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The article presents abstracts from the Special San Raffaele-Tosinvest Scholar Award Symposium at the 14th World Congress of the International Association for the Scientific Study of Intellectual Disabilities on topics related to developmental disabilities including lessening disparities in healthcare provisions to the developmentally disabled, bereavement in the developmentally disabled and a study of age-related behavioral changes.

The article presents the author's views about the Fourth Stromboli Conference on Aging and Cancer that was held on the island of Stromboli, Italy. The author says that Walter Pierpaoli, organizer of the conference has done a splendid job of assembling highly qualified clinicians and scientists from the four corners of the world. The author further said that most of the papers were excellent, adding to the scientific basis for future clinical improvements in the treatment of cancer and aging.

The article presents the author's views about the Fourth Stromboli Conference on Aging and Cancer that was held on the island of Stromboli, Italy. The author says that Walter Pierpaoli, organizer of the conference has done a splendid job of assembling highly qualified clinicians and scientists from the four corners of the world. The author further said that most of the papers were excellent, adding to the scientific basis for future clinical improvements in the treatment of cancer and aging.

Huntington's chorea is a late onset disease of the nervous system whose mode of inheritance conforms to the autosomal dominant model. The present paper shows how the problem of estimating the distribution of age at onset of the disease can be dealt with as an incomplete data problem via the EM algorithm, both in the parametric and non-parametric setting. In this way it is possible to take into account not only the heterozygotes in the population under study who are manifestly affected, but also those who are apparently unaffected. The estimation of the distribution of age at onset of the disease is required for estimating the posterior probability of heterozygosity of the individual at risk using Bayes' theorem. The proposed approach was applied to data derived from a survey carried out on the population of Latium, Italy.

This study examines collagen (N = 105) and apatite (N = 65) data from an Imperial Roman skeletal sample from the necropolis of Isola Sacra (Rome, Italy). This paper explores correlations between the isotopic composition of bone samples and the inferred age and sex of these individuals (aged 5-45+ years). The collagen of males, and older individuals in general, was significantly enriched in 15N but not 13C. Bone carbonate was somewhat depleted in 13C in some older individuals, suggesting increased consumption of olive oil and possibly wine. Subadults (>5 years) in the sample appear to have consumed an almost exclusively terrestrial diet. This study demonstrates a clear trend in dietary patterns between adult age groups, as well as between adults and children within a population. [ABSTRACT FROM AUTHOR]

Previous studies have shown that the presence of age‐based stereotypes in the workplace is often associated with lower levels of work engagement and adjustment among older employees. This study examines possible mediators and moderators of this relationship using data from a sample of 2,348 older (age > 50) employees at the Italian national rail company. We test a model in which the effects of age‐based stereotype threat on organizational involvement, future time perspective, and psychological well‐being are mediated by work–age identity integration (how much individuals see their age and organizational identities as compatible and blended). Secondly, we explored whether these effects are moderated by gender and job status. Results indicate that age‐based stereotypes are associated with negative outcomes for employees' work and personal adjustment, and that these relationships are partially mediated by variations in work–age identity integration. [ABSTRACT FROM AUTHOR]

Background and Aim: Whether aging affects left ventricular (LV) filling and ejection and the LV electric function is not well established. We investigated the effect of normal aging on echocardiographic measurements of LV morphology and function, LV electric function and the relationship between LV electric and mechanical function in asymptomatic individuals. Methods: As part of a cross‐sectional survey for the prevalence of coronary risk factors in the general population in Caltanissetta, Italy, individuals without signs or symptoms of coronary artery disease or heart failure were randomly selected and underwent electrocardiographic and echocardiographic examination. QRS duration and amplitude, PR, QT and QTc intervals, were automatically measured. Echocardiographic examination included the measurement of LV systolic and diastolic dimensions, volumes and ejection fraction (EF). From the spectral Doppler flow LV early diastolic (E wave) and atrial systolic (A wave) velocities, isovolumic relaxation time (IVRT) and isovolumic contraction time (IVCT) were measured. Global LV dyssynchrony was assessed using the total isovolumic time (T‐IVT) and the Tei index. Results: Aging reduced LV long‐axis function, LV filling time and E wave velocity and prolonged T‐IVT, IVRT and Tei index. It did not affect LV dimensions, ejection fraction, IVCT or QRS amplitude and duration. QRS duration correlated with LV dimensions, wall thickness and left atrial area. QRS amplitude and QTc interval correlated with the markers of LV dyssynchrony T‐IVT and Tei index. Conclusions: Overall, systolic and electric LV function are not affected by age, whereas subendocardial function, diastolic and synchronous function are significantly influenced. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the relationship between gait speed, recall memory, and mortality. Design A cohort study (last follow-up December 2009). Setting Tuscany, Italy. Participants Individual data from 1,014 community-dwelling older adults aged 60 years or older with baseline gait speed and recall memory measurements and follow-up for a median time of 9.10 ( IQR 7.1;9.3) years. Participants were a mean ( SD) age of 73.9 (7.3) years, and 55.8% women. Participants walking faster than 0.8 m/s were defined as fast walkers; good recall memory was defined as a score of 2 or 3 in the 3-word delayed recall section of the Mini-Mental State Examination. Measurements All-cause mortality. Results There were 302 deaths and the overall 100 person-year death rate was 3.77 (95% CI: 3.37-4.22). Both low gait speed and poor recall memory were associated with mortality when analysed separately ( HR = 2.47; 95% CI: 1.87-3.27 and HR = 1.47; 95% CI: 1.16-1.87, respectively). When we grouped participants according to both recall and gait speed, death rates (100 person-years) progressively increased from those with both good gait speed and memory (2.0; 95% CI: 1.6-2.5), to those with fast walk but poor memory (3.4; 95% CI: 2.8-4.2), to those with slow walk and good memory (8.8; 95% CI: 6.4-12.1), to those with both slow walk and poor memory (13.0; 95% CI: 10.6-16.1). In multivariate analysis, poor memory significantly increases mortality risk among persons with fast gait speed ( HR = 1.40; 95% CI: 1.04-1.89). Conclusion In older persons, gait speed and recall memory are independent predictors of expected survival. Information on memory function might better stratify mortality risk among persons with fast gait speed. [ABSTRACT FROM AUTHOR]

Objectives To assess the relationship between light to moderate alcohol consumption and mortality, particularly accounting for baseline health status and physical activity. Design Prospective, longitudinal, population-based study. Setting The Pianoro Study, which consisted of community-dwelling older adults in three towns in northern Italy. Participants Noninstitutionalized individuals of both sexes aged 65 and older (N = 5,256; 2,318 abstainers, 2,309 light to moderate drinkers (≤2 alcoholic units/d)). Measurements Baseline information about demographic characteristics, lifestyle factors, physical activity (Physical Activity Scale for the Elderly ( PASE)), perceived health status (visual analog scale ( VAS)), dependency level, risk factors, and previous cardiovascular events was obtained using a structured questionnaire. Follow-up information was obtained 6 years later from 2,752 survivors, and mortality information was obtained from death certificates. Results Male sex, being physically active, and good health status were independently associated with light to moderate drinking ( P < .001). An apparent protective effect of light to moderate drinking on mortality was evident in the unadjusted analysis and after adjusting for age, sex, risk factors, and cardiovascular events (adjusted hazard ratio ( aHR) = 0.77, 95% confidence interval ( CI) = 0.68-0.88, P < .001), but after also adjusting for PASE and VAS, the relationship was no longer significant ( aHR = 0.92, 95% CI = 0.80-1.05, P = .19). Follow-up physical activity was associated with baseline alcohol consumption; baseline physical activity did not predict alcohol consumption during follow-up. Conclusion After accounting for health status and physical activity, light to moderate alcohol drinking had no direct protective effect on mortality. [ABSTRACT FROM AUTHOR]

An increased life expectancy of people with Down syndrome ( DS) and the occurrence of early aging are now recognized. However, few data exist on functioning and disability profile of early-aging people with DS, which takes into account how health conditions interact with environmental factors. Based on the World Health Organization's International Classification of Functioning, Disability and Health ( ICF), the authors collected preliminary data describing functioning and disability about early aging from 31 adults with DS aged 45 and older residing in the greater Milan, Italy, area. ICF checklist was used to collect data. Of the 31, 18 were women (mean age = 51.1), all were unmarried, 21 lived with their family, and 23 never worked. Few problems in body functions (e.g., vision and hearing, cognitions) and body structures (e.g., ear and eye structures, cardiovascular, endocrine, and digestive systems, skin structures) were reported. ICF categories within Activity and Participation domain emphasized the facilitating effect of environmental factors on activities related to domestic life (e.g., doing housework, acquisition of goods and services, preparation of meals). Within the Environmental Factors domain there are few barriers, mainly with respect to labor services, and very strong facilitating factors, particularly related to product of technology (for personal indoor and outdoor mobility and transportation) and the support of family members. The authors note that the findings can set out premises for further study on aging people with DS and their caregivers at national and international levels. [ABSTRACT FROM AUTHOR]

Purpose (a) A psychometric validation of an Italian version of the Alzheimer's Functional Assessment Tool scale (AFAST-I), designed for informant-based assessment of the degree of impairment and of assistance required in seven basic daily activities in adult/elderly people with intellectual disabilities (ID) and (suspected) dementia; (b) a pilot analysis of its clinical significance with traditional statistical procedures and with an artificial neural network. Methods AFAST-I was administered to the professional caregivers of 61 adults/seniors with ID with a mean age (±) SD) of 53.4 (± 7.7) years (36% with Down syndrome). Internal consistency (Cronbach's α coefficient), inter/intra-rater reliabilities (intraclass coefficients, ICC) and concurrent, convergent and discriminant validity (Pearson's r coefficients) were computed. Clinical significance was probed by analysing the relationships among AFAST-I scores and the Sum of Cognitive Scores (SCS) and the Sum of Social Scores (SOS) of the Dementia Questionnaire for Persons with Intellectual Disabilities (DMR-I) after standardisation of their raw scores in equivalent scores (ES). An adaptive artificial system (AutoContractive Maps, AutoCM) was applied to all the variables recorded in the study sample, aimed at uncovering which variable occupies a central position and supports the entire network made up of the remaining variables interconnected among themselves with different weights. Results AFAST-I shows a high level of internal homogeneity with a Cronbach's α coefficient of 0.92. Inter-rater and intra-rater reliabilities were also excellent with ICC correlations of 0.96 and 0.93, respectively. The results of the analyses of the different AFAST-I validities all go in the expected direction: concurrent validity (r = -0.87 with ADL); convergent validity (r = 0.63 with SCS; r = 0.61 with SOS); discriminant validity (r = 0.21 with the frequency of occurrence of dementia-related Behavioral Excesses of the Assessment for Adults with Developmental Disabilities, AADS-I). In our sample age and gender do not correlate with the scale and comparing the distribution of the AFAST-I and DMR-SCS and DMR-SOS expressed as ES, it appears that memory disorders and temporal and spatial disorientation (SCS) precede the loss of functional abilities, whereas changes in social behaviour (SOS) are less specific in detecting cognitive deterioration sufficient to provoke functional disability and vice versa. The results of AutoCM analysis reveal that the hub (core) of the entire network is represented by the functional domain 'personal/oral hygiene' in the entire study sample and 'use of toilet' in a subgroup of subjects who obtained an ES equal to 0 at DMR-SCS. Conclusions These results confirm the reliability and validity of AFAST-I and emphasise the complexity of the relationship among functional status, cognitive functioning and behaviour also in adults/ seniors with ID. [ABSTRACT FROM AUTHOR]

ABSTRACT Age-related anatomical changes to the surface of the pubic symphysis are well-documented in the literature. However, aligning these morphological changes with chronological age has proven problematic, often resulting in biased age estimates. Statistical modeling provides an avenue for forensic anthropologists and bioarchaeologists to increase the accuracy of traditional aging methods. Locating appropriate samples to use as a basis for modeling age estimations can be challenging due to differing sample age distributions and potentially varying patterns of senescence. We compared two approaches, Rostock and Forensic, coupled with a Bayesian methodology, to address these issues. Transition analysis was run specific to each method (which differ by sample selection). A Gompertz model was derived from an informative prior that yielded the mortality and senescence parameters for constructing highest posterior density ranges, i.e., coverages, which are analogous to age ranges. These age ranges were generated from both approaches and are presented as reference tables useful for historic male and female Italian samples. The age ranges produced from each approach were tested on an historic Italian sample, using cumulative binomial tests. These two approaches performed similarly, with the Forensic approach showing a slight advantage. However, the Forensic approach is unable to identify varying senescence patterns between populations, thus preference for one approach over the other will depend on research design. Finally, we demonstrate that while populations exhibit similar morphological changes with advancing age, there are no significant sex differences in these samples, and the timing of these changes varies from population to population. Am J Phys Anthropol 156:466-473, 2015. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Objectives To examine relationships between eight markers of inflammation (interleukin ( IL)-6, IL-6 receptor (R), C-reactive protein ( CRP), tumor necrosis factor ( TNF)-alpha, TNF receptor 1 (R1), TNFR2, IL-1 receptor antagonist, IL-18) and incident loss of ability to walk 400 m. Design Prospective cohort study. Setting Older adults enrolled in the Invecchiare in Chianti Study. Participants Community-dwelling participants aged 65 and older (N = 1,006). Measurements The eight inflammatory markers were measured at baseline, and an inflammation score was calculated based on the number of inflammatory markers for which the participant was in the highest quartile. Incidence of mobility disability was determined in participants able to walk 400 m at baseline. Logistic regression models were used to determine whether each of the inflammatory markers and the inflammation score predicted loss of the ability to walk 400 m at 6-year follow-up. Results After adjusting for covariates, individuals with a TNFR1 level in each of the highest three quartiles (Q2, 3, 4) were more likely to be unable to walk 400 m at follow-up than those with TNFR1 levels in Q1. When adjusting for the same covariates, participants with an inflammation score of 3 or 4 were more likely to become unable to walk 400 m at follow-up than participants with a score of 0. Conclusion These results provide additional evidence that inflammation is a factor in the mechanisms that cause incident mobility disability and suggest that a combined measure of inflammatory markers may improve prediction of functional prognosis. [ABSTRACT FROM AUTHOR]

Objectives To test the hypothesis that, in older adults, living in a mildly iodine-deficient area, thyroid dysfunction may be associated with mortality independent of potential confounders. Design Longitudinal. Setting Community-based. Participants Nine hundred fifty-one individuals aged 65 and older. Measurements Plasma thyrotropin, free thyroxine, and free triiodothyronine concentrations and demographic features were evaluated in participants of the Invecchiare in Chianti Study aged 65 and older. Participants were classified according to thyroid function test. Kaplan-Meier survival and Cox proportional hazards models adjusted for confounders were used in the analysis. Results Eight hundred nineteen participants were euthyroid, 83 had subclinical hyperthyroidism ( SHyper), and 29 had subclinical hypothyroidism ( SHypo). Overt hypo- and hyperthyroidism were found in five and 15 subjects, respectively. During a median of 6 years of follow-up, 210 deaths occurred (22.1%), 98 (46.6%) of which were from cardiovascular causes. Kaplan-Meier analysis revealed higher overall mortality for SHyper ( P = .04) than euthyroid subjects. After adjusting for multiple confounders, participants with SHyper (hazard ratio ( HR) = 1.65, 95% confidence interval ( CI) = 1.02-2.69) had significantly higher all-cause mortality than those with normal thyroid function. No significant association was found between SHyper and cardiovascular mortality. In euthyroid subjects, thyrotropin was found to be predictive of lower risk of all-cause mortality ( HR = 0.76, 95% CI = 0.57-0.99). Conclusion SHyper is an independent risk factor for all-cause mortality in older adults. Low to normal circulating thyrotropin should be carefully monitored in elderly euthyroid individuals. [ABSTRACT FROM AUTHOR]

We analyzed MBL2 gene variants in two cohorts of centenarians, octo-nonagenarians and nonagenarians, and in the general population, one from Sardinia Island (Italy), recruited in the frame of the AKea study, and another from Campania (southern Italy), to search for haplotypes related to longevity. We also assessed in vitro the effect of mannose-binding lectin (MBL) on various human cells at different stage of senescence. The frequency of high and null activity haplotypes was significantly lower, and the frequency of intermediate activity haplotype significantly higher in centenarians and in subjects between 80 and 99 years from both the cohorts as compared each to the general population from the same geographic area. Furthermore, serum MBL concentration (also after normalization to serum albumin) was significantly lower in centenarians and in octo- and nonagenarians as compared to the general population, suggesting that intermediate MBL haplotype/activity may be protective. We also demonstrated that in vitro MBL protein bound to senescent IMR90 fibroblasts thereby causing cell lysis, but not to other types of cycle-arrested cells not in senescence. This implicates a novel role of MBL in the clearance of senescent cells. [ABSTRACT FROM AUTHOR]

Objectives To examine whether protein intake is associated with change in muscle strength in older persons. Because systemic inflammation has been associated with protein catabolism, the study also evaluated whether a synergistic effect exists between protein intake and inflammatory markers on change in muscle strength. Design Longitudinal. Setting The Invecchiare in Chianti Study. Participants Five hundred and ninety-eight older adults. Measurements Knee extension strength was measured at baseline (1998-2000) and during 3-year follow-up (2001-2003) using a handheld dynamometer. Protein intake was assessed using a detailed food frequency questionnaire. The inflammatory markers examined were C-reactive protein ( CRP), interleukin-6 ( IL-6), and tumor necrosis factor-alpha ( TNF-α). Results The main effect of protein intake on change in muscle strength was not significant. However, a significant interaction was found between protein intake and CRP ( P = .003), IL-6 ( P = .049), and TNF-α ( P = .02), indicating that lower protein intake was associated with greater decline in muscle strength in persons with high levels of inflammatory markers. Conclusion Lower protein intake was associated with decline in muscle strength in persons with high levels of inflammatory markers. These results may help to understand the factors contributing to decline in muscle strength with aging and to identify the target population of older persons who may benefit from nutritional interventions aimed at preventing or reducing age-associated muscle impairments and its detrimental consequences. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To investigate the characteristics of older adults who develop high interleukin-6 (IL-6) levels at 3-year follow-up. DESIGN: Population-based study of adults living in Tuscany, Italy. SETTING: Community. PARTICIPANTS: Adults aged 65 and older and were selected for this study. Of 1,155 baseline participants aged 65 and older, 741 had IL-6 measurements at baseline and 3-year follow-up. MEASUREMENTS: The uppermost quartile of IL-6 was used as the threshold for defining high IL-6 (≥4.18 pg/mL). Serum IL-6 levels were assessed using enzyme immunoassay. RESULTS: Of the 581 participants with IL-6 levels less than 4.18 pg/mL at baseline, 106 (18.2%) had developed high IL-6 at follow-up. Although women had lower IL-6 levels at baseline than men, the risk of developing high IL-6 did not differ according to sex. High adiposity, defined as a body mass index of 30.0 kg/m2 or higher (odds ratio (OR)=2.63, 95% confidence interval (CI)=1.40–4.96), and large waist circumference, defined as 102 cm or greater for men and 88 cm or greater for women (OR=2.05, 95% CI=1.24–3.40), were significant predictors of developing high IL-6 at follow-up. Other significant predictors were presence of three or more chronic diseases (OR=3.66, 95% CI=1.54–8.70), higher baseline IL-6 (OR=1.82, 95% CI=1.39–2.38) and higher white blood cell count (OR=1.24, 95% CI=1.06–1.45). Faster walking speed associated with decreased risk of progressing to elevated IL-6 (OR=0.83, 95% CI=0.74–0.92). CONCLUSION: Older age, greater adiposity, slower walking speed, higher disease burden, and higher white blood cell count were associated with greater risk of IL-6 elevation over a 3-year period. Future research should target older adults with these characteristics to prevent progression to a proinflammatory state. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Describe the methodology and preliminary results of the Progetto Veneto Anziani (PRO.V.A.) Study, an observational study of the Italian population aged 65 and older DESIGN: Cross-sectional cohort observation. SETTING: Northern Italy. PARTICIPANTS: Italians aged 65 and older, living in both the community and nursing homes. MEASUREMENTS: At baseline, participants were interviewed at their homes and subsequently examined by nurses and physicians at the two study clinics using an extensive battery of clinical, instrumental, biochemical, and physical performance tests. Hand, knee, hip, and chest x-rays and bone densitometry were performed in 92% of the participants, and 99% of the participants consented to blood drawing and deoxyribonucleic acid analyses. The physician who performed the physical examination determined disease presence based on several components of the interview and examination. A further, comprehensive determination was performed with standardized algorithms using all the information collected on each participant, including hospital records surveillance, standardized x-ray readings, and blood assays. In one of the study sites, a brain magnetic resonance imaging was performed in a subsample of the participants (820 persons). RESULTS: Overall response rate to the baseline clinic visit was 77% for men and 64% for women. Co-presence of at least one cardiovascular disease (CVD) and at least one osteoarticular disease (OAD) was identified in 10%, 22%, and 29% of men and 9%, 24%, and 40% of women aged 65 to 74, 75 to 84, and 85 and older, respectively. Overall, the mean number of coexisting chronic conditions was 1.8 for men and 2.4 for women. CONCLUSIONS: The PRO.V.A. study has the potential to provide an original contribution to clarify the mechanisms whereby diseases cause disability in older men and women; the particular focus on CVD and OADs will make it possible to comprehensively evaluate the development of disability as it relates to... [ABSTRACT FROM AUTHOR]