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1. An algorithm for the early diagnosis and correct approach to dementia management: results of a multiprofessional team.

Author: Gareri P, Cotroneo AM, Gelmini G, Mossello E, and Massaia M
Subjects: Humans, Cognitive Dysfunction diagnosis, Cognitive Dysfunction therapy, Risk Factors, Patient Care Team, Neuropsychological Tests, Dementia diagnosis, Dementia therapy, Algorithms, Early Diagnosis, Delphi Technique
Abstract: Backgroung: The early identification of cognitive disorder is a primary scope, because it could reduce the rate of severe cognitive impairment and thus contribute to reduce healthcare costs in the next future., Aims: The present paper aimed to build a virtuous diagnostic path of cognitive impairment, highlighting all the professionalism that can serve this purpose., Methods: The Delphi method was used by the experts, who reviewed the information available during each meeting related to the following topics: early diagnosis of cognitive impairment, definition of Mild Cognitive Impairment, unmet needs in post-stroke patients, critical decision-making nodes in complex patients, risk factors, neuropsychological, imaging diagnosis, blood tests, the criteria for differential diagnosis and the possible treatments., Results: The discussion panels analyzed and discussed the available evidences on these topics and the related items. At each meeting, the activities aimed at the creation of a diagnostic-welfare flow chart derived from the proposal of the board and the suggestions of the respondents. Subsequently, the conclusions of each panel were written, and the study group reviewed them until a global consensus was reached. Once this process was completed, the preparation of the final document was carried out., Conclusions: Eventually, we built an algorithm for the early diagnosis and treatment, the risk factors, with the possible differences among the different kinds of dementia., (© 2024. The Author(s).)
Published: 2024
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2. Screening for cognitive impairment in older adults with hypertension: the HYPER-COG study.

Author: Rivasi G, D'Andria MF, Bulgaresi M, Sgrilli F, Casini G, Falzone D, Turrin G, Tortù V, Giordano A, Mossello E, and Ungar A
Subjects: Humans, Female, Aged, Male, Sensitivity and Specificity, ROC Curve, Cognitive Dysfunction diagnosis, Dementia diagnosis, Hypertension complications, Hypertension diagnosis
Abstract: Hypertension is a major risk factor for dementia. Yet, the most suitable cognitive screening test for hypertensive patients has yet to be identified. This study investigated cognitive impairment in hypertensive older adults and compared the discriminative ability of the most widely used cognitive screening tests. The study involved hypertensive patients aged 65+ without prior diagnosis of cognitive impairment, from the Hypertension Clinic of Careggi Hospital, Florence, Italy. Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), MiniCog and Clock Drawing Test (CDT) were administered, using a comprehensive neuropsychological assessment as gold standard. The ROC curve analysis and the paired chi-square test were used to compare the discriminative ability, sensitivity and specificity for cognitive impairment of the different screening instruments. Cognitive impairment was diagnosed in 37% of 94 participants (mean age 76, 55% female), mainly involving attention and executive functions. The MoCA (AUC = 0.746), the MMSE (AUC = 0.689) and the MiniCog (AUC = 0.684) showed similar ability in detecting cognitive impairment, while the CDT had a poorer discriminative capacity (AUC = 0.535). The sensitivity of MoCA (80%) and of MMSE/MiniCog combination (74%) was higher in comparison with MiniCog alone (49%, p = 0.007 and 0.004, respectively), while MiniCog achieved the highest specificity (88%, p < 0.001 vs all). Cognitive impairment was detected in more than one-third of hypertensive older adults without prior diagnosis of dementia. MoCA, MMSE and MiniCog showed similar discriminative ability for cognitive impairment, with MoCa and MMSE showing greater sensitivity and MiniCog the highest specificity., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)
Published: 2023
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3. 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 AM, Del Signore S, Malara A, Mossello E, Fumagalli S, Volpato S, Monzani F, Bellelli G, Zia G, and Incalzi RA
Subjects: Male, Humans, Female, Aged, Aged, 80 and over, Cross-Sectional Studies, Antidepressive Agents therapeutic use, Trazodone adverse effects, Dementia epidemiology, COVID-19
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., (© 2023. The Author(s), under exclusive licence to European Geriatric Medicine Society.)
Published: 2023
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4. Italian guidance on Dementia Day Care Centres: A position paper.

Author: Mossello E, Baccini M, Caramelli F, Biagini CA, Cester A, De Vreese LP, Darvo G, Vampini C, Gotti M, Fabbo A, Marengoni A, Cavallini MC, Gori G, Chattat R, Marini M, Ceron D, Lanzoni A, Pizziolo P, Mati A, Zilli I, Cantini C, Caleri V, Tonon E, Simoni D, Mecocci P, Ungar A, and Masotti G
Subjects: Humans, Aged, Day Care, Medical, Syndrome, Caregivers psychology, Dementia therapy, Dementia psychology, COVID-19 prevention & control
Abstract: Dementia Day Care Centres (DDCCs) are defined as services providing care and rehabilitation to people with dementia associated with behavioural and psychological symptoms (BPSD) in a semi-residential setting. According to available evidence, DDCCs may decrease BPSD, depressive symptoms and caregiver burden. The present position paper reports a consensus of Italian experts of different disciplines regarding DDCCs and includes recommendations about architectural features, requirements of personnel, psychosocial interventions, management of psychoactive drug treatment, prevention and care of geriatric syndromes, and support to family caregivers. DDCCs architectural features should follow specific criteria and address specific needs of people with dementia, supporting independence, safety, and comfort. Staffing should be adequate in size and competence and should be able to implement psychosocial interventions, especially focused on BPSD. Individualized care plan should include prevention and treatment of geriatric syndromes, a targeted vaccination plan for infectious diseases including COVID-19, and adjustment of psychotropic drug treatment, all in cooperation with the general practitioner. Informal caregivers should be involved in the focus of intervention, with the aim of reducing assistance burden and promoting the adaptation to the ever-changing relationship with the patient., (© 2023. The Author(s).)
Published: 2023
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5. Health literacy of informal caregivers of older adults with dementia: results from a cross-sectional study conducted in Florence (Italy).

Author: Lorini C, Buscemi P, Mossello E, Schirripa A, Giammarco B, Rigon L, Albora G, Giorgetti D, Biamonte MA, Fattorini L, Bruno RM, Giusti G, Longobucco Y, Ungar A, and Bonaccorsi G
Subjects: Humans, Female, Aged, Caregivers psychology, Cross-Sectional Studies, Activities of Daily Living psychology, Dementia epidemiology, Health Literacy
Abstract: Aim: The aim of this study was to measure the prevalence of inadequate health literacy (HL) in a sample of family caregivers of older adults with dementia, and to assess the relationship of HL with characteristics of caregiver and persons with dementia., Methods: The study followed a cross-sectional design. Persons with dementia and their family caregivers were enrolled in an outpatients' geriatric memory clinic. For the caregivers, the following information was collected: socio-demographic data, level of HL, cognitive impairment (using the Mini-Cog). For persons with dementia, the following data were collected: socio-demographic data, functional status (using the Basic and Instrumental Activities of Daily Living), cognitive impairment (using the Mini Mental State Evaluation, and the Global Deterioration Scale) behavioral and psychological symptoms associated with dementia (assessed using the Neuropsychiatric Inventory)., Results: A total of 174 person with dementia/caregiver dyads were enrolled. About 45% of the caregivers presented a possibility or a high likelihood of inadequate HL. The percentage of caregivers with inadequate HL was higher among spousal caregivers than in offspring. Female gender, higher age and lower education were independent predictors of low HL. On multiple logistic regression analysis, persons with dementia assisted by caregivers with a high likelihood of limited HL presented higher risk of a more severe disease., Conclusion: The results of this study suggest that the HL of dementia caregivers has to be included in the comprehensive geriatric assessment, to develop an appropriate individualized care plan. Moreover, public health interventions are needed to increase the HL of dementia caregivers., (© 2022. The Author(s).)
Published: 2023
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6. 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, and Bellelli G
Subjects: Activities of Daily Living, Aged, Cross-Sectional Studies, Humans, Prevalence, Delirium epidemiology, Dementia epidemiology
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., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
Published: 2022
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7. Truly unexplained falls after evaluation for syncope: A new diagnostic entity with severe prognosis.

Author: Ungar A, Ceccofiglio A, Mussi C, Bo M, Rivasi G, Rafanelli M, Martone AM, Bellelli G, Nicosia F, Riccio D, Boccardi V, Tonon E, Curcio F, Landi F, Abete P, and Mossello E
Subjects: Aged, Aged, 80 and over, Female, Humans, Male, Prognosis, Risk Factors, Dementia complications, Dementia diagnosis, Syncope complications, Syncope etiology
Abstract: Objective: To compare one-year mortality risk associated with syncope and unexplained fall in older adults with dementia., Methods: 522 patients (aged >65 years) with dementia and history of transient loss of consciousness and/or unexplained falls were evaluated. The diagnosis of syncope was based on European Society of Cardiology guidelines. A "Syncopal Fall" was defined in patients with an initial clinical presentation of unexplained fall, but a final diagnosis of syncope after complete assessment. A "Truly Unexplained Fall" was defined in patients with an initial clinical presentation of unexplained fall, in whom a diagnosis of syncope had been excluded after the diagnostic work-up. One-year follow-up was assessed by phone interview., Results: Follow-up data were available for 501 participants (mean age 83 ± 6 years, 65% female). After a mean follow-up of 324 ± 93 days, death from any cause was reported in 188 participants (24%). Advanced age, male sex, cognitive and functional impairment were associated with a higher mortality rate. Patients with "Truly Unexplained Falls" had a higher mortality risk compared with syncope and "Syncopal Fall". A diagnosis of "Truly Unexplained Falls" remained an independent predictor of one-year all-cause mortality in multivariate model., Conclusions: We propose the novel diagnostic category of "Truly Unexplained Fall", resulting from the application of syncope guidelines to subjects with unexplained falls. This condition in older adults with dementia is a predictor of one-year all-cause mortality. For this new high risk profile, we advice a comprehensive geriatric assessment focused on risk factors for fall, aimed at a possible improvement of prognosis., (Copyright © 2022. Published by Elsevier B.V.)
Published: 2022
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8. The 4-DSD: A New Tool to Assess Delirium Superimposed on Moderate to Severe Dementia.

Author: Morandi A, Grossi E, Lucchi E, Zambon A, Faraci B, Severgnini J, MacLullich A, Smith H, Pandharipande P, Rizzini A, Galeazzi M, Massariello F, Corradi S, Raccichini A, Scrimieri A, Morichi V, Gentile S, Lucchini F, Pecorella L, Mossello E, Cherubini A, and Bellelli G
Subjects: Attention, Cross-Sectional Studies, Hospitalization, Humans, Delirium diagnosis, Dementia complications, Dementia diagnosis
Abstract: Objectives: The purpose of this study was to create, standardize, and validate a new instrument, named 4-DSD, and determine its diagnostic accuracy in the diagnosis of delirium in subjects with moderate to severe dementia., Design: Multicenter cross-sectional observational study., Setting and Participants: Older patients consecutively admitted to acute and rehabilitation hospital wards., Measures: The DSM-5 was used as the reference standard delirium assessment. The presence and severity of dementia was defined using the AD8 and the Global Deterioration Scale (GDS). The 4-DSD is a 4-item tool that ranges from 0 to 12. Item 1 measures alertness, item 2 altered function, item 3 attention, and item 4 acute change or fluctuation in mental status., Results: A total of 134 patients were included in the study. Most of the patients were enrolled in acute hospital wards (60%), with 40% in rehabilitation settings. A minority of the patients were categorized with moderate dementia, with a GDS score of 5 (4%). Most of the patients were in the moderate-severe stage with a GDS score ≤6 (77%); 19% were classed as severe, with a GDS score of 7. A 4-DSD cutoff score ≥5 had a sensitivity of 80% and specificity of 80% with a positive predictive value (PPV) of 67% and a negative predictive value (NPV) of 89%. In the subgroup with moderate-severe dementia (n = 108), the sensitivity and the specificity were 79% and 82%, respectively, with a PPV and NPV of 62% and 92%. In the subgroup with severe dementia (n = 26) the sensitivity was 82% and the specificity 56% with a PPV of 78% and a NPV of 63%., Conclusions and Implications: The availability of a specific tool to detect delirium in patients with moderate-severe dementia has important clinical and research implications, allowing all health care providers to improve their ability to identify it., (Crown Copyright © 2021. Published by Elsevier Inc. All rights reserved.)
Published: 2021
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9. Hypertension, hypotension, longevity and dementia.

Author: Mossello E
Subjects: Aged, Antihypertensive Agents therapeutic use, Humans, Longevity, Dementia epidemiology, Hypertension drug therapy, Hypertension epidemiology, Hypotension
Abstract: High blood pressure at midlife has been consistently identified as a risk factor for dementia in late life, while dementia onset is typically associated with a subsequent decline of blood pressure values. A previous meta-analysis of randomized controlled studies of anti-hypertensive treatment in old age has shown a borderline effect of active treatment in reducing the risk of dementia. The cognitive sub-studies of SPRINT (SPRINT-MIND) and of HOPE-3, published in 2019, were aimed at assessing the cognitive effect of aggressive antihypertensive treatment. In SRINT-MIND, that included subjects with high vascular risk, the risk of dementia (primary outcome) did not differ between groups, but the risk of mild cognitive impairment was significantly reduced in the treatment group. Conversely in HOPE-3, that included subjects with intermediate vascular risk, no significant cognitive effect was observed, with a trend for a better outcome in the placebo arm in the subgroup with lower baseline systolic blood pressure. These data add to observational studies showing detrimental cognitive effect of lower blood pressure values in very old subjects, with cognitive impairment, disability, and complex health problems. Regarding longevity, observational studies confirm protective effects of lower blood pressure values, although systolic blood pressure <130 mmHg are associated with greater mortality risk in subjects with cognitive and/or motor impairment. On the whole antihypertensive treatment might decrease the risk of cognitive impairment in older, robust, high vascular risk subjects. Yet the presence of cognitive impairment might modify the prognostic effect of antihypertensive treatment and advise against aggressive blood pressure lowering.
Published: 2020
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10. Atrial Fibrillation in Older Patients with Syncope and Dementia: Insights from the Syncope and Dementia Registry.

Author: Ceccofiglio A, Fumagalli S, Mussi C, Mossello E, Bo M, Martone AM, Bellelli G, Nicosia F, Riccio D, Langellotto A, Tava G, Boccardi V, Tonon E, Abete P, and Ungar A
Subjects: Aged, Aged, 80 and over, Anticoagulants therapeutic use, Female, Humans, Male, Registries, Risk Factors, Syncope epidemiology, Atrial Fibrillation complications, Atrial Fibrillation drug therapy, Atrial Fibrillation epidemiology, Dementia epidemiology, Stroke
Abstract: Objectives: To evaluate the clinical characteristics and the long-term outcome of atrial fibrillation (AF) patients with dementia and history of syncope or falls., Design: Observational: analysis of a prospective registry., Setting and Participants: Between 2012 and 2016, the Syncope and Dementia Registry enrolled patients in 12 geriatric departments. Follow-up evaluation was at 12 months., Measures: Clinical, functional, and cognitive assessment., Results: Of the 522 patients (women, 62.1%; Mini-Mental State Examination 17 ± 6), 26.4% have or presented an AF history. Patients with AF were older (85 ± 6 vs 83 ± 6 years, P = .012), with higher heart rate (78 ± 17 vs. 73 ± 14 bpm, P < .001), prescribed drugs (6.9 ± 2.9 vs 5.9 ± 2.7, P < .001), and an increased number (3.9 ± 2.0 vs 3.0 ± 1.8, P < .001) and severity of comorbidities. Oral anticoagulant therapy was underprescribed (39.9%). Cardiac syncope was more frequently diagnosed (18.8 vs 4.9%, P < .001). At multivariate analysis, AF patients were characterized by advanced age, a higher severity of comorbidities, a greater number of prescribed drugs, an increased heart rate, and a more frequent presence of cardiac symptoms. One-year mortality differed little between patients with and without AF (27.7 vs 22.1%, P = .229). In the arrhythmia group, multivariate predictors of prognosis were disability (number of lost BADLs; P = .020) and a higher heart rate (P = .006)., Conclusions and Implications: AF and postural stability-related issues often co-exist in persons with dementia. This complex of conditions is associated with an intricate clinical picture, underprescription of oral anticoagulants, and high long-term mortality. Future studies are needed to evaluate the effects of therapy optimization in this population., (Copyright © 2020 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)
Published: 2020
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11. Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia.

Author: Morandi A, Zambon A, Di Santo SG, Mazzone A, Cherubini A, Mossello E, Bo M, Marengoni A, and Bellelli G
Subjects: Aged, Cross-Sectional Studies, Humans, Inpatients, Italy epidemiology, Delirium epidemiology, Dementia epidemiology
Abstract: Objectives: Few studies have analyzed factors associated with delirium subtypes. In this study, we investigate factors associated with subtypes of delirium only in patients with dementia to provide insights on the possible prevention and treatments., Design: This is a cross-sectional study nested in the "Delirium Day" study, a nationwide Italian point-prevalence study., Setting and Participants: Older patients admitted to 205 acute and 92 rehabilitation hospital wards., Measures: Delirium was evaluated with the 4-AT and the motor subtypes with the Delirium Motor Subtype Scale. Dementia was defined by the presence of a documented diagnosis in the medical records and/or prescription of acetylcholinesterase inhibitors or memantine prior to admission., Results: Of the 1057 patients with dementia, 35% had delirium, with 25.6% hyperactive, 33.1% hypoactive, 34.5% mixed, and 6.7% nonmotor subtype. There were higher odds of having venous catheters in the hypoactive (OR 1.82, 95% CI 1.18-2.81) and mixed type of delirium (OR 2.23, CI 1.43-3.46), whereas higher odds of urinary catheters in the hypoactive (OR 2.91, CI 1.92-4.39), hyperactive (OR 1.99, CI 1.23-3.21), and mixed types of delirium (OR 2.05, CI 1.36-3.07). We found higher odds of antipsychotics both in the hyperactive (OR 2.87, CI 1.81-4.54) and mixed subtype (OR 1.84, CI 1.24-2.75), whereas higher odds of antibiotics was present only in the mixed subtype (OR 1.91, CI 1.26-2.87)., Conclusions and Implications: In patients with dementia, the mixed delirium subtype is the most prevalent followed by the hypoactive, hyperactive, and nonmotor subtype. Motor subtypes of delirium may be triggered by clinical factors, including the use of venous and urinary catheters, and the use of antipsychotics. Future studies are necessary to provide further insights on the possible pathophysiology of delirium in patients with dementia and to address the optimization of the management of potential risk factors., (Copyright © 2020 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)
Published: 2020
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12. Delirium, Dementia, and In-Hospital Mortality: The Results From the Italian Delirium Day 2016, A National Multicenter Study.

Author: Morandi A, Di Santo SG, Zambon A, Mazzone A, Cherubini A, Mossello E, Bo M, Marengoni A, Bianchetti A, Cappa S, Fimognari F, Antonelli Incalzi R, Gareri P, Perticone F, Campanini M, Penco I, Montorsi M, Di Bari M, Trabucchi M, and Bellelli G
Subjects: Aged, Aged, 80 and over, Cognitive Dysfunction epidemiology, Comorbidity, Delirium epidemiology, Dementia epidemiology, Female, Humans, Italy epidemiology, Male, Prevalence, Cognitive Dysfunction diagnosis, Delirium diagnosis, Dementia diagnosis, Hospital Mortality, Hospitalization
Abstract: Background: There is little evidence about the prevalence of cognitive disorders and their effect on in-hospital mortality in large multicenter studies. The objectives of the 2016th edition of the "Italian Delirium Day," a large multicenter study on in-hospital older patients, were to assess (i) the point prevalence of cognitive impairment/no dementia, dementia, delirium, and delirium superimposed on dementia and (ii) the effect of these conditions on in-hospital mortality., Methods: This multicenter study and included 2,037 older patients (aged ≥65 years) admitted to acute medical and surgical wards across 205 acute hospitals. The four cognitive disorders groups were defined with a structured approach including the four AT and the presence of a documented diagnosis of dementia. The outcome measure was in-hospital mortality, as reported by the researchers involved in the study in each center., Results: The mean age was 81.17 ± 7.7 years. Overall, 893 patients (43.8%) had neither delirium nor dementia nor cognitive impairment, 483 (23.7%) had cognitive impairment/no dementia, 230 (11.3%) dementia alone, 187 (9.2%) delirium alone, and 244 (12.0%) delirium superimposed on dementia. Overall, 99 (4.8%) patients died. Participants with delirium alone (odds ratio 2.56; 95% confidence interval: 1.29-5.09) and those with delirium superimposed on dementia (odds ratio 2.60; 95% confidence interval: 1.39-4.85) had higher mortality risk compared with the reference group of patients with "no cognitive impairment.", Conclusions: Delirium and delirium superimposed on dementia were highly prevalent among older hospitalized patients and significantly increased in-hospital mortality. Clinicians should systematically assess these conditions and recognize them as markers of critical conditions and predictors of imminent death., (© The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Published: 2019
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13. Differential diagnosis of unexplained falls in dementia: Results of "Syncope & Dementia" registry.

Author: Mossello E, Ceccofiglio A, Rafanelli M, Riccardi A, Mussi C, Bellelli G, Nicosia F, Bo M, Riccio D, Martone AM, Langellotto A, Tonon E, Noro G, Abete P, and Ungar A
Subjects: Aged, Aged, 80 and over, Dementia drug therapy, Diagnosis, Differential, Female, Geriatric Assessment, Humans, Italy, Logistic Models, Male, Mental Status and Dementia Tests, ROC Curve, Registries, Syncope drug therapy, Accidental Falls statistics & numerical data, Dementia diagnosis, Syncope diagnosis
Published: 2018
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14. A Point Prevalence Study of Delirium in Italian Nursing Homes.

Author: Morichi V, Fedecostante M, Morandi A, Di Santo SG, Mazzone A, Mossello E, Bo M, Bianchetti A, Rozzini R, Zanetti E, Musicco M, Ferrari A, Ferrara N, Trabucchi M, Cherubini A, and Bellelli G
Subjects: Aged, Aged, 80 and over, Antipsychotic Agents, Cognitive Dysfunction complications, Comorbidity, Cross-Sectional Studies, Delirium diagnosis, Dementia diagnosis, Geriatric Assessment statistics & numerical data, Humans, Italy, Male, Psychometrics, Delirium epidemiology, Dementia epidemiology, Nursing Homes statistics & numerical data
Abstract: Background: Delirium is a common geriatric syndrome. Few studies have been conducted in nursing home (NH) residents. The aim of this project was to perform a point prevalence study of delirium in Italian NHs., Methods: Data collected in 71 NHs are presented. Inclusion criteria were age ≥65 years and native Italian speaker. Exclusion criteria were coma, aphasia, and end-of-life status. Sociodemographic and medical data were recorded. Delirium was assessed using the Assessment Test for Delirium and Cognitive Impairment (4-AT). Patients with a 4-AT score ≥4 were considered to have delirium. Motor subtype was evaluated using the Delirium Motor Subtype Scale (DMSS)., Results: A total of 1,454 patients were evaluated (mean age 84.4 ± 7.4 years, 70.2% female), of whom 535 (36.8%) had delirium. In multivariate logistic regression analysis, variables significantly associated with delirium were education (OR 0.94, 95% CI 0.91-0.97), dementia (OR 3.12, 95% CI 2.38-4.09), functional dependence (OR 6.13, 95% CI 3.08-12.19 for ADL score 0; OR 1.99, 95% CI 1.03-3.84 for ADL score 1-5), malnutrition (OR 4.87, 95% CI 2.68-8.84), antipsychotics (OR 2.40, 95% CI 1.81-3.18), and physical restraints (OR 2.48, 95% CI 1.71-3.59)., Conclusion: Delirium is common in older NH residents. Simple assessment tools might facilitate its recognition in this vulnerable population., (© 2018 S. Karger AG, Basel.)
Published: 2018
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15. Clinical Features Associated with Delirium Motor Subtypes in Older Inpatients: Results of a Multicenter Study.

Author: Morandi A, Di Santo SG, Cherubini A, Mossello E, Meagher D, Mazzone A, Bianchetti A, Ferrara N, Ferrari A, Musicco M, Trabucchi M, and Bellelli G
Subjects: Aged, Aged, 80 and over, Comorbidity, Delirium complications, Delirium epidemiology, Female, Humans, Hyperkinesis epidemiology, Hyperkinesis etiology, Hypokinesia epidemiology, Hypokinesia etiology, Italy epidemiology, Male, Delirium classification, Delirium diagnosis, Dementia epidemiology, Hyperkinesis diagnosis, Hypokinesia diagnosis, Severity of Illness Index
Abstract: Objective: To date motor subtypes of delirium have been evaluated in single-center studies with a limited examination of the relationship between predisposing factors and motor profile of delirium. We sought to report the prevalence and clinical profile of subtypes of delirium in a multicenter study., Methods: This is a point prevalence study nested in the "Delirium Day 2015", which included 108 acute and 12 rehabilitation wards in Italy. Delirium was detected using the 4-AT and motor subtypes were measured with the Delirium Motor Subtype Scale (DMSS). A multinomial logistic regression was used to determine the factors associated with delirium subtypes., Results: Of 429 patients with delirium, the DMSS was completed in 275 (64%), classifying 21.5% of the patients with hyperactive delirium, 38.5% with hypoactive, 27.3% with mixed and 12.7% with the non-motor subtype. The 4-AT score was higher in the hyperactive subtype, similar in the hypoactive, mixed subtypes, while it was lowest in the non-motor subtype. Dementia was associated with all three delirium motor subtypes (hyperactive, OR 3.3, 95% CI: 1.2-8.7; hypoactive, OR 2.8, 95% CI: 1.2-6.5; mixed OR 2.6, 95% CI: 1.1-6.2). Atypical antipsychotics were associated with hypoactive delirium (OR 0.23, 95% CI: 0.1-0.7), while intravenous lines were associated with mixed delirium (OR 2.9, 95% CI: 1.2-6.9)., Conclusions: The study shows that hypoactive delirium is the most common subtype among hospitalized older patients. Specific clinical features were associated with different delirium subtypes. The use of standardized instruments can help to characterize the phenomenology of different motor subtypes of delirium., (Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.)
Published: 2017
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16. Effects of low blood pressure in cognitively impaired elderly patients treated with antihypertensive drugs.

Author: Mossello E, Pieraccioli M, Nesti N, Bulgaresi M, Lorenzi C, Caleri V, Tonon E, Cavallini MC, Baroncini C, Di Bari M, Baldasseroni S, Cantini C, Biagini CA, Marchionni N, and Ungar A
Subjects: Aged, Aged, 80 and over, Blood Pressure, Blood Pressure Monitoring, Ambulatory, Cognition, Cognitive Dysfunction epidemiology, Cohort Studies, Dementia epidemiology, Disease Progression, Female, Follow-Up Studies, Humans, Hypotension epidemiology, Italy epidemiology, Male, Memory, Neuropsychological Tests, Sample Size, Severity of Illness Index, Antihypertensive Agents administration & dosage, Antihypertensive Agents adverse effects, Cognitive Dysfunction etiology, Dementia etiology, Hypertension drug therapy, Hypotension chemically induced, Hypotension psychology
Abstract: Importance: The prognostic role of high blood pressure and the aggressiveness of blood pressure lowering in dementia are not well characterized., Objective: To assess whether office blood pressure, ambulatory blood pressure monitoring, or the use of antihypertensive drugs (AHDs) predict the progression of cognitive decline in patients with overt dementia and mild cognitive impairment (MCI)., Design, Setting, and Participants: Cohort study between June 1, 2009, and December 31, 2012, with a median 9-month follow-up of patients with dementia and MCI in 2 outpatient memory clinics., Main Outcomes and Measures: Cognitive decline, defined as a Mini-Mental State Examination (MMSE) score change between baseline and follow-up., Results: We analyzed 172 patients, with a mean (SD) age of 79 (5) years and a mean (SD) MMSE score of 22.1 (4.4). Among them, 68.0% had dementia, 32.0% had MCI, and 69.8% were being treated with AHDs. Patients in the lowest tertile of daytime systolic blood pressure (SBP) (≤ 128 mm Hg) showed a greater MMSE score change (mean [SD], -2.8 [3.8]) compared with patients in the intermediate tertile (129-144 mm Hg) (mean [SD], -0.7 [2.5]; P = .002) and patients in the highest tertile (≥ 145 mm Hg) (mean [SD], -0.7 [3.7]; P = .003). The association was significant in the dementia and MCI subgroups only among patients treated with AHDs. In a multivariable model that included age, baseline MMSE score, and vascular comorbidity score, the interaction term between low daytime SBP tertile and AHD treatment was independently associated with a greater cognitive decline in both subgroups. The association between office SBP and MMSE score change was weaker. Other ambulatory blood pressure monitoring variables were not associated with MMSE score change., Conclusions and Relevance: Low daytime SBP was independently associated with a greater progression of cognitive decline in older patients with dementia and MCI among those treated with AHDs. Excessive SBP lowering may be harmful for older patients with cognitive impairment. Ambulatory blood pressure monitoring can be useful to help avoid high blood pressure overtreatment in this population.
Published: 2015
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17. Day Care for older dementia patients: favorable effects on behavioral and psychological symptoms and caregiver stress.

Author: Mossello E, Caleri V, Razzi E, Di Bari M, Cantini C, Tonon E, Lopilato E, Marini M, Simoni D, Cavallini MC, Marchionni N, Biagini CA, and Masotti G
Subjects: Activities of Daily Living, Adaptation, Psychological, Aged, Aged, 80 and over, Analysis of Variance, Case-Control Studies, Female, Follow-Up Studies, Home Nursing, Humans, Male, Psychiatric Status Rating Scales, Stress, Psychological, Caregivers psychology, Day Care, Medical, Dementia nursing
Abstract: Objective: To assess the effects of Day Care (DC) on older subjects with dementia and their caregivers., Methods: Thirty patients with dementia, consecutively admitted to a DC, were compared with 30 patients, matched for age and cognitive function, who received usual home care (HC). Primary caregivers were compared as well. At baseline and after 2 months, patients were assessed for cognitive and functional status, behavioral and psychological symptoms [Neuropsychiatric Inventory (NPI)] and psychotropic drugs use, and caregivers were evaluated for care burden [Caregiver Burden Inventory (CBI)] and depressive symptoms., Results: After adjusting for potential confounders, NPI score significantly decreased in DC group, with a reduction of psychotropic drugs prescription, whereas it increased in HC. No significant between-group difference was observed for cognitive and functional change. CBI significantly decreased in DC, but not HC, caregivers, with no significant between-group difference in depressive symptoms change., Conclusions: A 2-month period of DC assistance is effective in reducing behavioral and psychological symptoms of dementia patients and in alleviating caregivers' burden., (Copyright (c) 2008 John Wiley & Sons, Ltd.)
Published: 2008
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18. 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

19. 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

20. Being the Family Caregiver of a Patient With Dementia During the Coronavirus Disease 2019 Lockdown

Author: Zucca, M., Isella, V., Lorenzo, R. D., Marra, Camillo, Cagnin, A., Cupidi, C., Bonanni, L., Lagana, V., Rubino, E., Vanacore, N., Agosta, F., Caffarra, P., Sambati, R., Quaranta, Davide, Guglielmi, Valeria, Appollonio, I. M., Logroscino, G., Filippi, M., Tedeschi, G., Ferrarese, C., Rainero, I., Bruni, A. C., Gallo, E., Grassini, A., Marcinno, A., Roveta, F., Martino, P. D., Frangipane, F., Puccio, G., Colao, R., Mirabelli, M., Martellacci, N., Lino, F., Mozzetta, S., Busse, C., Camporese, G., Sacco, S., Lechiara, M. C., Carrarini, Claudia, Russo, M., Casalena, A., Sucapane, P., Tiraboschi, P., Caroppo, P., Redaelli, V., Fede, G. D., Coppa, D., Peluso, L., Insarda, P., Bartolo, M. D., Esposito, S., Iavarone, A., Orsini, A. V. M., Salvatore, E., Criscuolo, C., Sambati, L., Santoro, R., Gragnaniello, D., Pedriali, I., Ludovico, L., Chiari, A., Fabbo, A., Bevilacqua, P., Galli, C., Magarelli, S., Perini, M., Spalletta, G., Banaj, N., Porcari, D. E., Caruso, G., Cipollini, V., Casini, A. R., Ursini, F., Bruno, G., Rozzini, R., Brambilla, M., Magnani, G., Caso, F., Spinelli, E. G., Ramusino, M. C., Perini, G., Luzzi, S., Cacchio, G., Ciccola, A., Cionfrini, L., Giuli, C., Fabi, K., Guidi, M., Paci, C., Castellano, A., Petrucci, R., Accogli, M., Carapelle, E., Calabrese, G., Trevisi, G. N., Coluccia, B., Giuliano, A. V., Caggiula, M., Impagnatiello, V., Beretta, F., Milia, A., Pilia, G., Mascia, M. G., Putzu, V., Piccoli, T., Cuffaro, L., Monastero, R., Battaglia, A., Blandino, V., Lupo, F., Cumbo, E., Luca, A., Caravaglios, G., Vezzosi, A., Bessi, V., Tognoni, G., Calsolaro, V., Mossello, E., Amici, S., Trequattrini, A., Pezzuto, S., Mecocci, P., Fichera, G., Pradelli, S., Formilan, M., Coin, A., Togni, L. D., Sala, F., Nicolosi, V., Gallucci, M., Mazzarolo, A. P., Bergamelli, C., Zucca M., Isella V., Lorenzo R.D., Marra C., Cagnin A., Cupidi C., Bonanni L., Lagana V., Rubino E., Vanacore N., Agosta F., Caffarra P., Sambati R., Quaranta D., Guglielmi V., Appollonio I.M., Logroscino G., Filippi M., Tedeschi G., Ferrarese C., Rainero I., Bruni A.C., Gallo E., Grassini A., Marcinno A., Roveta F., Martino P.D., Frangipane F., Puccio G., Colao R., Mirabelli M., Martellacci N., Lino F., Mozzetta S., Busse C., Camporese G., Sacco S., Lechiara M.C., Carrarini C., Russo M., Casalena A., Sucapane P., Tiraboschi P., Caroppo P., Redaelli V., Fede G.D., Coppa D., Peluso L., Insarda P., Bartolo M.D., Esposito S., Iavarone A., Orsini A.V.M., Salvatore E., Criscuolo C., Sambati L., Santoro R., Gragnaniello D., Pedriali I., Ludovico L., Chiari A., Fabbo A., Bevilacqua P., Galli C., Magarelli S., Perini M., Spalletta G., Banaj N., Porcari D.E., Caruso G., Cipollini V., Casini A.R., Ursini F., Bruno G., Rozzini R., Brambilla M., Magnani G., Caso F., Spinelli E.G., Ramusino M.C., Perini G., Luzzi S., Cacchio G., Ciccola A., Cionfrini L., Giuli C., Fabi K., Guidi M., Paci C., Castellano A., Petrucci R., Accogli M., Carapelle E., Calabrese G., Trevisi G.N., Coluccia B., Giuliano A.V., Caggiula M., Impagnatiello V., Beretta F., Milia A., Pilia G., Mascia M.G., Putzu V., Piccoli T., Cuffaro L., Monastero R., Battaglia A., Blandino V., Lupo F., Cumbo E., Luca A., Caravaglios G., Vezzosi A., Bessi V., Tognoni G., Calsolaro V., Mossello E., Amici S., Trequattrini A., Pezzuto S., Mecocci P., Fichera G., Pradelli S., Formilan M., Coin A., Togni L.D., Sala F., Nicolosi V., Gallucci M., Mazzarolo A.P., Bergamelli C., Zucca, M, Isella, V, Di Lorenzo, R, Marra, C, Cagnin, A, Cupidi, C, Bonanni, L, Laganà, V, Rubino, E, Vanacore, N, Agosta, F, Caffarra, P, Sambati, R, Quaranta, D, Guglielmi, V, Appollonio, I, Logroscino, G, Filippi, M, Tedeschi, G, Ferrarese, C, Rainero, I, Bruni, A, Gallo, E, Grassini, A, Marcinnò, A, Roveta, F, De Martino, P, Frangipane, F, Puccio, G, Colao, R, Mirabelli, M, Martellacci, N, Lino, F, Mozzetta, S, Bussè, C, Camporese, G, Sacco, S, Lechiara, M, Carrarini, C, Russo, M, Casalena, A, Sucapane, P, Tiraboschi, P, Caroppo, P, Redaelli, V, Di Fede, G, Coppa, D, Peluso, L, Insarda, P, De Bartolo, M, Esposito, S, Iavarone, A, Orsini, A, Salvatore, E, Criscuolo, C, Sambati, L, Santoro, R, Gragnaniello, D, Pedriali, I, Ludovico, L, Chiari, A, Fabbo, A, Bevilacqua, P, Galli, C, Magarelli, S, Perini, M, Spalletta, G, Banaj, N, Porcari, D, Caruso, G, Cipollini, V, Casini, A, Ursini, F, Bruno, G, Rozzini, R, Brambilla, M, Magnani, G, Caso, F, Spinelli, E, Cotta Ramusino, M, Perini, G, Luzzi, S, Cacchiò, G, Ciccola, A, Cionfrini, L, Giuli, C, Fabi, K, Guidi, M, Paci, C, Castellano, A, Petrucci, R, Accogli, M, Carapelle, E, Calabrese, G, Trevisi, G, Coluccia, B, Vasquez Giuliano, A, Caggiula, M, Impagnatiello, V, Beretta, F, Milia, A, Pilia, G, Mascia, M, Putzu, V, Piccoli, T, Cuffaro, L, Monastero, R, Battaglia, A, Blandino, V, Lupo, F, Cumbo, E, Luca, A, Caravaglios, G, Vezzosi, A, Bessi, V, Tognoni, G, Calsolaro, V, Mossello, E, Amici, S, Trequattrini, A, Pezzuto, S, Mecocci, P, Fichera, G, Pradelli, S, Formilan, M, Coin, A, De Togni, L, Sala, F, Nicolosi, V, Gallucci, M, Mazzarolo, A, Bergamelli, C, Zucca, Milena, Isella, Valeria, Lorenzo, Raffaele Di, Marra, Camillo, Cagnin, Annachiara, Cupidi, Chiara, Bonanni, Laura, Laganà, Valentina, Rubino, Elisa, Vanacore, Nicola, Agosta, Federica, Caffarra, Paolo, Sambati, Renato, Quaranta, Davide, Guglielmi, Valeria, Appollonio, Ildebrando M., Logroscino, Giancarlo, Filippi, Massimo, Tedeschi, Gioacchino, Ferrarese, Carlo, Rainero, Innocenzo, and Bruni, Amalia C.
Subjects: Aging, medicine.medical_specialty, Cognitive Neuroscience, Population, Psychological intervention, Protective factor, Neurosciences. Biological psychiatry. Neuropsychiatry, burden, 03 medical and health sciences, stress, 0302 clinical medicine, stre, medicine, Dementia, caregiver, COVID-19, dementia, Psychiatry, education, Original Research, MED/26 - NEUROLOGIA, education.field_of_study, 030214 geriatrics, burden, caregiver, COVID-19, dementia, stress, Family caregivers, business.industry, medicine.disease, Mental health, Settore MED/26 - NEUROLOGIA, Anxiety, Caregiver stress, M-PSI/08 - PSICOLOGIA CLINICA, medicine.symptom, business, 030217 neurology & neurosurgery, Neuroscience, RC321-571
Abstract: Background: Family caregivers of patients with dementia are at high risk of stress and burden, and quarantine due to the coronavirus disease 2019 (COVID-19) pandemic may have increased the risk of psychological disturbances in this population. The current study was carried out during the national lockdown declared in March 2020 by the Italian government as a containment measure of the first wave of the coronavirus pandemic and is the first nationwide survey on the impact of COVID-19 lockdown on the mental health of dementia informal caregivers.Methods: Eighty-seven dementia centers evenly distributed on the Italian territory enrolled 4,710 caregiver–patient pairs. Caregivers underwent a telephone interview assessing classical symptoms of caregiver stress and concern for the consequences of COVID-19 infection on patient’s health. We calculated prevalence of symptoms and regressed them on various potential stress risk factors: caregivers’ sociodemographic characteristics and lifestyle, patients’ clinical features, and lockdown-related elements, like discontinuity in medical care.Results: Approximately 90% of caregivers reported at least one symptom of stress, and nearly 30% reported four or more symptoms. The most prevalent symptoms were concern for consequences of COVID-19 on patient’s health (75%) and anxiety (46%). The main risk factors for stress were identified as a conflicting relationship with the patient and discontinuity in assistance, but caregiver’s female sex, younger age, lower education, and cohabitation with the patient also had an impact. Availability of help from institutions or private individuals showed a protective effect against sense of abandonment but a detrimental effect on concern about the risk for the patient to contract COVID-19. The only protective factor was mild dementia severity, which was associated with a lower risk of feeling isolated and abandoned; type of dementia, on the other hand, did not affect stress risk.Conclusion: Our results demonstrate the large prevalence of stress in family caregivers of patients with dementia during the COVID-19 pandemic and have identified both caregivers and situations at a higher risk of stress, which should be taken into account in the planning of interventions in support of quarantined families and patients.
Published: 2021

21. Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia

Author: Morandi, A, Zambon, A, Di Santo SG, Mazzone, A, Cherubini, A, Mossello, E, Bo, M, Marengoni, A, Bellelli, G, Rispoli, V, Malara, A, Spadea, F, Di Cello, S, Ceravolo, F, Fabiano, F, Chiaradia, G, Amedeo, G, Peluso, L, Taristano, A, Settembrini, V, Capomolla, D, Citrino, A, Scriva, A, Bruno, I, Secchi, R, De Martino, E, Muccinelli, R, Lupi, G, Paonessa, P, Fabbri, A, Passuti, Mt, Castellari, S, Po, A, Gaggioli, G, Varesi, M, Moneti, P, Capurso, S, Latini, V, Ghidotti, S, Riccardelli, F, Macchi, M, Rigo, R, Pascale, C, Bosio, A, Cerrato, F, Bardelli, B, Boffelli, S, Cassinadri, A, Franzoni, S, Spazzini, E, Andretto, D, Tonini, G, Andreani, L, Coralli, M, Balotta, A, Cancelliere, R, Ballardini, G, Simoncelli, M, Mancini, A, Strazzacapa, M, Cavallino, P, Fabio, S, De Filippi, F, Giudice, C, Floris, P, D’Elia, K, Dentizzi, C, Azzini, M, Cazzadori, M, Mastroeni, V, Bertassello, P, Santana, H, Benati, C, Nesta, E, Tobaldini, C, Antonioli, A, Guerini, F, Tambare, E, Mombelloni, P, Fontanini, F, Lassa, G, Pizzorni, C, Oliverio, M, Del Grosso LL, Giavedoni, C, Bidoli, G, Mazzei, B, Corsonello, A, Fusco, S, Vena, S, De Vuono, T, Maiuri, G, Fimognari, Fl, Arone, A, Sgrò, G, Nicolazzo, R, Castegnaro, E, De Rosa, S, Bazzano Sechi, R, Benvenuti, E, Del Lungo, I, Giardini, S, Giulietti, C, Di Bari, M, Barghini, E, Paoli, M, Fiordelli, I, Barucci, R, Sgrilli, F, Bertoletti, E, D'Amico, F, Caronzolo, F, Grippa, A, Lombardo, G, Pipicella, T, Satta, A, Corica, F, Prestipino, Gv, Larosa, D, Cucinotta, D, Basile, G, March, A, Nitti, Mt, Felici, A, Pavan, S, Piazzani, F, Lunelli, A, Dimori, S, Margotta, A, Soglia, T, Postacchini, D, Brunelli, R, Santini, S, Francavilla, M, Macchiati, I, Sorvillo, F, Giuli, C, Mecocci, P, Longo, A, Conestabile della Staffa, M, Perticone, F, Addesi, D, Cella Rosa, P, Bencardino, G, Falbo, T, Grillo, N, Marco, F, Mirella, F, Fantò, F, Isaia, G, Pezzilli, S, Bergamo, D, Furno, E, Rrodhe, S, Lucarini, S, Dijk, B, Dall'Acqua, F, Cappelletto, F, Calvani, D, Becheri, D, Mottino, G, Mitidieri, C, Vito, A, Bartalucci, F, Magherini, L, Malin, N, Boni, F, Gambardella, L, Valente, C, Bracali, I, Foschini, A, Porrino, P, Ceci, G, Bottignole, G, Tibaldi, M, Coppo, E, Ettore, E, Camellini, C, Servello, A, Grassi, A, Rozzini, R, Tironi, S, Grassi, Mg, Troisi, E, Caltagirone, C, Franchini, F, Ratto, F, Pavani, B, Toniolo, S, Gabutto, A, Quazzo, L, Rosatello, A, Suraci, D, Tagliabue, B, Perrone, C, Ferrara, L, Castagna, A, Tremolada, Ml, Castoldi, G, Barbero, S, Oltramonti, D, Piano, S, Serviddio, G, Lo Buglio, A, Gurrera, T, Merlo, V, Rovai, C, Cotroneo, Am, Carlucci, R, Abbaldo, A, Monzani, F, Qasem, Aa, Bini, G, Tafuto, S, Galli, G, Bruni, Ac, Mancuso, G, Calipari, D, De Luca GM, Bernardini, B, Corsini, C, Ciccarelli, M, Dal Farra, S, Cagnin, A, Fragiacomo, F, Pompanin, S, Amodio, P, Cagnin, M, Zurlo, A, Guerra, G, Pala, M, Menozzi, L, Delli Gatti, C, Magon, S, Manfredini, R, De Giorgi, A, Fabbian, F, Tiseo, R, Misurati, E, Boari, B, Molino, C, Gallerani, M, Di Francesco, V, Faccioli, S, Pellizzari, L, Fontana, G, Barbagallo, G, Limone, G, Lunardelli, Ml, Martini, E, Ferrari, E, Macchiarulo, M, Corneli, M, Bacci, M, Battaglia, G, Anastasio, L, Lo Storto MS, Seresin, C, Simonato, M, Loreggian, M, Cestonaro, F, Durando, M, Latella, R, Mazzoleni, M, Russo, G, Ponte, M, Valchera, A, Salustri, G, Petritola, D, Costa, A, Sinforiani, E, Cotta, Mr, Pizio, Rn, Cester, A, Formilan, M, Bonometto, P, Carbone, P, Cazzaniga, I, Appollonio, I, Cereda, D, Stabile, A, Xhani, R, Acampora, R, Tremolizzo, L, Pieruzzi, F, Ciaccio, A, Pontecorvi, V, Butti, C, Mokini, Z, Vitale, G, Amigoni, M, Sparacino, M, Bottacchi, E, Bucciantini, E, Di Giovanni, M, Franchi, F, Lucchetti, L, Mariani, C, Grande, G, Rapazzini, P, Mauri, M, Romanelli, G, Nicosia, F, Margola, A, Bonardelli, A, Latronico, N, Porcella, L, Portolani, N, Concoreggi, C, Grassini, C, Salvi, A, Banchetti, L, Spagnoli, F, Apuzzo, R, Fontanella, M, Ceraso, A, Castelli, F, Fugazza, 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Mr, Prestano, R, Dalise, Am, Barra, D, Dal Bosco, L, Asprinio, V, Dallape, L, Perina, E, Incalzi, Ra, Rossi Bartoli, I, Pluderi, A, Maina, A, Pecoraro, E, Sciarra, M, Prudente, A, Maina, P, Mete, F, Ventura, M, Cesari, L, Pernigotti, Lm, Santangelo, T, Benini, L, Levato, F, Mhiuta, V, Alius, F, Davidoaia, D, Giardini, V, Garancini, M, Bellamoli, C, Terranova, L, Bozzini, C, Tosoni, P, Provoli, E, Cascone, L, Dioli, A, Ferrarin, G, Bucci, A, Bua, G, Fenu, S, Bianchi, G, Casella, S, Romano, V, Poli, M, Mascherona, I, Belotti, G, Cavaliere, S, Cuni, E, Merciuc, N, Oberti, R, Veneziani, S, Capoferri, E, De Bernardi, E, Colombo, K, Bellini, G, Bravi, M, Negrinotti, N, D'Arcangelo, P, Montenegro, N, Montanari, R, Lamanna, P, Gasperini, B, Montesi, I, Diotallevi, S, Altobelli, G, Calcinaro, F, Palamà, C, Di Emidio, C, Scarpini, E, Arighi, A, Fumagalli, G, Basilico, P, De Amicis Migone, M, Mancarella, M, Maira, D, Granata, A, Ranalli, C, Cammilli, A, Cavallini, Mc, Tricca, M, Natella, D, 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Serra, F, D’Agostino, V, Gianolla, F, Pietrangeli, L, Velardi, A, Di Cello, E, Rosati, C, Casali, N, Sessa, M, Abruzzi, L, Costanzi, C, Bini, P, Pignata, M, Bonagurio, E, Vollery, M, Carrieri, G, Cioni, G, Toschi, A, Metra, M, Ranieri, P, Zucchelli, A, Ceccon, A, Magrin, L, Marin, S, Barbara, S, Ghedini, L, Moroni, M, Pitagora, M, Pallotti, Mc, Gottardi, F, Tomasoni, C, Cappuccio, M, Guerini, S, Guerini, V, Merla, L, Tovaglieri, M, Bongiorni, N, Grillo, A, Arenare, F, Tonino, M, Kanah, D, Vianello, Pg, Balducci, U, Sidoti, V, Montanari, S, Murelli, T, Busonera, F, Albanese, P, Maselli, M, Bolzetta, F, Fabris, R, Durante Mangoni, E, Testoni, M, Di Stefano, F, Seccia, L, Morabito, D, Sonzina, V, Fabiano, M, Di Giorgio Annabella, De Cosmo Salvatore, Greco, A, D’Onofrio, G, Sancarlo, D, Resta, G, Girardello, R, Minervini, S, Boni, M, Vitali, Mg, Pizzoni, M, De Colle, P, Frattola, A, Orlandini, F, La Regina, M, Filice, M, Padulo, F, Margheriti, C, Rolano, D, Sacchelli, C, Moscatelli, G, Radaelli, G, Montini, E, Novello, M, Bramuzzo, I, Bertin, N, Rinaldo, E, Paolillo, C, Riccardi, A, Benedetti, C, Ricci, B, Montagna, F, Cutaia, C, Baca, O, Colombo, M, Procino, G, Tararà, R, Dell’Acqua, D, Cislaghi, S, Cairati, M, Porta, M, Scaglione, L, De Feo, M, Vertolli, P, Salvati, L, Cinotti, S, De Santis, V, Biferi, E, Cheli, P, Rebizzo, R, Minisola, S, Colangelo, L, Abete, P, Liguori, I, Curcio, F, Spassini, G, Engheben, M, Rotunno, S, Arosio, P, Angelini, C, Reggiani, F, Cappelli, A, Marcheselli, S, Fratticci, L, Ranzani, P, Cesarini, S, Cerini, A, Generoso, U, Gallucci, F, Serra, E, Sola, M, Delitala, A, Pes, C, Lobianco, G, Giani, A, Famularo, S, Sandini, M, Pinotti, E, Gianotti, L, Alessandro, D, Chiara, P, Giulia, L, Alessandro, G, Giannotti, L, Battuello, A, Pintore, G, Rossi, A, Rubele, S, Sant, S, Vignati, M, Clerici, D, Rosa, F, Bandirali, Mp, Cattaneo, N, Boffi, L, Avalli, L, Scanziani, M, De Notaris, S, Del Santo, P, Catalano, F, Fogli, D, Di Bella, G, Landi, F, 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A., Morandi A., Zambon A., Di Santo S.G., Mazzone A., Cherubini A., Mossello E., Bo M., Marengoni A., Piccoli T., Bellelli G., Rispoli V., Malara A., Spadea F., Di Cello S., Ceravolo F., Fabiano F., Chiaradia G., Gabriele A., Lenino P., Andrea T., Settembrini V., Capomolla D., Citrino A., Scriva A., Bruno I., Secchi R., De Martino E., Muccinelli R., Lupi G., Paonessa P., Fabbri A., Passuti M.T., Castellari S., Po A., Gaggioli G., Varesi M., Moneti P., Capurso S., Latini V., Ghidotti S., Riccardelli F., Macchi M., Rigo R., Claudio P., Angelo B., Flavio C., Benedetta B., Boffelli S., Cassinadri A., Franzoni S., Spazzini E., Andretto D., Tonini G., Andreani L., Coralli M., Balotta A., Cancelliere R., Ballardini G., Simoncelli M., Mancini A., Strazzacapa M., Fabio S., De Filippi F., Giudice C., Dentizzi C., Azzini M., Cazzadori M., Mastroeni V., Bertassello P., Claudia Benati H.S., Nesta E., Tobaldini C., Guerini F., Elena T., Mombelloni P., Fontanini F., Gabriella L., Pizzorni C., Oliverio M., Del Grosso L.L., Giavedoni C., Bidoli G., Mazzei B., Corsonello A., Fusco S., Vena S., De Vuono T., Maiuri G., Luca F.F., Andrea A., Giovanni S., Rossella N., Castegnaro E., De Rosa S., Sechi R.B., Benvenuti E., Del Lungo I., Giardini S., Giulietti C., Mauro D.B., Eleonora B., Martina P., Irene F., Riccardo B., Federica S., Ilaria D.L., Bertoletti E., D'Amico F., Caronzolo F., Grippa A., Lombardo G., Pipicella T., Antonino S., Francesco C., Valeria P.G., Daniela L., Domenico C., Giorgio B., March A., Nitti M.T., Felici A., Pavan S., Piazzani F., Lunelli A., Dimori S., Margotta A., Soglia T., Postacchini D., Brunelli R., Santini S., Francavilla M., Macchiati I., Sorvillo F., Giuli C., Mecocci P., Longo A., Perticone F., Addesi D., Rosa P.C., Bencardino G., Falbo T., Grillo N., Marco F., Mirella F., Fanto F., Isaia G., Pezzilli S., Bergamo D., Furno E., Rrodhe S., Lucarini S., Dijk B., Dall'Acqua F., Cappelletto F., Calvani D., Becheri D., Giuseppe M., Costanza M., Vito A., Francesca B., Magherini L., Novella M., Franca B., Lucia Gambardella P.M., Valente C., Ilaria B., Alice F., Porrino P., Ceci G., Giuliana B., Michela T., Eleonora C., Ettore E., Camellini C., Servello A., Grassi A., Rozzini R., Tironi S., Grassi M.G., Troisi E., Carlo C., Simona Gabriella D.S., Flaminia F., Federica R., Beatrice P., Sofia T., Gabutto A., Quazzo L., Rosatello A., Suraci D., Tagliabue B., Perrone C., Ferrara L., Castagna A., Tremolada M.L., Giuseppe C., Stefano B., Davide O., Piano S., Serviddio G., Lo Buglio A., Gurrera T., Merlo V., Rovai C., Cotroneo A.M., Carlucci R., Abbaldo A., Monzani F., Qasem A.A., Bini G., Tafuto S., Galli G., Bruni A.C., Mancuso G., Calipari D., Giuseppe Massimiliano D.L., Bernardini B., Corsini C., Michele C., Sara D.F., Cagnin A., Fragiacomo F., Pompanin S., Piero A., Marco C., Zurlo A., Guerra G., Pala M., Menozzi L., Gatti C.D., Magon S., Roberto M., Alfredo D.G., Fabio F., Ruana T., Elisa M., Christian M., Marco P., Massimo G., Di Francesco V., Faccioli S., Pellizzari L., Giorgia F., Barbagallo G., Lunardelli M.L., Martini E., Ferrari E., Macchiarulo M., Corneli M., Bacci M., Battaglia G., Anastasio L., Lo Storto M.S., Seresin C., Simonato M., Loreggian M., Cestonaro F., Durando M., Latella R., Mazzoleni M., Russo G., Ponte M., Valchera A., Salustri G., Petritola D., Costa A., Sinforiani E., Cotta M.R., Pizio R.N., Cester A., Formilan M., Pietro B., Carbone P., Cazzaniga I., Appollonio I., Cereda D., Stabile A., Xhani R., Acampora R., Tremolizzo L., Federico P., Antonio C., Valerio P., Cesare B., Zhirajr M., Giovanni V., Maria A., Mariaelena S., Bottacchi E., Bucciantini E., Di Giovanni M., Franchi F., Lucchetti L., Mariani C., Grande G., Rapazzini P., Marco M., Romanelli G., Franco N., Alessio M., Nicola L., Laura P., Nazario P., Chiara G., Soccorso P., Andrea S., Luca B., Francesca S., Roberto A., Anna C., Fugazza L., Guerrini C., De Paduanis G., Iallonardo L., Palumbo P., Zuliani G., Ortolani B., Capatti E., Soavi C., Bianchi L., Francesconi D., Miselli A., Gloria B., Tommaso R., Chiara P., Agata M.M., Marco D.A., Luca M., Gianluca G., Suardi T., Zaccarini C., Manuela R., Mirra G., Muti E., Bottura R., Gianpaolo M., Secreto P., Bisio E., Cecchettani M., Naldi T., Pallavicino A., Pugliese M., Iozzo R.C., Grassi G., Michele B., Raffaella D.O., Fosca Q.T., Giorgio G.C., Giovanni P., Ernesto C., Mannironi A., Giorli E., Oberti S., Fierro B., Giacalone F., Mandas A., Serchisu L., Costaggiu D., Pinna E., Orru F., Mannai M., Cordioli Z., Pelizzari L., Turcato E., Arduini P., Cacace C., Chiloiro R., Cimino R., Ruberto C., Giovanni R., Pietro G., Laura G., Alberto C., Carmen R., Santo P.D., Andriolli A., Burattin G., Rossi L., Andreolli Antonino C.G., Tezza F., Maddalena P., Laura S., Crippa P., Aloisio P., Di Monda T., Malighetti A., Galbassini G., Salutis D., Ivaldi C., Russo A.M., Bennati E., Pino E., Zavarise G., Pesci A., Suigo G., Faverio P., Andrea G., Sabrina P., Zanasi M., Moniello G., Rostagno C., Cartei A., Polidori G., Ungar A., Melis M.R., Martellini E., Enrico M., Monica T., Antonella G., Giovanna L., Migliorini M., Caramelli F., Battiston B., Berardino M., Cavallo S., Alessandro M., Anna S., Lombardi B., D'Ippolito P., Furini A., Villani D., Clara R., Guarneri M., Paolucci S., Bassi A., Coiro P., De Angelis D., Morone G., Venturiero V., Palleschi L., Raganato P., Di Niro G., Rosa C.A., Loredana B., Imoscopi A., Tibaldi V., Bottignole G G., Calvi E., Clementi C., Zanocchi M., Agosta L., Nortarelli A., Provenzano G., Mari D., Romano F.Y., Rosini F., Mansi M., Rossi S., Geriatria A.R., Inzaghi L., Bonini G., Rossi P., Potena A., Lichii M., Candiani T., Grimaldi W., Bertani E., Alessandra P., Calogero P., Pinto D., Bernardi R., Nicolino F., Galetti C., Gianstefani A., Giulia C., Lorenzo M., Odetti P., Monacelli F., Prefumo M., Fiammetta M., Canepa M., Minaglia C., Paolisso G., Rizzo M.R., Prestano R., Dalise A.M., Barra D., Bosco L.D., Asprinio V., Dallape L., Perina E., Incalzi R.A., Bartoli I.R., Pluderi A., Maina A., Pecoraro E., Sciarra M., Prudente A., Paola M., Francesca M., Manuel V., Luisella C., Maria P.L., Tina S., Benini L., Levato F., Mhiuta V., Alius F., Davidoaia D., Giardini V., Garancini M., Bellamoli C., Terranova L., Bozzini C., Tosoni P., Provoli E., Cascone L., Dioli A., Ferrarin G., Bucci A., Bua G., Fenu S., Bianchi G., Casella S., Romano V., Maurizio P., Mascherona I., Belotti G., Cavaliere S., Cuni E., Merciuc N., Oberti R., Veneziani S., Capoferri E., De Bernardi E., Colombo K., Bravi M., Nicoletta N., D'Arcangelo P., Montenegro N., Montanari R., Lamanna P., Gasperini B., Isabella M., Stefania D., Gaia A., Filippo C., Palama C., Di Emidio C., Scarpini E., Arighi A., Fumagalli G., Basilico P., De Amicis Margherita M., Marta M., Diletta M., Granata A., Ranalli C., Cammilli A., Cavallini M.C., Tricca M., Natella D., Gabbani L., Tesi F., Martella L., Imbrici R., Guerrini G., Scotuzzi A.M., Sozzi F., Valenti L., Chiarello A., Monia M., Pilotto A., Prete C., Senesi B., Meta A.C., Pendenza E., Pasqualetti G., Polini A., Tognini S., Ballino E., Dell'Aquila G., Gasparrini P.M., Marotti E., Migale M., Scrimieri A., Falsetti L., Salvi A., Toigo G., Ceschia G., Rosso A., Tongiorgi C., Scarpa C., De Dominicis L., Pucci E., Renzi S., Cartechini E., Tomassini P.F., Del Gobbo M., Ugenti F., Romeo P., Nardelli A., Lauretani F., Visioli S., Montanari I., Ermini F., Giordano A., Pigato G., Simeone E., Barbujani M., Giampieri M., Amoruso R., Piccinini M., Ferrari C., Gambetti C., Sfrappini M., Semeraro L., Striuli R., Pelliccioni G., Marinelli D., Fabi K., Rossi T., Pesallaccia M., Sabbatini D., Gobbi B., Cerqua R., Tagliani G., Schlauser E., Caser L., Caramello E., Sandigliano F., Rosso G., Ferrari A., Bendini C., Luisa D.M., Casella M., Prampolini R., Scevola M., Vitale E., Roberto B., Carlo F., Sergio F., Alberto S., Daniela Z., Giulia B., Serena G., Maugeri D., Sorace R., Anzaldi M., De Gesu R., Morrone G., Davolio F., Fabbo A., Palmieri M., Zoli M., Forti P., Pirazzoli L., Fabbri E., Terenzi L., Bergolari F., Wenter C., Ruffini I., Insam M., Abraham E., Kirchlechner C., Cucinotta D., Antonino L., Basile G., Grazia A.M., Parise P., Boccali A., Amici S., Gambacorta M., Lasagni A., Lovati R., Giovinazzo F., Kimak E., Zappa P., Medici F., Lo Castro M., Mauro F., De Luca A., Sancesario G., Martorana A., Scaricamazza B., Toniolo S., Di Lorenzo F., Liguori C., Lasco A., Vita N., Giomi M., Forte F., Padovani A., Rozzini L., Ceraso A., Salvatore C., Cottino M., Vitali S., Marelli E., Tripi G., Miceli S., Urso G., Grioni G., Vezzadini G., Misaggi G., Forlani C., Avanzi S., Serena S., Claudia C., Marilena V., Alberto L., Diego G., Alessandro G., Iemolo F., Sanzaro E., D'Asta G., Proietto M., Carnemolla A., Razza G., Spadaro D., Bertolotti M., Mussi C., Neviani F., Roberto C., Valentina G., Linda M., Francesca V., Tarozzi A., Balestri F., Mannarino G., Bigolari M., Natale A., Grassi S., Bottaro C., Stefanelli S., Bovone U., Tortorolo U., Quadri R., Leone G., Ponzetto M., Frasson P., Annoni G., Bruni A., Confalonieri R., Corsi M., Moretti D., Teruzzi F., Umidi S., Mazzola P., Perego S., Persico I., Olivieri G., Bonfanti A., Hajnalka S., Galeazzi M., Massariello F., Anzuini A., Caffarra P., Barocco F., Spallazzi M., Paolo C.G., Simonetta M., Chioatto P., Bortolamei S., Soattin L., Ruotolo G., Beneamino B., Giuseppe B., Bertazzoli M., Rota E., Adobati A., Scarpa A., Granziera S., Zuccher P., Fabbro A.D., Zara D., Lo Nigro A., Franchetti L., Toniolo M., Marcuzzo C., Rollone M., Guerriero F., Sgarlata C., Masse A., Zatti G., Piatti M., Graci J., Benati G., Boschi F., Biondi M., Fiumi N., Erika T., Locatelli S.M., Mauri S., Beretta M., Margheritis L., Desideri G., Liberatore E., Carucci A.C., Bonino P., Caput M., Antonietti M.P., Polistena G., De la Pierre F., Mari M., Massignani P., Tombesi F., Selvaggio F., Verbo B., Bodoni P., Marchionni N., Sabatini T., Mussio E., Magni E., Bianchetti A., Crucitti A., Titoldini G., Cossu B., Fascendini S., Licini C., Tomasoni A., Calderazzo M., Daniela T., Valentina L., Melotti R.M., Lilli A., Buda S., Adversi M., Noro G., Turco R., Ubezio M.C., Mantovani A.R., Viola M.C., Serrati C., Pretta S., Infante M., Gentile S., D'Ambrosio V., Mazzanti P., Brambilla C., Sportelli S., Platto C., Faraci B., Quattrocchi D., Pernigotti L.M., Pisu C., Sicuro F., Zagnoni P., Ghiglia S., Mosca M., Corazzin I., Deola M., Biagini C.A., Bencini F., Cantini C., Tonon E., Pierinelli S., Onofrj M., Thomas A., Filomena B., Bonanni L., Gabriella C., Comi G., Magnani G., Santangelo R., Mazzeo S., Francesca C., Giordano C., Roberto S.A., Barbieri C., Giroldi L., Bandini F., Masina M., Malservisi S., Cicognani A., Ricca L., Piccininni M., Tassinari T., Brogi D., Sugo A., Alessandra F., Sonia M., Valerio V., Andrea U.C., Enrico C., Vera R.F., Assunta S., Gianmaria Z., Mauro P., Barone A., Razzano M., Giuseppe I., Angela B., Francesco S., Valeria D.A., Federico G., Lucia P., Antonella V., Elisabetta D.C., Cristina R., Nadia C., Maria S., Luciano A., Chiara C., Bini P., Pignata M., Enrico B., Maria V., Giovanni C., Giorgio C., Piera R., Alberto Z., Ceccon A., Magrin L., Marin S., Barbara S., Matteo M., Caterina P.M., Carla R., Federica G., Clara T., Melania C., Giampaolo B., Stefano G., Valeria G., Lucia M., Giovambattista D., Ester L., Cecilia C.A., Maurizio T., Nadia B., Grillo A., Arenare F., Tonino M., David K., Giorgio V.P., Ubaldo B., Vincenzo S., Stefano M., Marino F., Busonera Flavio M.T., Paolo A., Monica M., Francesco B., Roberto F., Paolo B., DuranteMangoni E., Testoni M., Fabio D.S., Loredana S., Valeria S., Fabiano M., Annabella D.G., Salvatore D.C., Greco A., Grazia D.O., Daniele S., Gianluca R., Renzo G., Sergio M., Morena B., Vitali M., Marina P., Paolo D.C., Cristina S., Orlandini F., La Regina M., Desiree A., Mario B., Paola P., Padulo F., Cristina M., Dario R., Giancarla M., Guido R., Elena M., Marileda N., Igor B., Nicole B., Elena R., Paolillo C., Riccardi A., Claudia B., Barbara R., Silvia V., Oliver B., Mauro C., Eleonora M., Giuseppe P., Rosaria T., Maria C., Davide D.A., Stefania C., Massimo P., Luca S., Martina D.F., Paola V., Lia S., Sandro C., Valentina D.S., Erminia B., Paola C., Romina R., Minisola S., Luciano C., Pasquale A., Ilaria L., Guglielmo S., Marco E., Sara R., Paola A., Claudio A., Francesco R., Alessandro C., Simona M., Lara F., Paola R., Simonetta C., Antonella C., Generoso U., Fernando G., Giuliano C., Emanuela S., Mariolina S., Alessandro D., Giulia L., Famularo S., Sandini M., Pinotti E., Gianotti L., Antonella B., Giulia P., Sante G., Rossi A., Rubele S., Sant S., Marco V., Danila C., Fabio R., Bandirali M.P., Nicoletta C., Laura B., Paolo T., Luciano T., Leonello A., Margherita S., Stefania D.N., Pierluigi D.S., Laura R., Fabiana T., Giovanna C., Antonino A., Felice C., Danilo F., Giovanna D.B., Francesco L., Salini S., Angela B.M., Giorgetta C., Giovanni G., Gerardo B., Silvio R., Letizia S., Davide B., Rosaria R.M., Maria D.A., Raffaele P., Palmieri V.O., Palasciano G., Belfiore A., Portincasa P., Carlo S., Alessia D., Valiani V., Carolina B., Tiziana C., Paola T., Ugo P., Giacomo P., Castellano M., Anna G., Elisa C., Federica C., Antonietta C.M., Luigi M., Fabio L., Salvatore B., Gelosa G., Viviana A.T., Piras V., Andrea C., Alessandra B., Coen D., Magliola R., Milanesio D., Muzzulini C.L., Paolo F., Marinella T., Sofia C.M., Marta B., Siano P., Capo G., Napoletano R., Cecilia P., Mancini C., Del Buono C., De Bartolomeo G., Addolorata M., Carmen C., Giovanni V.A., Moschettini G., Franco M., Daniela R., D'Amico G., Mirella P., Endrizzi C., Trotta L., Ciarambino T., Orazio Z., Emanuela T., Marta S., Thomas F., Giacomo T., Ignazio D.F., Andrea B., Giuseppe O., Emanuela F., Serena A., Elena D.I., Serena B., Erika N., Roberto S., Elena S., Manuela P., Francesca A., Angelo T., Morandi, A, Zambon, A, Di Santo, S, Mazzone, A, Cherubini, A, Mossello, E, Bo, M, Marengoni, A, Bellelli, G, Rispoli, V, Malara, A, Spadea, F, Di Cello, S, Ceravolo, F, Fabiano, F, Chiaradia, G, Gabriele, A, Lenino, P, Andrea, T, Settembrini, V, Capomolla, D, Citrino, A, Scriva, A, Bruno, I, Secchi, R, De Martino, E, Muccinelli, R, Lupi, G, Paonessa, P, Fabbri, A, Passuti, M, Castellari, S, Po, A, Gaggioli, G, Varesi, M, Moneti, P, Capurso, S, Latini, V, Ghidotti, S, Riccardelli, F, Macchi, M, Rigo, R, Claudio, P, Angelo, B, Flavio, C, Benedetta, B, Boffelli, S, Cassinadri, A, Franzoni, S, Spazzini, E, Andretto, D, Tonini, G, Andreani, L, Coralli, M, Balotta, A, Cancelliere, R, Ballardini, G, Simoncelli, M, Mancini, A, Strazzacapa, M, Fabio, S, De Filippi, F, Giudice, C, Dentizzi, C, Azzini, M, Cazzadori, M, Mastroeni, V, Bertassello, P, Claudia Benati, H, Nesta, E, Tobaldini, C, Guerini, F, Elena, T, Mombelloni, P, Fontanini, F, Gabriella, L, Pizzorni, C, Oliverio, M, Del Grosso, L, Giavedoni, C, Bidoli, G, Mazzei, B, Corsonello, A, Fusco, S, 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Caramelli, F, Battiston, B, Berardino, M, Cavallo, S, Alessandro, M, Anna, S, Lombardi, B, D'Ippolito, P, Furini, A, Villani, D, Clara, R, Guarneri, M, Paolucci, S, Bassi, A, Coiro, P, De Angelis, D, Morone, G, Venturiero, V, Palleschi, L, Raganato, P, Di Niro, G, Rosa, C, Loredana, B, Imoscopi, A, Tibaldi, V, Bottignole G, G, Calvi, E, Clementi, C, Zanocchi, M, Agosta, L, Nortarelli, A, Provenzano, G, Mari, D, Romano, F, Rosini, F, Mansi, M, Rossi, S, Geriatria, A, Inzaghi, L, Bonini, G, Rossi, P, Potena, A, Lichii, M, Candiani, T, Grimaldi, W, Bertani, E, Alessandra, P, Calogero, P, Pinto, D, Bernardi, R, Nicolino, F, Galetti, C, Gianstefani, A, Giulia, C, Lorenzo, M, Odetti, P, Monacelli, F, Prefumo, M, Fiammetta, M, Canepa, M, Minaglia, C, Paolisso, G, Rizzo, M, Prestano, R, Dalise, A, Barra, D, Bosco, L, Asprinio, V, Dallape, L, Perina, E, Incalzi, R, Bartoli, I, Pluderi, A, Maina, A, Pecoraro, E, Sciarra, M, Prudente, A, Paola, M, Francesca, M, Manuel, V, Luisella, C, Maria, P, Tina, S, Benini, L, Levato, F, Mhiuta, V, Alius, F, Davidoaia, D, Giardini, V, Garancini, M, Bellamoli, C, Terranova, L, Bozzini, C, Tosoni, P, Provoli, E, Cascone, L, Dioli, A, Ferrarin, G, Bucci, A, Bua, G, Fenu, S, Bianchi, G, Casella, S, Romano, V, Maurizio, P, Mascherona, I, Belotti, G, Cavaliere, S, Cuni, E, Merciuc, N, Oberti, R, Veneziani, S, Capoferri, E, De Bernardi, E, Colombo, K, Bravi, M, Nicoletta, N, D'Arcangelo, P, Montenegro, N, Montanari, R, Lamanna, P, Gasperini, B, Isabella, M, Stefania, D, Gaia, A, Filippo, C, Palama, C, Di Emidio, C, Scarpini, E, Arighi, A, Fumagalli, G, Basilico, P, De Amicis Margherita, M, Marta, M, Diletta, M, Granata, A, Ranalli, C, Cammilli, A, Cavallini, M, Tricca, M, Natella, D, Gabbani, L, Tesi, F, Martella, L, Imbrici, R, Guerrini, G, Scotuzzi, A, Sozzi, F, Valenti, L, Chiarello, A, Monia, M, Pilotto, A, Prete, C, Senesi, B, Meta, A, Pendenza, E, Pasqualetti, G, Polini, A, Tognini, S, Ballino, E, Dell'Aquila, G, Gasparrini, P, Marotti, E, Migale, M, Scrimieri, A, Falsetti, L, Salvi, A, Toigo, G, Ceschia, G, Rosso, A, Tongiorgi, C, Scarpa, C, De Dominicis, L, Pucci, E, Renzi, S, Cartechini, E, Tomassini, P, Del Gobbo, M, Ugenti, F, Romeo, P, Nardelli, A, Lauretani, F, Visioli, S, Montanari, I, Ermini, F, Giordano, A, Pigato, G, Simeone, E, Barbujani, M, Giampieri, M, Amoruso, R, Piccinini, M, Ferrari, C, Gambetti, C, Sfrappini, M, Semeraro, L, Striuli, R, Pelliccioni, G, Marinelli, D, Fabi, K, Rossi, T, Pesallaccia, M, Sabbatini, D, Gobbi, B, Cerqua, R, Tagliani, G, Schlauser, E, Caser, L, Caramello, E, Sandigliano, F, Rosso, G, Ferrari, A, Bendini, C, Luisa, D, Casella, M, Prampolini, R, Scevola, M, Vitale, E, Roberto, B, Carlo, F, Sergio, F, Alberto, S, Daniela, Z, Giulia, B, Serena, G, Michele, B, Maugeri, D, Sorace, R, Anzaldi, M, De Gesu, R, Morrone, G, Davolio, F, Fabbo, A, Palmieri, M, Zoli, M, Forti, P, Pirazzoli, L, Fabbri, E, Terenzi, L, Bergolari, F, Wenter, C, Ruffini, I, Insam, M, Abraham, E, Kirchlechner, C, Cucinotta, D, Antonino, L, Basile, G, Grazia, A, Parise, P, Boccali, A, Amici, S, Gambacorta, M, Lasagni, A, Lovati, R, Giovinazzo, F, Kimak, E, Zappa, P, Medici, F, Lo Castro, M, Mauro, F, De Luca, A, Sancesario, G, Martorana, A, Scaricamazza, B, Toniolo, S, Di Lorenzo, F, Liguori, C, Lasco, A, Vita, N, Giomi, M, Forte, F, Padovani, A, Rozzini, L, Ceraso, A, Salvatore, C, Cottino, M, Vitali, S, Marelli, E, Tripi, G, Miceli, S, Urso, G, Grioni, G, Vezzadini, G, Misaggi, G, Forlani, C, Avanzi, S, Serena, S, Claudia, C, Marilena, V, Alberto, L, Diego, G, Alessandro, G, Iemolo, F, Sanzaro, E, D'Asta, G, Proietto, M, Carnemolla, A, Razza, G, Spadaro, D, Bertolotti, M, Mussi, C, Neviani, F, Roberto, C, Valentina, G, Linda, M, Francesca, V, Tarozzi, A, Balestri, F, Mannarino, G, Bigolari, M, Natale, A, Grassi, S, Bottaro, C, Stefanelli, S, Bovone, U, Tortorolo, U, Quadri, R, Leone, G, Ponzetto, M, Frasson, P, Annoni, G, Confalonieri, R, Corsi, M, Moretti, D, Teruzzi, F, Umidi, S, Mazzola, P, Perego, S, Persico, I, Olivieri, G, Bonfanti, A, Hajnalka, S, Galeazzi, M, Massariello, F, Anzuini, A, Caffarra, P, Barocco, F, Spallazzi, M, Paolo, C, Simonetta, M, Chioatto, P, Bortolamei, S, Soattin, L, Ruotolo, G, Beneamino, B, Giuseppe, B, Bertazzoli, M, Rota, E, Adobati, A, Scarpa, A, Granziera, S, Zuccher, P, Fabbro, A, Zara, D, Lo Nigro, A, Franchetti, L, Toniolo, M, Marcuzzo, C, Rollone, M, Guerriero, F, Sgarlata, C, Masse, A, Zatti, G, Piatti, M, Graci, J, Benati, G, Boschi, F, Biondi, M, Fiumi, N, Erika, T, Locatelli, S, Mauri, S, Beretta, M, Margheritis, L, Desideri, G, Liberatore, E, Carucci, A, Bonino, P, Caput, M, Antonietti, M, Polistena, G, De la Pierre, F, Mari, M, Massignani, P, Tombesi, F, Selvaggio, F, Verbo, B, Bodoni, P, Marchionni, N, Sabatini, T, Mussio, E, Magni, E, Bianchetti, A, Crucitti, A, Titoldini, G, Cossu, B, Fascendini, S, Licini, C, Tomasoni, A, Calderazzo, M, Daniela, T, Valentina, L, Melotti, R, Lilli, A, Buda, S, Adversi, M, Noro, G, Turco, R, Ubezio, M, Mantovani, A, Viola, M, Serrati, C, Pretta, S, Infante, M, Gentile, S, D'Ambrosio, V, Mazzanti, P, Brambilla, C, Sportelli, S, Platto, C, Faraci, B, Quattrocchi, D, Pernigotti, L, Pisu, C, Sicuro, F, Zagnoni, P, Ghiglia, S, Mosca, M, Corazzin, I, Deola, M, Biagini, C, Bencini, F, Cantini, C, Tonon, E, Pierinelli, S, Onofrj, M, Thomas, A, Filomena, B, Bonanni, L, Gabriella, C, Comi, G, Magnani, G, Santangelo, R, Mazzeo, S, Francesca, C, Giordano, C, Roberto, S, Barbieri, C, Giroldi, L, Bandini, F, Masina, M, Malservisi, S, Cicognani, A, Ricca, L, Piccininni, M, Tassinari, T, Brogi, D, Sugo, A, Alessandra, F, Sonia, M, Valerio, V, Andrea, U, Enrico, C, Vera, R, Assunta, S, Gianmaria, Z, Mauro, P, Barone, A, Razzano, M, Giuseppe, I, Angela, B, Francesco, S, Valeria, D, Federico, G, Lucia, P, Antonella, V, Elisabetta, D, Cristina, R, Nadia, C, Maria, S, Luciano, A, Chiara, C, Bini, P, Pignata, M, Enrico, B, Maria, V, Giovanni, C, Giorgio, C, Piera, R, Alberto, Z, Ceccon, A, Magrin, L, Marin, S, Barbara, S, Matteo, M, Caterina, P, Carla, R, Federica, G, Clara, T, Melania, C, Giampaolo, B, Stefano, G, Valeria, G, Lucia, M, Giovambattista, D, Ester, L, Cecilia, C, Maurizio, T, Nadia, B, Grillo, A, Arenare, F, Tonino, M, David, K, Giorgio, V, Ubaldo, B, Vincenzo, S, Stefano, M, Marino, F, Busonera Flavio, M, Paolo, A, Monica, M, Francesco, B, Roberto, F, Paolo, B, Durantemangoni, E, Testoni, M, Fabio, D, Loredana, S, Valeria, S, Fabiano, M, Annabella, D, Salvatore, D, Greco, A, Grazia, D, Daniele, S, Gianluca, R, Renzo, G, Sergio, M, Morena, B, Vitali, M, Marina, P, Paolo, D, Cristina, S, Orlandini, F, La Regina, M, Desiree, A, Mario, B, Paola, P, Padulo, F, Cristina, M, Dario, R, Giancarla, M, Guido, R, Elena, M, Marileda, N, Igor, B, Nicole, B, Elena, R, Paolillo, C, Riccardi, A, Claudia, B, Barbara, R, Silvia, V, Oliver, B, Mauro, C, Eleonora, M, Giuseppe, P, Rosaria, T, Maria, C, Davide, D, Stefania, C, Massimo, P, Luca, S, Martina, D, Paola, V, Lia, S, Sandro, C, Valentina, D, Erminia, B, Paola, C, Romina, R, Minisola, S, Luciano, C, Pasquale, A, Ilaria, L, Guglielmo, S, Marco, E, Sara, R, Paola, A, Claudio, A, Francesco, R, Alessandro, C, Simona, M, Lara, F, Paola, R, Simonetta, C, Antonella, C, Generoso, U, Fernando, G, Giuliano, C, Emanuela, S, Mariolina, S, Alessandro, D, Giulia, L, Famularo, S, Sandini, M, Pinotti, E, Gianotti, L, Antonella, B, Giulia, P, Sante, G, Rossi, A, Rubele, S, Sant, S, Marco, V, Danila, C, Fabio, R, Bandirali, M, Nicoletta, C, Laura, B, Paolo, T, Luciano, T, Leonello, A, Margherita, S, Pierluigi, D, Laura, R, Fabiana, T, Giovanna, C, Antonino, A, Felice, C, Danilo, F, Giovanna, D, Francesco, L, Salini, S, Giorgetta, C, Giovanni, G, Gerardo, B, Silvio, R, Letizia, S, Davide, B, Rosaria, R, Maria, D, Raffaele, P, Palmieri, V, Palasciano, G, Belfiore, A, Portincasa, P, Carlo, S, Alessia, D, Valiani, V, Carolina, B, Tiziana, C, Paola, T, Ugo, P, Giacomo, P, Castellano, M, Anna, G, Elisa, C, Federica, C, Antonietta, C, Luigi, M, Fabio, L, Salvatore, B, Gelosa, G, Viviana, A, Piras, V, Andrea, C, Alessandra, B, Coen, D, Magliola, R, Milanesio, D, Muzzulini, C, Paolo, F, Marinella, T, Sofia, C, Marta, B, Siano, P, Capo, G, Napoletano, R, Cecilia, P, Mancini, C, Del Buono, C, De Bartolomeo, G, Addolorata, M, Carmen, C, Moschettini, G, Franco, M, Daniela, R, D'Amico, G, Mirella, P, Endrizzi, C, Trotta, L, Ciarambino, T, Orazio, Z, Emanuela, T, Marta, S, Thomas, F, Giacomo, T, Ignazio, D, Andrea, B, Giuseppe, O, Emanuela, F, Serena, A, Elena, D, Serena, B, Erika, N, Elena, S, Manuela, P, Francesca, A, Angelo, T, Di Santo SG, Rizzo, Maria Rosaria, Paolisso, Giuseppe, and Italian Study Group on Delirium, (ISGoD).
Subjects: Rehabilitation hospital, medicine.medical_specialty, Urinary system, Socio-culturale, dementia, elderly, Motor subtypes of delirium, Aged, Cross-Sectional Studies, Humans, Inpatients, Italy, Delirium, Dementia, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, mental disorders, medicine, Motor subtypes of delirium, dementia, elderly, dementia, elderly, Motor subtypes of delirium, 030212 general & internal medicine, LS4_4, Medical prescription, General Nursing, Psychomotor learning, business.industry, Health Policy, Medical record, Memantine, General Medicine, medicine.disease, Settore MED/26 - NEUROLOGIA, Geriatrics and Gerontology, medicine.symptom, business, 030217 neurology & neurosurgery, medicine.drug
Abstract: Objectives Few studies have analyzed factors associated with delirium subtypes. In this study, we investigate factors associated with subtypes of delirium only in patients with dementia to provide insights on the possible prevention and treatments. Design This is a cross-sectional study nested in the "Delirium Day" study, a nationwide Italian point-prevalence study. Setting and participants Older patients admitted to 205 acute and 92 rehabilitation hospital wards. Measures Delirium was evaluated with the 4-AT and the motor subtypes with the Delirium Motor Subtype Scale. Dementia was defined by the presence of a documented diagnosis in the medical records and/or prescription of acetylcholinesterase inhibitors or memantine prior to admission. Results Of the 1057 patients with dementia, 35% had delirium, with 25.6% hyperactive, 33.1% hypoactive, 34.5% mixed, and 6.7% nonmotor subtype. There were higher odds of having venous catheters in the hypoactive (OR 1.82, 95% CI 1.18-2.81) and mixed type of delirium (OR 2.23, CI 1.43-3.46), whereas higher odds of urinary catheters in the hypoactive (OR 2.91, CI 1.92-4.39), hyperactive (OR 1.99, CI 1.23-3.21), and mixed types of delirium (OR 2.05, CI 1.36-3.07). We found higher odds of antipsychotics both in the hyperactive (OR 2.87, CI 1.81-4.54) and mixed subtype (OR 1.84, CI 1.24-2.75), whereas higher odds of antibiotics was present only in the mixed subtype (OR 1.91, CI 1.26-2.87). Conclusions and implications In patients with dementia, the mixed delirium subtype is the most prevalent followed by the hypoactive, hyperactive, and nonmotor subtype. Motor subtypes of delirium may be triggered by clinical factors, including the use of venous and urinary catheters, and the use of antipsychotics. Future studies are necessary to provide further insights on the possible pathophysiology of delirium in patients with dementia and to address the optimization of the management of potential risk factors.
Published: 2020

22. 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

23. The association of indwelling urinary catheter with delirium in hospitalized patients and nursing home residents: an explorative analysis from the 'Delirium Day 2015'

Author: Bo, M, Porrino, P, Di Santo SG, Mazzone, A, Cherubini, A, Mossello, E, Bianchetti, A, Musicco, M, Ferrari, A, Ferrara, N, Filippini, C, Trabucchi, M, Morandi, A, Bellelli, G, on behalf of the Italian Study Group on Delirium (ISGoD): Boffelli, S, Di Stefano, F, De Filippi, F, Guerini, F, Bertoletti, E, March, A, Margiotta, A, Mecocci, P, Ruggiero, C, Addesi, D, Fantò, F, Isaia, G, Dijik, B, Cotroneo, Am, Galli, G, Bruni, Ac, Bernardini, B, Corsini, C, Cagnin, A, Zurlo, G, Barbagallo, G, Lunardelli, Ml, Martini, E, Battaglia, G, Latella, R, Petritola, D, Sinforiani, E, Cester, A, Formilan, M, Carbone, P, Appollonio, I, Cereda, D, Tremolizzo, L, Bottacchi, E, Lucchetti, L, Mariani, C, Rapazzini, P, Romanelli, G, Marengoni, A, Zuliani, G, Bianchi, L, Suardi, T, Muti, E, Bottura, R, Sgrò, G, Mandas, A, Serchisu, L, Crippa, P, Ivaldi, C, Ungar, A, Villani, D, Raimondi, C, Mussi, C, Provenzano, G, Mari, D, Odetti, P, Monacelli, F, Antonelli Incalzi, R, Pluderi, A, Bellamoli, C, Terranova, L, Scarpini, E, D’Amico, F, Cavallini, Mc, Guerrini, G, Scotuzzi, Am, Chiarello, A, Pilotto, A, Tognini, S, Dell’Aquila, G, Toigo, G, Ceschia, G, Piccinini, M, Fabbo, A, Zoli, M, Forti, P, Wenter, C, Basile, G, Lasagni, A, Padovani, A, Rozzini, L, Cottino, M, Vitali, S, Tripi, G, Avanzi, S, Umidi, S, Moretti, D, Ruotolo, G, Boschi, F, Bonino, P, Marchionni, N, Fascendini, S, Noro, G, Turco, R, Ubezio, Mc, Serrati, C, Infante, M, Gentile, S, Pernigotti, Lm, Biagini, Ca, Canonico, E, Bonati, P, Gareri, P, Caffarra, P, Castagna, A, Ceretti, A, Castiglia, R, Gabelli, C, Lo Storto, M, Putzu, P, Di Santo, S, Rozzini, R, Zanetti, E, Trabucchi, M., Bo, M, Porrino, P, Di Santo, S, Mazzone, A, Cherubini, A, Mossello, E, Bianchetti, A, Musicco, M, Ferrari, A, Ferrara, N, Filippini, C, Trabucchi, M, Morandi, A, Bellelli, G, Bo, Mario, Porrino, Paola, Di Santo, Simona G., Mazzone, Andrea, Cherubini, Antonio, Mossello, Enrico, Bianchetti, Angelo, Musicco, Massimo, Ferrari, Alberto, Ferrara, Nicola, Filippini, Claudia, Trabucchi, Marco, Morandi, Alessandro, and Bellelli, Giuseppe
Subjects: Male, Aging, medicine.medical_specialty, 4AT test, Cognition, Delirium, Geriatric assessment, Aged, Aged, 80 and over, Catheters, Indwelling, Female, Humans, Logistic Models, Urinary Catheterization, Nursing Homes, Catheters, Hospitalized patients, medicine.medical_treatment, Logistic regression, behavioral disciplines and activities, Urinary catheterization, 03 medical and health sciences, 0302 clinical medicine, Informed consent, Internal medicine, mental disorders, medicine, 80 and over, Dementia, 030212 general & internal medicine, Coma, business.industry, Geriatrics and Gerontology, medicine.disease, Indwelling, medicine.symptom, Nursing homes, business, 030217 neurology & neurosurgery
Abstract: Backround: Use of indwelling urinary catheter (IUC) in older adults has negative consequences, including delirium. Aim: This analysis, from the "Delirium Day 2015", a nationwide multicenter prevalence study, aim to evaluate the association of IUC with delirium in hospitalized and Nursing Homes (NHs) patients. Methods: Patients underwent a comprehensive geriatric assessment, including the presence of IUC; inclusion criteria were age > 65 years, being Italian speaker and providing informed consent; exclusion criteria were coma, aphasia, end-of-life status. Delirium was assessed using the 4AT test (score >= 4: possible delirium; scores 1-3: possible cognitive impairment). Results: Among 1867 hospitalized patients (mean age 82.0 ± 7.5 years, 58% female), 539 (28.9%) had IUC, 429 (22.9%) delirium and 675 (36.1%) cognitive impairment. IUC was significantly associated with cognitive impairment (OR 1.60, 95% CI 1.19-2.16) and delirium (2.45, 95% CI 1.73-3.47), this latter being significant also in the subset of patients without dementia (OR 2.28, 95% CI 1.52-3.43). Inattention and impaired alertness were also independently associated with IUC. Among 1454 NHs residents (mean age 84.4 ± 7.4 years, 70.% female), 63 (4.3%) had IUC, 535 (36.8%) a 4AT score >= 4, and 653 (44.9%) a 4AT score 1-3. The multivariate logistic regression analysis did not show a significant association between 4AT test or its specific items with IUC, neither in the subset of patients without dementia. Discussion: We confirmed a significant association between IUC and delirium in hospitalized patients but not in NHs residents. Conclusion: Environmental and clinical factors of acute setting might contribute to IUC-associated delirium occurrence.
Published: 2019

24. Delirium, Dementia, and In-Hospital Mortality: The Results From the Italian Delirium Day 2016, A National Multicenter Study

Author: Morandi, A, Di Santo SG, Zambon, A, Mazzone, A, Cherubini, A, Mossello, E, Bo, M, Marengoni, A, Bianchetti, A, Cappa, S, Fimognari, Fl, Antonelli Incalzi, R, Gareri, P, Perticone, F, Campanini, M, Penco, I, Montorsi, M, Di Bari, M, Trabucchi, M, Bellelli, G, Italian Study Group on Delirium (ISGoD), Mecocci, P, Morandi, A, Di Santo, S, Zambon, A, Mazzone, A, Cherubini, A, Mossello, E, Bo, M, Marengoni, A, Bianchetti, A, Cappa, S, Fimognari, F, Antonelli Incalzi, R, Gareri, P, Perticone, F, Campanini, M, Penco, I, Montorsi, M, Di Bari, M, Trabucchi, M, and Bellelli, G
Subjects: Male, Aging, Pediatrics, medicine.medical_specialty, Prevalence, Outcomes, Comorbidity, 03 medical and health sciences, 0302 clinical medicine, mental disorders, 80 and over, medicine, Dementia, Humans, Cognitive Dysfunction, 030212 general & internal medicine, Hospital Mortality, Confusion, Outcome, Acute hospital, Cognitive impairment, Aged, Aged, 80 and over, business.industry, Delirium, Cognition, Odds ratio, medicine.disease, Confidence interval, Hospitalization, Multicenter study, Italy, Female, Geriatrics and Gerontology, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract: Background There is little evidence about the prevalence of cognitive disorders and their effect on in-hospital mortality in large multicenter studies. The objectives of the 2016th edition of the "Italian Delirium Day," a large multicenter study on in-hospital older patients, were to assess (i) the point prevalence of cognitive impairment/no dementia, dementia, delirium, and delirium superimposed on dementia and (ii) the effect of these conditions on in-hospital mortality. Methods This multicenter study and included 2,037 older patients (aged ≥65 years) admitted to acute medical and surgical wards across 205 acute hospitals. The four cognitive disorders groups were defined with a structured approach including the four AT and the presence of a documented diagnosis of dementia. The outcome measure was in-hospital mortality, as reported by the researchers involved in the study in each center. Results The mean age was 81.17 ± 7.7 years. Overall, 893 patients (43.8%) had neither delirium nor dementia nor cognitive impairment, 483 (23.7%) had cognitive impairment/no dementia, 230 (11.3%) dementia alone, 187 (9.2%) delirium alone, and 244 (12.0%) delirium superimposed on dementia. Overall, 99 (4.8%) patients died. Participants with delirium alone (odds ratio 2.56; 95% confidence interval: 1.29-5.09) and those with delirium superimposed on dementia (odds ratio 2.60; 95% confidence interval: 1.39-4.85) had higher mortality risk compared with the reference group of patients with "no cognitive impairment." Conclusions Delirium and delirium superimposed on dementia were highly prevalent among older hospitalized patients and significantly increased in-hospital mortality. Clinicians should systematically assess these conditions and recognize them as markers of critical conditions and predictors of imminent death.
Published: 2018

25. Prevalence and Correlates of Behavioral Disorders in Old Age Subjects with Cognitive Impairment: Results from the ReGAl Project

Author: Boccardi, Virginia, Conestabile Della Staffa, Manuela, Baroni, Marta, Ercolani, Sara, Croce, Michele Francesco, Ruggiero, Carmelinda, Mecocci, Patrizia, Gabelli, C, Codemo, A, Marinelli, K, Capurso, A, Cucinotta, D, Reggiani, A, Ellena, L, Zanetti, O, Putzu, P, Del Prete, M, Spaccamento, S, Abate, G, Di Iorio, A, Cester, A, Formilan, M, Busonera, F, Anzivino, F, Masotti, G, Cavallini, C, Mossello, E, Odetti, P, Cataldi, Ag, Estraneo, A, Sica, G, Renna, S, Nicita-Mauro, V, Basile, G, Salvioli, G, Mussi, C, Ascari, S, Casale, R, Frazzitta, G, Scognamiglio, M, Di Palma, A, Rengo, F, Canonico, V, Fortunato, F, Enzi, G, Giordano, M, Vitrano Catania, T, Ferrari, E, Cuzzoni, G, Del Re ML, Guizzardi, G, Biagini, C, Bavazzano, A, Ferrari, A, Dallari, A, Carbonin, P, Bernabei, R, Silveri, Mc, Bartorelli, L, Gandolfi, B, Cerqua, R, Pilotto, A, Cascavilla, L, Chiaranti, A, Marinelli, M, Tripi, G, Gallucci, M, Marchetti, C, Masiello, V, Sacco, D, and Ricci, G.
Subjects: Male, Behavioral disturbances, cognitive impairment, dementia, old age, Settore M-PSI/02 - PSICOBIOLOGIA E PSICOLOGIA FISIOLOGICA, Behavioral Symptoms, Comorbidity, Severity of Illness Index, Sex Factors, Prevalence, Humans, Cognitive Dysfunction, Longitudinal Studies, Aged, Psychotropic Drugs, Age Factors, Clinical Psychology, Logistic Models, Socioeconomic Factors, Psychiatry and Mental Health, Female, Geriatrics and Gerontology, Factor Analysis, Statistical
Abstract: Presence of behavioral and psychological symptoms of dementia (BPSD) is very common in subjects with cognitive impairment, representing an important determinant of disease progression, institutionalization, and worse prognosis. Knowledge of the prevalence and correlates of BPSD in community-living old subjects with cognitive impairment is limited so far, but it is essential for establishing specifically tailored care and cure in such a vulnerable population.With this study, we aimed at investigating, in a large sample of old age subjects with cognitive impairment, BPSD prevalence and correlates including the main demographic, clinical, and socio-environmental characteristics.Data were gathered from the ReGAl project (Rete Geriatrica Alzheimer; Geriatric Network on Alzheimer's disease), a large longitudinal Italian multicentric clinical-based study, promoted by the Italian Society of Gerontology and Geriatrics (SIGG).We evaluated data from 4,157 old-age subjects affected by mild cognitive impairment (MCI) (541; 13%) or dementia (3616; 87%). 85.2% of all the population presented with at least one BPSD. Using a factor analysis, we identified four factors of BPSD: psychotic, affective, maniac, and impulse control behaviors. Logistic regression analyses revealed that among the main demographic, clinical, and socio-environmental aspects considered, only comorbidity was associated with all factors, independently of multiple covariates.Identification of BPSD is crucial in everyday clinical practice and necessary to develop specific interventions and to define appropriate outcomes in their management. BPSD occur in a complex psychopathological context, influenced by several demographic and environmental factors that must be taken into account for a correct diagnosis and treatment.
Published: 2017

26. Truly unexplained falls after evaluation for syncope: A new diagnostic entity with severe prognosis

Author: Andrea Ungar, Alice Ceccofiglio, Chiara Mussi, Mario Bo, Giulia Rivasi, Martina Rafanelli, Anna Maria Martone, Giuseppe Bellelli, Franco Nicosia, Daniela Riccio, Virginia Boccardi, Elisabetta Tonon, Francesco Curcio, Francesco Landi, Pasquale Abete, Enrico Mossello, Ungar, A, Ceccofiglio, A, Mussi, C, Bo, M, Rivasi, G, Rafanelli, M, Martone, A, Bellelli, G, Nicosia, F, Riccio, D, Boccardi, V, Tonon, E, Curcio, F, Landi, F, Abete, P, Mossello, E, Ungar, A., Ceccofiglio, A., Mussi, C., Bo, M., Rivasi, G., Rafanelli, M., Martone, A. M., Bellelli, G., Nicosia, F., Riccio, D., Boccardi, V., Tonon, E., Curcio, F., Landi, F., Abete, P., and Mossello, E.
Subjects: Aged, 80 and over, Male, Prognosi, Prognosis, Syncopal fall, Syncope, Risk Factors, Dementia, Mortality, Unexplained fall, Internal Medicine, Humans, Female, Aged
Abstract: Objective: To compare one-year mortality risk associated with syncope and unexplained fall in older adults with dementia. Methods: 522 patients (aged >65 years) with dementia and history of transient loss of consciousness and/or unexplained falls were evaluated. The diagnosis of syncope was based on European Society of Cardiology guidelines. A “Syncopal Fall” was defined in patients with an initial clinical presentation of unexplained fall, but a final diagnosis of syncope after complete assessment. A “Truly Unexplained Fall” was defined in patients with an initial clinical presentation of unexplained fall, in whom a diagnosis of syncope had been excluded after the diagnostic work-up. One-year follow-up was assessed by phone interview. Results: Follow-up data were available for 501 participants (mean age 83 ± 6 years, 65% female). After a mean follow-up of 324 ± 93 days, death from any cause was reported in 188 participants (24%). Advanced age, male sex, cognitive and functional impairment were associated with a higher mortality rate. Patients with “Truly Unexplained Falls” had a higher mortality risk compared with syncope and “Syncopal Fall”. A diagnosis of “Truly Unexplained Falls” remained an independent predictor of one-year all-cause mortality in multivariate model. Conclusions: We propose the novel diagnostic category of “Truly Unexplained Fall”, resulting from the application of syncope guidelines to subjects with unexplained falls. This condition in older adults with dementia is a predictor of one-year all-cause mortality. For this new high risk profile, we advice a comprehensive geriatric assessment focused on risk factors for fall, aimed at a possible improvement of prognosis.
Published: 2022

27. Atrial Fibrillation in Older Patients with Syncope and Dementia: Insights from the Syncope and Dementia Registry

Author: Alice Ceccofiglio, Stefano Fumagalli, Enrico Mossello, Assunta Langellotto, Giuseppe Bellelli, Pasquale Abete, Franco Nicosia, Virginia Boccardi, Mario Bo, Daniela Riccio, Anna Maria Martone, Chiara Mussi, Elisabetta Tonon, Gianni Tava, Andrea Ungar, Ceccofiglio, A., Fumagalli, S., Mussi, C., Mossello, E., Bo, M., Martone, A. M., Bellelli, G., Nicosia, F., Riccio, D., Langellotto, A., Tava, G., Boccardi, V., Tonon, E., Abete, P., Ungar, A., Ceccofiglio, A, Fumagalli, S, Mussi, C, Mossello, E, Bo, M, Martone, A, Bellelli, G, Nicosia, F, Riccio, D, Langellotto, A, Tava, G, Boccardi, V, Tonon, E, Abete, P, and Ungar, A
Subjects: Male, Pediatrics, medicine.medical_specialty, Future studies, fall, Population, elderly, Syncope, Older patients, Risk Factors, falls, Atrial Fibrillation, Heart rate, medicine, Humans, Dementia, Registries, education, General Nursing, Aged, Aged, 80 and over, education.field_of_study, Atrial fibrillation, dementia, oral anticoagulant therapy, syncope, biology, business.industry, Health Policy, Syncope (genus), Anticoagulants, General Medicine, medicine.disease, biology.organism_classification, Stroke, Female, Observational study, Geriatrics and Gerontology, business
Abstract: Objectives: To evaluate the clinical characteristics and the long-term outcome of atrial fibrillation (AF) patients with dementia and history of syncope or falls. Design: Observational: analysis of a prospective registry. Setting and Participants: Between 2012 and 2016, the Syncope and Dementia Registry enrolled patients in 12 geriatric departments. Follow-up evaluation was at 12 months. Measures: Clinical, functional, and cognitive assessment. Results: Of the 522 patients (women, 62.1%; Mini-Mental State Examination 17 ± 6), 26.4% have or presented an AF history. Patients with AF were older (85 ± 6 vs 83 ± 6 years, P = .012), with higher heart rate (78 ± 17 vs. 73 ± 14 bpm, P < .001), prescribed drugs (6.9 ± 2.9 vs 5.9 ± 2.7, P < .001), and an increased number (3.9 ± 2.0 vs 3.0 ± 1.8, P < .001) and severity of comorbidities. Oral anticoagulant therapy was underprescribed (39.9%). Cardiac syncope was more frequently diagnosed (18.8 vs 4.9%, P < .001). At multivariate analysis, AF patients were characterized by advanced age, a higher severity of comorbidities, a greater number of prescribed drugs, an increased heart rate, and a more frequent presence of cardiac symptoms. One-year mortality differed little between patients with and without AF (27.7 vs 22.1%, P = .229). In the arrhythmia group, multivariate predictors of prognosis were disability (number of lost BADLs; P = .020) and a higher heart rate (P = .006). Conclusions and Implications: AF and postural stability-related issues often co-exist in persons with dementia. This complex of conditions is associated with an intricate clinical picture, underprescription of oral anticoagulants, and high long-term mortality. Future studies are needed to evaluate the effects of therapy optimization in this population.
Published: 2020

28. Behavioral and psychological effects of coronavirus disease-19 quarantine in patients with dementia

Author: Annachiara Cagnin, Raffaele Di Lorenzo, Camillo Marra, Laura Bonanni, Chiara Cupidi, Valentina Laganà, Elisa Rubino, Alessandro Vacca, Paolo Provero, Valeria Isella, Nicola Vanacore, Federica Agosta, Ildebrando Appollonio, Paolo Caffarra, Ilaria Pettenuzzo, Renato Sambati, Davide Quaranta, Valeria Guglielmi, Giancarlo Logroscino, Massimo Filippi, Gioacchino Tedeschi, Carlo Ferrarese, Innocenzo Rainero, Amalia C. Bruni, SINdem COVID-19 Study Group, Erica Gallo, Alberto Grassini, Andrea Marcinnò, Fausto Roveta, Paola De Martino, Francesca Frangipane, Gianfranco Puccio, Rosanna Colao, Maria Mirabelli, Noemi Martellacci, Federica Lino, Stefano Mozzetta, Cinzia Bussè, Giulia Camporese, Simona Sacco, Maria Carmela Lechiara, Claudia Carrarini, Mirella Russo, Alfonsina Casalena, Patrizia Sucapane, Pietro Tiraboschi, Paola Caroppo, Veronica Redaelli, Giuseppe Di Fede, Daniela Coppa, Lenino Peluso, Pasqualina Insarda, Matteo De Bartolo, Sabrina Esposito, Alessandro Iavarone, Anna Vittoria Marta Orsini, Elena Salvatore, Chiara Criscuolo, Luisa Sambati, Rossella Santoro, Daniela Gragnaniello, Ilaria Pedriali, Livia Ludovico, Annalisa Chiari, Andrea Fabbo, Petra Bevilacqua, Chiara Galli, Silvia Magarelli, Marta Perini, Gianfranco Spalletta, Nerisa Banaj, Desirée Estela Porcari, Giulia Caruso, Virginia Cipollini, Anna Rosa Casini, Francesca Ursini, Giuseppe Bruno, Renzo Rozzini, Michela Brambilla, Giuseppe Magnani, Francesca Caso, Edoardo G. Spinelli, Matteo Cotta Ramusino, Giulia Perini, Simona Luzzi, Gabriella Cacchiò, Rossano Angeloni, Cinzia Giuli, Katia Fabi, Marco Guidi, Cristina Paci, Annaelisa Castellano, Elena Carapelle, Rossella Petrucci, Miriam Accogli, Gianluigi Calabrese, Giovanna Nicoletta Trevisi, Brigida Coluccia, Antonella Vasquez Giuliano, Marcella Caggiula, Fulvio Da Re, Antonio Milia, Giuseppina Pilia, Maria Giuseppina Mascia, Valeria Putzu, Tommaso Piccoli, Luca Cuffaro, Roberto Monastero, Antonella Battaglia, Valeria Blandino, Federica Lupo, Eduardo Cumbo, Luca Antonina, Giuseppe Caravaglios, Annalisa Vezzosi, Valentina Bessi, Gloria Tognoni, Valeria Calsolaro, Enrico Mossello, Serena Amici, Alberto Trequattrini, Salvatore Pezzuto, Patrizia Mecocci, Giulia Fichera, Samantha Pradelli, Marino Formilan, Alessandra Coin, Laura Detogni, Francesca Sala, Giulia Sandri, Maurizio Gallucci, Anna Paola Mazzarolo, Cristina Bergamelli, Cagnin, A., Di Lorenzo, R., Marra, C., Bonanni, L., Cupidi, C., Lagana, V., Rubino, E., Vacca, A., Provero, P., Isella, V., Vanacore, N., Agosta, F., Appollonio, I., Caffarra, P., Pettenuzzo, I., Sambati, R., Quaranta, D., Guglielmi, V., Logroscino, G., Filippi, M., Tedeschi, G., Ferrarese, C., Rainero, I., Bruni, A. C., Cagnin A., Di Lorenzo R., Marra C., Bonanni L., Cupidi C., Lagana V., Rubino E., Vacca A., Provero P., Isella V., Vanacore N., Agosta F., Appollonio I., Caffarra P., Pettenuzzo I., Sambati R., Quaranta D., Guglielmi V., Logroscino G., Filippi M., Tedeschi G., Ferrarese C., Rainero I., Bruni A.C., Gallo E., Grassini A., Marcinno A., Roveta F., De Martino P., Frangipane F., Puccio G., Colao R., Mirabelli M., Martellacci N., Lino F., Mozzetta S., Busse C., Camporese G., Sacco S., Lechiara M.C., Carrarini C., Russo M., Casalena A., Sucapane P., Tiraboschi P., Caroppo P., Redaelli V., Di Fede G., Coppa D., Peluso L., Insarda P., De Bartolo M., Esposito S., Iavarone A., Orsini A.V.M., Salvatore E., Criscuolo C., Sambati L., Santoro R., Gragnaniello D., Pedriali I., Ludovico L., Chiari A., Fabbo A., Bevilacqua P., Galli C., Magarelli S., Perini M., Spalletta G., Banaj N., Porcari D.E., Caruso G., Cipollini V., Casini A.R., Ursini F., Bruno G., Rozzini R., Brambilla M., Magnani G., Caso F., Spinelli E.G., Ramusino M.C., Perini G., Luzzi S., Cacchio G., Angeloni R., Giuli C., Fabi K., Guidi M., Paci C., Castellano A., Carapelle E., Petrucci R., Accogli M., Calabrese G., Trevisi G.N., Coluccia B., Giuliano A.V., Caggiula M., Da Re F., Milia A., Pilia G., Mascia M.G., Putzu V., Piccoli T., Cuffaro L., Monastero R., Battaglia A., Blandino V., Lupo F., Cumbo E., Antonina L., Caravaglios G., Vezzosi A., Bessi V., Tognoni G., Calsolaro V., Mossello E., Amici S., Trequattrini A., Pezzuto S., Mecocci P., Fichera G., Pradelli S., Formilan M., Coin A., Detogni L., Sala F., Sandri G., Gallucci M., Mazzarolo A.P., Bergamelli C., Gallo, E., Grassini, A., Marcinno, A., Roveta, F., De Martino, P., Frangipane, F., Puccio, G., Colao, R., Mirabelli, M., Martellacci, N., Lino, F., Mozzetta, S., Busse, C., Camporese, G., Sacco, S., Lechiara, M. C., Carrarini, C., Russo, M., Casalena, A., Sucapane, P., Tiraboschi, P., Caroppo, P., Redaelli, V., Di Fede, G., Coppa, D., Peluso, L., Insarda, P., De Bartolo, M., Esposito, S., Iavarone, A., Orsini, A. V. M., Salvatore, E., Criscuolo, C., Sambati, L., Santoro, R., Gragnaniello, D., Pedriali, I., Ludovico, L., Chiari, A., Fabbo, A., Bevilacqua, P., Galli, C., Magarelli, S., Perini, M., Spalletta, G., Banaj, N., Porcari, D. E., Caruso, G., Cipollini, V., Casini, A. R., Ursini, F., Bruno, G., Rozzini, R., Brambilla, M., Magnani, G., Caso, F., Spinelli, E. G., Ramusino, M. C., Perini, G., Luzzi, S., Cacchio, G., Angeloni, R., Giuli, C., Fabi, K., Guidi, M., Paci, C., Castellano, A., Carapelle, E., Petrucci, R., Accogli, M., Calabrese, G., Trevisi, G. N., Coluccia, B., Giuliano, A. V., Caggiula, M., Da Re, F., Milia, A., Pilia, G., Mascia, M. G., Putzu, V., Piccoli, T., Cuffaro, L., Monastero, R., Battaglia, A., Blandino, V., Lupo, F., Cumbo, E., Antonina, L., Caravaglios, G., Vezzosi, A., Bessi, V., Tognoni, G., Calsolaro, V., Mossello, E., Amici, S., Trequattrini, A., Pezzuto, S., Mecocci, P., Fichera, G., Pradelli, S., Formilan, M., Coin, A., Detogni, L., Sala, F., Sandri, G., Gallucci, M., Mazzarolo, A. P., Bergamelli, C., Cagnin, A, Di Lorenzo, R, Marra, C, Bonanni, L, Cupidi, C, Lagana, V, Rubino, E, Vacca, A, Provero, P, Isella, V, Vanacore, N, Agosta, F, Appollonio, I, Caffarra, P, Pettenuzzo, I, Sambati, R, Quaranta, D, Guglielmi, V, Logroscino, G, Filippi, M, Tedeschi, G, Ferrarese, C, Rainero, I, and Bruni, A
Subjects: Pediatrics, medicine.medical_specialty, lcsh:RC435-571, Irritability, Behavioral symptoms, 03 medical and health sciences, 0302 clinical medicine, lcsh:Psychiatry, Psychological symptoms, medicine, Dementia, Apathy, Vascular dementia, Behavioral and psychological symptoms, Behavioral symptoms, Caregiver, Coronavirus disease, Dementia, Gender, Psychological symptoms, Quarantine, Original Research, MED/26 - NEUROLOGIA, Psychiatry, Behavioral symptom, Dementia with Lewy bodies, Family caregivers, business.industry, Behavioral and psychological symptoms, Gender, Behavioral and psychological symptom, Caregiver burden, medicine.disease, Multiinfarct dementia, Caregiver, 030227 psychiatry, Coronavirus disease, Quarantine, Psychiatry and Mental health, Settore MED/26 - NEUROLOGIA, MED/17 - MALATTIE INFETTIVE, MED/25 - PSICHIATRIA, M-PSI/08 - PSICOLOGIA CLINICA, Psychological symptom, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract: Background: In March 2020, the World Health Organization declared a global pandemic due to the novel coronavirus SARS-CoV-2 and several governments planned a national quarantine in order to control the virus spread. Acute psychological effects of quarantine in frail elderly subjects with special needs, such as patients with dementia, have been poorly investigated. The aim of this study was to assess modifications of neuropsychiatric symptoms during quarantine in patients with dementia and their caregivers. Methods: This is a sub-study of a multicenter nation-wide survey. A structured telephone interview was delivered to family caregivers of patients with diagnosis of Alzheimer disease (AD), dementia with Lewy bodies (DLB), frontotemporal dementia (FTD), and vascular dementia (VD), followed regularly at 87 Italian memory clinics. Variations in behavioral and psychological symptoms (BPSD) were collected after 1 month since quarantine declaration and associations with disease type, severity, gender, and caregiver’s stress burden were analyzed. Results: A total of 4,913 caregivers participated in the survey. Increased BPSD was reported in 59.6% of patients as worsening of preexisting symptoms (51.9%) or as new onset (26%), and requested drug modifications in 27.6% of these cases. Irritability, apathy, agitation, and anxiety were the most frequently reported worsening symptoms and sleep disorder and irritability the most frequent new symptoms. Profile of BPSD varied according to dementia type, disease severity, and patients’ gender. Anxiety and depression were associated with a diagnosis of AD (OR 1.35, CI: 1.12–1.62), mild to moderate disease severity and female gender. DLB was significantly associated with a higher risk of worsening hallucinations (OR 5.29, CI 3.66–7.64) and sleep disorder (OR 1.69, CI 1.25–2.29), FTD with wandering (OR 1.62, CI 1.12–2.35), and change of appetite (OR 1.52, CI 1.03–2.25). Stress-related symptoms were experienced by two-thirds of caregivers and were associated with increased patients’ neuropsychiatric burden (p
Published: 2020

29. Drug Prescription and Delirium in Older Inpatients: Results From the Nationwide Multicenter Italian Delirium Day 2015-2016

Author: Aloisi, Gaetano, Marengoni, Alessandra, Morandi, Alessandro, Zucchelli, Alberto, Cherubini, Antonio, Mossello, Enrico, Mario, Bo, Di Santo Simona, Mazzone, Andrea, Trabucchi, Marco, Cappa, Stefano, Fimognari, Filippo, Antonelli Incalzi Raffaele, Gareri, Pietro, Perticone, Francesco, Campanini, Mauro, Montorsi, Marco, Latronico, Nicola, Zambon, Antonella, Bellelli, Giuseppe, Rispoli, Vincenzo, Malara, Alba, Spadea, Fausto, Di Cello Serena, Ceravolo, Francesco, Fabiano, Francesco, Chiaradia, Giuseppe, Gabriele, Amedeo, Lenino, Peluso, Andrea, Taristano, Settembrini, Vincenzo, Capomolla, Domenico, Citrino, Antonella, Scriva, Antonietta, Bruno, Irene, Secchi, Roberto, De Martino Eugenio, Muccinelli, Roberto, Lupi, Gerardo, Paonessa, Patrizio, Fabbri, Andrea, Passuti Maria Teresa, Castellari, Sofia, Andrea, Po, Gaggioli, Guido, Varesi, Massimo, Moneti, Paolo, Capurso, Sebastiano, Latini, Vincenzo, Ghidotti, Stefano, Riccardelli, Francesco, Macchi, Maurizio, Rigo, Rosaria, Claudio, Pascale, Bosio, Angelo, Cerrato, Flavio, Bardelli, Benedetta, Boffelli, Stefano, Cassinadri, Angela, Franzoni, Simone, Spazzini, Elena, Andretto, Daniela, Tonini, Gabriele, Andreani, Laura, Coralli, Mirco, Balotta, Antonio, Cancelliere, Roberto, Ballardini, Giorgio, Simoncelli, Margherita, Mancini, Annarita, Strazzacapa, Mara, Fabio, Stefano, De Filippi Francesco, Giudice, Chiara, Dentizzi, Cosimo, Azzini, Margherita, Cazzadori, Marco, Mastroeni, Valeria, Bertassello, Paolo, Santana, Helena, Benati, Claudia, Nesta, Elisa, Tobaldini, Chiara, Guerini, Fabio, Tambara, Elena, Mombelloni, Paolo, Fontanini, Fulvio, Lassa, Gabriella, Lassa, Pizzorni, Crosio, Oliverio, Martina, Del, Grosso, Luciano, Luca, Giavedoni, Cristina, Bidoli, Giuliano, Mazzei, Bruno, Corsonello, Andrea, Fusco, Sergio, Vena, Silvio, De Vuono Tommaso, Maiuri, Giorgio, Fimognari Filippo Luca, Arone, Andrea, Sgro, Giovanni, Nicolazzo, Rossella, Castegnaro, Eugenio, De Rosa Salvatore, Sechi Bazzano Rossella, Benvenuti, Enrico, Del Lungo Ilaria, Giardini, Sante, Giulietti, Chiara, Di Bari Mauro, Barghini, Eleonora, Paoli, Martina, Fiordelli, Irene, Barucci, Riccardo, Sgrilli, Federica, Bertoletti, Erik, D'Amico, Ferdinando, Caronzolo, Francesco, Grippa, Alessandro, Lombardo, Giuseppina, Pipicella, Tiziana, Saitta, Antonino, Corica, Francesco, Cucinotta, Valeria, Giaritta, Prestipino, Larosa, Daniela, Cucinotta, Domenico, Basile, Giorgio, March, Albert, Nitti Maria Teresa, Felici, Alessandro, Pavan, Silvia, Piazzani, Fabrizio, Lunelli, Alessandra, Dimori, Sergio, Margotta, Alessandro, Soglia, Tiziano, Postacchini, Demetrio, Brunelli, Roberto, Santini, Silvia, Francavilla, Monia, Macchiati, Ilenia, Sorvillo, Francesca, Giuli, Cinzia, Mecocci, Patrizia, Longo, Annalisa, Addesi, Desiree, Rosa Paola Cerra, Bencardino, Giuseppe, Falbo, Tania, Grillo, Nadia, Filice, Marco, Mirella, Filippo, Fanto, Fausto, Isaia, Gianluca, Pezzilli, Stella, Bergamo, Daniele, Furno, Elisabetta, Rrodhe, Sokol, Lucarini, Simonetta, Dijk, Babette, Dall'Acqua, Francesca, Cappelletto, Francesco, Calvani, Donatella, Becheri, Dimitri, Mottino, Giuseppe, Mitidieri, Costanza, Antonio, Vito, Bartalucci, Francesca, Magherini, Lorenza, Malin, Novella, Boni, Franca, Gambardella Paoli Martina Lucia, Valente, Carlo, Bracali, Ilaria, Bracali, Foschini, Alice, Porrino, Paola, Ceci, Giacomo, Bottignole, Giuliana, Tibaldi, Michela, Coppo, Eleonora, Ettore, Evaristo, Camellini, Cinzia, Servello, Adriana, Grassi, Alessandro, Rozzini, Renzo, Tironi, Sara, Grassi Maria Grazia, Troisi, Elio, Caltagirone, Carlo, Franchini, Flaminia, Ratto, Federica, Pavoni, Beatrice, Toniolo, Sofia, Gabutto, Anna, Quazzo, Loredana, Rosatello, Annalisa, Suraci, Domenico, Tagliabue, Benedetta, Perrone, Chiara, Ferrara, Lucia, Castagna, Alberto, Tremolada Maria Luisa, Castoldi, Giuseppe, Barbero, Stefano, Oltramonti, Davide, Piano, Simonetta, Serviddio, Gaetano, Lo Buglio Aurelio, Gurrera, Tiziana, Merlo, Valeria, Rovai, Carla, Cotroneo Antonino Maria, Carlucci, Rosaria, Abbaldo, Anna, Monzani, Fabio, Qasem Ahmad Amedeo, Bini, Giacomo, Tafuto, Silvia, Galli, Giovanni, Bruni Amalia Cecilia, Mancuso, Giovanna, Mancuso, Gerardo, De Luca Giuseppe Massimiliano, Calipari Daniela., Bernardini, Bruno, Corsini, Carla, Ciccarelli, Michele, Dal Farra Sara, Dal, Farra, Cagnin, Annachiara, Fragiacomo, Federica, Pompanin, Sara, Amodio, Piero, Cagnin, Marco, Zurlo, Amedeo, Guerra, Gianluca, Pala, Marco, Menozzi, Luca, Delli Gatti Chiara, Magon, Stefania, Manfredini, Roberto, De Giorgi Alfredo, Fabbian, Fabio, Tiseo, Ruana, Misurati, Elisa, Boari, Benedetta, Molino, Christian, Gallerani, Massimo, Di Francesco Vincenzo, Faccioli, Silvia, Pellizzari, Luca, Fontana, Giorgia, Barbagallo, Giuseppe, Lunardelli Maria Lia, Martini, Emilio, Ferrari, Eleonora, Macchiarulo, Maria, Corneli, Maria, Bacci, Monica, Battaglia, Giuseppe, Anastasio, Luigi, Lo Storto Mario Sostene, Seresin, Chiara, Simonato, Matteo, Loreggian, Michele, Cestonaro, Fausta, Durando, Mario, Latella, Raffaele, Mazzoleni, Marta, Russo, Giuseppe, Ponte, Martino, Valchera, Alessandro, Salustri, Giuseppe, Petritola, Donatella, Costa, Alfredo, Sinforiani, Elena, Cotta Matteo Ramusino, Pizio Renato Nicola, Cester, Alberto, Formilan, Marino, Bonometto, Pietro, Carbone, Pasqualina, Cazzaniga, Ilaria, Appollonio, Ildebrando, Cereda, Diletta, Stabile, Andrea, Xhani, Rubjona, Acampora, Roberto, Tremolizzo, Lucio, Pieruzzi, Federico, Ciaccio, Antonio, Pontecorvi, Valerio, Burti, Cesare, Mokini, Zhirajr, Vitale, Giovanni, Amigoni, Maria, Sparacino, Mariaelena, Bottacchi, Edo, Bucciantini, Elisabetta, Di Giovanni Marco, Franchi, Fabrizio, Lucchetti, Lucio, Mariani, Claudio, Grande, Giulia, Rapazzini, Piero, Mauri, Marco, Romanelli, Giuseppe, Nicosia, Franco, Margola, Alessio, Bonardelli, Stefano, Porcella, Laura, Portolani, Nazario, Concoreggi, Carlo, Grassini, Chiara, Salvi, Andrea, Bianchetti, Luca, Spagnoli, Francesca, Apuzzo, Roberto, Fontanella, Ceraso, Anna, Castelli, Francesco, Fugazza, Luciano, Guerrini, Chiara, De Paduanis Giovanna, Iallonardo, Lucia, Palumbo, Pasquale, Zuliani, Giovanni, Ortolani, Beatrice, Capatti, Eleonora, Soavi, Cecilia, Bianchi, Lara, Francesconi, Daniela, Miselli, Agata, Brombo, Gloria, Romagnoli, Tommaso, Pazzaglini, Chiara, Miselli Maria Agata, Dall'Agata, Marco, Suardi, Teresa, Zaccarini, Cinzia, Riva, Manuela, Mirra, Gianluca, Muti, Ettore, Bottura, Renato, Moretti, Gianpaolo, Secreto, Piero, Bisio, Erika, Cecchettani, Marco, Naldi, Tamara, Pallavicino, Alessandra, Pugliese, Michela, Iozzo Rosaria Cosima, Grassi, Guido, Bombelli, Michele, Delloro, Raffaella, Quarti Trevano Fosca, Giussani Carlo Giorgio, Paterno, Giovanni, Contro, Ernesto, Mannironi, Antonio, Giorli, Elisa, Oberti, Sara, Fierro, Brigida, Piccoli, Tommaso, Giacalone, Fabio, Mandas, Antonella, Serchisu, Luca, Costaggiu, Diego, Pinna, Elisa, Orru, Francesca, Mannai, Martina, Cordioli, Zeno, Pelizzari, Luca, Turcato, Emanuela, Arduini, Pietro, Cacace, Carlo, Chiloiro, Roberta, Cimino, Rosella, Ruberto, Carmen, Ruotolo, Giovanni, Greco, Laura, Dal Santo Pierluigi, Andriolli, Antonino, Burattin, Giuseppe, Rossi, Laura, Andreolli, Antonino, Cervati, Giovanna, Catalano, Giuseppe, Tezza, Fabiana, Pizzardini, Maddalena, Stievano, Laura, Crippa, Patrizia, Aloisio, Paola, Di Monda Tiziana, Malighetti, Alessandro, Galbassini, Gloria, Ivaldi, Claudio, Russo Anna Maria, Bennati, Ettore, Pino, Elisabetta, Zavarise, Gianmaria, Pesci, Alberto, Suigo, Giulia, Faverio, Paola, Gori, Andrea, Perego Sabrina Perego, Zanasi, Massimo, Moniello, Giovanni, Rostagno, Carlo, Cartei, Alessandro, Polidori, Gianluca, Ungar, Andrea, Melis Maria Ramona, Martellini, Eleonora, Torrini, Monica, Giordano, Antonella, Leone, Giovanna, Migliorini, Marta, Caramelli, Francesca, Battiston, Bruno, Berardino, Maurizio, Cavallo, Simona, Masse, Alessandro, Santoro, Anna, Lombardi, Bruna, D'Ippolito, Pierpaolo, Furini, Angela, Villani, Daniele, Raimondi, Clara, Guarneri, Massimo, Paolucci, Stefano, Bassi, Andrea, Coiro, Paola, De Angelis Domenico, Morone, Giovanni, Venturiero, Vincenzo, Palleschi, Lorenzo, Raganato, Paolo, Di Niro Giuseppina, Casini Anna Rosa, Bove, Loredana, Imoscopi, Alessandra, Isaia, Giancarlo, Tibaldi, Vittoria, Calvi, Elisa, Clementi, Carlotta, Zanocchi, Mauro, Agosta, Luca, Criasia, Antonio, Spertino, Elena, Nortarelli, Antonella, Provenzano, Giuseppe, Principato, Pietro, Rizzo, Anita, Cellura, Eleonora, Mari, Daniela, Romano Federica Ylenia, Rosini, Francesca, Mansi, Marta, Rossi, Silvia, Riccardelli, Alex, Inzaghi, Lorenzo, Bonini, Giulia, Rossi, Paolo, Potena, Alfredo, Lichii, Mihaela, Candiani, Tiziana, Grimaldi, William, Bertani, Emiliano, Porta, Alessandra, Calogero, Pietro, Pinto, Daniela, Bernardi, Roberto, Nicolino, Francesco, Galetti, Caterina, Gianstefani, Alice, Corvalli, Giulia, Mulazzani, Lorenzo, Odetti, Patrizio, Monacelli, Fiammetta, Prefumo, Matteo, Canepa, Marta, Minaglia, Cecilia, Paolisso, Giuseppe, Rizzo Maria Rosaria, Prestano, Raffaele, Dalise Anna Maria, Barra, Davide, Dal Bosco Livio, Asprinio, Vincenzo, Dallape, Luciana, Maina, Paola, Perina, Elisa, Bartoli Rossi Isaura, Pluderi, Alice, Maina, Antonella, Pecoraro, Elisabetta, Sciarra, Michela, Prudente, Angela, Mete, Francesca, Ventura, Manuel, Cesari, Luisella, Pernigotti Luigi Maria, Santangelo, Tina, Benini, Lucia, Levato, Francesco, Mhiuta, Victor, Alius, Florin, Davidoaia, Diana, Giardini, Vittorio, Garancini, Mattia, Bellamoli, Claudio, Terranova, Luciano, Bozzini, Claudia, Tosoni, Paolo, Provoli, Emma, Cascone, Luisa, Dioli, Andrea, Ferrarin, Gianfranco, Bucci, Adelmo, Bua, Guido, Fenu, Sara, Bianchi, Giovanna, Casella, Silvia, Romano, Valentina, Poli, Maurizio, Mascherona, Ilenia, Belotti, Gloria, Cavaliere, Sabina, Cuni, Estella, Merciuc, Nina, Oberti, Rosella, Veneziani, Silvia, Capoferri, Emanuela, De Bernardi Elisabetta, Colombo, Katia, Bravi, Marco, Negrinotti, Nicoletta, D'Arcangelo, Paolo, Montenegro, Nicola, Montanari, Roberto, Lamanna, Pierpaolo, Gasperini, Beatrice, Montesi, Isabella, Diotallevi, Stefania, Altobelli, Gaia, Cacinaro, Filippo, Palama, Chiara, Di Emidio Chiara, Scarpini, Elio, Arighi, Andrea, Scrimieri, Antonia, Fumagalli, Giorgio, Basilico, Paola, Migone De Amicis Margherita, Mancarella, Marta, Maira, Diletta, Granata, Antonino, Ranalli, Claudia, Cammilli, Alessandra, Cavallini Maria Chiara, Tricca, Manola, Natella, Daniela, Gabbani, Luciano, Tesi, Francesca, Martella, Letizia, Imbrici, Rosalba, Pacchioni, Maurizio, Gianbattista, Guerrini, Scotuzzi Anna Maria, Sozzi, Ferdinando, Valenti, Luigi, Chiarello, Antonino, Monella, Monia, Pilotto, Alberto, Prete, Camilla, Senesi, Barbara, Meta Anna Cristina, Pendenza, Enrico, Pasqualetti, Giuseppe, Polini, Antonio, Tognini, Sara, Ballino, Elena, Dell'Aquila, Giuseppina, Gasparrini Pina Maria, Marotti, Elisabetta, Migale, Monica, Falsetti, Lorenzo, Salvi, Aldo, Toigo, Gabriele, Ceschia, Giuliano, Rosso, Alessia, Tongiorgi, Chiara, Scarpa, Cristina, De Dominicis Luigino, Pucci, Eugenio, Renzi, Sara, Cartechini, Elisabetta, Tomassini Pia Francesca, Del Gobbo Maurizio, Ugenti, Francesca, Romeo, Pasquale, Nardelli, Anna, Lauretani, Fulvio, Visioli, Sandra, Montanari, Ilaria, Ermini, Francesca, Giordano, Antonio, Pigato, Giorgio, Simeone, Emilio, Colameco, Franco, Cecamore, Antonella, Scurti, Rosa, Lupinetti Maria Cristina, Barbujani, Mario, Perazzi, Beatrice, Giampieri, Marina, Amoruso, Raffaele, Piccinini, Maristella, Ferrari, Camilla, Gambetti, Claudio, Sfrappini, Mario, Semeraro, Letizia, Striuli, Rinaldo, Mariani, Claudia, Pelliccioni, Giuseppe, Marinelli, Donatella, Fabi, Katia, Rossi, Tommaso, Pesallaccia, Martina, Sabbatini, Debora, Gobbi, Beatrice, Cerqua, Raffaella, Tagliani, Giancarla, Schlauser, Elena, Caser, Luciano, Caramello, Elisa, Sandigliano, Franca, Rosso, Giorgio, Bendini, Chiara, Davoli, Maria, Casella, Monica, Prampolini, Raffaella, Scevola, Moreno, Vitale, Enrico, Brugiolo, Roberto, Brugiolo, Fagherazzi, Carlo, Scarpa, Alberto, Zara, Daniela, Bertozzo, Giulia, Granziera, Serena, Barazzuol, Michele, Maugeri, Domenico, Sorace, Rosaria, Anzaldi, Massimiliano, De Gesu Roberto, Morrone, Giuseppe, Davolio, Federica, Fabbo, Andrea, Palmieri, Marina, Forti, Paola, Pirazzoli, Luca, Fabbri, Elisa, Terenzi, Laura, Bergolari, Federica, Wenter, Christian, Ruffini, Ingrid, Insam, Miriam, Abraham, Elisabeth, Kirchlechner, Christine, Lasco, Antonino, Arena Maria Grazia, Parise, Pasquale, Boccali, Andrea, Amici, Serena, Gambacorta, Maurizia, Ferrari, Alberto, Lasagni, Anna, Lovati, Roberto, Giovinazzo, Francesca, Kimak, Elzbieta, Zappa, Paolo, Medici, Francesco, Lo Castro Marika, Mauro, Flavia, De Luca Alessandro, Sancesario, Giuseppe, Martorana, Alessandro, Scaricamazza, Beatrice, Di Lorenzo Francesco, Liguori, Claudio, Vita, Natale, Giomi, Mirna, Forte, Floriana, Padovani, Alessandro, Rozzini, Luca, Caratozzolo, Salvatore, Cottino, Maria, Vitali, Silvia, Marelli, Eleonora, Tripi, Gabriele, Miceli, Salvatore, Urso, Giovanni, Grioni, Giuseppe, Vezzadini, Giuliana, Misaggi, Giulia, Forlani, Chiara, Avanzi, Stefano, Saulle, Serena, Casarini, Claudia, Viggiano, Marilena, Alberto, Luisa, Ghianda, Diego, Giordano, Alessandro, Iemolo, Francesco, Giordano, Antonello, Sanzaro, Enzo, D'Asta, Gabriele, Proietto, Maria, Carnemolla, Anna, Razza, Grazia, Spadaro, Daniela, Bertolotti, Marco, Mussi, Chiara, Neviani, Francesca, Chiesa, Roberto, Guerzoni, Valentina, Morselli, Linda, Venturelli, Francesca, Tarozzi, Adriano, Balestri, Francesca, Mannarino, Giulio, Bigolari, Michela, Natale, Alessia, Grassi, Simona, Bottaro, Cinzia, Stefanelli, Sara, Bovone, Ugo, Tortorolo, Umberto, Quadri, Roberto, Leone, Giuseppe, Ponzetto, Maria, Frasson, Paola, Annoni, Giorgio, Bruni, Adriana, Confalonieri, Roberto, Corsi, Maurizio, Moretti, Daniela, Teruzzi, Fabiola, Umidi, Simona, Mazzola, Paolo, Perego, Sabrina, Persico, Ilaria, Olivieri, Giulia, Bonfanti, Alessandra, Hajnalka, Szabo, Galeazzi, Marianna, Massariello, Francesca, Anzuini, Alessandra, Caffarra, Paolo, Barocco, Federica, Spallazzi, Marco, Ceda Gian Paolo, Morganti, Simonetta, Artoni, Andrea, Chioatto, Paolo, Bortolamei, Sandra, Soattin, Lucia, Beneamino, Borelli, Barilaro, Giuseppe, Bertazzoli, Marco, Rota, Elisabetta, Adobati, Annamaria, Zuccher, Paola, Dal Fabbro Angela, Lo Nigro Ambra, Franchetti, Lorena, Toniolo, Marika, Marcuzzo, Cinzia, Rollone, Marco, Guerriero, Fabio, Sgarlata, Carmelo, Anna, Santoro, Zatti, Giovanni, Piatti, Massimiliano, Graci, Jole, Benati, Giuseppe, Boschi, Federica, Biondi, Mario, Fiumi, Nicoletta, Erika, Tamburini, Locatelli Sergio Mario, Mauri, Sabrina, Beretta, Mauro, Margheritis, Laura, Desideri, Giovanbattista, Liberatore, Ester, Carucci Anna Cecilia, Bonino, Paolo, Caput, Margherita, Antonietti Maria Paola, Polistena, Giuseppe, De la Pierre Franz, Mari, Marcello, Massignani, Paola, Tombesi, Fabio, Selvaggio, Fabio, Verbo, Brunella, Bodoni, Paolo, Marchionni, Niccolo, Sabatini, Tony, Mussio, Eleonora, Magni, Eugenio, Bianchetti, Angelo, Crucitti, Andrea, Titoldini, Giulia, Cossu, Beatrice, Fascendini, Sara, Licini, Cristina, Tomasoni, Angela, Calderazzo, Massimo, Tropiano, Daniela, Lagana, Valentina, Melotti Rita Maria, Lilli, Albina, Buda, Simona, Adversi, Marco, Noro, Gabriele, Turco, Renato, Chiara, Ubezio M., Mantovani Anna Roberta, Viola Maria Cristina, Serrati, Carlo, Pretta, Stefano, Infante, Maria, Gentile, Simona, D'Ambrosio, Viviana, Mazzanti, Paolo, Brambilla, Cristina, Sportelli, Silvia, Platto, Caterina, Faraci, Bianca, Quattrocchi, Daniela, Pisu, Cristina, Sicuro, Francesca, Del Grosso Luciano Luca, Zagnoni, Piergiuseppe, Ghiglia, Stefania, Mosca, Massimiliano, Corazzin, Ileana, Deola, Mariangela, Biagini Carlo Adriano, Bencini, Francesca, Cantini, Claudia, Tonon, Elisabetta, Pierinelli, Silvia, Onofrj, Marco, Thomas, Astrid, Borbone, Filomena, Bonanni, Laura, Cacchio, Gabriella, Comi, Giancarlo, Magnani, Giuseppe, Santangelo, Roberto, Mazzeo, Salvatore, Caso, Francesca, Cecchetti, Giordano, Sant’Angelo, Roberto, Barbieri, Cristina, Giroldi, Liviana, Bandini, Fabio, Masina, Marco, Malservisi, Simona, Cicognani, Annalena, Ricca, Laura, Piccininni, Maristella, Tassinari, Tiziana, Brogi, Davide, Sugo, Annalisa, Filippi, Alessandra, Manfredi, Sonia, Vanni, Valerio, Usai carlo Andrea, Colombo, Enrico, Renna Vera Francesca, Sauchella, Assunta, Prete, Mauro, Bisagni, Pietro, Masini, Roberto, Carrabetta, Salvatore, Barone, Antonella, Razzano, Monica, Imperoli, Giuseppe, Bini, Angela, Serra, Francesco, D’Agostino, Valeria, Gianolla, Federico, Pietrangeli, Lucia, Velardi, Antonella, Di Cello Elisabetta, Rosati, Cristina, Casali, Nadia, Casali, Sessa, Maria, Abruzzi, Luciano, Costanzi, Chiara, Bini, Paolo, Pignata, Michele, Buonaugurio, Enrico, Vollery, Maria, Carrieri, Giovanni, Cioni, Giorgio, Toschi, Andrea, Metra, Marco, Ranieri, Piera, Ceccon, Anna, Magrin, Laura, Marin, Sara, Barbara, Sofia, Ghedini, Laura, Moroni, Matteo, Paragona, Marco, Pallotti Maria Caterina, Rota, Carla, Gottardi, Federica, Tomasoni, Clara, Cappuccio, Melania, Bonini, Giampaolo, Guerini, Stefano, Guerini, Valeria, Merlaj, Lucia, Tovaglieri, Maurizio, Antonio, Grillo, Francesca, Arenare, Mineo, Tonino, Kanah, David, Vianello, Giorgio, Vianello, Piero, Balducci, Ubaldo, Sidoti, Vincenzo, Montanari, Stefano, Murelli Flavio Teodolindo Busonera, Albanese, Paolo, Maselli, Monica, Bolzetta, Francesco, Fabris, Roberto, Durante-Mangoni, Emanuele, Testoni, Michela, Di Stefano Fabio, Seccia, Loredana, Sonzini, Valeria, Fabiano, Maria, Di Giorgio Annabella, De Cosmo Salvatore, Greco, Antonio, D’Onofrio, Grazia, Sancarlo, Daniele, Resta, Gianluca, Girardello, Renzo, Girardello, Minervini, Sergio, Boni, Morena, Vitali, Mariagrazia, Pizzoni, Marina, De Colle Paolo, Frattola, Alessandra, Orlandini, Francesco, La Regina Micaela, Padulo, Filomena, Margheriti, Cristina, Rolano, Dario, Moscatelli, Giancarla, Radaelli, Guido, Montini, Elena, Prete, Cosimo, Novello, Marileda, Bramuzzo, Igor, Bertin, Nicole, Rinaldo, Elena, Paolillo, Ciro, Riccardi, Angela, Benedetti, Claudia, Rizzi, Barbara, Montagna, Francesca, Cutaia, Chiara, Baca, Oliver, Colombo, Mauro, Procino, Giuseppe, Tarara, Rosaria, Dell’Acqua, Davide, Cislaghi, Stefania, Cairati, Marco, Porta, Massimo, Scaglione, Luca, De Feo Martina, Vertolli, Paola, Salvati, Lia, Cinotti, Sandro, De Santis Valentina, Biferi, Erminia, Cheli, Paola, Rebizzo, Romina, Salvatore, Minisola, Luciano, Colangelo, Abete, Pasquale, Liguori, Ilaria, Curcio, Francesca, Spassini, Guglielmo, Engheben, Marco, Rotunno, Sara, Rotunno, Arosio, Paola, Angelini, Claudio, Reggiani, Francesco, Cappelli, Alessandro, Marcheselli, Simona, Fratticci, Lara, Ranzani, Paola, Cesarini, Simonetta, Cerini, Antonella, Gallucci, Fernando, Serra, Emanuela, Sola, Mariolina, Delitala, Alessandro, Pes, Chiara, Lobianco, Giulia, Giani, Alessandro, Famularo, Simone, Sandini, Marta, Pinotti, Enrico, Gianotti, Luca, Battuello, Antonella, Pintore, Giulia, Rossi, Andrea, Rubele, Sofia, Sant, Selena, Vignati, Marco, Clerici, Danila, Rosa, Fabio, Bandirali Maria Pia, Cattaneo, Nicoletta, Boffi, Laura, Avalli, Leonello, Scanziani, Margherita, De Notaris Stefania, Del Santo Pierluigi, Del, Santo, Catalano, Felice, Fogli, Danilo, Di Bella Giovanna, Landi, Francesco, Salini, Sara, Brunetti Maria Angela, Cappa, Giorgetta, Galvagno, Giovanni, Cena, Paola, Bruno, Gerardo, Raspo, Silvio, Semeraro, Pedrotti, Sabrina, Palmieri Vincenzo Ostilio, Palasciano, Giuseppe, Belfiore, Anna, Portincasa, Piero, Sabbà, Carlo, Solfrizzi, Vincenzo, D’Introno, Alessia, Valiani, Vincenzo, Bologna, Carolina, Ciarambino, Tiziana, Magnani, Turelli, Paola, Pazzaglia, Ugo, Rodella, Federica, Piana, Giacomo, Castellano, Maurizio, Garelli, Anna, Garelli, Casella, Elisa, Campana, Federica, Coschigliano Maria Antonietta, Marinangeli, Luigi, Lorico, Fabio, Bazzano, Salvatore, Menculini, Giuseppe, Gelosa, Giorgio, Viviana Ambrogio Teresa, Piras, Valentina, Ciricugno, Andrea, Bollari, Alessandra, Coen, Daniele, Magliola, Renata, Milanesio, Deborah, Muzzulini Carlo Lorenzo, Fogliacco, Paolo, Marinella, Turla, Cotelli Maria Sofia, Bianchi, Marta, Siano, Pietro, Capo, Giuseppe, Napoletano, Rosa, Politi, Cecilia, Mancini, Concetta, Del Buono Corrado, De Bartolomeo Giuseppe, Martinelli, Addolorata, Cefalogli, Carmen, Cozzi, Roberto, Virtuani Angelo Giovanni, Moschettini, Gianfilippo, Mastroianni, Franco, Roglia, Daniela, D'Amico, Gabriella, Palella, Mirella, Endrizzi, Cristina, Trotta, Lucia, Zanetti, Orazio, Terazzi, Emanuela, Sacchetti, Marta, Fleetwood, Thomas, Tondo, Giacomo, Di Fazio Ignazio, Bruni, Andrea, Orsitto, Giuseppe, Fabbro, Emanuela, D’Imporzano, Elena, Casanova, Anna, Bertolio, Serena, Nervo, Silvestri, Roberto, Semproni, Elena, Pintus, Manuela, Aloe, Francesca, Tagliaccica, Angelo., Aloisi G., Marengoni A., Morandi A., Zucchelli A., Cherubini A., Mossello E., Bo M., Di Santo S.G., Mazzone A., Trabucchi M., Cappa S., Fimognari F.L., Incalzi R.A., Gareri P., Perticone F., Campanini M., Montorsi M., Latronico N., Zambon A., Bellelli G., Rispoli V., Malara A., Spadea F., Di Cello S., Ceravolo F., Fabiano F., Chiaradia G., Gabriele A., Lenino P., Andrea T., Settembrini V., Capomolla D., Citrino A., Scriva A., Bruno I., Secchi R., De Martino E., Muccinelli R., Villa Del Sole R.S.A., Lupi G., Paonessa P., Fabbri A., Passuti M.T., Castellari S., Po A., Gaggioli G., Varesi M., Moneti P., Capurso S., Latini V., Ghidotti S., Riccardelli F., Macchi M., Rigo R., Claudio P., Angelo B., Flavio C., Benedetta B., Boffelli S., Cassinadri A., Franzoni S., Spazzini E., Andretto D., Tonini G., Andreani L., Coralli M., Balotta A., Cancelliere R., Ballardini G., Simoncelli M., Mancini A., Strazzacapa M., Fabio S., De Filippi F., Giudice C., Dentizzi C., Azzini M., Cazzadori M., Mastroeni V., Bertassello P., Benati H.S.C., Nesta E., Tobaldini C., Guerini F., Elena T., Mombelloni P., Fontanini F., Gabriella L., Pizzorni C., Oliverio M., Del Grosso L.L., Giavedoni C., Bidoli G., Mazzei B., Corsonello A., Fusco S., Vena S., De Vuono T., Maiuri G., Luca F.F., Andrea A., Giovanni S., Rossella N., Castegnaro E., De Rosa S., Benvenuti E., Del Lungo I., Giardini S., Giulietti C., Mauro D.B., Eleonora B., Martina P., Irene F., Riccardo B., Federica S., Bertoletti E., D'Amico F., Caronzolo F., Grippa A., Lombardo G., Pipicella T., Antonino S., Francesco C., Valeria P.G., Daniela L., Domenico C., Giorgio B., March A., Nitti M.T., Felici A., Pavan S., Piazzani F., Lunelli A., Dimori S., Margotta A., Soglia T., Postacchini D., Brunelli R., Santini S., Francavilla M., Macchiati I., Sorvillo F., Giuli C., Mecocci P., Longo A., Addesi D., Rosa P.C., Bencardino G., Falbo T., Grillo N., Marco F., Mirella F., Fanto F., Isaia G., Pezzilli S., Bergamo D., Furno E., Rrodhe S., Lucarini S., Dijk B., Dall'Acqua F., Calvani D., Becheri D., Giuseppe M., Costanza M., Vito A., Francesca B., Magherini L., Novella M., Franca B., Gambardella P.M.L., Valente C., Ospedale N., Ilaria B., Alice F., Porrino P., Ceci G., Giuliana B., Michela T., Eleonora C., Ettore E., Camellini C., Servello A., Grassi A., Rozzini R., Tironi S., Grassi M.G., Troisi E., Carlo C., Gabriella D.S.S., Flaminia F., Federica R., Beatrice P., Sofia T., Gabutto A., Quazzo L., Rosatello A., Suraci D., Tagliabue B., Perrone C., Ferrara L., Castagna A., Tremolada M.L., Giuseppe C., Stefano B., Davide O., Piano S., Serviddio G., Lo Buglio A., Gurrera T., Merlo V., Rovai C., Cotroneo A.M., Carlucci R., Abbaldo A., Monzani F., Qasem A.A., Bini G., Tafuto S., Galli G., Bruni A.C., Mancuso G., Calipari D., Bernardini B., Corsini C., Michele C., Sara D.F., Cagnin A., Fragiacomo F., Pompanin S., Piero A., Marco C., Zurlo A., Guerra G., Pala M., Menozzi L., Delli Gatti C., Magon S., Roberto M., Alfredo D.G., Fabio F., Ruana T., Elisa M., Christian M., Marco P., Massimo G., Di Francesco V., Faccioli S., Pellizzari L., Giorgia F., Barbagallo G., Lunardelli M.L., Martini E., Ferrari E., Macchiarulo M., Corneli M., Bacci M., Battaglia G., Anastasio L., Lo Storto M.S., Seresin C., Simonato M., Loreggian M., Cestonaro F., Durando M., Latella R., Mazzoleni M., Russo G., Ponte M., Valchera A., Salustri G., Petritola D., Costa A., Sinforiani E., Cotta M.R., Pizio R.N., Cester A., Formilan M., Pietro B., Carbone P., Cazzaniga I., Appollonio I., Cereda D., Stabile A., Xhani R., Acampora R., Tremolizzo L., Federico P., Antonio C., Valerio P., Cesare B., Zhirajr M., Giovanni V., Maria A., Mariaelena S., Bottacchi E., Bucciantini E., Di Giovanni M., Franchi F., Lucchetti L., Mariani C., Grande G., Rapazzini P., Marco M., Romanelli G., Franco N., Alessio M., Nicola L., Laura P., Nazario P., Chiara G., Soccorso P., Andrea S., Luca B., Francesca S., Roberto A., Anna C., Infettive M., Fugazza L., Guerrini C., De Paduanis G., Iallonardo L., Palumbo P., Zuliani G., Ortolani B., Capatti E., Soavi C., Bianchi L., Francesconi D., Miselli A., Gloria B., Tommaso R., Chiara P., Agata M.M., Dall'Agata M., Luca M., Gianluca G., Suardi T., Zaccarini C., Manuela R., Mirra G., Muti E., Bottura R., Gianpaolo M., Secreto P., Bisio E., Cecchettani M., Naldi T., Pallavicino A., Pugliese M., Iozzo R.C., Grassi G., Michele B., Dell'Oro R., Fosca Q.T., Giorgio G.C., Giovanni P., Ernesto C., Mannironi A., Giorli E., Oberti S., Fierro B., Piccoli T., Giacalone F., Mandas A., Serchisu L., Costaggiu D., Pinna E., Orru F., Mannai M., Cordioli Z., Pelizzari L., Turcato E., Arduini P., Cacace C., Chiloiro R., Cimino R., Ruberto C., Giovanni R., Pietro G., Laura G., Alberto C., Carmen R., Dal Santo P., Andriolli A., Burattin G., Rossi L., Antonino C.G.A., Tezza F., Maddalena P., Laura S., Crippa P., Aloisio P., Di Monda T., Malighetti A., Galbassini G., Ivaldi C., Russo A.M., Bennati E., Pino E., Zavarise G., Pesci A., Suigo G., Faverio P., Andrea G., Sabrina P., Zanasi M., Moniello G., Rostagno C., Cartei A., Polidori G., Ungar A., Melis M.R., Martellini E., Enrico M., Monica T., Antonella G., Giovanna L., Migliorini M., Caramelli F., Battiston B., Berardino M., Cavallo S., Alessandro M., Anna S., Lombardi B., D'Ippolito P., Furini A., Villani D., Clara R., Guarneri M., Paolucci S., Bassi A., Coiro P., De Angelis D., Morone G., Venturiero V., Palleschi L., Raganato P., Di Niro G., Rosa C.A., Loredana B., Imoscopi A., Tibaldi V., Bottignole G.G., Calvi E., Clementi C., Zanocchi M., Agosta L., Criasia A., Spertino E., Nortarelli A., Provenzano G., Principato P., Rizzo A., Cellura E., Mari D., Romano F.Y., Rosini F., Mansi M., Rossi S., Riccardelli A., Inzaghi L., Bonini G., Rossi P., Potena A., Lichii M., Candiani T., Grimaldi W., Bertani E., Alessandra P., Calogero P., Pinto D., Bernardi R., Nicolino F., Galetti C., Gianstefani A., Giulia C., Lorenzo M., Odetti P., Monacelli F., Prefumo M., Fiammetta M., Canepa M., Minaglia C., Paolisso G., Rizzo M.R., Prestano R., Dalise A.M., Barra D., Dal Bosco L., Asprinio V., Dallape L., Perina E., Bartoli I.R., Pluderi A., Maina A., Pecoraro E., Sciarra M., Prudente A., Paola M., Francesca M., Manuel V., Luisella C., Maria P.L., Tina S., Benini L., Levato F., Mhiuta V., Alius F., Davidoaia D., Giardini V., Garancini M., Bellamoli C., Terranova L., Bozzini C., Tosoni P., Provoli E., Cascone L., Dioli A., Ferrarin G., Bucci A., Bua G., Fenu S., Bianchi G., Casella S., Romano V., Maurizio P., Mascherona I., Belotti G., Cavaliere S., Cuni E., Merciuc N., Oberti R., Veneziani S., Capoferri E., De Bernardi E., Colombo K., Bravi M., Nicoletta N., D'Arcangelo P., Montenegro N., Montanari R., Lamanna P., Gasperini B., Isabella M., Stefania D., Gaia A., Filippo C., Palama C., Di Emidio C., Scarpini E., Arighi A., Fumagalli G., Basilico P., De Amicis Margherita M., Marta M., Diletta M., Granata A., Ranalli C., Cammilli A., Cavallini M.C., Tricca M., Natella D., Gabbani L., Tesi F., Martella L., Imbrici R., Guerrini G., Scotuzzi A.M., Sozzi F., Valenti L., Chiarello A., Monia M., Pilotto A., Prete C., Senesi B., Meta A.C., Pendenza E., Pasqualetti G., Polini A., Tognini S., Ballino E., Dell'Aquila G., Gasparrini P.M., Marotti E., Migale M., Scrimieri A., Falsetti L., Salvi A., Toigo G., Ceschia G., Rosso A., Tongiorgi C., Scarpa C., De Dominicis L., Pucci E., Renzi S., Cartechini E., Tomassini P.F., Del Gobbo M., Ugenti F., Romeo P., Nardelli A., Lauretani F., Visioli S., Montanari I., Ermini F., Giordano A., Pigato G., Simeone E., Colameco F., Cecamore A., Scurti R., Lupinetti M.C., Barbujani M., Perazzi B., Giampieri M., Amoruso R., Piccinini M., Ferrari C., Gambetti C., Sfrappini M., Semeraro L., Striuli R., Pelliccioni G., Marinelli D., Fabi K., Rossi T., Pesallaccia M., Sabbatini D., Gobbi B., Cerqua R., Tagliani G., Schlauser E., Caser L., Caramello E., Sandigliano F., Rosso G., Ferrari A., Bendini C., Luisa D.M., Casella M., Prampolini R., Scevola M., Vitale E., Roberto B., Carlo F., Sergio F., Alberto S., Daniela Z., Giulia B., Serena G., Maugeri D., Sorace R., Anzaldi M., De Gesu R., Morrone G., Davolio F., Fabbo A., Palmieri M., Zoli M., Forti P., Pirazzoli L., Fabbri E., Terenzi L., Bergolari F., Wenter C., Ruffini I., Insam M., Abraham E., Kirchlechner C., Cucinotta D., Antonino L., Basile G., Grazia A.M., Parise P., Boccali A., Amici S., Gambacorta M., Lasagni A., Lovati R., Giovinazzo F., Kimak E., Zappa P., Medici F., Lo Castro M., Mauro F., De Luca A., Sancesario G., Martorana A., Scaricamazza B., Toniolo S., Di Lorenzo F., Liguori C., Lasco A., Vita N., Giomi M., Forte F., Padovani A., Rozzini L., Ceraso A., Salvatore C., Cottino M., Vitali S., Marelli E., Tripi G., Miceli S., Urso G., Grioni G., Vezzadini G., Misaggi G., Forlani C., Avanzi S., Serena S., Claudia C., Marilena V., Alberto L., Diego G., Alessandro G., Iemolo F., Sanzaro E., D'Asta G., Proietto M., Carnemolla A., Razza G., Spadaro D., Bertolotti M., Mussi C., Neviani F., Roberto C., Valentina G., Linda M., Francesca V., Tarozzi A., Balestri F., Mannarino G., Bigolari M., Natale A., Grassi S., Bottaro C., Stefanelli S., Bovone U., Tortorolo U., Quadri R., Leone G., Ponzetto M., Frasson P., Annoni G., Bruni A., Confalonieri R., Corsi M., Moretti D., Teruzzi F., Umidi S., Mazzola P., Perego S., Persico I., Olivieri G., Bonfanti A., Hajnalka S., Galeazzi M., Massariello F., Anzuini A., Caffarra P., Barocco F., Spallazzi M., Paolo C.G., Simonetta M., Chioatto P., Bortolamei S., Soattin L., Ruotolo G., Beneamino B., Giuseppe B., Bertazzoli M., Rota E., Adobati A., Scarpa A., Granziera S., Zuccher P., Dal Fabbro A., Zara D., Lo Nigro A., Franchetti L., Toniolo M., Marcuzzo C., Rollone M., Guerriero F., Sgarlata C., Masse A., Zatti G., Piatti M., Graci J., Benati G., Boschi F., Biondi M., Fiumi N., Erika T., Locatelli S.M., Mauri S., Beretta M., Margheritis L., Desideri G., Liberatore E., Carucci A.C., Bonino P., Caput M., Antonietti M.P., Polistena G., De La Pierre F., Mari M., Massignani P., Tombesi F., Selvaggio F., Verbo B., Bodoni P., Marchionni N., Sabatini T., Mussio E., Magni E., Bianchetti A., Crucitti A., Titoldini G., Cossu B., Fascendini S., Licini C., Tomasoni A., Calderazzo M., Daniela T., Valentina L., Melotti R.M., Lilli A., Buda S., Adversi M., Noro G., Turco R., Ubezio M.C., Mantovani A.R., Viola M.C., Serrati C., Pretta S., Infante M., Gentile S., D'Ambrosio V., Mazzanti P., Brambilla C., Sportelli S., Platto C., Faraci B., Quattrocchi D., Pernigotti L.M., Pisu C., Sicuro F., Zagnoni P., Ghiglia S., Mosca M., Corazzin I., Deola M., Di Agordo O., Biagini C.A., Bencini F., Cantini C., Tonon E., Pierinelli S., Onofrj M., Thomas A., Filomena B., Bonanni L., Gabriella C., Comi G., Magnani G., Santangelo R., Mazzeo S., Francesca C., Giordano C., Roberto S., Barbieri C., Giroldi L., Bandini F., Masina M., Malservisi S., Cicognani A., Ricca L., Piccininni M., Tassinari T., Brogi D., Sugo A., Alessandra F., Sonia M., Valerio V., Andrea U.C., Enrico C., Vera R.F., Assunta S., Gianmaria Z., Mauro P., Barone A., Razzano M., Giuseppe I., Angela B., Francesco S., D'Agostino V., Federico G., Lucia P., Antonella V., Di Cello E., Cristina C., Nadia C., Maria S., Luciano A., Chiara C., Bini P., Pignata M., Enrico B., Maria V., Giovanni C., Giorgio C., Piera R., Alberto Z., Ceccon A., Magrin L., Marin S., Barbara S., Matteo M., Caterina P.M., Carla R., Federica G., Clara T., Melania C., Giampaolo B., Stefano G., Valeria G., Lucia M., Giovambattista D., Ester L., Cecilia C.A., Maurizio T., Nadia B., Grillo A., Arenare F., Tonino M., David K., Giorgio V.P., Ubaldo B., Vincenzo S., Stefano M., Marino F., Flavio M.T.B., Paolo A., Monica M., Francesco B., Roberto F., Paolo B., Durante-Mangoni E., Testoni M., Di Stefano F., Loredana S., Daniela M., Valeria S., Fabiano M., Di Giorgio A., De Cosmo S., Greco A., D'Onofrio G., Daniele S., Gianluca R., Renzo G., Sergio M., Morena B., Vitali M., Marina P., De Colle P., Cristina S., Orlandini F., La Regina M., Desiree A., Mario B., Paola P., Padulo F., Cristina M., Dario R., Giancarla M., Guido R., Elena M., Marileda N., Igor B., Nicole B., Elena R., Paolillo C., Riccardi A., Claudia B., Barbara R., Silvia V., Oliver B., Mauro C., Eleonora M., Giuseppe P., Rosaria T., Maria C., Dell'Acqua D., Stefania C., Massimo P., Luca S., De Feo M., Paola V., Lia S., Sandro C., De Santis V., Erminia B., Paola C., Romina R., Minisola S., Luciano C., Pasquale A., Ilaria L., Guglielmo S., Marco E., Sara R., Paola A., Claudio A., Francesco R., Alessandro C., Simona M., Lara F., Paola R., Simonetta C., Antonella C., Generoso U., Fernando G., Giuliano C., Emanuela S., Mariolina S., Alessandro D., Giulia L., Famularo S., Sandini M., Pinotti E., Gianotti L., Antonella B., Giulia P., Sante G., Rossi A., Rubele S., Sant S., Marco V., Danila C., Fabio R., Bandirali M.P., Nicoletta C., Laura B., Paolo T., Luciano T., Leonello A., Margherita S., De Notaris S., Del Santo P., Laura R., Fabiana T., Giovanna C., Antonino A., Felice C., Danilo F., Di Bella G., Francesco L., Salini S., Angela B.M., Giorgetta C., Giovanni G., Gerardo B., Silvio R., Letizia S., Davide B., Rosaria R.M., Maria D.A., Raffaele P., Palmieri V.O., Palasciano G., Belfiore A., Portincasa P., Carlo S., D'Introno A., Valiani V., Carolina B., Tiziana C., Paola T., Ugo P., Giacomo P., Castellano M., Anna G., Elisa C., Federica C., Antonietta C.M., Luigi M., Fabio L., Salvatore B., Gelosa G., Viviana A.T., Piras V., Andrea C., Alessandra B., Coen D., Magliola R., Milanesio D., Muzzulini C.L., Paolo F., Marinella T., Sofia C.M., Marta B., Siano P., Capo G., Napoletano R., Cecilia P., Mancini C., Del Buono C., De Bartolomeo G., Addolorata M., Carmen C., Giovanni V.A., Moschettini G., Franco M., Mulli O.F., Daniela R., D'Amico G., Mirella P., Endrizzi C., Trotta L., Ciarambino T., Orazio Z., Emanuela T., Marta S., Thomas F., Giacomo T., Di Fazio I., Andrea B., Giuseppe O., Emanuela F., Serena A., D'Imporzano E., Serena B., Erika N., Elena S., Manuela P., Francesca A., Angelo T., Aloisi, G., Marengoni, A., Morandi, A., Zucchelli, A., Cherubini, A., Mossello, E., Bo, M., Di Santo, S.G., Mazzone, A., Trabucchi, M., Cappa, S., Fimognari, F.L., Incalzi, R.A., Gareri, P., Perticone, F., Campanini, M., Montorsi, M., Latronico, N., Zambon, A., Bellelli, G., Rispoli, V., Malara, A., Spadea, F., Di Cello, S., Ceravolo, F., Fabiano, F., Chiaradia, G., Gabriele, A., Lenino, P., Andrea, T., Settembrini, V., Capomolla, D., Citrino, A., Scriva, A., Bruno, I., Secchi, R., De Martino, E., Muccinelli, R., Villa Del Sole, R.S.A., Lupi, G., Paonessa, P., Fabbri, A., Passuti, M.T., Castellari, S., Po, A., Gaggioli, G., Varesi, M., Moneti, P., Capurso, S., Latini, V., Ghidotti, S., Riccardelli, F., Macchi, M., Rigo, R., Claudio, P., Angelo, B., Flavio, C., Benedetta, B., Boffelli, S., Cassinadri, A., Franzoni, S., Spazzini, E., Andretto, D., Tonini, G., Andreani, L., Coralli, M., Balotta, A., Cancelliere, R., Ballardini, G., Simoncelli, M., Mancini, A., Strazzacapa, M., Fabio, S., De Filippi, F., Giudice, C., Dentizzi, C., Azzini, M., Cazzadori, M., Mastroeni, V., Bertassello, P., Benati, H.S.C., Nesta, E., Tobaldini, C., Guerini, F., Elena, T., Mombelloni, P., Fontanini, F., Gabriella, L., Pizzorni, C., Oliverio, M., Del Grosso, L.L., Giavedoni, C., Bidoli, G., Mazzei, B., Corsonello, A., Fusco, S., Vena, S., De Vuono, T., Maiuri, G., Luca, F.F., Andrea, A., Giovanni, S., Rossella, N., Castegnaro, E., De Rosa, S., Benvenuti, E., Del Lungo, I., Giardini, S., Giulietti, C., Mauro, D.B., Eleonora, B., Martina, P., Irene, F., Riccardo, B., Federica, S., Bertoletti, E., D'Amico, F., Caronzolo, F., Grippa, A., Lombardo, G., Pipicella, T., Antonino, S., Francesco, C., Valeria, P.G., Daniela, L., Domenico, C., Giorgio, B., March, A., Nitti, M.T., Felici, A., Pavan, S., Piazzani, F., Lunelli, A., Dimori, S., Margotta, A., Soglia, T., Postacchini, D., Brunelli, R., Santini, S., Francavilla, M., Macchiati, I., Sorvillo, F., Giuli, C., Mecocci, P., Longo, A., Addesi, D., Rosa, P.C., Bencardino, G., Falbo, T., Grillo, N., Marco, F., Mirella, F., Fantò, F., Isaia, G., Pezzilli, S., Bergamo, D., Furno, E., Rrodhe, S., Lucarini, S., Dijk, B., Dall'Acqua, F., Calvani, D., Becheri, D., Giuseppe, M., Costanza, M., Vito, A., Francesca, B., Magherini, L., Novella, M., Franca, B., Gambardella, P.M.L., Valente, C., Ospedale, N., Ilaria, B., Alice, F., Porrino, P., Ceci, G., Giuliana, B., Michela, T., Eleonora, C., Ettore, E., Camellini, C., Servello, A., Grassi, A., Rozzini, R., Tironi, S., Grassi, M.G., Troisi, E., Carlo, C., Gabriella, D.S.S., Flaminia, F., Federica, R., Beatrice, P., Sofia, T., Gabutto, A., Quazzo, L., Rosatello, A., Suraci, D., Tagliabue, B., Perrone, C., Ferrara, L., Castagna, A., Tremolada, M.L., Giuseppe, C., Stefano, B., Davide, O., Piano, S., Serviddio, G., Lo Buglio, A., Gurrera, T., Merlo, V., Rovai, C., Cotroneo, A.M., Carlucci, R., Abbaldo, A., Monzani, F., Qasem, A.A., Bini, G., Tafuto, S., Galli, G., Bruni, A.C., Mancuso, G., Mancuso, G., Calipari, D., Bernardini, B., Corsini, C., Michele, C., Sara, D.F., Cagnin, A., Fragiacomo, F., Pompanin, S., Piero, A., Marco, C., Zurlo, A., Guerra, G., Pala, M., Menozzi, L., Delli Gatti, C., Magon, S., Roberto, M., Alfredo, D.G., Fabio, F., Ruana, T., Elisa, M., Benedetta, B., Christian, M., Marco, P., Massimo, G., Di Francesco, V., Faccioli, S., Pellizzari, L., Giorgia, F., Barbagallo, G., Lunardelli, M.L., Martini, E., Ferrari, E., Macchiarulo, M., Corneli, M., Bacci, M., Battaglia, G., Anastasio, L., Lo Storto, M.S., Seresin, C., Simonato, M., Loreggian, M., Cestonaro, F., Durando, M., Latella, R., Mazzoleni, M., Russo, G., Ponte, M., Valchera, A., Salustri, G., Petritola, D., Costa, A., Sinforiani, E., Cotta, M.R., Piano, S., Pizio, R.N., Cester, A., Formilan, M., Pietro, B., Carbone, P., Cazzaniga, I., Appollonio, I., Cereda, D., Stabile, A., Xhani, R., Acampora, R., Tremolizzo, L., Federico, P., Antonio, C., Valerio, P., Cesare, B., Zhirajr, M., Giovanni, V., Maria, A., Mariaelena, S., Bottacchi, E., Bucciantini, E., Di Giovanni, M., Franchi, F., Lucchetti, L., Mariani, C., Grande, G., Rapazzini, P., Marco, M., Romanelli, G., Franco, N., Alessio, M., Stefano, B., Nicola, L., Laura, P., Nazario, P., Carlo, C., Chiara, G., Soccorso, P., Andrea, S., Luca, B., Francesca, S., Roberto, A., Marco, F., Anna, C., Francesco, C., Infettive, M., Fugazza, L., Guerrini, C., De Paduanis, G., Iallonardo, L., Palumbo, P., Zuliani, G., Ortolani, B., Capatti, E., Soavi, C., Bianchi, L., Francesconi, D., Miselli, A., Gloria, B., Tommaso, R., Chiara, P., Agata, M.M., Dall'Agata, M., Luca, M., Gianluca, G., Suardi, T., Zaccarini, C., Manuela, R., Mirra, G., Muti, E., Bottura, R., Gianpaolo, M., Secreto, P., Bisio, E., Cecchettani, M., Naldi, T., Pallavicino, A., Pugliese, M., Iozzo, R.C., Grassi, G., Michele, B., Dell'Oro, R., Fosca, Q.T., Giorgio, G.C., Giovanni, P., Ernesto, C., Mannironi, A., Giorli, E., Oberti, S., Fierro, B., Piccoli, T., Giacalone, F., Mandas, A., Serchisu, L., Costaggiu, D., Pinna, E., Orrù, F., Mannai, M., Cordioli, Z., Pelizzari, L., Turcato, E., Arduini, P., Cacace, C., Chiloiro, R., Cimino, R., Ruberto, C., Giovanni, R., Pietro, G., Laura, G., Alberto, C., Carmen, R., Dal Santo, P., Andriolli, A., Burattin, G., Rossi, L., Antonino, C.G.A., Giuseppe, C., Tezza, F., Maddalena, P., Laura, S., Crippa, P., Aloisio, P., Di Monda, T., Malighetti, A., Galbassini, G., Ivaldi, C., Russo, A.M., Bennati, E., Pino, E., Zavarise, G., Pesci, A., Suigo, G., Faverio, P., Andrea, G., Sabrina, P., Zanasi, M., Moniello, G., Rostagno, C., Cartei, A., Polidori, G., Ungar, A., Melis, M.R., Martellini, E., Enrico, M., Monica, T., Antonella, G., Giovanna, L., Migliorini, M., Caramelli, F., Battiston, B., Berardino, M., Cavallo, S., Alessandro, M., Anna, S., Lombardi, B., D'Ippolito, P., Furini, A., Villani, D., Clara, R., Guarneri, M., Paolucci, S., Bassi, A., Coiro, P., De Angelis, D., Morone, G., Venturiero, V., Palleschi, L., Raganato, P., Di Niro, G., Rosa, C.A., Loredana, B., Imoscopi, A., Isaia, G., Tibaldi, V., Bottignole, G.G., Calvi, E., Clementi, C., Zanocchi, M., Agosta, L., Criasia, A., Spertino, E., Nortarelli, A., Provenzano, G., Principato, P., Rizzo, A., Cellura, E., Mari, D., Romano, F.Y., Rosini, F., Mansi, M., Rossi, S., Riccardelli, A., Inzaghi, L., Bonini, G., Rossi, P., Potena, A., Lichii, M., Candiani, T., Grimaldi, W., Bertani, E., Alessandra, P., Calogero, P., Pinto, D., Bernardi, R., Nicolino, F., Galetti, C., Gianstefani, A., Giulia, C., Lorenzo, M., Odetti, P., Monacelli, F., Prefumo, M., Fiammetta, M., Canepa, M., Minaglia, C., Paolisso, G., Rizzo, M.R., Prestano, R., Dalise, A.M., Barra, D., Dal Bosco, L., Asprinio, V., Dallape, L., Perina, E., Bartoli, I.R., Pluderi, A., Maina, A., Pecoraro, E., Sciarra, M., Prudente, A., Paola, M., Francesca, M., Manuel, V., Luisella, C., Maria, P.L., Tina, S., Benini, L., Levato, F., Mhiuta, V., Alius, F., Davidoaia, D., Giardini, V., Garancini, M., Bellamoli, C., Terranova, L., Bozzini, C., Tosoni, P., Provoli, E., Cascone, L., Dioli, A., Ferrarin, G., Bucci, A., Bua, G., Fenu, S., Bianchi, G., Casella, S., Romano, V., Maurizio, P., Mascherona, I., Belotti, G., Cavaliere, S., Cuni, E., Merciuc, N., Oberti, R., Veneziani, S., Capoferri, E., De Bernardi, E., Colombo, K., Bravi, M., Nicoletta, N., D'Arcangelo, P., Montenegro, N., Galli, G., Montanari, R., Lamanna, P., Gasperini, B., Isabella, M., Stefania, D., Gaia, A., Filippo, C., Palamà, C., Di Emidio, C., Scarpini, E., Arighi, A., Fumagalli, G., Basilico, P., De Amicis Margherita, M., Marta, M., Diletta, M., Granata, A., Ranalli, C., Cammilli, A., Cavallini, M.C., Tricca, M., Natella, D., Gabbani, L., Tesi, F., Martella, L., Imbrici, R., Guerrini, G., Scotuzzi, A.M., Sozzi, F., Valenti, L., Chiarello, A., Monia, M., Pilotto, A., Prete, C., Senesi, B., Meta, A.C., Pendenza, E., Pasqualetti, G., Polini, A., Tognini, S., Ballino, E., Dell'Aquila, G., Gasparrini, P.M., Marotti, E., Migale, M., Scrimieri A., Falsetti, L., Salvi A., Toigo, G., Ceschia, G., Rosso, A., Tongiorgi, C., Scarpa, C., Maurizio, P., De Dominicis, L., Pucci, E., Renzi, S., Cartechini, E., Tomassini, P.F., Del Gobbo, M., Ugenti, F., Romeo, P., Nardelli, A., Lauretani, F., Visioli, S., Montanari, I., Ermini, F., Giordano, A., Pigato, G., Simeone, E., Colameco, F., Cecamore, A., Scurti, R., Lupinetti, M.C., Barbujani, M., Perazzi, B., Giampieri, M., Amoruso, R., Piccinini, M., Ferrari, C., Gambetti, C., Sfrappini, M., Semeraro, L., Striuli, R., Mariani, C., Pelliccioni, G., Marinelli, D., Fabi, K., Rossi, T., Pesallaccia, M., Sabbatini, D., Gobbi, B., Cerqua, R., Tagliani, G., Schlauser, E., Caser, L., Caramello, E., Sandigliano, F., Rosso, G., Ferrari, A., Bendini, C., Luisa, D.M., Casella, M., Prampolini, R., Scevola, M., Vitale, E., Roberto, B., Carlo, F., Sergio, F., Alberto, S., Daniela, Z., Giulia, B., Serena, G., Michele, B., Maugeri, D., Sorace, R., Anzaldi, M., De Gesu, R., Morrone, G., Davolio, F., Fabbo, A., Palmieri, M., Barbagallo, G., Zoli, M., Forti, P., Pirazzoli, L., Fabbri, E., Terenzi, L., Bergolari, F., Wenter, C., Ruffini, I., Insam, M., Abraham, E., Kirchlechner, C., Cucinotta, D., Antonino, L., Basile, G., Grazia, A.M., Parise, P., Boccali, A., Amici, S., Gambacorta, M., Lasagni, A., Lovati, R., Giovinazzo, F., Kimak, E., Zappa, P., Medici, F., Lo Castro, M., Mauro, F., De Luca, A., Sancesario, G., Martorana, A., Scaricamazza, B., Toniolo, S., Di Lorenzo, F., Liguori, C., Lasco, A., Vita, N., Giomi, M., Forte, F., Padovani, A., Rozzini, L., Ceraso, A., Salvatore, C., Cottino, M., Vitali, S., Marelli, E., Tripi, G., Miceli, S., Urso, G., Grioni, G., Vezzadini, G., Misaggi, G., Forlani, C., Avanzi, S., Serena, S., Claudia, C., Marilena, V., Alberto, L., Diego, G., Alessandro, G., Iemolo, F., Giordano, A., Sanzaro, E., D'Asta, G., Proietto, M., Carnemolla, A., Razza, G., Spadaro, D., Bertolotti, M., Mussi, C., Neviani, F., Roberto, C., Valentina, G., Linda, M., Francesca, V., Tarozzi, A., Balestri, F., Mannarino, G., Bigolari, M., Natale, A., Grassi, S., Bottaro, C., Stefanelli, S., Bovone, U., Tortorolo, U., Quadri, R., Leone, G., Ponzetto, M., Frasson, P., Annoni, G., Bruni, A., Confalonieri, R., Corsi, M., Moretti, D., Teruzzi, F., Umidi, S., Mazzola, P., Perego, S., Persico, I., Olivieri, G., Bonfanti, A., Hajnalka, S., Galeazzi, M., Massariello, F., Anzuini, A., Caffarra, P., Barocco, F., Spallazzi, M., Paolo, C.G., Simonetta, M., Andrea, A., Chioatto, P., Bortolamei, S., Soattin, L., Ruotolo, G., Beneamino, B., Giuseppe, B., Bertazzoli, M., Rota, E., Adobati, A., Scarpa, A., Granziera, S., Zuccher, P., Dal Fabbro, A., Zara, D., Lo Nigro, A., Franchetti, L., Toniolo, M., Marcuzzo, C., Piano, S., Rollone, M., Guerriero, F., Sgarlata, C., Massè, A., Zatti, G., Piatti, M., Graci, J., Benati, G., Boschi, F., Biondi, M., Fiumi, N., Erika, T., Locatelli, S.M., Mauri, S., Beretta, M., Margheritis, L., Desideri, G., Liberatore, E., Carucci, A.C., Bonino, P., Caput, M., Antonietti, M.P., Polistena, G., De La Pierre, F., Mari, M., Massignani, P., Tombesi, F., Selvaggio, F., Verbo, B., Bodoni, P., Marchionni, N., Sabatini, T., Mussio, E., Magni, E., Bianchetti, A., Crucitti, A., Titoldini, G., Cossu, B., Fascendini, S., Licini, C., Tomasoni, A., Calderazzo, M., Daniela, T., Valentina, L., Prampolini, R., Melotti, R.M., Lilli, A., Buda, S., Adversi, M., Noro, G., Turco, R., Ubezio, M.C., Mantovani, A.R., Viola, M.C., Serrati, C., Pretta, S., Infante, M., Gentile, S., D'Ambrosio, V., Mazzanti, P., Brambilla, C., Sportelli, S., Platto, C., Faraci, B., Quattrocchi, D., Pernigotti, L.M., Pisu, C., Sicuro, F., Del Grosso, L.L., Zagnoni, P., Ghiglia, S., Mosca, M., Corazzin, I., Deola, M., Di Agordo, O., Biagini, C.A., Bencini, F., Cantini, C., Tonon, E., Pierinelli, S., Onofrj, M., Thomas, A., Filomena, B., Bonanni, L., Gabriella, C., Comi, G., Magnani, G., Santangelo, R., Mazzeo, S., Giuseppe, M., Francesca, C., Giordano, C., Roberto, S., Barbieri, C., Giroldi, L., Bandini, F., Masina, M., Malservisi, S., Cicognani, A., Ricca, L., Ricca, L., Piccininni, M., Tassinari, T., Brogi, D., Sugo, A., Alessandra, F., Sonia, M., Valerio, V., Andrea, U.C., Enrico, C., Vera, R.F., Assunta, S., Gianmaria, Z., Mauro, P., Pietro, B., Roberto, M., Salvatore, C., Barone, A., Razzano, M., Giuseppe, I., Angela, B., Francesco, S., D'Agostino, V., Federico, G., Lucia, P., Antonella, V., Di Cello, E., Cristina, C., Nadia, C., Maria, S., Luciano, A., Chiara, C., Bini, P., Pignata, M., Enrico, B., Maria, V., Giovanni, C., Giorgio, C., Andrea, T., Marco, M., Piera, R., Alberto, Z., Ceccon, A., Magrin, L., Marin, S., Barbara, S., Marco, M., Laura, G., Matteo, M., Marco, P., Caterina, P.M., Carla, R., Federica, G., Clara, T., Melania, C., Giampaolo, B., Stefano, G., Valeria, G., Lucia, M., Giovambattista, D., Ester, L., Cecilia, C.A., Maurizio, T., Vera, R.F., Nadia, B., Grillo, A., Arenare, F., Tonino, M., David, K., Giorgio, V.P., Ubaldo, B., Vincenzo, S., Stefano, M., Marino, F., Flavio, M.T.B., Paolo, A., Monica, M., Francesco, B., Roberto, F., Paolo, B., Durante-Mangoni, E., Testoni, M., Di Stefano, F., Loredana, S., Daniela, M., Valeria, S., Fabiano, M., Di Giorgio, A., De Cosmo, S., Greco, A., D'Onofrio, G., Daniele, S., Gianluca, R., Renzo, G., Sergio, M., Morena, B., Vitali, M., Marina, P., De Colle, P., Cristina, S., Alessandra, F., Orlandini, F., La Regina, M., Desirée, A., Mirella, F., Mario, B., Paola, P., Padulo, F., Cristina, M., Dario, R., Giancarla, M., Guido, R., Elena, M., Prete, C., Marileda, N., Igor, B., Nicole, B., Elena, R., Paolillo, C., Riccardi, A., Claudia, B., Barbara, R., Francesca, M., Silvia, V., Chiara, C., Oliver, B., Mauro, C., Eleonora, M., Giuseppe, P., Rosaria, T., Maria, C., Dell'Acqua, D., Stefania, C., Marco, C., Massimo, P., Luca, S., De Feo, M., Paola, V., Lia, S., Sandro, C., De Santis, V., Erminia, B., Paola, C., Romina, R., Minisola, S., Luciano, C., Pasquale, A., Ilaria, L., Francesca, C., Guglielmo, S., Marco, E., Sara, R., Paola, A., Claudio, A., Francesco, R., Alessandro, C., Simona, M., Lara, F., Paola, R., Simonetta, C., Antonella, C., Generoso, U., Fernando, G., Giuliano, C., Emanuela, S., Mariolina, S., Alessandro, D., Chiara, P., Giulia, L., Alessandro, G., Famularo, S., Sandini, M., Pinotti, E., Gianotti, L., Antonella, B., Giulia, P., Sante, G., Rossi, A., Rubele, S., Sant, S., Marco, V., Danila, C., Fabio, R., Bandirali, M.P., Nicoletta, C., Laura, B., Paolo, T., Luciano, T., Leonello, A., Margherita, S., De Notaris, S., Del Santo, P., Laura, R., Fabiana, T., Giovanna, C., Antonino, A., Felice, C., Giuseppe, B., Danilo, F., Di Bella, G., Francesco, L., Salini, S., Angela, B.M., Giorgetta, C., Giovanni, G., Paola, C., Gerardo, B., Silvio, R., Letizia, S., Sabrina, P., Davide, B., Rosaria, R.M., Maria, D.A., Raffaele, P., Palmieri, V.O., Palasciano, G., Belfiore, A., Portincasa, P., Carlo, S., Vincenzo, S., D'Introno, A., Valiani, V., Carolina, B., Tiziana, C., Giordano, C., Paola, T., Ugo, P., Federica, R., Giacomo, P., Castellano, M., Anna, G., Elisa, C., Federica, C., Antonietta, C.M., Luigi, M., Fabio, L., Salvatore, B., Giuseppe, M., Gelosa, G., Viviana, A.T., Piras, V., Andrea, C., Alessandra, B., Coen, D., Magliola, R., Milanesio, D., Muzzulini, C.L., Paolo, F., Marinella, T., Sofia, C.M., Marta, B., Siano, P., Capo, G., Napoletano, R., Cecilia, P., Mancini, C., Del Buono, C., De Bartolomeo, G., Addolorata, M., Carmen, C., Roberto, C., Giovanni, V.A., Moschettini, G., Franco M., Mulli, O.F., Daniela, R., D'Amico, G., Mirella, P., Endrizzi, C., Trotta, L., Ciarambino, T., Orazio, Z., Emanuela, T., Marta, S., Thomas, F., Giacomo, T., Di Fazio, I., Andrea, B., Giuseppe, O., Emanuela, F., Serena, A., D'Imporzano, E., Anna, C., Serena, B., Erika, N., Roberto, S., Elena, S., Manuela, P., Francesca, A., Angelo, T., Aloisi, G, Marengoni, A, Morandi, A, Zucchelli, A, Cherubini, A, Mossello, E, Bo, M, Di Santo, S, Mazzone, A, Trabucchi, M, Cappa, S, Fimognari, F, Incalzi, R, Gareri, P, Perticone, F, Campanini, M, Montorsi, M, Latronico, N, Zambon, A, Bellelli, G, and Faverio, P
Subjects: Male, diagnosis, medications, 0302 clinical medicine, prevention, Aged, 80 and over, Delirium, Drug Prescriptions, Female, Hospital Departments, Humans, Prevalence, Polypharmacy, Prescription Drugs, 80 and over, Medicine, LS4_4, 030212 general & internal medicine, Acute hospital, media_common, Confounding, elderly patients, hip fracture, hospitalized patients, prediction rule, risk factor, dementia, events, medications, prevention, diagnosis, risk-factor, risk factor, hip fracture, Psychiatry and Mental Health, medicine.symptom, events, Drug, medicine.medical_specialty, hospitalized-patients, media_common.quotation_subject, MEDLINE, Socio-culturale, elderly-patients, elderly patients, behavioral disciplines and activities, 03 medical and health sciences, Internal medicine, mental disorders, Dementia, Medical prescription, prediction rule, Aged, business.industry, hospitalized patients, medicine.disease, nervous system diseases, dementia, business, 030217 neurology & neurosurgery
Abstract: Objective This study aimed to evaluate the association between polypharmacy and delirium, the association of specific drug categories with delirium, and the differences in drug-delirium association between medical and surgical units and according to dementia diagnosis. Methods Data were collected during 2 waves of Delirium Day, a multicenter delirium prevalence study including patients (aged 65 years or older) admitted to acute and long-term care wards in Italy (2015-2016); in this study, only patients enrolled in acute hospital wards were selected (n = 4,133). Delirium was assessed according to score on the 4 "A's" Test. Prescriptions were classified by main drug categories; polypharmacy was defined as a prescription of drugs from 5 or more classes. Results Of 4,133 participants, 969 (23.4%) had delirium. The general prevalence of polypharmacy was higher in patients with delirium (67.6% vs 63.0%, P = .009) but varied according to clinical settings. After adjustment for confounders, polypharmacy was associated with delirium only in patients admitted to surgical units (OR = 2.9; 95% CI, 1.4-6.1). Insulin, antibiotics, antiepileptics, antipsychotics, and atypical antidepressants were associated with delirium, whereas statins and angiotensin receptor blockers exhibited an inverse association. A stronger association was seen between typical and atypical antipsychotics and delirium in subjects free from dementia compared to individuals with dementia (typical: OR = 4.31; 95% CI, 2.94-6.31 without dementia vs OR = 1.64; 95% CI, 1.19-2.26 with dementia; atypical: OR = 5.32; 95% CI, 3.44-8.22 without dementia vs OR = 1.74; 95% CI, 1.26-2.40 with dementia). The absence of antipsychotics among the prescribed drugs was inversely associated with delirium in the whole sample and in both of the hospital settings, but only in patients without dementia. Conclusions Polypharmacy is significantly associated with delirium only in surgical units, raising the issue of the relevance of medication review in different clinical settings. Specific drug classes are associated with delirium depending on the clinical setting and dementia diagnosis, suggesting the need to further explore this relationship.
Published: 2019

30. Assessing the impact of COVID-19 on the health of geriatric patients: The European GeroCovid Observational Study

Author: Giuseppe Bellelli, Gianluca Zia, Alba Malara, Alessandra Coin, Pietro Gareri, Stefano Fumagalli, Fabio Monzani, Enrico Mossello, Raffaele Antonelli Incalzi, Caterina Trevisan, Stefano Volpato, Anette Hylen Ranhoff, Susanna Del Signore, Trevisan, C, Del Signore, S, Fumagalli, S, Gareri, P, Malara, A, Mossello, E, Volpato, S, Monzani, F, Coin, A, Bellelli, G, Zia, G, Ranhoff, A, and Antonelli Incalzi, R
Subjects: Adult, Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Health Services for the Aged, COVID-19, Inpatients, Outpatients, Nursing Homes, Health Services for the Aged, Observational Study, Observational Study, Disease, 030204 cardiovascular system & hematology, NO, 03 medical and health sciences, 0302 clinical medicine, Pandemic, Outpatients, COVID-19, Inpatients, Nursing Homes, Aged, Aged, 80 and over, Female, Humans, Italy, Middle Aged, Norway, Retrospective Studies, SARS-CoV-2, Spain, Treatment Outcome, 80 and over, Internal Medicine, medicine, Dementia, 030212 general & internal medicine, Protocol (science), business.industry, Outpatient, Retrospective cohort study, medicine.disease, Nursing Home, Family medicine, Observational study, Original Article, Inpatient, business, Inclusion (education)
Abstract: Background Despite the growing evidence on COVID-19, there are still many gaps in the understanding of this disease, especially in individuals in advanced age. We describe the study protocol of GeroCovid Observational, a multi-purpose, multi-setting and multicenter initiative that aims at investigating: risk factors, clinical presentation and outcomes of individuals affected by COVID-19 in acute and residential care settings; best strategies to prevent infection in long-term care facilities; and, impact of the pandemic on neuropsychologic, functional and physical health, and on medical management in outpatients and home care patients at risk of COVID-19, with a special focus on individuals with dementia. Methods GeroCovid involves individuals aged ≥60 years, at risk of or affected by COVID-19, prospectively or retrospectively observed since March 1st, 2020. Data are collected in multiple investigational sites across Italy, Spain and Norway, and recorded in a de-identified clinical e-Registry. A common framework was adapted to different care settings: acute wards, long-term care facilities, geriatric outpatient and home care, and outpatient memory clinics. Results At September 16th, 2020, 66 investigational sites obtained their Ethical Committee approval and 1618 cases (mean age 80.6 [SD=9.0] years; 45% men) have been recorded in the e-Registry. The average inclusion rate since the study start on April 25th, 2020, is 11.2 patients/day. New cases enrollment will ended on December 31st , 2020, and the clinical follow-up will end on June 30th, 2021. Conclusion GeroCovid will explore relevant aspects of COVID-19 in adults aged ≥60 years with high-quality and comprehensive data, which will help to optimize COVID-19 prevention and management, with practical implications for ongoing and possible future pandemics. Trial registration NCT04379440 (clinicaltrial.gov).
Published: 2021

31. Visual and Hearing Impairment Are Associated With Delirium in Hospitalized Patients: Results of a Multisite Prevalence Study

Author: Alessandro Morandi, Marco Inzitari, Cristina Udina, Neus Gual, Miriam Mota, Elena Tassistro, Anita Andreano, Antonio Cherubini, Simona Gentile, Enrico Mossello, Alessandra Marengoni, Anna Olivé, Francesc Riba, Domingo Ruiz, Elisabet de Jaime, Giuseppe Bellelli, 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, T. Candiani, A. Ballestrero, F. Santolini, 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. 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, 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, 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, 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. 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, G. Bellelli, G. Annoni, A. Marengoni, A. Crescenzo, G. Noro, R. Turco, M. Ponzetto, L. Giuseppe, B. Mazzei, G. Maiuri, D. Costaggiu, R. Damato, M. Formilan, G. Patrizia, M. Gallucci, 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, E. D'Imporzano, S. DeNotariis, F. Bonometti, C. Paolillo, A. Riccardi, A. Tiozzo, M. DiBari, S. Vanni, A. Scarpa, D. Zara, P. Ranieri, M. Alessandro, F. Di, D. Pezzoni, C. Platto, V. D'Ambrosio, C. Ivaldi, P. Milia, F. DeSalvo, C. Solaro, M. Strazzacappa, M. Cazzadori, S. Confente, M. Grasso, E. Troisi, V. Guerini, B. Bernardini, C. Corsini, S. Boffelli, A. Filippi, K. Delpin, B. Faraci, E. Bertoletti, M. Vannucci, F. Tesi, P. Crippa, A. Malighetti, D. Bettini, F. Maltese, G. Abruzzese, D. Cosimo, M. Azzini, M. Colombo, G. Procino, S. Fascendini, F. Barocco, P. Del, A. Mazzone, E. Riva, D. Dell'Acqua, M. Cottino, G. Vezzadini, S. Avanzi, C. Brambilla, S. Orini, F. Sgrilli, A. Mello, L. Lombardi, E. Muti, B. Dijk, S. Fenu, C. Pes, P. Gareri, 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, M. Macchi, F. Zambon, 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, 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, Morandi, A, Inzitari, M, Udina, C, Gual, N, Mota, M, Tassistro, E, Andreano, A, Cherubini, A, Gentile, S, Mossello, E, Marengoni, A, Olivé, A, Riba, F, Ruiz, D, de Jaime, E, Bellelli, G, Alessandro Morandi, Marco Inzitari, Cristina Udina, Neus Gual, Miriam Mota, Elena Tassistro, Anita Andreano, Antonio Cherubini, Simona Gentile, Enrico Mossello, Alessandra Marengoni, Anna Olivé, Francesc Riba, Domingo Ruiz, Elisabet de Jaime, Giuseppe Bellelli, Italian Study Group of Delirium, Claudio Borghi, Morandi, Alessandro, Inzitari, Marco, Udina, Cristina, Gual, Neu, Mota, Miriam, Tassistro, Elena, Andreano, Anita, Cherubini, Antonio, Gentile, Simona, Mossello, Enrico, Marengoni, Alessandra, Olivé, Anna, Riba, Francesc, Ruiz, Domingo, de Jaime, Elisabet, Bellelli, Giuseppe, 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, C Borghi, A Bianchetti, A Crucitti, V DiFrancesco, 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, 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 Bambara, A Saitta, F Corica, M Braga, E Ettorre, C Camellini, G 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, 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, E D'Imporzano, S DeNotariis, F Bonometti, C Paolillo, A Riccardi, A Tiozzo, 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, S Confente, 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, F Tesi, P Crippa, A Malighetti, 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, C Brambilla, 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: medicine.medical_specialty, Activities of daily living, Cross-sectional study, Hearing loss, medicine.medical_treatment, Visual impairment, Psychological intervention, visual impairment, Socio-culturale, behavioral disciplines and activities, Hearing impairment, delirium, older, sensory deficits, visual impairment, sensory deficit, Hearing impairment, 03 medical and health sciences, delirium, older, sensory deficits, 0302 clinical medicine, Risk Factors, Activities of Daily Living, mental disorders, medicine, Humans, Dementia, 030212 general & internal medicine, LS4_4, Hearing Loss, General Nursing, Rehabilitation, business.industry, Health Policy, General Medicine, medicine.disease, nervous system diseases, Cross-Sectional Studies, Italy, Emergency medicine, Delirium, Geriatrics and Gerontology, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract: Objective: Sensory deficits are important risk factors for delirium but have been investigated in single-center studies and single clinical settings. This multicenter study aims to evaluate the association between hearing and visual impairment or bi-sensory impairment (visual and hearing impairment) and delirium. Design: Cross-sectional study nested in the 2017 "Delirium Day" project. Setting and participants: Patients 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes, and hospices in Italy. Methods: Delirium was assessed with the 4AT (a short tool for delirium assessment) and sensory deficits with a clinical evaluation. We assessed the association between delirium, hearing and visual impairment in multivariable logistic regression models, adjusting for: Model 1, we included predisposing factors for delirium (ie, dementia, weight loss and autonomy in the activities of daily living); Model 2, we added to Model 1 variables, which could be considered precipitating factors for delirium (ie, psychoactive drugs and urinary catheters). Results: A total of 3038 patients were included; delirium prevalence was 25%. Patients with delirium had a higher prevalence of hearing impairment (30.5% vs 18%; P < .001), visual impairment (24.2% vs 15.7%; P < .01) and bi-sensory impairment (16.2% vs 7.5%) compared with those without delirium. In the multivariable logistic regression analysis, the presence of bi-sensory impairment was associated with delirium in Model 1 [odds ratio (OR) 1.5, confidence interval (CI) 1.2-2.1; P = .00] and in Model 2 (OR 1.4; CI 1.1-1.9; P = .02), whereas the presence of visual and hearing impairment alone was not associated with delirium either in Model 1 (OR 0.8; CI 0.6-1.2, P = .36; OR 1.1; CI 0.8-1.4; P = .42) or in Model 2 (OR 0.8, CI 0.6-1.2, P = .27; OR 1.1, CI 0.8-1.4, P = .63). Conclusions and implications: Our findings support the importance of routine screening and specific interventions by a multidisciplinary team to implement optimal management of sensory impairments and hence prevention and the management of the patients with delirium.
Published: 2021

32. The 4-DSD: A New Tool to Assess Delirium Superimposed on Moderate to Severe Dementia

Author: Alessandra Raccichini, Flaminia Lucchini, Eleonora Grossi, Jessica Severgnini, Heidi A. B. Smith, Marianna Galeazzi, Giuseppe Bellelli, Bianca Faraci, Enrico Mossello, Elena Lucchi, Simona Gentile, Alasdair M.J. MacLullich, Antonia Scrimieri, Laura Pecorella, Alessandro Morandi, Pratik P. Pandharipande, Antonella Zambon, Antonio Cherubini, Francesca Massariello, Andrea Rizzini, Samanta Corradi, Valeria Morichi, Morandi, A, Grossi, E, Lucchi, E, Zambon, A, Faraci, B, Severgnini, J, Maclullich, A, Smith, H, Pandharipande, P, Rizzini, A, Galeazzi, M, Massariello, F, Corradi, S, Raccichini, A, Scrimieri, A, Morighi, V, Gentile, S, Lucchini, F, Pecorella, L, Mossello, E, Cherubini, A, and Bellelli, G
Subjects: Rehabilitation hospital, medicine.medical_specialty, Cross-sectional study, medicine.medical_treatment, behavioral disciplines and activities, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, mental disorders, medicine, older, Dementia, Humans, Attention, 030212 general & internal medicine, Stage (cooking), General Nursing, Rehabilitation, business.industry, delirium superimposed on dementia, Health Policy, Delirium, General Medicine, medicine.disease, Hospitalization, Cross-Sectional Studies, Severe dementia, Observational study, Geriatrics and Gerontology, medicine.symptom, business, 030217 neurology & neurosurgery, dementia
Abstract: Objectives The purpose of this study was to create, standardize, and validate a new instrument, named 4-DSD, and determine its diagnostic accuracy in the diagnosis of delirium in subjects with moderate to severe dementia. Design Multicenter cross-sectional observational study. Setting and Participants Older patients consecutively admitted to acute and rehabilitation hospital wards. Measures The DSM-5 was used as the reference standard delirium assessment. The presence and severity of dementia was defined using the AD8 and the Global Deterioration Scale (GDS). The 4-DSD is a 4-item tool that ranges from 0 to 12. Item 1 measures alertness, item 2 altered function, item 3 attention, and item 4 acute change or fluctuation in mental status. Results A total of 134 patients were included in the study. Most of the patients were enrolled in acute hospital wards (60%), with 40% in rehabilitation settings. A minority of the patients were categorized with moderate dementia, with a GDS score of 5 (4%). Most of the patients were in the moderate-severe stage with a GDS score ≤6 (77%); 19% were classed as severe, with a GDS score of 7. A 4-DSD cutoff score ≥5 had a sensitivity of 80% and specificity of 80% with a positive predictive value (PPV) of 67% and a negative predictive value (NPV) of 89%. In the subgroup with moderate-severe dementia (n = 108), the sensitivity and the specificity were 79% and 82%, respectively, with a PPV and NPV of 62% and 92%. In the subgroup with severe dementia (n = 26) the sensitivity was 82% and the specificity 56% with a PPV of 78% and a NPV of 63%. Conclusions and Implications The availability of a specific tool to detect delirium in patients with moderate-severe dementia has important clinical and research implications, allowing all health care providers to improve their ability to identify it.
Published: 2021

33. Recognition of Delirium Features in Clinical Practice: Data from the 'Delirium Day 2015' National Survey

Author: Alberto U. Ferrari, Marco Trabucchi, Enrico Mossello, Simona Di Santo, Mario Bo, Massimo Musicco, M. Torrini, Francesca Tesi, Alessandro Morandi, Nicola Ferrara, Andrea Mazzone, Giuseppe Bellelli, Angelo Bianchetti, Antonio Cherubini, Mossello, E, Tesi, F, Di Santo, S, Mazzone, A, Torrini, M, Cherubini, A, Mario, B, Musicco, M, Bianchetti, A, Ferrari, A, Ferrara, N, Trabucchi, M, Morandi, A, Bellelli, G, Mossello, Enrico, Tesi, Francesca, Di Santo, Simona G., Mazzone, Andrea, Torrini, Monica, Cherubini, Antonio, Bo, Mario, Musicco, Massimo, Bianchetti, Angelo, Ferrari, Alberto, Ferrara, Nicola, Trabucchi, Marco, Morandi, Alessandro, and Bellelli, Giuseppe
Subjects: Male, medicine.medical_specialty, arousal, delirium, dementia, health services for the aged, inpatients, Aged, 80 and over, Cognitive Dysfunction, Delirium, Dementia, Female, Humans, Inpatients, Italy, Nursing Staff, Hospital, Prevalence, Prospective Studies, Psychiatric Status Rating Scales, Surveys and Questionnaires, Comorbidity, behavioral disciplines and activities, Arousal, Hospital, Health services for the aged, 03 medical and health sciences, 0302 clinical medicine, mental disorders, 80 and over, medicine, Geriatrics and Gerontology, 030212 general & internal medicine, Prospective cohort study, Psychiatry, Aged, business.industry, Cognition, medicine.disease, nervous system diseases, Clinical Practice, Multicenter study, Nursing Staff, Inpatient, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract: Background/Objectives Delirium is underrecognized in clinical practice. The primary aim of the present multicenter study was to compare the ability of nurses to identify delirium features with a standardized assessment. The secondary aim was to identify predictors of missed or incorrect identifications of delirium by nurses. Design Point prevalence study in 120 wards across Italy. Setting “Delirium Day 2015.” Participants Inpatients aged 65 and older (N = 1,867). Measurements Participants and nurses were asked specific questions to investigate their perceptions of the presence of delirium features (acute cognitive change, inattention, cognitive fluctuations, impaired arousal). Delirium was identified according to the results of the Assessment Test for Delirium and Cognitive Impairment (4AT), completed by a physician. Comorbidities including dementia, disability, drug treatments, and delirium motor subtype according to the Delirium Motor Subtype Scale were recorded. Results Delirium was present in 429 subjects (23%) according to the 4AT. Cognitive fluctuations was the delirium feature that the nurses most often recognized. Nurses’ perceptions of acute cognitive change, cognitive fluctuations, or impaired arousal had 84% sensitivity and 81% specificity for delirium. The nonmotor subtype of delirium was less likely to be recognized (80%) than the hyperactive (97%), mixed (92%), and hypoactive (90%) subtypes. Incorrect perception of delirium was more frequent in subjects with dementia (specificity 64%). Conclusions The delirium feature that nurses were best able to recognize was cognitive fluctuations. The nonmotor subtype was associated with a lower recognition rate. Routine observation and registration of delirium features by nurses in clinical practice might be helpful to increase formal diagnosis of delirium.
Published: 2017

34. Increasing Prevalence of Orthostatic Hypotension as a Cause of Syncope With Advancing Age and Multimorbidity

Author: Pasquale Abete, Giulia Rivasi, Mario Bo, Martina Rafanelli, Enrico Mossello, Chiara Mussi, Anna Maria Martone, Alice Ceccofiglio, Andrea Ungar, Ceccofiglio, A., Mussi, C., Rafanelli, M., Rivasi, G., Bo, M., Mossello, E., Martone, A. M., Abete, P., and Ungar, A.
Subjects: medicine.medical_specialty, Drug-Related Side Effects and Adverse Reactions, Blood Pressure, Syncope, Orthostatic vital signs, Hypotension, Orthostatic, Internal medicine, medicine, Prevalence, Dementia, Humans, Multicenter Studies as Topic, General Nursing, Aged, Aged, 80 and over, biology, business.industry, Health Policy, Syncope (genus), Multimorbidity, General Medicine, biology.organism_classification, medicine.disease, Cardiology, Geriatrics and Gerontology, business
Published: 2019

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34 results on '"Mossello, E"'

1. An algorithm for the early diagnosis and correct approach to dementia management: results of a multiprofessional team.

2. Screening for cognitive impairment in older adults with hypertension: the HYPER-COG study.

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

4. Italian guidance on Dementia Day Care Centres: A position paper.

5. Health literacy of informal caregivers of older adults with dementia: results from a cross-sectional study conducted in Florence (Italy).

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

7. Truly unexplained falls after evaluation for syncope: A new diagnostic entity with severe prognosis.

8. The 4-DSD: A New Tool to Assess Delirium Superimposed on Moderate to Severe Dementia.

9. Hypertension, hypotension, longevity and dementia.

10. Atrial Fibrillation in Older Patients with Syncope and Dementia: Insights from the Syncope and Dementia Registry.

11. Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia.

12. Delirium, Dementia, and In-Hospital Mortality: The Results From the Italian Delirium Day 2016, A National Multicenter Study.

13. Differential diagnosis of unexplained falls in dementia: Results of "Syncope & Dementia" registry.

14. A Point Prevalence Study of Delirium in Italian Nursing Homes.

15. Clinical Features Associated with Delirium Motor Subtypes in Older Inpatients: Results of a Multicenter Study.

16. Effects of low blood pressure in cognitively impaired elderly patients treated with antihypertensive drugs.

17. Day Care for older dementia patients: favorable effects on behavioral and psychological symptoms and caregiver stress.

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

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

20. Being the Family Caregiver of a Patient With Dementia During the Coronavirus Disease 2019 Lockdown

21. Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia

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

23. The association of indwelling urinary catheter with delirium in hospitalized patients and nursing home residents: an explorative analysis from the 'Delirium Day 2015'

24. Delirium, Dementia, and In-Hospital Mortality: The Results From the Italian Delirium Day 2016, A National Multicenter Study

25. Prevalence and Correlates of Behavioral Disorders in Old Age Subjects with Cognitive Impairment: Results from the ReGAl Project

26. Truly unexplained falls after evaluation for syncope: A new diagnostic entity with severe prognosis

27. Atrial Fibrillation in Older Patients with Syncope and Dementia: Insights from the Syncope and Dementia Registry

28. Behavioral and psychological effects of coronavirus disease-19 quarantine in patients with dementia

29. Drug Prescription and Delirium in Older Inpatients: Results From the Nationwide Multicenter Italian Delirium Day 2015-2016

30. Assessing the impact of COVID-19 on the health of geriatric patients: The European GeroCovid Observational Study

31. Visual and Hearing Impairment Are Associated With Delirium in Hospitalized Patients: Results of a Multisite Prevalence Study

32. The 4-DSD: A New Tool to Assess Delirium Superimposed on Moderate to Severe Dementia

33. Recognition of Delirium Features in Clinical Practice: Data from the 'Delirium Day 2015' National Survey

34. Increasing Prevalence of Orthostatic Hypotension as a Cause of Syncope With Advancing Age and Multimorbidity

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34 results on '"Mossello, E"'

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