, Fullin, G, Saggioro, D., Zucchelli, A, Manzoni, F, Morandi, A, Di Santo, S, Rossi, E, Valsecchi, M, Inzitari, M, Cherubini, A, Bo, M, Mossello, E, Marengoni, A, Bellelli, G, Citerio, G, Zucchelli, Alberto, Valsecchi, M G, and A Tarasconi, M Sella, S Auriemma, G Paternò, G Faggian, C Lucarelli, N De Grazia, C Alberto, A Margola, L Porcella, I Nardiello, E Chimenti, M Zeni, A Giani, S Famularo, E Romairone, C Minaglia, C Ceccotti, G Guerra, G Mantovani, F Monacelli, C Minaglia, T Candiani, A Ballestrero, C Minaglia, F Santolini, C Minaglia, M Rosso, V Bono, S Sibilla, P Dal Santo, M Ceci, P Barone, T Schirinzi, A Formenti, G Nastasi, G Isaia, D Gonella, A Battuello, S Casson, D Calvani, F Boni, A Ciaccio, R Rosa, G Sanna, S Manfredini, L Cortese, M Rizzo, R Prestano, A Greco, M Lauriola, G Gelosa, V Piras, M Arena, D Cosenza, A Bellomo, M LaMontagna, L Gabbani, L Lambertucci, S Perego, G Parati, G Basile, V Gallina, G Pilone, C Giudice, F De, L Pietrogrande, B De, M Mosca, I Corazzin, P Rossi, V Nunziata, F D'Amico, A Grippa, S Giardini, R Barucci, A Cossu, L Fiorin, M Arena, M Distefano, M Lunardelli, M Brunori, I Ruffini, E Abraham, A Varutti, E Fabbro, A Catalano, G Martino, D Leotta, A Marchet, G Dell'Aquila, A Scrimieri, M Davoli, M Casella, A Cartei, G Polidori, G Basile, D Brischetto, S Motta, R Saponara, P Perrone, G Russo, D Del, C Car, T Pirina, S Franzoni, A Cotroneo, F Ghiggia, G Volpi, C Menichetti, M Bo, A Panico, P Calogero, G Corvalli, M Mauri, E Lupia, R Manfredini, F Fabbian, A March, M Pedrotti, M Veronesi, E Strocchi, A Bianchetti, A Crucitti, V Di Francesco, G Fontana, L Bonanni, F Barbone, C Serrati, G Ballardini, M Simoncelli, G Ceschia, C Scarpa, R Brugiolo, S Fusco, T Ciarambino, C Biagini, E Tonon, M Porta, D Venuti, M DelSette, M Poeta, G Barbagallo, G Trovato, A Delitala, P Arosio, F Reggiani, G Zuliani, B Ortolani, E Mussio, A Girardi, A Coin, G Ruotolo, A Castagna, M Masina, R Cimino, A Pinciaroli, G Tripodi, U Cannistrà, F Cassadonte, M Vatrano, F Cassandonte, L Scaglione, P Fogliacco, C Muzzuilini, F Romano, A Padovani, L Rozzini, A Cagnin, F Fragiacomo, G Desideri, E Liberatore, A Bruni, G Orsitto, M Franco, L Bonfrate, M Bonetto, N Pizio, G Magnani, G Cecchetti, A Longo, V Bubba, L Marinan, M Cotelli, M Turla, M Brunori, M Sessa, L Abruzzi, G Castoldi, D LoVetere, C Musacchio, M Novello, A Cavarape, A Bini, A Leonardi, F Seneci, W Grimaldi, F Fimognari, V Bambara, A Saitta, F Corica, M Braga, E Ettorre, C Camellini, A Marengoni, A Bruni, A Crescenzo, G Noro, R Turco, M Ponzetto, L Giuseppe, B Mazzei, G Maiuri, D Costaggiu, R Damato, E Fabbro, G Patrizia, L Santuari, M Gallucci, C Minaglia, M Paragona, P Bini, D Modica, C Abati, M Clerici, I Barbera, F NigroImperiale, A Manni, C Votino, C Castiglioni, M Di, M Degl'Innocenti, G Moscatelli, S Guerini, C Casini, D Dini, S DeNotariis, F Bonometti, C Paolillo, A Riccardi, A Tiozzo, A SamySalamaFahmy, A Riccardi, C Paolillo, M DiBari, S Vanni, A Scarpa, D Zara, P Ranieri, P Calogero, G Corvalli, D Pezzoni, S Gentile, A Morandi, C Platto, V D'Ambrosio, B Faraci, C Ivaldi, P Milia, F DeSalvo, C Solaro, M Strazzacappa, M Bo, A Panico, M Cazzadori, S Confente, M Bonetto, G Magnani, G Cecchetti, V Guerini, B Bernardini, C Corsini, S Boffelli, A Filippi, K Delpin, E Bertoletti, M Vannucci, F Tesi, P Crippa, A Malighetti, C Caltagirone, S DiSant, D Bettini, F Maltese, M Formilan, G Abruzzese, C Minaglia, D Cosimo, M Azzini, M Cazzadori, M Colombo, G Procino, S Fascendini, F Barocco, P Del, F D'Amico, A Grippa, A Mazzone, E Riva, D Dell'Acqua, M Cottino, G Vezzadini, S Avanzi, S Orini, F Sgrilli, A Mello, L Lombardi, E Muti, B Dijk, S Fenu, C Pes, P Gareri, A Castagna, M Passamonte, F De, R Rigo, L Locusta, L Caser, G Rosso, S Cesarini, R Cozzi, C Santini, P Carbone, I Cazzaniga, R Lovati, A Cantoni, P Ranzani, D Barra, G Pompilio, S Dimori, S Cernesi, C Riccò, F Piazzolla, E Capittini, C Rota, F Gottardi, L Merla, A Barelli, A Millul, G De, G Morrone, M Bigolari, C Minaglia, M Macchi, F Zambon, F D'Amico, F D'Amico, C Pizzorni, G DiCasaleto, G Menculini, M Marcacci, G Catanese, D Sprini, T DiCasalet, M Bocci, S Borga, P Caironi, C Cat, E Cingolani, L Avalli, G Greco, G Citerio, L Gandini, G Cornara, R Lerda, L Brazzi, F Simeone, M Caciorgna, D Alampi, S Francesconi, E Beck, B Antonini, K Vettoretto, M Meggiolaro, E Garofalo, A Bruni, S Notaro, R Varutti, F Bassi, G Mistraletti, A Marino, R Rona, E Rondelli, I Riva, A Scapigliati, A Cortegiani, F Vitale, L Pistidda, R D'Andrea, L Querci, P Gnesin, M Todeschini, M Lugano, G Castelli, M Ortolani, A Cotoia, S Maggiore, L DiTizio, R Graziani, I Testa, E Ferretti, C Castioni, F Lombardi, R Caserta, M Pasqua, S Simoncini, F Baccarini, M Rispoli, F Grossi, L Cancelliere, M Carnelli, F Puccini, G Biancofiore, A Siniscalchi, C Laici, E Mossello, M Torrini, G Pasetti, S Palmese, R Oggioni, V Mangani, S Pini, M Martelli, E Rigo, F Zuccalà, A Cherri, R Spina, I Calamai, N Petrucci, A Caicedo, F Ferri, P Gritti, N Brienza, R Fonnesu, M Dessena, G Fullin, D Saggioro

Subjects
Male, Aging, medicine.medical_specialty, Sarcopenia, medicine.medical_treatment, Socio-culturale, Older person, Logistic regression, Delirium, Older persons, Sarcopenia, Internal medicine, mental disorders, Delirium, Older persons, medicine, Dementia, Humans, LS4_4, Muscle, Skeletal, Pathological, Aged, Rehabilitation, business.industry, Area under the curve, Settore MED/23 - Chirurgia Cardiaca, Skeletal, medicine.disease, Skeletal muscle mass, Cross-Sectional Studies, Italy, Muscle, Female, Geriatrics and Gerontology, medicine.symptom, business
Abstract

Introduction Delirium and sarcopenia are common, although underdiagnosed, geriatric syndromes. Several pathological mechanisms can link delirium and low skeletal muscle mass, but few studies have investigated their association. We aimed to investigate (1) the association between delirium and low skeletal muscle mass and (2) the possible role of calf circumference mass in finding cases with delirium. Methods The analyses were conducted employing the cross-sectional “Delirium Day” initiative, on patient 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes and hospices in Italy in 2017. Delirium was diagnosed as a 4 + score at the 4-AT scale. Low skeletal muscle mass was operationally defined as calf circumference ≤ 34 cm in males and ≤ 33 cm in females. Logistic regression models were used to investigate the association between low skeletal muscle mass and delirium. The discriminative ability of calf circumference was evaluated using non-parametric ROC analyses. Results A sample of 1675 patients was analyzed. In total, 73.6% of participants had low skeletal muscle mass and 24.1% exhibited delirium. Low skeletal muscle mass and delirium showed an independent association (OR: 1.50; 95% CI 1.09–2.08). In the subsample of patients without a diagnosis of dementia, the inclusion of calf circumference in a model based on age and sex significantly improved its discriminative accuracy [area under the curve (AUC) 0.69 vs 0.57, p Discussion and conclusion Low muscle mass is independently associated with delirium. In patients without a previous diagnosis of dementia, calf circumference may help to better identify those who develop delirium.

Published
2022

24. Delirium and Clusters of Older Patients Affected by Multimorbidity in Acute Hospitals

Author

Monacelli, F, Signori, A, Marengoni, A, Di Santo, S, Rossi, E, Valsecchi, Mg, Morandi, A, Bellelli, G, Tarasconi, A, Sella, M, Auriemma, S, Paternò, G, Faggian, G, Lucarelli, C, De Grazia, N, Alberto, C, Porcella, L, Nardiello, I, Chimenti, E, Zeni, M, Giani, A, Famularo, S, Romairone, E, Minaglia, C, Ceccotti, C, Guerra, G, Mantovani, G, Candiani, T, Ballestrero, A, Santolini, F, Rosso, M, Bono, V, Sibilla, S, Dal Santo, P, Ceci, M, Barone, P, Schirinzi, T, Formenti, A, Nastasi, G, Isaia, G, Gonella, D, Battuello, A, Casson, S, Calvani, D, Boni, F, Ciaccio, A, Rosa, R, Sanna, G, Manfredini, S, Cortese, L, Rizzo, M, Prestano, R, Greco, A, Lauriola, M, Gelosa, G, Piras, V, Arena, M, Cosenza, D, Bellomo, A, Lamontagna, M, Gabbani, L, Lambertucci, L, Perego, S, Parati, G, Basile, G, Gallina, V, Pilone, G, Giudice, C, Pietrogrande, L, Mosca, M, Corazzin, I, Rossi, P, Nunziata, V, D'Amico, F, Grippa, A, Giardini, S, Barucci, R, Cossu, A, Fiorin, L, Distefano, M, Lunardelli, M, Brunori, M, Ruffini, I, Abraham, E, Varutti, A, Fabbro, E, Catalano, A, Martino, G, Leotta, D, Marchet, A, Dell'Aquila, G, Scrimieri, A, Davoli, M, Casella, M, Cartei, A, Polidori, G, Brischetto, D, Motta, S, Saponara, R, Perrone, P, Russo, G, Del, D, Car, C, Pirina, T, Franzoni, S, Cotroneo, A, Ghiggia, F, Volpi, G, Menichetti, C, Bo, M, Panico, A, Calogero, P, Corvalli, G, Mauri, M, Lupia, E, Manfredini, R, Fabbian, F, March, A, Pedrotti, M, Veronesi, M, Strocchi, E, Borghi, C, Bianchetti, A, Crucitti, A, Difrancesco, V, Fontana, G, Bonanni, L, Barbone, F, Serrati, C, Ballardini, G, Simoncelli, M, Ceschia, G, Scarpa, C, Brugiolo, R, Fusco, S, Ciarambino, T, Biagini, C, Tonon, E, Porta, M, Venuti, D, Delsette, M, Poeta, M, Barbagallo, G, Trovato, G, Delitala, A, Arosio, P, Reggiani, F, Zuliani, G, Ortolani, B, Mussio, E, Girardi, A, Coin, A, Ruotolo, G, Castagna, A, Masina, M, Cimino, R, Pinciaroli, A, Tripodi, G, Cannistrà, U, Cassadonte, F, Vatrano, M, Scaglione, L, Fogliacco, P, Muzzuilini, C, Romano, F, Padovani, A, Rozzini, L, Cagnin, A, Fragiacomo, F, Desideri, G, Liberatore, E, Bruni, A, Orsitto, G, Franco, M, Bonfrate, L, Bonetto, M, Pizio, N, Magnani, G, Cecchetti, G, Longo, A, Bubba, V, Marinan, L, Cotelli, M, Turla, M, Sessa, M, Abruzzi, L, Castoldi, G, Lovetere, D, Musacchio, C, Novello, M, Cavarape, A, Bini, A, Leonardi, A, Seneci, F, Grimaldi, W, Fimognari, F, Bambara, V, Saitta, A, Corica, F, Braga, M, Ettorre, E, Camellini, C, Annoni, G, Crescenzo, A, Noro, G, Turco, R, Ponzetto, M, Giuseppe, L, Mazzei, B, Maiuri, G, Costaggiu, D, Damato, R, Formilan, M, Patrizia, G, Santuari, L, Gallucci, M, Paragona, M, Bini, P, Modica, D, Abati, C, Clerici, M, Barbera, I, Nigroimperiale, F, Manni, A, Votino, C, Castiglioni, C, Degl'Innocenti, M, Moscatelli, G, Guerini, S, Casini, C, Dini, D, D'Imporzano, E, Denotariis, S, Bonometti, F, Paolillo, C, Riccardi, A, Tiozzo, A, Samy Salama Fahmy, A, Dibari, M, Vanni, S, Scarpa, A, Zara, D, Ranieri, P, Alessandro, M, Pezzoni, D, Platto, C, D'Ambrosio, V, Ivaldi, C, Milia, P, Desalvo, F, Solaro, C, Strazzacappa, M, Cazzadori, M, Confente, S, Grasso, M, Troisi, E, Guerini, V, Bernardini, B, Corsini, C, Boffelli, S, Filippi, A, Delpin, K, Faraci, B, Bertoletti, E, Vannucci, M, Tesi, F, Crippa, P, Malighetti, A, Caltagirone, C, Disant, S, Bettini, D, Maltese, F, Abruzzese, G, Cosimo, D, Azzini, M, Colombo, M, Procino, G, Fascendini, S, Barocco, F, Del, P, Mazzone, A, Riva, E, Dell'Acqua, D, Cottino, M, Vezzadini, G, Avanzi, S, Brambilla, C, Orini, S, Sgrilli, F, Mello, A, Lombardi, L, Muti, E, Dijk, B, Fenu, S, Pes, C, Gareri, P, Passamonte, M, Rigo, R, Locusta, L, Caser, L, Rosso, G, Cesarini, S, Cozzi, R, Santini, C, Carbone, P, Cazzaniga, I, Lovati, R, Cantoni, A, Ranzani, P, Barra, D, Pompilio, G, Dimori, S, Cernesi, S, Riccò, C, Piazzolla, F, Capittini, E, Rota, C, Gottardi, F, Merla, L, Barelli, A, Millul, A, Morrone, G, Bigolari, M, Macchi, M, Zambon, F, Pizzorni, C, Dicasaleto, G, Menculini, G, Marcacci, M, Catanese, G, Sprini, D, Dicasalet, T, Bocci, M, Borga, S, Caironi, P, Cingolani, E, Avalli, L, Greco, G, Citerio, G, Gandini, L, Cornara, G, Lerda, R, Brazzi, L, Simeone, F, Caciorgna, M, Alampi, D, Francesconi, S, Beck, E, Antonini, B, Vettoretto, K, Meggiolaro, M, Garofalo, E, Notaro, S, Varutti, R, Bassi, F, Mistraletti, G, Marino, A, Rona, R, Rondelli, E, Riva, I, Cortegiani, A, Vitale, F, Pistidda, L, D'Andrea, R, Querci, L, Gnesin, P, Todeschini, M, Lugano, M, Castelli, G, Ortolani, M, Cotoia, A, Maggiore, S, Ditizio, L, Graziani, R, Testa, I, Ferretti, E, Castioni, C, Lombardi, F, Caserta, R, Pasqua, M, Simoncini, S, Baccarini, F, Rispoli, M, Grossi, F, Cancelliere, L, Carnelli, M, Puccini, F, Biancofiore, G, Siniscalchi, A, Laici, C, Mossello, E, Torrini, M, Pasetti, G, Palmese, S, Oggioni, R, Mangani, V, Pini, S, Martelli, M, Rigo, E, Zuccalà, F, Cherri, A, Spina, R, Calamai, I, Petrucci, N, Caicedo, A, Ferri, F, Gritti, P, Brienza, N, Fonnesu, R, Dessena, M, Fullin, G, Saggioro, D., Monacelli, F, Signori, A, Marengoni, A, Di Santo, S, Rossi, E, Valsecchi, M, Morandi, A, and Bellelli, G

Subjects
medicine.medical_specialty, multimorbidity, Delirium, multimorbidity, Socio-culturale, Older patients, mental disorders, Medicine, Dementia, Multimorbidity, Humans, Medical history, LS4_4, General Nursing, Aged, Aged, 80 and over, Routine screening, business.industry, Health Policy, Delirium, General Medicine, Targeted interventions, medicine.disease, Hospitals, Cross-Sectional Studies, Charlson comorbidity index, Emergency medicine, Geriatrics and Gerontology, medicine.symptom, business
Abstract

Objectives Delirium is commonly seen in older adults with multimorbidity, during a hospitalization, resulting from the interplay between predisposing factors such as advanced age, frailty, and dementia, and a series of precipitating factors. The association between delirium and specific multimorbidity is largely unexplored so far although of potential key relevance for targeted interventions. The aim of the study was to check for a potential association of multimorbidity with delirium in a large cohort of older patients hospitalized for an acute medical or surgical condition. Design This is a cross-sectional study nested in the 2017 Delirium Day project. Setting and Participants The study includes 1829 hospitalized patients (age: 81.8, SD: 5.5). Of them, 419 (22.9%) had delirium. Methods Sociodemographic and medical history were collected. The 4AT was used to assess the presence of delirium. The Charlson Comorbidity index was used to assess multimorbidity. Results The results identified neurosensorial multimorbidity as the most prevalent, including patients with dementia, cerebrovascular diseases, and sensory impairments. In light of the highest co-occurrence of 3 neurosensorial chronic conditions, we could hypothesize that a baseline altered brain functional and neural connectivity might determine the vulnerability signature for incipient overall system disruption in presence of acute insults. Conclusions and Implications Eventually, our findings moved a step forward in supporting the key importance of routine screening for sensory impairments and cognitive status of older patients for the highest risk of in-hospital delirium. In fact, preventive interventions could be particularly relevant and effective in preventing delirium in such vulnerable populations and might help refining this early diagnosis.

Published
2022

25. Phosphorylation patterns in the AT1R C-terminal tail specify distinct downstream signaling pathways

Author

Gareri, Clarice, Pfeiffer, Conrad T., Jiang, Xue, Paulo, Joao A., Gygi, Steven P., Pham, Uyen, Chundi, Anand, Wingler, Laura M., Staus, Dean P., Stepniewski, Tomasz Maciej, Selent, Jana, Lucero, Emilio Y., Grogan, Alyssa, Rajagopal, Sudarshan, and Rockman, Howard A.

Abstract

Different ligands stabilize specific conformations of the angiotensin II type 1 receptor (AT1R) that direct distinct signaling cascades mediated by heterotrimeric G proteins or β-arrestin. These different active conformations are thought to engage distinct intracellular transducers because of differential phosphorylation patterns in the receptor C-terminal tail (the “barcode” hypothesis). Here, we identified the AT1R barcodes for the endogenous agonist AngII, which stimulates both G protein activation and β-arrestin recruitment, and for a synthetic biased agonist that only stimulates β-arrestin recruitment. The endogenous and β-arrestin–biased agonists induced two different ensembles of phosphorylation sites along the C-terminal tail. The phosphorylation of eight serine and threonine residues in the proximal and middle portions of the tail was required for full β-arrestin functionality, whereas phosphorylation of the serine and threonine residues in the distal portion of the tail had little influence on β-arrestin function. Similarly, molecular dynamics simulations showed that the proximal and middle clusters of phosphorylated residues were critical for stable β-arrestin–receptor interactions. These findings demonstrate that ligands that stabilize different receptor conformations induce different phosphorylation clusters in the C-terminal tail as barcodes to evoke distinct receptor-transducer engagement, receptor trafficking, and signaling.

Published
2024
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26. DEPRESCRIBING IN OLDER POLY‐TREATED PATIENTS AFFECTED WITH DEMENTIA: A SHARED EXPERIENCE BETWEEN UNIVERSITY AND TERRITORY.

Author

Gareri, Pietro, Gallelli, Luca, Palleria, Caterina, Gareri, Ilaria, and De Sarro, Giovambattista

Abstract

Introduction: The present study aimed to assess geriatric poly‐treated patients of the Center for Cognitive Disorders and Dementia of Catanzaro Lido, in collaboration with the School of Pharmacology, University of Catanzaro, Faculty of Medicine. We used the Beers, and STOPP & START criteria for assessing poly‐treatment and deprescribing in the population under investigation. Patients and Methods: In the time range between October 2021 and September 2022, we randomly assessed 205 patients, 114 outpatients, and 91 home care patients.The primary outcomes were: 1) deprescribing inappropriate drugs through the Beers and STOPP & START criteria;2) assessing duplicate drugs, and the risk of iatrogenic damage due to drug‐drug and drug‐disease interactions. Results: 69 men and 136 women, mean age of 82.7±7.4 years old, were studied. Of these, 91 patients were home care patients and 114 were outpatients. The average of the drugs used in the sample was 9.4 drugs/patient; after the first visit and the consequent deprescribing process, the average dropped to 8.7 drugs/patient (p = 0.04). Potentially inappropriate drugs were overall 74(36.1%). Of these, long half‐life benzodiazepines (8.8%), non‐steroidal anti‐inflammatory drugs in chronic use (> 15 days) (3.4%), tricyclic antidepressants (3.4%), first‐generation antihistamines (1.4%), anticholinergics (11.7%), ticlopidine (1.4%), prokinetics in chronic use (1.4%), digoxin at dosage > 0.125 mg (1.4%), amiodarone (0.97), a‐lytics (1.9%). The so‐called "duplicate" drugs were overall 26 (12.7%). 10 potentially dangerous prescriptions were found for interactions (4.8%). Discussion and conclusions: Applying the Beers and STOPP&START criteria can improve the use of drugs in the poly‐treated patient. We underline the importance of checking all the drugs taken periodically, discontinuing drugs with the lowest benefit/harm ratio and the lowest probability of adverse reactions due to withdrawal. Currently, there are no guidelines to properly address the management complexities of the older patient. Computer tools and properly trained teams (doctors, nurses, pharmacists) could identify, treat and prevent possible drug interactions. [ABSTRACT FROM AUTHOR]

Published
2023
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28. Teleconsultation by a nurse as preliminary approach to home visits in older patients affected with dementia.

Author

Gareri, Pietro, Pagano, Lucia, Nisticò, Michelangelo, and Armeli, Carmela

Abstract

Introduction: Telehealth uses video calling and other technologies to support patients and their caregivers at home. Teleconsultation by a nurse provides advantages for collecting information about older people's health. The present study was aimed to assess the benefits of teleconsultation by a nurse in older home patients affected with dementia. Patients and Methods: In the time range between January 1st and December 31th 2021, 851 requests for geriatric home multidimensional assessments were addressed to the Center for Cognitive Disorders and Dementia, Catanzaro Lido, ASP Catanzaro, Italy. Teleconsultation by a nurse was used as preliminary approach to patients affected with dementia when the request for having a home consultation by a geriatrician was not performed yet, due to the great overload even in time of pandemics, or for the difficulties of reaching people living in rural and mountain areas. The call was made to patient's caregiver who gave an informal and verbal consent to the interview. Tests administered included functional abilities in the activities of daily living (ADL and IADL); main disease and comorbidities, drugs taken by every patient were collected too. A simple questionnaire investigated the extent patient's caregiver appreciated this way of preliminary contact, according to the following scale: 0 = no appreciation; 1 = poor; 2 = sufficient; 3 = moderate; 4 = good; 5 = very good appreciation. Results: 130 older patients, 69 women and 61 men, mean age 79.2 ± 4.5 years old were tele‐consulted; mean ADL was 3.45 ± 0.91; IADL 0.96 ± 0.4. People were affected with Alzheimer's dementia in 39% out of the cases, vascular dementia 34%, mixed dementia 21%, other types of dementia 6%. Teleconsultation was overall appreciated, mean score 4.07 ± 0.23. Discussion and conclusions: Teleconsultation performed by a nurse is a fast and valuable opportunity for helping doctors in a preliminary assessment of older patients suffering from dementia. The opportunity of being monitored remotely may be particularly helpful for older adults with limited mobility and those living in rural areas. This modality of approach represents a new frontier in care and assistance to old frail people with dementia. [ABSTRACT FROM AUTHOR]

Published
2023
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29. Monitoring COVID-19 vaccine use in Italian long term care centers: The GeroCovid VAX study

Author

Angela Marie Abbatecola, Raffaele Antonelli Incalzi, Alba Malara, Annapina Palmieri, Anna Di Lonardo, Giorgio Fedele, Paola Stefanelli, Gilda Borselli, Marcello Russo, Marianna Noale, Stefano Fumagalli, Pietro Gareri, Enrico Mossello, Caterina Trevisan, Stefano Volpato, Fabio Monzani, Alessandra Coin, Giuseppe Bellelli, Chukwuma Okoye, Susanna Del Signore, Gianluca Zia, Elisa Bottoni, Carmine Cafariello, Graziano Onder, Abbatecola, A, Incalzi, R, Malara, A, Palmieri, A, Di Lonardo, A, Fedeli, G, Stefanelli, P, Borselli, G, Russo, M, Noale, M, Fumagalli, S, Gareri, P, Mossello, E, Trevisan, C, Volpato, S, Monzani, F, Coin, A, Bellelli, G, Okoye, C, Del Signore, S, Zia, G, Bottoni, E, Cafariello, C, and Onder, G

Subjects
Aged, 80 and over, COVID-19 Vaccines, Frailty, General Veterinary, General Immunology and Microbiology, SARS-CoV-2, Public Health, Environmental and Occupational Health, COVID-19, COVID-19 vaccine, Elderly, Frailty syndrome, GeroCovid Vax, Long term care (LTC), Nursing homes (NH), Safety, Aged, Humans, Long-Term Care, Infectious Diseases, 80 and over, Molecular Medicine
Abstract

The COVID-19 pandemic has changed routine care practice for older persons, especially in those with frailty living in long term care (LTC) facilities. Due to the high mortality rates of Nursing home (NH) residents during the first wave of the COVID-19 pandemic, priority for COVID-19 vaccinations was given to this vulnerable population. However, the safety and efficacy of such vaccines in older frail elders remains questionable due to the fact that initial randomized clinical trials (RCTs) for such vaccines did not include this population. This type of discrimination in patient participation in RCTs continues and has been recognized in the literature. Nevertheless, in the context of a worldwide emergency, COVID-19 vaccination in older persons living in LTC facilities may provide a solid basis to protect against negative outcomes, such as COVID-19 infection and death. In this report, we present the protocol of the GeroCovid Vax study, an Italian study that began in February 2021 which is aimed at investigating the safety and efficacy of the anti-SARS-CoV-2 vaccinations in older persons living in LTCs. This protocol specially aims to continuously and closely monitor events related to- and following- the anti-SARS-CoV-2 vaccination in elderly living in LTC facilities. In this report, we will provide information related to the study protocol and describe baseline characteristics of the sample.

Published
2022
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30. Efficacy of COVID-19 control measures on post-vaccination outbreak in Italian Long Term Care Facilities: implications for policies

Author

Malara, Alba, Noale, Marianna, Trevisan, Caterina, Abbatecola, Angela Marie, Borselli, Gilda, Cafariello, Carmine, Gareri, Pietro, Fumagalli, Stefano, Mossello, Enrico, Volpato, Stefano, Monzani, Fabio, Coin, Alessandra, Okoye, Chukwuma, Bellelli, Giuseppe, Del Signore, Stefania, Zia, Gianluca, Antonelli Incalzi, Raffaele, Palmieri, Annapina, Fedele, Giorgio, Onder, Graziano, Malara, A, Noale, M, Trevisan, C, Abbatecola, A, Borselli, G, Cafariello, C, Gareri, P, Fumagalli, S, Mossello, E, Volpato, S, Monzani, F, Coin, A, Okoye, C, Bellelli, G, Del Signore, S, Zia, G, Antonelli Incalzi, R, Palmieri, A, Fedele, G, and Onder, G

Subjects
COVID-19 vaccination, pandemic fatigue, outbreak control measure, Public Health, Environmental and Occupational Health, SARS CoV-2 infection, Long Term Care Facilities (LTCFS)
Abstract

BackgroundNumerous individual and organizational factors can influence the spread of SARS-CoV-2 infection in Long Term Care Facilities (LTCFs). A range of outbreak control measures are still implemented in most facilities involving administrations, staff, residents and their families. This study aims to evaluate which measure could influence the transmission of SARS-CoV-2 infection among residents during the period March 2021-June 2022. MethodsWe enrolled 3,272 residents aged >= 60 years. The outbreak control measures adopted to prevent or manage the infection included entry regulations, contact-regulating procedures, and virological surveillance of residents and staff. The association between LTCFs' and participants' characteristics with new cases of COVID-19 infections was analyzed using multilevel logistic regression models. ResultsIn 33.8% of the facilities 261 cases of SARS-CoV-2 infection were reported. Among participant characteristics, gender and age were not associated with SARS-CoV-2 infection, while having received the vaccine booster dose was protective against infection [Odds Ratio (OR) = 0.34, 95% Confidence Interval (CI) 0.12-0.99, p = 0.048]. In addition, the implementation of protected areas for family visits was associated with a significant reduction of the probability of infections (OR = 0.18, 95% CI 0.03-0.98, p = 0.047). Overall, about 66% of the variability in the probability of SARS-CoV-2 infection during the observational period may be due to facility structure characteristics and 34% to the participant characteristics. ConclusionsThese data showed that vaccination booster doses and family visit restriction-control are still needed to make the LTCFs safer against SARS-CoV-2 infection.

Published
2023

31. COVID-19 Signs and Symptom Clusters in Long-Term Care Facility Residents: Data from the GeroCovid Observational Study

Author

Malara, Alba, Noale, Marianna, Abbatecola, Angela Marie, Borselli, Gilda, Cafariello, Carmine, Fumagalli, Stefano, Gareri, Pietro, Mossello, Enrico, Trevisan, Caterina, Volpato, Stefano, Monzani, Fabio, Coin, Alessandra, Bellelli, Giuseppe, Okoye, Chukwuma, Del Signore, Stefania, Zia, Gianluca, Incalzi, Raffaele Antonelli, Malara, A, Noale, M, Abbatecola, A, Borselli, G, Cafariello, C, Fumagalli, S, Gareri, P, Mossello, E, Trevisan, C, Volpato, S, Monzani, F, Coin, A, Bellelli, G, Okoye, C, Del Signore, S, Zia, G, and Incalzi, R

Subjects
gerocovid observational study, symptoms cluster, COVID-19, Electrical and Electronic Engineering, long term care facilitie, Atomic and Molecular Physics, and Optics, long term care facilities
Abstract

Background: Long-term care facility (LTCF) residents often present asymptomatic or paucisymptomatic features of SARS-CoV-2 infection. We aimed at investigating signs/symptoms, including their clustering on SARS-CoV-2 infection and mortality rates associated with SARS-CoV-2 infection in LTCF residents. Methods: This is a cohort study of 586 aged ≥ 60 year-old residents at risk of or affected with COVID-19 enrolled in the GeroCovid LTCF network. COVID-19 signs/symptom clusters were identified using cluster analysis. Cluster analyses associated with SARS-CoV-2 infection and mortality were evaluated using logistic regression and Cox proportional hazard models. Results: Cluster 1 symptoms (delirium, fever, low-grade fever, diarrhea, anorexia, cough, increased respiratory rate, sudden deterioration in health conditions, dyspnea, oxygen saturation, and weakness) affected 39.6% of residents and were associated with PCR swab positivity (OR = 7.21, 95%CI 4.78–10.80; p < 0.001). Cluster 1 symptoms were present in deceased COVID-19 residents. Cluster 2 (increased blood pressure, sphincter incontinence) and cluster 3 (new-onset cognitive impairment) affected 20% and 19.8% of residents, respectively. Cluster 3 symptoms were associated with increased mortality (HR = 5.41, 95%CI 1.56–18.8; p = 0.008), while those of Cluster 2 were not associated with mortality (HR = 0.82, 95%CI 0.26–2.56; p = 730). Conclusions: Our study highlights that delirium, fever, and low-grade fever, alone or in clusters should be considered in identifying and predicting the prognosis of SARS-CoV-2 infection in older LTCF patients.

Published
2022

32. Covid-19 as a paradigmatic model of the heterogeneous disease presentation in older people: data from the GeroCovid Observational study

Author

Caterina, Trevisan, Francesca, Remelli, Stefano, Fumagalli, Enrico, Mossello, Chukwuma, Okoye, Giuseppe, Bellelli, Alessandra, Coin, Alba, Malara, Pietro, Gareri, Fabio, Monzani, Susanna, Del Signore, Gianluca, Zia, Raffaele, Antonelli Incalzi, Stefano, Volpato, Sonia, Zotti, Trevisan, C, Remelli, F, Fumagalli, S, Mossello, E, Okoye, C, Bellelli, G, Coin, A, Malara, A, Gareri, P, Monzani, F, Del Signore, S, Zia, G, Antonelli Incalzi, R, and Volpato, S

Subjects
Aged, 80 and over, Male, Aging, SARS-CoV-2, signs and symptom, Delirium, COVID-19, Syndrome, mortality, aged, Dyspnea, cluster analysi, Humans, Female, Geriatrics and Gerontology
Abstract

COVID-19 may have a heterogeneous onset, especially in older age. However, whether and how COVID-19 signs and symptoms may present and aggregate together according to sociodemographic and health factors is unclear, as well as their prognostic value. This study included 981 COVID-19 inpatients who participated in the GeroCovid Observational study. Signs/symptoms at disease onset, sociodemographic, health, cognitive status, and mobility were systematically recorded. Clusters of signs/symptoms were identified through agglomerative hierarchical clustering. The associations of single signs/symptoms and symptom clusters with longer hospitalization (≥16 days) and in-hospital mortality were explored through logistic and Cox regressions. The signs/symptoms most reported in our sample (age 78.3 ± 9.39 years; 49.4% women) were fever (62.5%), cough (45.5%), and dyspnea (62.7%). Atypical symptoms were reported by up to one-third of patients, and delirium by 9.1%. Atypical symptoms were more frequent with advancing age and with lower pre-COVID-19 cognitive and mobility levels. Older men more likely reported respiratory symptoms than women. Dyspnea (hazard ratio [HR] = 1.47, 95% confidence interval [CI]: 1.02-2.12), tachypnea (HR = 1.53, 95% CI: 1.14-2.07), low oxygen saturation (HR = 1.95, 95% CI: 1.32-2.88) and delirium (HR = 1.60, 95% CI: 1.13-2.28) were associated with higher in-hospital mortality. Four symptom clusters were identified. Compared with the mild respiratory symptoms cluster, the severe clinical impairment cluster was associated with higher mortality (HR = 2.57, 95% CI: 1.58-4.18). The severe clinical impairment and aspecific symptoms clusters were associated with longer hospitalization (odds ratio [OR] = 2.38, 95% CI: 1.56-3.63, and OR = 1.75, 95% CI: 1.08-2.83, respectively). Multiple health aspects influence COVID-19 clinical presentation. A symptom clusters approach may help predict adverse health outcomes in older patients. In addition to respiratory symptoms, delirium is independently associated with mortality risk. ClinicalTrials.gov (NCT04379440).

Published
2022

33. Disentangling the impact of COVID-19 infection on clinical outcomes and preventive strategies in older persons: An Italian perspective

Author

Elisa Bottoni, Raffaele Antonelli Incalzi, Annapina Palmieri, Marianna Noale, Gianluca Zia, Alessandra Coin, GeroCovid Observational, Alba Malara, Gilda Borselli, Enrico Mossello, Pietro Gareri, Stefano Volpato, Stefano Fumagalli, Fabio Monzani, Caterina Trevisan, Anna Di Lonardo, Angela Marie Abbatecola, Chukwuma Okoye, Marcello Russo, Giuseppe Bellelli, Susanna Del Signore, Graziano Onder, Carmine Cafariello, Abbatecola, A, Antonelli Incalzi, R, Malara, A, Palmieri, A, Di Lonardo, A, Borselli, G, Russo, M, Noale, M, Fumagalli, S, Gareri, P, Mossello, E, Trevisan, C, Volpato, S, Monzani, F, Coin, A, Bellelli, G, Okoye, C, Del Signore, S, Zia, G, Bottoni, E, Cafariello, C, and Onder, G

Subjects
Gerontology, Aging, Elderly, Coronavirus disease 2019 (COVID-19), Italy, Depression, Perspective (graphical), COVID-19, Geriatrics and Gerontology, Psychology, Vaccines in long term care
Abstract

Italy was one of the first western countries to embrace the first wave of COVID-19 and undergo detrimental outcomes in older adults in different clinical settings, especially in those with comorbidity and frailty. In addition, older nursing home (NH) residents had significantly higher mortality rates most likely due to the increased susceptibility of infection due to combined physical vulnerability and risks linked to the NH living environment itself. Different reports throughout Italy have rapidly highlighted selected outcomes related to COVID-19 in older patients being treated in acute and long-term care (LTC) settings. However, the majority of these studies are single center studies. Thus, it remains fundamental to collect large data from prospective based-population studies in order to identify preventive and therapeutic COVID-19 risk/protective factors correlated with COVID-19 health status outcomes. In this commentary paper, we will discuss different Italian reports according to clinical settings and highlight the importance of GeroCovid Observational and GeroCovid Vax, two large population based prospective studies in Italy.

Published
2022

34. Management of Older Outpatients during the COVID-19 Pandemic: The GeroCovid Ambulatory Study

Author

Stefano Volpato, Gianluca Zia, Pietro Gareri, Alessandra Coin, Alba Malara, Valeria Calsolaro, Stefano Fumagalli, Anette Hylen Ranhoff, Caterina Trevisan, Giuseppe Bellelli, Susanna Del Signore, Enrico Mossello, Raffaele Antonelli Incalzi, Gareri, P, Fumagalli, S, Malara, A, Mossello, E, Trevisan, C, Volpato, S, Coin, A, Calsolaro, V, Bellelli, G, Del Signore, S, Zia, G, Ranhoff, A, and Incalzi, R

Subjects
Aging, medicine.medical_specialty, Activities of daily living, Home care patient, Socio-culturale, Older patient, Quality of life (healthcare), Rating scale, Outpatients, medicine, Older patients, COVID-19, GeroCovid study, Home care patients, business.industry, Outpatient, Mood, Cohort, Ambulatory, Physical therapy, Anxiety, Geriatric Depression Scale, Clinical Section: Brief Report, Geriatrics and Gerontology, medicine.symptom, business
Abstract

Objectives: The GeroCovid Study is a multi-setting, multinational, and multi-scope registry that includes the GeroCovid home and outpatients’ care cohort. The present study aims to evaluate whether outpatient and home care services with remote monitoring and consultation could mitigate the impact of the COVID-19 pandemic on mental and affective status, perceived well-being, and personal capabilities of outpatients and home care patients with cognitive disorders. Methods: Prospectively recorded patients in an electronic web registry provided by BlueCompanion Ltd. Up to October 31, 2020, the sample included 90 patients receiving regular care from the Center for Cognitive Disorders and Dementia in Catanzaro Lido, Italy. It was made of 52 ambulatory outpatients and 38 home care patients, mean age 83.3 ± 7.54 years. Participants underwent a multidimensional assessment at baseline (T0) and after 90 days (T1). For each patient, we administered the Mini-Mental State Examination (MMSE) for cognitive functions, the Activities of Daily Living (ADL) and Instrumental ADL (IADL) scales for functional capabilities, the Cumulative Illness Rating Scale (CIRS) for comorbidities and their impact on patients’ health, the 5-items Geriatric Depression Scale (GDS) for mood, and the Euro Quality of Life (EuroQoL) for perceived quality of life. Contacts with both ambulatory and home care patients were managed in person or via telephone, preferably through video calls (WhatsApp or FaceTime). Results: Contacts with patients were kept at T0 through telephone. At T1, visits were made in person for over 95% out of the cases. The ADL, IADL, CIRS, GDS, MMSE, and EuroQoL changed slightly between T0 and T1. Most of the patients were clinically stable over time on the majority of the scales explored, but behavioral changes were found in 24.4% of patients and anxiety and insomnia in 17.7% of patients. Conclusion: Our study suggests that contacts through telephone and video consultations are likely associated with a health status preservation of the patients.

Published
2022

36. Real-World Use of Trazodone in Older Persons in Long Term Care Setting: A Retrospective Study.

Author

Coin A, Malara A, Noale M, Trevisan C, Devita M, Abbatecola AM, Gareri P, Del Signore S, Bellelli G, Fumagalli S, Monzani F, Mossello E, Volpato S, Zia G, and Antonelli Incalzi R

Subjects
Humans, Aged, Male, Female, Aged, 80 and over, Cross-Sectional Studies, Retrospective Studies, Sleep Initiation and Maintenance Disorders drug therapy, Dementia drug therapy, Middle Aged, Antidepressive Agents, Second-Generation therapeutic use, Antidepressive Agents, Second-Generation adverse effects, SARS-CoV-2, Depression drug therapy, Trazodone therapeutic use, Trazodone adverse effects, COVID-19, Long-Term Care
Abstract

Background: Trazodone, an antidepressant drug is also largely used in several medical contexts. Insomnia, behavioral disorders, and anxiety may be underlying symptoms for prescribing trazodone. This cross-sectional study aims to identify reasons for trazodone prescription, assess the efficacy, as well as identify any related side effects in older persons living in long term care facilities (LTCFs)., Methods: Older adults aged ≥ 60 years, at risk of or affected with Covid-19 and enrolled in the GeroCovid Observational study from LTCFs, and using trazodone were included. A structured questionnaire was administered to treating physicians regarding reasons for trazodone prescription, discontinuation, possible adverse events and benefits., Results: Thirty-seven out 74 LTCFs participating in both the GeroCovid and GeroCovid Vax studies completed the questionnaire regarding trazodone use. Of the 427 participants included in this study analysis, we found that 43% had diagnoses of dementia and depression, 33% had dementia, no behavioral and psychological symptoms of dementia (BPSD) and no depression, 14% had dementia with BPSD and no depression, and < 11% had only depression. The main reasons for trazodone prescription included agitation, insomnia, depression and anxiety. Trazodone use was reported as partially or totally effective in more than 90% of participants using the drug. Falls were the most frequent adverse event (30% of participants)., Conclusions: Our data suggest that trazodone behaves as an eclectic antidepressant that, in the clinical practice, may also be used for BPSD and insomnia, especially in older people with dementia., (© 2024 John Wiley & Sons Ltd.)

Published
2024
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37. Deprescribing in Older Poly-Treated Patients Affected with Dementia.

Author

Gareri P, Gallelli L, Gareri I, Rania V, Palleria C, and De Sarro G

Abstract

Polypharmacy is an important issue in older patients affected by dementia because they are very vulnerable to the side effects of drugs'. Between October 2021 and September 2022, we randomly assessed 205 old-aged outpatients. The study was carried out in a Center for Dementia in collaboration with a university center. The primary outcomes were: (1) deprescribing inappropriate drugs through the Beers and STOPP&START criteria; (2) assessing duplicate drugs and the risk of iatrogenic damage due to drug-drug and drug-disease interactions. Overall, 69 men and 136 women (mean age 82.7 ± 7.4 years) were assessed. Of these, 91 patients were home care patients and 114 were outpatient. The average number of the drugs used in the sample was 9.4 drugs per patient; after the first visit and the consequent deprescribing process, the average dropped to 8.7 drugs per patient ( p = 0.04). Overall, 74 potentially inappropriate drugs were used (36.1%). Of these, long half-life benzodiazepines (8.8%), non-steroidal anti-inflammatory drugs (3.4%), tricyclic antidepressants (3.4%), first-generation antihistamines (1.4%), anticholinergics (11.7%), antiplatelet drugs (i.e., ticlopidine) (1.4%), prokinetics in chronic use (1.4%), digoxin (>0.125 mg/day) (1.4%), antiarrhythmics (i.e., amiodarone) (0.97%), and α-blockers (1.9%) were included. The so-called "duplicate" drugs were overall 26 (12.7%). In total, ten potentially dangerous prescriptions were found for possible interactions (4.8%). We underline the importance of checking all the drugs taken periodically and discontinuing drugs with the lowest benefit-to-harm ratio and the lowest probability of adverse reactions due to withdrawal. Computer tools and adequately trained teams (doctors, nurses, and pharmacists) could identify, treat, and prevent possible drug interactions.

Published
2024
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38. Citicoline: A Cholinergic Precursor with a Pivotal Role in Dementia and Alzheimer's Disease.

Author

Gareri P, Cotroneo AM, Montella R, Gaglianone M, and Putignano S

Subjects
Humans, Male, Female, Aged, Aged, 80 and over, Activities of Daily Living, Dementia drug therapy, Dementia psychology, Nootropic Agents therapeutic use, Drug Therapy, Combination, Mental Status and Dementia Tests, Treatment Outcome, Cytidine Diphosphate Choline therapeutic use, Memantine therapeutic use, Cholinesterase Inhibitors therapeutic use, Alzheimer Disease drug therapy, Alzheimer Disease psychology
Abstract

Background: Citicoline is a naturally occurring compound with pleiotropic effects on neuronal function and cognitive processes., Objective: Based on previous studies, which shed light on the positive effects of citicoline 1 g when combined with acetylcholinesterase inhibitors (AChEIs) and/or memantine, we further investigated the benefits of citicoline in combination therapy in Alzheimer's disease and mixed dementia., Methods: We integrated the datasets of CITIMEM and CITIDEMAGE, increasing the overall sample size to enhance statistical power. We analyzed data from these two investigator-initiated studies involving 295 patients. The primary outcome was the assessment over time of the effects of combined treatment versus memantine given alone or AChEI plus memantine on cognitive functions assessed by Mini-Mental State Examination (MMSE). The secondary outcomes were the influence of combined treatment on daily life functions, mood, and behavioral symptoms assessed by activities of daily life (ADL) and instrumental ADL, Geriatric Depression Scale, and Neuropsychiatric Inventory Scale. One-hundred-forty-three patients were treated with memantine and/or AChEI (control group), and 152 patients were treated with memantine and/or AChEI plus citicoline 1 g/day orally (Citicoline group)., Results: A significant difference in MMSE score was found in the average between the two groups of treatment at 6 and 12 months., Conclusions: This study confirmed the effectiveness of combined citicoline treatment in patients with mixed dementia and Alzheimer's disease, with a significant effect on the increase of MMSE score over time. The treated group also showed a significant reduction in the Geriatric Depression Scale and a significant increase in the instrumental ADL scale.

Published
2024
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39. Frailty, psychological well-being, and social isolation in older adults with cognitive impairment during the SARS-CoV-2 pandemic: data from the GeroCovid initiative.

Author

Terziotti C, Ceolin C, Devita M, Raffaelli C, Antenucci S, Bazzano S, Capasso A, Castellino M, Signore SD, Lubian F, Maiotti M, Monacelli F, Mormile MT, Sgarito C, Vella F, Sergi G, Gareri P, Trevisan C, Bellio A, Fini F, Malara A, Mossello E, Fumagalli S, Volpato S, Monzani F, Bellelli G, Zia G, Incalzi RA, and Coin A

Subjects
Humans, Female, Aged, Aged, 80 and over, Male, Activities of Daily Living, SARS-CoV-2, Pandemics, Psychological Well-Being, Communicable Disease Control, Social Isolation, Frail Elderly, Geriatric Assessment, Frailty epidemiology, Frailty diagnosis, COVID-19 epidemiology, Cognitive Dysfunction epidemiology
Abstract

Background: The containment measures linked to the COVID-19 pandemic negatively affected the phyco-physical well-being of the population, especially older adults with neurocognitive disorders (NCDs). This study aims to evaluate whether the frailty of NCD patients was associated with different changes in multiple health domains, in particular in relation to loneliness and social isolation, pre- and post-lockdown., Materials and Methods: Patients were recruited from 10 Italian Centers for Cognitive Disorders and Dementia. Data were collected in the pre-pandemic period (T0), during the pandemic lockdown (T1), and 6-9 months post-lockdown (T2). The UCLA Loneliness Scale-3, Activities of Daily Living (ADL), Instrumental ADL (IADL), Mini-Mental State Examination, and Neuropsychiatric Inventory (NPI) were administered. Caregivers' burden was also tested. Patients were categorized as non-frail, pre-frail, and frail according to the Fatigue, Resistance, Ambulation, Illness, and Loss of Weight scale., Results: The sample included 165 subjects (61.9% women, mean age 79.5 ± 4.9 years). In the whole sample, the ADL, IADL, and NPI scores significantly declined between T0 and T2. There were no significative variations in functional and cognitive domains between the frail groups. During lockdown we recorded higher Depression Anxiety Stress Scales and Perceived Stress Scale scores in frail people. In multivariable logistic regression, frailty was associated with an increase in social isolation, and a loss of IADL., Conclusions: We observed a global deterioration in functional and neuro-psychiatric domains irrespective of the degree of frailty. Frailty was associated with the worsening of social isolation during lockdown. Frail patients and their caregivers seemed to experience more anxiety and stress disorders during SARS-CoV-2 pandemic., (© 2023 The Authors. Psychogeriatrics published by John Wiley & Sons Australia, Ltd on behalf of Japanese Psychogeriatric Society.)

Published
2023
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40. Efficacy of COVID-19 control measures on post-vaccination outbreak in Italian Long Term Care Facilities: implications for policies.

Author

Malara A, Noale M, Trevisan C, Abbatecola AM, Borselli G, Cafariello C, Gareri P, Fumagalli S, Mossello E, Volpato S, Monzani F, Coin A, Okoye C, Bellelli G, Del Signore S, Zia G, Antonelli Incalzi R, Palmieri A, Fedele G, and Onder G

Subjects
Humans, Long-Term Care methods, SARS-CoV-2, Policy, Disease Outbreaks prevention & control, Vaccination, COVID-19 epidemiology, COVID-19 prevention & control
Abstract

Background: Numerous individual and organizational factors can influence the spread of SARS-CoV-2 infection in Long Term Care Facilities (LTCFs). A range of outbreak control measures are still implemented in most facilities involving administrations, staff, residents and their families. This study aims to evaluate which measure could influence the transmission of SARS-CoV-2 infection among residents during the period March 2021-June 2022., Methods: We enrolled 3,272 residents aged ≥60 years. The outbreak control measures adopted to prevent or manage the infection included entry regulations, contact-regulating procedures, and virological surveillance of residents and staff. The association between LTCFs' and participants' characteristics with new cases of COVID-19 infections was analyzed using multilevel logistic regression models., Results: In 33.8% of the facilities 261 cases of SARS-CoV-2 infection were reported. Among participant characteristics, gender and age were not associated with SARS-CoV-2 infection, while having received the vaccine booster dose was protective against infection [Odds Ratio (OR) = 0.34, 95% Confidence Interval (CI) 0.12-0.99, p = 0.048]. In addition, the implementation of protected areas for family visits was associated with a significant reduction of the probability of infections (OR = 0.18, 95% CI 0.03-0.98, p = 0.047). Overall, about 66% of the variability in the probability of SARS-CoV-2 infection during the observational period may be due to facility structure characteristics and 34% to the participant characteristics., Conclusions: These data showed that vaccination booster doses and family visit restriction-control are still needed to make the LTCFs safer against SARS-CoV-2 infection., Competing Interests: SD was employed by Bluecompanion Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Malara, Noale, Trevisan, Abbatecola, Borselli, Cafariello, Gareri, Fumagalli, Mossello, Volpato, Monzani, Coin, Okoye, Bellelli, Del Signore, Zia, Antonelli Incalzi, Palmieri, Fedele, Onder and The GeroCovid Vax Working Group.)

Published
2023
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42. Health trajectories in older patients hospitalized for COVID-19: Results from the GeroCovid multicenter study.

Author

Trevisan C, Tonarelli F, Zucchelli A, Parrotta I, Calvani R, Malara A, Monzani F, Gareri P, Zia G, and Antonelli Incalzi R

Subjects
Humans, Male, Female, Aged, Aged, 80 and over, Hospitalization, Hospitals, Patient Discharge, Disease Progression, Retrospective Studies, COVID-19 epidemiology
Abstract

Background: COVID-19 has disproportionately affected older adults. Yet, healthcare trajectories experienced by older persons hospitalized for COVID-19 have not been investigated. This study aimed at estimating the probabilities of transitions between severity states in older adults admitted in COVID-19 acute wards and at identifying the factors associated with such dynamics., Methods: COVID-19 patients aged ≥60 years hospitalized between March and December 2020 were involved in the multicentre GeroCovid project-acute wards substudy. Sociodemographic and health data were obtained from medical records. Clinical states during hospitalization were categorized on a seven-category scale, ranging from hospital discharge to death. Based on the transitions between these states, first, we defined patients' clinical course as positive (only improvements), negative (only worsening), or fluctuating (both improvements and worsening). Second, we focused on the single transitions between clinical states and estimated their probability (through multistage Markov modeling) and associated factors (with proportional intensity models)., Results: Of the 1024 included patients (mean age 78.1 years, 51.1% women), 637 (62.2%) had a positive, 66 (6.4%) had a fluctuating, and 321 (31.3%) had a negative clinical course. Patients with a fluctuating clinical course were younger, had better mobility and cognitive levels, fewer diseases, but a higher prevalence of cardiovascular disease and obesity. Considering the single transitions, the probability that older COVID-19 patients experienced clinical changes was higher within a 10-day timeframe, especially for milder clinical states. Older age, male sex, lower mobility level, multimorbidity, and hospitalization during the COVID-19 first wave (compared with the second one) were associated with an increased probability of progressing towards worse clinical states or with a lower recovery., Conclusion: COVID-19 in older inpatients has a complex and dynamic clinical course. Identifying individuals more likely to experience a fluctuating clinical course and sudden worsening may help organize healthcare resources and clinical management across settings at different care intensity levels., Competing Interests: Declaration of competing interest Authors declare no conflict of interests for this article., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Published
2023
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43. Efficacy of OM-85 in Recurrent Respiratory Tract Infections.

Author

Gareri P, Trevisan C, Abbatecola AM, Malara A, and Incalzi RA

Subjects
Humans, Aged, Longitudinal Studies, SARS-CoV-2, Research Design, COVID-19, Respiratory Tract Infections drug therapy, Respiratory Tract Infections prevention & control
Abstract

Background: In older patients, prevention of acute respiratory tract infections (RTIs) is challenging. Experimental studies have consistently underlined an immune-potentiating effect of the bacterial lysates product OM85, on both cellular and humoral responses., Objective: This work aimed to assess the potential efficacy of OM-85 for RTIs' prevention in older individuals., Methods: This explorative longitudinal study included 24 patients aged 65 years or older recruited in the GeroCovid Observational Study- home and outpatient care cohort. For the study purposes, we included 8 patients treated with OM-85 from December 2020 to June 2021 (group A), and a control group of 16 patients, matched for sex and age, who did not receive bacterial lysates (group B). RTIs were recorded from the participants' medical documentation in an e-registry from March 2020 to December 2021., Results: In 2020, group A experienced a total of 8 RTIs, which affected 6 out of 8 patients (75%); group B reported 21 RTIs, with at least one event in 11 out of 16 patients (68.7%). In 2021, RTIs affected 2 out of 8 patients (25%) in group A (p < 0.02), and 13 out of 16 patients (81.2%) in group B (within this group, 5 patients had two RTIs). The RTIs' cumulative incidence over the observation period significantly differed between groups (66.7% in group A vs. 24.3% in group B; p < 0.002), as well as the decrease in RTIs frequency from 2020 to 2021. No patients in group A were affected by COVID-19 during the observation period, while among controls, two patients had SARS-CoV-2 infection, notwithstanding three doses of vaccine., Conclusion: This study suggests that bacterial lysates may provide clinical benefits for preventing RTIs. Additional research involving larger cohorts is required to verify the effectiveness of OM-85 in preventing RTIs in older adults., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Published
2023
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44. Citicoline: pharmacological and clinical review, 2022 update.

Author

Secades JJ and Gareri P

Subjects
Humans, Cytidine Diphosphate Choline pharmacology, Cytidine Diphosphate Choline therapeutic use, Nootropic Agents pharmacology, Nootropic Agents therapeutic use, Stroke drug therapy, Cognitive Dysfunction drug therapy, Brain Injuries, Traumatic drug therapy
Abstract

This review is based on the previous one published in 2016 (Secades JJ. Citicoline: pharmacological and clinical review, 2016 update. Rev Neurol 2016; 63 (Supl 3): S1-S73), incorporating 176 new references, having all the information available in the same document to facilitate the access to the information in one document. This review is focused on the main indications of the drug, as acute stroke and its sequelae, including the cognitive impairment, and traumatic brain injury and its sequelae. There are retrieved the most important experimental and clinical data in both indications.

Published
2022
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45. Validation of PARADISE 24 and Development of PARADISE-EDEN 36 in Patients with Dementia.

Author

Talarico F, Fellinghauer C, De Biase GA, Gareri P, Capurso S, Moneti P, Caruso A, Chiatante V, Gentile E, Malerba M, Marsico L, Mauro M, Magro M, Melendugno A, Pirrotta F, Putrino L, Putrino C, Propati A, Rotondaro V, Spadea F, Villella A, and Malara A

Subjects
Cross-Sectional Studies, Disability Evaluation, Humans, Psychometrics, Brain Diseases, Dementia, Persons with Disabilities
Abstract

Dementia was one of the conditions focused on in an EU (European Union) project called "PARADISE" (Psychosocial fActors Relevant to brAin DISorders in Europe) that later produced a measure called PARADISE 24, developed within the biopsychosocial model proposed in the International Classification of Functioning Disability and Health (ICF). The aims of this study are to validate PARADISE 24 on a wider sample of patients with mild to moderate dementia to expand PARADISE 24 by defining a more specific scale for dementia, by adding 18 questions specifically selected for dementia, which eventually should be reduced to 12. We enrolled 123 persons with dementia, recruited between July 2017 and July 2019 in home care and long-term care facilities, in Italy, and 80 participants were recruited in Warsaw between January and July 2012 as part of a previous cross-sectional study. The interviews with the patient and/or family were conducted by health professionals alone or as a team by using the Paradise data collection protocol. The psychometric analysis with the Rasch analysis has shown that PARADISE 24 and the selection of 18 additional condition-specific items can be expected to have good measurement properties to assess the functional state in persons with dementia.

Published
2022
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46. COVID-19 as a Paradigmatic Model of the Heterogeneous Disease Presentation in Older People: Data from the GeroCovid Observational Study.

Author

Trevisan C, Remelli F, Fumagalli S, Mossello E, Okoye C, Bellelli G, Coin A, Malara A, Gareri P, Monzani F, Del Signore S, Zia G, Antonelli Incalzi R, and Volpato S

Subjects
Aged, Aged, 80 and over, Dyspnea, Female, Humans, Male, SARS-CoV-2, Syndrome, COVID-19, Delirium
Abstract

COVID-19 may have a heterogeneous onset, especially in older age. However, whether and how COVID-19 signs and symptoms may present and aggregate together according to sociodemographic and health factors is unclear, as well as their prognostic value. This study included 981 COVID-19 inpatients who participated in the GeroCovid Observational study. Signs/symptoms at disease onset, sociodemographic, health, cognitive status, and mobility were systematically recorded. Clusters of signs/symptoms were identified through agglomerative hierarchical clustering. The associations of single signs/symptoms and symptom clusters with longer hospitalization (≥16 days) and in-hospital mortality were explored through logistic and Cox regressions. The signs/symptoms most reported in our sample (age 78.3 ± 9.39 years; 49.4% women) were fever (62.5%), cough (45.5%), and dyspnea (62.7%). Atypical symptoms were reported by up to one-third of patients, and delirium by 9.1%. Atypical symptoms were more frequent with advancing age and with lower pre-COVID-19 cognitive and mobility levels. Older men more likely reported respiratory symptoms than women. Dyspnea (hazard ratio [HR] = 1.47, 95% confidence interval [CI]: 1.02-2.12), tachypnea (HR = 1.53, 95% CI: 1.14-2.07), low oxygen saturation (HR = 1.95, 95% CI: 1.32-2.88) and delirium (HR = 1.60, 95% CI: 1.13-2.28) were associated with higher in-hospital mortality. Four symptom clusters were identified. Compared with the mild respiratory symptoms cluster, the severe clinical impairment cluster was associated with higher mortality (HR = 2.57, 95% CI: 1.58-4.18). The severe clinical impairment and aspecific symptoms clusters were associated with longer hospitalization (odds ratio [OR] = 2.38, 95% CI: 1.56-3.63, and OR = 1.75, 95% CI: 1.08-2.83, respectively). Multiple health aspects influence COVID-19 clinical presentation. A symptom clusters approach may help predict adverse health outcomes in older patients. In addition to respiratory symptoms, delirium is independently associated with mortality risk. ClinicalTrials.gov (NCT04379440).

Published
2022
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47. Management of Older Outpatients during the COVID-19 Pandemic: The GeroCovid Ambulatory Study.

Author

Gareri P, Fumagalli S, Malara A, Mossello E, Trevisan C, Volpato S, Coin A, Calsolaro V, Bellelli G, Del Signore S, Zia G, Ranhoff AH, and Incalzi RA

Subjects
Aged, Aged, 80 and over, Humans, Outpatients, Pandemics, Quality of Life, Activities of Daily Living, COVID-19 epidemiology
Abstract

Objectives: The GeroCovid Study is a multi-setting, multinational, and multi-scope registry that includes the GeroCovid home and outpatients' care cohort. The present study aims to evaluate whether outpatient and home care services with remote monitoring and consultation could mitigate the impact of the COVID-19 pandemic on mental and affective status, perceived well-being, and personal capabilities of outpatients and home care patients with cognitive disorders., Methods: Prospectively recorded patients in an electronic web registry provided by BlueCompanion Ltd. Up to October 31, 2020, the sample included 90 patients receiving regular care from the Center for Cognitive Disorders and Dementia in Catanzaro Lido, Italy. It was made of 52 ambulatory outpatients and 38 home care patients, mean age 83.3 ± 7.54 years. Participants underwent a multidimensional assessment at baseline (T0) and after 90 days (T1). For each patient, we administered the Mini-Mental State Examination (MMSE) for cognitive functions, the Activities of Daily Living (ADL) and Instrumental ADL (IADL) scales for functional capabilities, the Cumulative Illness Rating Scale (CIRS) for comorbidities and their impact on patients' health, the 5-items Geriatric Depression Scale (GDS) for mood, and the Euro Quality of Life (EuroQoL) for perceived quality of life. Contacts with both ambulatory and home care patients were managed in person or via telephone, preferably through video calls (WhatsApp or FaceTime)., Results: Contacts with patients were kept at T0 through telephone. At T1, visits were made in person for over 95% out of the cases. The ADL, IADL, CIRS, GDS, MMSE, and EuroQoL changed slightly between T0 and T1. Most of the patients were clinically stable over time on the majority of the scales explored, but behavioral changes were found in 24.4% of patients and anxiety and insomnia in 17.7% of patients., Conclusion: Our study suggests that contacts through telephone and video consultations are likely associated with a health status preservation of the patients., (© 2021 S. Karger AG, Basel.)

Published
2022
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49. An Overview of Combination Treatment with Citicoline in Dementia.

Author

Gareri P, Veronese N, and Cotroneo AM

Subjects
Acetylcholinesterase, Aged, Cholinesterase Inhibitors therapeutic use, Humans, Memantine therapeutic use, Prospective Studies, Alzheimer Disease drug therapy, Alzheimer Disease psychology, Cytidine Diphosphate Choline therapeutic use
Abstract

Introduction: The present article reports an overview of the studies about combination treatment with citicoline of Alzheimer's (AD) and mixed dementia (MD)., Methods: A Medline search was carried out by using the keywords Alzheimer's dementia, mixed dementia, older people, treatment with citicoline, memantine, and acetylcholinesterase inhibitors (AchEIs)., Results: Six studies were found to match the combination treatment of citicoline with AcheIs and/or memantine. The CITIRIVAD and CITICHOLINAGE studies were the first to report the potential benefits of adding citicoline to acetylcholinesterase inhibitors (AchEIs). Then, we added citicoline to memantine in the CITIMEM study, and finally, we demonstrated benefits in terms of delay in cognitive worsening with the triple therapy (citicoline + AchEIs + memantine). Other authors also reinforced our hypothesis through two further studies., Conclusion: Open, prospective studies are advised to confirm the utility of combination therapy with citicoline for the treatment of AD and MD., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Published
2022
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