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1. Vascular Function Is Improved After an Environmental Enrichment Program

Author

Bruno, Rosa Maria, Stea, Francesco, Sicari, Rosa, Ghiadoni, Lorenzo, Taddei, Stefano, Ungar, Andrea, Bonuccelli, Ubaldo, Tognoni, Gloria, Cintoli, Simona, Del Turco, Serena, Sbrana, Silverio, Gargani, Luna, D'Angelo, Gennaro, Pratali, Lorenza, Berardi, Nicoletta, Maffei, Lamberto, Picano Eugenio, on behalf of Train the Brain Consortium. Full list of consortium members: Maffei L, Picano E, Andreassi MG, Angelucci A, Baldacci F, Baroncelli L, Begenisic T, Bellinvia PF, Berardi N, Biagi L, Bonaccorsi J, Bonanni E, Bonuccelli U, Borghini A, Braschi C, Broccardi M, Bruno RM, Caleo M, Carlesi C, Carnicelli L, Cartoni G, Cecchetti L, Cenni MC, Ceravolo R, Chico L, Cintoli S, Cioni G, Costa M, D’Angelo G, D’Ascanio P, De Nes M, Del Turco S, Di Coscio E, Di Galante M, di Lascio N, Faita F, Falorni I, Faraguna U, Fenu A, Fortunato L, Franco R, Gargani L, Gargiulo R, Ghiadoni L, Giorgi FS, Iannarella R, Iofrida C, Kusmic C, Limongi F, Maestri M, Maffei M, Maggi S, Mainardi M, Mammana L, Marabotti A, Mariotti V, Melissari E, Mercuri A, Molinaro S, Narducci R, Navarra T, Noale M, Pagni C, Palumbo S, Pasquariello R, Pellegrini S, Pietrini P, Pizzorusso T, Poli A, Pratali L, Retico A, Ricciardi E, Rota G, Sale A, Sbrana S, Scabia G, Scali M, Scelfo D, Sicari R, Siciliano G, Stea F, Taddei S, Tognoni G, Tonacci A, Tosetti M, Turchi S, Volpi L, Bruno, Rosa Maria, Stea, Francesco, Sicari, Rosa, Ghiadoni, Lorenzo, Taddei, Stefano, Ungar, Andrea, Bonuccelli, Ubaldo, Tognoni, Gloria, Cintoli, Simona, Del Turco, Serena, Sbrana, Silverio, Gargani, Luna, D'Angelo, Gennaro, Pratali, Lorenza, Berardi, Nicoletta, Maffei, Lamberto, Picano, Eugenio, on behalf of Train the Brain Consortium., Full list of consortium members: Maffei L, Picano, E, Andreassi, Mg, Angelucci, A, Baldacci, F, Baroncelli, L, Begenisic, T, Bellinvia, Pf, Berardi, N, Biagi, L, Bonaccorsi, J, Bonanni, E, Bonuccelli, U, Borghini, A, Braschi, C, Broccardi, M, Bruno, Rm, Caleo, M, Carlesi, C, Carnicelli, L, Cartoni, G, Cecchetti, L, Cenni, Mc, Ceravolo, R, Chico, L, Cintoli, S, Cioni, G, Costa, M, D’Angelo, G, D’Ascanio, P, De Nes, M, Del Turco, S, Di Coscio, E, Di Galante, M, di Lascio, N, Faita, F, Falorni, I, Faraguna, U, Fenu, A, Fortunato, L, Franco, R, Gargani, L, Gargiulo, R, Ghiadoni, L, Giorgi, F, Iannarella, R, Iofrida, C, Kusmic, C, Limongi, F, Maestri, M, Maffei, M, Maggi, S, Mainardi, M, Mammana, L, Marabotti, A, Mariotti, V, Melissari, E, Mercuri, A, Molinaro, S, Narducci, R, Navarra, T, Noale, M, Pagni, C, Palumbo, S, Pasquariello, R, Pellegrini, S, Pietrini, P, Pizzorusso, T, Poli, A, Pratali, L, Retico, A, Ricciardi, E, Rota, G, Sale, A, Sbrana, S, Scabia, G, Scali, M, Scelfo, D, Sicari, R, Siciliano, G, Stea, F, Taddei, S, Tognoni, G, Tonacci, A, Tosetti, M, Turchi, S, and Volpi, L

Subjects
Male, control groups, medicine.medical_specialty, Brachial Artery, Pulse Wave Analysis, 030204 cardiovascular system & hematology, 03 medical and health sciences, endothelial progenitor cell, 0302 clinical medicine, cognitive dysfunction, Internal medicine, medicine.artery, Internal Medicine, medicine, human, Brachial artery, Cognitive decline, humans, Pulse wave velocity, Aged, endothelial progenitor cells, Aged, 80 and over, Environmental enrichment, business.industry, control group, Area under the curve, Neuropsychology, Brain, vascular stiffness, Cognition, Middle Aged, medicine.disease, Exercise Therapy, Vasodilation, Cross-Sectional Studies, Cardiovascular Diseases, Cardiology, Female, Endothelium, Vascular, Alzheimer's disease, business, 030217 neurology & neurosurgery
Abstract

Environmental enrichment may slow cognitive decay possibly acting through an improvement in vascular function. Aim of the study was to assess the effects of a 7-month cognitive, social, and physical training program on cognitive and vascular function in patients with mild cognitive impairment. In a single-center, randomized, parallel-group study, 113 patients (age, 65–89 years) were randomized to multidomain training (n=55) or usual care (n=58). All participants underwent neuropsychological tests and vascular evaluation, including brachial artery flow-mediated dilation, carotid–femoral pulse wave velocity, carotid distensibility, and assessment of circulating hematopoietic CD34+ and endothelial progenitor cells. At study entry, an age-matched control group (n=45) was also studied. Compared with controls, patients had at study entry a reduced flow-mediated dilation (2.97±2.14% versus 3.73±2.06%; P =0.03) and hyperemic stimulus (shear rate area under the curve, 19.1±15.7 versus 25.7±15.1×10 −3 ; P =0.009); only the latter remained significant after adjustment for confounders ( P =0.03). Training improved Alzheimer disease assessment scale cognitive (training, 14.0±4.8 to 13.1±5.5; nontraining, 12.1±3.9 to 13.2±4.8; P for interaction visit×training=0.02), flow-mediated dilation (2.82±2.19% to 3.40±1.81%, 3.05±2.08% to 2.24±1.59%; P =0.006; P =0.023 after adjustment for diameter and shear rate area under the curve), and circulating hematopoietic CD34 + cells and prevented the decline in carotid distensibility (18.4±5.3 to 20.0±6.6, 23.9±11.0 to 19.5±7.1 Pa −1 ; P =0.005). The only clinical predictor of improvement of cognitive function after training was established hypertension. There was no correlation between changes in measures of cognitive and vascular function. In conclusion, a multidomain training program slows cognitive decline, especially in hypertensive individuals. This effect is accompanied by improved systemic endothelial function, mobilization of progenitor CD34 + cells, and preserved carotid distensibility. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01725178.

Published
2018
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2. Factors Associated With Functional Decline in Hand and Hip/Knee Osteoarthritis After One Year:Data From a Population-Based Study

Author

Siviero, P., Limongi, F., Gesmundo, A., Zambon, S., Cooper, C., Dennison, E.M., Edwards, M.H., Pas, S. van der, Timmermans, E.J., Schoor, N.M. van, Schaap, L.A., Dallmeier, D., Denkinger, M.D., Peter, R., Castell, M.V., Otero, A., Pedersen, N.L., Deeg, D.J.H., Maggi, S., European Project Osteoarthrit Res, Nutrition and Health, APH - Aging & Later Life, APH - Health Behaviors & Chronic Diseases, AMS - Musculoskeletal Health, Sociology and Social Gerontology, Epidemiology and Data Science, and APH - Personalized Medicine

Subjects
Male, Time Factors, Knee Joint, Emotions, Minimal Clinically Important Difference, Osteoarthritis, Disease, Comorbidity, Osteoarthritis, Hip, Grip strength, Disability Evaluation, Cognition, Risk Factors, 80 and over, Medicine, Longitudinal Studies, Prospective Studies, Aged, 80 and over, education.field_of_study, Osteoarthritis, Knee, Europe, Mental Health, Treatment Outcome, Antirheumatic Agents, Disease Progression, Anxiety, Female, Hip Joint, medicine.symptom, musculoskeletal diseases, medicine.medical_specialty, Hand Joints, Population, Context (language use), Risk Assessment, Rheumatology, SDG 3 - Good Health and Well-being, Aged, Functional Status, Humans, Patient Reported Outcome Measures, Knee, education, Hip, business.industry, medicine.disease, Obesity, Physical therapy, Observational study, business
Abstract

OBJECTIVE: The study investigated factors that together with hand or hip/knee osteoarthritis (OA) could contribute to functional decline over a year's time in elderly individuals.METHODS: The data of 1,886 individuals between the ages of 65-85 in a prospective, observational population-based study with 12-18 month follow-up in the context of the European Project on OSteoArthritis were analyzed. The outcome measures were self-reported hand and hip/knee functional decline evaluated using a Minimal Clinically Important Difference of 4 on the AUStralian/CANadian hand OA Index and of 2 on the Western Ontario and McMaster Universities hip/knee OA physical function subscales, both normalized to 0-100. Using regression models adjusted for sex, age, country, and education level, the baseline factors considered were: clinical hand or hip/knee OA, pain, analgesic/anti-inflammatory medications, comorbidities, social isolation, income, walking time, grip strength, physical activity time, and medical/social care.RESULTS: After a year, 453 participants were identified as having "worse" hand functionality and 1,389 as "not worse". Hand OA, anxiety, walking time and grip strength were risk factors for hand functional decline; pain was a confounder of the effect of hand OA. Analgesic/anti-inflammatory medications mediated the combined effect of hip/knee OA+pain on functional decline in the 554 individuals classified as having "worse" hip/knee functionality and the 1,291 "not worse" persons. Peripheral artery disease, obesity, and cognitive impairment were other baseline risk factors.CONCLUSION: Study findings showed that together with emotional status, chronic physical and cognitive conditions, OA affects hand and hip/knee functional decline.

Published
2021
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3. Brain Hemodynamic Intermediate Phenotype Links Vitamin B12 to Cognitive Profile of Healthy and Mild Cognitive Impaired Subjects

Author

Cecchetti L., Lettieri G., Handjaras G., Leo A., Ricciardi E., Pietrini P., Pellegrini S., Andreassi M. G., Angelucci A., Baldacci F., Baroncelli L., Begenisic T., Bellinvia P. F., Biagi L., Bonaccorsi J., Bonanni E., Borghini A., Braschi C., Broccardi M., Caleo M., Carlesi C., Carnicelli L., Cartoni G., Cenni M. C., Ceravolo R., Chico L., Cioni G., Costa M., D'Ascanio P., De Nes M., Di Coscio E., Di Galante M., di Lascio N., Faita F., Falorni I., Faraguna U., Fenu A., Fortunato L., Franco R., Gargiulo R., Giorgi F. S., Iannarella R., Iofrida C., Kusmic C., Limongi F., Maestri M., Maffei M., Maggi S., Mainardi M., Mammana L., Marabotti A., Mariotti V., Melissari E., Mercuri A., Molinaro S., Narducci R., Navarra T., Noale M., Pagni C., Palumbo S., Pasquariello R., Pizzorusso T., Poli A., Retico A., Rota G., Sale A., Scabia G., Scali M., Scelfo D., Siciliano G., Tonacci A., Tosetti M., Turchi S., Volpi L., Cecchetti, L., Lettieri, G., Handjaras, G., Leo, A., Ricciardi, E., Pietrini, P., Pellegrini, S., Andreassi, M. G., Angelucci, A., Baldacci, F., Baroncelli, L., Begenisic, T., Bellinvia, P. F., Biagi, L., Bonaccorsi, J., Bonanni, E., Borghini, A., Braschi, C., Broccardi, M., Caleo, M., Carlesi, C., Carnicelli, L., Cartoni, G., Cenni, M. C., Ceravolo, R., Chico, L., Cioni, G., Costa, M., D'Ascanio, P., De Nes, M., Di Coscio, E., Di Galante, M., di Lascio, N., Faita, F., Falorni, I., Faraguna, U., Fenu, A., Fortunato, L., Franco, R., Gargiulo, R., Giorgi, F. S., Iannarella, R., Iofrida, C., Kusmic, C., Limongi, F., Maestri, M., Maffei, M., Maggi, S., Mainardi, M., Mammana, L., Marabotti, A., Mariotti, V., Melissari, E., Mercuri, A., Molinaro, S., Narducci, R., Navarra, T., Noale, M., Pagni, C., Palumbo, S., Pasquariello, R., Pizzorusso, T., Poli, A., Retico, A., Rota, G., Sale, A., Scabia, G., Scali, M., Scelfo, D., Siciliano, G., Tonacci, A., Tosetti, M., Turchi, S., and Volpi, L.

Subjects
Vitamin, Male, medicine.medical_specialty, Article Subject, Homocysteine, Brain activity and meditation, Longitudinal Studie, Settore BIO/09 - Fisiologia, lcsh:RC321-571, Cohort Studies, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Cognition, Neuroimaging, Internal medicine, medicine, Humans, Cognitive Dysfunction, Vitamin B12, Hemodynamic, Longitudinal Studies, lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry, Anterior cingulate cortex, 030304 developmental biology, Aged, Aged, 80 and over, 0303 health sciences, business.industry, Neuropsychology, Hemodynamics, Brain, Vitamin B 12, medicine.anatomical_structure, Endocrinology, Phenotype, Neurology, chemistry, Female, Neurology (clinical), Cohort Studie, business, 030217 neurology & neurosurgery, Human, Research Article
Abstract

Vitamin B12, folate, and homocysteine are implicated in pivotal neurodegenerative mechanisms and partake in elders' mental decline. Findings on the association between vitamin-related biochemistry and cognitive abilities suggest that the structural and functional properties of the brain may represent an intermediate biomarker linking vitamin concentrations to cognition. Despite this, no previous study directly investigated whether vitamin B12, folate, and homocysteine levels are sufficient to explain individual neuropsychological profiles or, alternatively, whether the activity of brain regions modulated by these compounds better predicts cognition in elders. Here, we measured the relationship between vitamin blood concentrations, scores at seventeen neuropsychological tests, and brain activity of sixty-five elders spanning from normal to Mild Cognitive Impairment. We then evaluated whether task-related brain responses represent an intermediate phenotype, providing a better prediction of subjects' neuropsychological scores, as compared to the one obtained considering blood biochemistry only. We found that the hemodynamic activity of the right dorsal anterior cingulate cortex was positively associated (p value < 0 05 cluster corrected) with vitamin B12 concentrations, suggesting that elders with higher B12 levels had a more pronounced recruitment of this salience network region. Crucially, the activity of this area significantly predicted subjects' visual search and attention abilities (p value = 0 0023), whereas B12 levels per se failed to do so. Our results demonstrate that the relationship between blood biochemistry and elders' cognitive abilities is revealed when brain activity is included into the equation, thus highlighting the role of brain imaging as intermediate phenotype. Vitamin B12, folate, and homocysteine are implicated in pivotal neurodegenerative mechanisms and partake in elders' mental decline. Findings on the association between vitamin-related biochemistry and cognitive abilities suggest that the structural and functional properties of the brain may represent an intermediate biomarker linking vitamin concentrations to cognition. Despite this, no previous study directly investigated whether vitamin B12, folate, and homocysteine levels are sufficient to explain individual neuropsychological profiles or, alternatively, whether the activity of brain regions modulated by these compounds better predicts cognition in elders. Here, we measured the relationship between vitamin blood concentrations, scores at seventeen neuropsychological tests, and brain activity of sixty-five elders spanning from normal to Mild Cognitive Impairment. We then evaluated whether task-related brain responses represent an intermediate phenotype, providing a better prediction of subjects' neuropsychological scores, as compared to the one obtained considering blood biochemistry only. We found that the hemodynamic activity of the right dorsal anterior cingulate cortex was positively associated (p value < 0 05 cluster corrected) with vitamin B12 concentrations, suggesting that elders with higher B12 levels had a more pronounced recruitment of this salience network region. Crucially, the activity of this area significantly predicted subjects' visual search and attention abilities (p value = 0 0023), whereas B12 levels per se failed to do so. Our results demonstrate that the relationship between blood biochemistry and elders' cognitive abilities is revealed when brain activity is included into the equation, thus highlighting the role of brain imaging as intermediate phenotype.

Published
2019

4. Effects of combined training on neuropsychiatric symptoms and quality of life in patients with cognitive decline

Author

Cintoli, S., Radicchi, C., Noale, M., Maggi, S., Meucci, G., Tognoni, G., Bonuccelli, U., Sale, A., Berardi, N., Maffei, L., Picano, E., Andreassi, M. G., Angelucci, A., Baldacci, F., Baroncelli, L., Begenisic, T., Bellinvia, P. F., Biagi, L., Bonaccorsi, J., Bonanni, E., Borghini, A., Braschi, C., Broccardi, M., Bruno, R. M., Caleo, M., Carlesi, C., Carnicelli, L., Cartoni, G., Cecchetti, L., Cenni, M. C., Ceravolo, R., Chico, L., Cioni, G., Coscia, M., Costa, M., D'Angelo, G., D'Ascanio, P., Denes, M., Delturco, S., Dicoscio, E., Digalante, M., Dilascio, N., Faita, F., Falorni, I., Faraguna, U., Fenu, A., Fortunato, L., Franco, R., Gargani, L., Gargiulo, R., Ghiadoni, L., Giorgi, F. S., Iannarella, R., Iofrida, C., Kusmic, C., Limongi, F., Maestri, M., Maffei, M., Mainardi, M., Mammana, L., Marabotti, A., Mariotti, V., Melissari, E., Mercuri, A., Micera, S., Molinaro, S., Narducci, R., Navarra, T., Pagni, C., Palumbo, S., Pasquariello, R., Pellegrini, S., Pietrini, P., Pizzorusso, T., Poli, A., Pratali, L., Retico, A., Ricciardi, E., Rota, G., Sbrana, S., Scabia, G., Scali, M., Scelfo, D., Sicari, R., Siciliano, G., Stea, F., Taddei, S., Tonacci, A., Tosetti, M., Turchi, S., Volpi, L., Cintoli, S., Radicchi, C., Noale, M., Maggi, S., Meucci, G., Tognoni, G., Bonuccelli, U., Sale, A., Berardi, N., Maffei, L., Picano, E., Andreassi, M. G., Angelucci, A., Baldacci, F., Baroncelli, L., Begenisic, T., Bellinvia, P. F., Biagi, L., Bonaccorsi, J., Bonanni, E., Borghini, A., Braschi, C., Broccardi, M., Bruno, R. M., Caleo, M., Carlesi, C., Carnicelli, L., Cartoni, G., Cecchetti, L., Cenni, M. C., Ceravolo, R., Chico, L., Cioni, G., Coscia, M., Costa, M., D'Angelo, G., D'Ascanio, P., Denes, M., Delturco, S., Dicoscio, E., Digalante, M., Dilascio, N., Faita, F., Falorni, I., Faraguna, U., Fenu, A., Fortunato, L., Franco, R., Gargani, L., Gargiulo, R., Ghiadoni, L., Giorgi, F. S., Iannarella, R., Iofrida, C., Kusmic, C., Limongi, F., Maestri, M., Maffei, M., Mainardi, M., Mammana, L., Marabotti, A., Mariotti, V., Melissari, E., Mercuri, A., Micera, S., Molinaro, S., Narducci, R., Navarra, T., Pagni, C., Palumbo, S., Pasquariello, R., Pellegrini, S., Pietrini, P., Pizzorusso, T., Poli, A., Pratali, L., Retico, A., Ricciardi, E., Rota, G., Sbrana, S., Scabia, G., Scali, M., Scelfo, D., Sicari, R., Siciliano, G., Stea, F., Taddei, S., Tonacci, A., Tosetti, M., Turchi, S., and Volpi, L.

Subjects
Quality of life, medicine.medical_specialty, Aging, education, Psychological intervention, Neuropsychiatric symptom, Disease, Neuropsychological Tests, Settore BIO/09 - Fisiologia, 03 medical and health sciences, 0302 clinical medicine, Alzheimer Disease, mental disorders, Medicine, Dementia, Humans, Mild cognitive impairment, Neuropsychiatric symptoms, Non-pharmacological interventions, Physical and cognitive training, In patient, Cognitive Dysfunction, 030212 general & internal medicine, Cognitive decline, Aged, business.industry, Non-pharmacological intervention, Cognition, medicine.disease, Cognitive training, humanities, Physical therapy, Neuropsychological Test, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery, Human
Abstract

Background and aims: Cognitive impairments associated with aging and dementia are major sources of neuropsychiatric symptoms (NPs) and deterioration in quality of life (QoL). Preventive measures to both reduce disease and improve QoL in those affected are increasingly targeting individuals with mild cognitive impairment (MCI) at early disease stage. However, NPs and QoL outcomes are too commonly overlooked in intervention trials. The purpose of this study was to test the effects of physical and cognitive training on NPs and QoL in MCI. Methods: Baseline data from an MCI court (N = 93, mean age 74.9 ± 4.7) enrolled in the Train the Brain (TtB) study were collected. Subjects were randomized in two groups: a group participated to a cognitive and physical training program, while the other sticked to usual standard care. Both groups underwent a follow-up re-evaluation after 7months from baseline. NPs were assessed using the Neuropsychiatric Inventory (NPI) and QoL was assessed using Quality of Life-Alzheimer’s Disease (QOL-AD) scale. Results: After 7months of training, training group exhibited a significant reduction of NPs and a significant increase in QOL-AD with respect to no-training group (p = 0.0155, p = 0.0013, respectively). Our preliminary results suggest that a combined training can reduce NPs and improve QoL. Conclusions: Measuring QoL outcomes is a potentially important factor in ensuring that a person with cognitive deficits can ‘live well’ with pathology. Future data from non-pharmacological interventions, with a larger sample and a longer follow-up period, could confirm the results and the possible implications for such prevention strategies for early cognitive decline. Background and aims: Cognitive impairments associated with aging and dementia are major sources of neuropsychiatric symptoms (NPs) and deterioration in quality of life (QoL). Preventive measures to both reduce disease and improve QoL in those affected are increasingly targeting individuals with mild cognitive impairment (MCI) at early disease stage. However, NPs and QoL outcomes are too commonly overlooked in intervention trials. The purpose of this study was to test the effects of physical and cognitive training on NPs and QoL in MCI. Methods: Baseline data from an MCI court (N = 93, mean age 74.9 ± 4.7) enrolled in the Train the Brain (TtB) study were collected. Subjects were randomized in two groups: a group participated to a cognitive and physical training program, while the other sticked to usual standard care. Both groups underwent a follow-up re-evaluation after 7 months from baseline. NPs were assessed using the Neuropsychiatric Inventory (NPI) and QoL was assessed using Quality of Life-Alzheimer’s Disease (QOL-AD) scale. Results: After 7 months of training, training group exhibited a significant reduction of NPs and a significant increase in QOL-AD with respect to no-training group (p = 0.0155, p = 0.0013, respectively). Our preliminary results suggest that a combined training can reduce NPs and improve QoL. Conclusions: Measuring QoL outcomes is a potentially important factor in ensuring that a person with cognitive deficits can ‘live well’ with pathology. Future data from non-pharmacological interventions, with a larger sample and a longer follow-up period, could confirm the results and the possible implications for such prevention strategies for early cognitive decline.

Published
2019

5. Incidence of dementia: evidence for an effect modification by gender. The ILSA Study

Author

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

Subjects
Male, Longitudinal study, medicine.medical_specialty, Lower risk, Body Mass Index, Sex Factors, Risk Factors, medicine, Humans, Dementia, Longitudinal Studies, Family history, Psychiatry, Aged, Proportional Hazards Models, Aged, 80 and over, Depression, Proportional hazards model, business.industry, Incidence, Incidence (epidemiology), Age Factors, medicine.disease, Psychiatry and Mental health, Clinical Psychology, Educational Status, Population study, Female, Geriatrics and Gerontology, business, Gerontology, Demography, Cohort study
Abstract

Background:Gender differences for incidence of dementia among elderly people have been usually investigated considering gender as a predictor and not as a stratification variable.Methods:Analyses were based on data collected by the Italian Longitudinal Study on Aging (ILSA), which enrolled 5,632 participants aged 65–84 years between 1992 and 2000. During a median follow-up of 7.8 years, there were 194 cases of incident dementia in the participants with complete data. Cox proportional hazard models for competing risks, stratified by sex, were defined to determine risk factors in relation to developing dementia.Results:The incidence rate of dementia increased from 5.57/1,000 person-years at 65–69 years of age to 30.06/1,000 person-years at 80–84 years. Cox proportional hazard models for competing risks of incidence of dementia and death revealed that, among men, significant risk factors were heart failure, Parkinson's disease, family history of dementia, mild depressive symptomatology and age, while triglycerides were associated with a lower risk of developing dementia. Significant risk factors in women were age, both mild and severe depressive symptomatology, glycemia ≥109 mg/dL, and a BMI < 24.1 kg/m2. Even as little as three years of schooling was found to be a significant protective factor against the incidence of dementia only for women.Conclusions:Our results suggest that there is an effect modification by gender in our study population in relation to the association between low education level, lipid profile, BMI, and glycemia and dementia.

Published
2013
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6. Adolescents in southern regions of Italy adhere to the Mediterranean diet more than those in the northern regions

Author

Noale, M, Nardi, Mariateresa, Limongi, F, Siviero, P, CAREGARO NEGRIN, Lorenza, Crepaldi, G, Maggi, S, and Mediterranean Diet Foundation Study Group

Subjects
Mediterranean diet score, Male, Vitamin, Pediatrics, medicine.medical_specialty, Adolescent, Mediterranean diet, Endocrinology, Diabetes and Metabolism, Adult population, Mediterranean, Adolescents, Diet, Mediterranean, chemistry.chemical_compound, Endocrinology, Surveys and Questionnaires, medicine, Humans, Life Style, Eating habits, Italy, Lifestyle, Cross-Sectional Studies, Female, Mediterranean Region, Food Habits, Nutrition and Dietetics, mediterranean diet, Feeding Behavior, Diet, Northern italy, Diabetes and Metabolism, Lifestyle factors, Geography, Folic acid, chemistry, Research council, adolescents, Body mass index, Demography
Abstract

There is a large amount of literature regarding the benefits of the Mediterranean diet in the adult population; however, there is growing curiosity about the individuals who naturally adhere to those principles early in life. The "Evaluation of Dietary Habits in Adolescents," carried out by the National Research Council of Italy in 2009, is a survey that aimed to assess the dietary habits and lifestyles of Italian adolescents and their adherence to the Mediterranean diet. We hypothesized that there would be differences across regions, with a higher adherence in Southern Italy compared with Northern Italy based on geography. The survey was conducted in 3 different geographic locations in Italy and included a convenience sample of adolescents who attended either a middle or high school. The participants were asked to fill out a questionnaire concerning demographic data, lifestyle factors, and eating patterns, and scores were assigned according to adherence to the Mediterranean diet, as calculated using Trichopoulou's Mediterranean diet scale. The final sample included 565 adolescents, between 12 and 19 years old, who attended school in the northeastern, northwestern, or southern regions of Italy in 2009. According to the findings, 38.6% of the respondents had scores indicating a low adherence to the Mediterranean diet, whereas only 14% had scores showing a high adherence. Teenagers from the Southern region showed the highest adherence. Those with a high adherence to the Mediterranean diet consumed higher quantities of fiber, iron, vitamin B6, vitamin C, folic acid, vitamin A, vitamin D, and monounsaturated fats.

Published
2014
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7. Quantitative ultrasound criteria for risk stratification in clinical practice: a comparative assessment

Author

Noale M, Maggi S, Gonnelli S, Limongi F, Zanoni S, Zambon S, Rozzini R, Crepaldi G, Accardi A, Angeli A, Baglio S, Baldoncini A, Ballardini P, Bancheri C, Beghe F, Bernini L, Bevilacqua M, Bianchi G, Bonomi G, Bottai M, Brogi G, Candioto G, Candiotto S, Cecchetti R, Serqua R, Cervelli S, Coaccioli S, Coin F, Colella C, Costi D, Cravero M, D'Auria S, D'Avola G, De Gennaro N, Del Forno L, D'Elia A, Di Munno O, Di Virgilio R, Favazzi F, Ferraris M, FILIPPINI, Pietro, Francucci CM, Frediani B, Gandolini G, Gasparini R, Gatti R, Gatto S, Gemini E, Gismondi T, Grassi S, Isaia GC, Izzo T, La Montagna G, La forgia R, Lapadula G, Martina GL, Lombardi P, Lovato R, Maglitto R, Magnani F, Malavolta N, Mancini G, Masellis G, Maugeri D, Micale C, Mora R, Muratore M, Occhipinti R, Oliva G, Palummeri E, Panzavecchia D, Parello S, Pellerito R, Pisanu G, Policicchio D, Pozone M, Pucci G, Respizzi S, Roberti G, Rossini M, Rossitto S, Sabadini L, Salvarani C, Salvini S, Santeufemia G, Santi I, Sartori L, Sfrappini M, Silveri F, Sinigaglia L, Vibo MS, Spinazzè R, Stancati G, Tartarelli G, Topini D, Trotta F, Varcasia G, Zanatta A., IOLASCON, Giovanni, Noale, M, Maggi, S, Gonnelli, S, Limongi, F, Zanoni, S, Zambon, S, Rozzini, R, Crepaldi, G, Accardi, A, Angeli, A, Baglio, S, Baldoncini, A, Ballardini, P, Bancheri, C, Beghe, F, Bernini, L, Bevilacqua, M, Bianchi, G, Bonomi, G, Bottai, M, Brogi, G, Candioto, G, Candiotto, S, Cecchetti, R, Serqua, R, Cervelli, S, Coaccioli, S, Coin, F, Colella, C, Costi, D, Cravero, M, D'Auria, S, D'Avola, G, De Gennaro, N, Del Forno, L, D'Elia, A, Di Munno, O, Di Virgilio, R, Favazzi, F, Ferraris, M, Filippini, Pietro, Francucci, Cm, Frediani, B, Gandolini, G, Gasparini, R, Gatti, R, Gatto, S, Gemini, E, Gismondi, T, Grassi, S, Iolascon, Giovanni, Isaia, Gc, Izzo, T, La Montagna, G, La forgia, R, Lapadula, G, Martina, Gl, Lombardi, P, Lovato, R, Maglitto, R, Magnani, F, Malavolta, N, Mancini, G, Masellis, G, Maugeri, D, Micale, C, Mora, R, Muratore, M, Occhipinti, R, Oliva, G, Palummeri, E, Panzavecchia, D, Parello, S, Pellerito, R, Pisanu, G, Policicchio, D, Pozone, M, Pucci, G, Respizzi, S, Roberti, G, Rossini, M, Rossitto, S, Sabadini, L, Salvarani, C, Salvini, S, Santeufemia, G, Santi, I, Sartori, L, Sfrappini, M, Silveri, F, Sinigaglia, L, Vibo, M, Spinazzè, R, Stancati, G, Tartarelli, G, Topini, D, Trotta, F, Varcasia, G, and Zanatta, A.

Subjects
Male, Fracture risk, medicine.medical_specialty, Acoustics and Ultrasonics, Osteoporosis, Biophysics, Logistic regression, Risk Assessment, Sensitivity and Specificity, Quantitative heel ultrasound, Environmental health, Epidemiology, Prevalence, medicine, Humans, Radiology, Nuclear Medicine and imaging, Aged, Ultrasonography, Radiological and Ultrasound Technology, business.industry, Reproducibility of Results, medicine.disease, Surgery, Clinical Practice, Quantitative ultrasound, Italy, Risk factors, Osteoporosis risk, Risk stratification, Female, Osteoporotic Fractures, ESOPO study, Quantitative heel ultrasound, Osteoporosis risk, Fracture risk, Risk factors, ESOPO study, Risk assessment, business
Abstract

This study aimed to compare two different classifications of the risk of fracture/osteoporosis (OP) based on quantitative ultrasound (QUS). Analyses were based on data from the Epidemiological Study on the Prevalence of Osteoporosis, a cross-sectional study conducted in 2000 aimed at assessing the risk of OP in a representative sample of the Italian population. Subjects were classified into 5 groups considering the cross-classification found in previous studies; logistic regression models were defined separately for women and men to study the fracture risk attributable to groups defined by the cross-classification, adjusting for traditional risk factors. Eight-thousand six-hundred eighty-one subjects were considered in the analyses. Logistic regression models revealed that the two classifications seem to be able to identify a common core of individuals at low and at high risk of fractures, and the importance of a multidimensional assessment in older patients to evaluate clinical risk factors together with a simple, inexpensive, radiation-free device such as QUS.

Published
2012

8. Neighborhood environment, social participation, and physical activity in older adults with lower limb osteoarthritis: A mediation analysis

Author

Paola Siviero, Suzan van der Pas, Ángel Otero, Dhayana Dallmeier, Maria Victoria Castell, Nicola Veronese, Florian Herbolsheimer, Federica Limongi, Brendon Stubbs, Dorly J. H. Deeg, Elaine M. Dennison, Richard Peter, Erja Portegijs, Laura A. Schaap, Erik J. Timmermans, Nadine Ungar, Natasja M. van Schoor, Toby O. Smith, Mark H. Edwards, Epidemiology and Data Science, APH - Aging & Later Life, APH - Personalized Medicine, Herbolsheimer, F., Ungar, N., Portegijs, E., Dallmeier, D., Schaap, L., Smith, T., Stubbs, B., Deeg, D., Peter, R., Castell, M.V., Otero, Á., Edwards, M., Siviero, P., Limongi, F., Dennison, E., van Schoor, N., Veronese, N., Timmermans, E.J., van der Pas, S., Nutrition and Health, APH - Health Behaviors & Chronic Diseases, and AMS - Musculoskeletal Health

Subjects
Gerontology, Male, Health (social science), Longitudinal data, Geography, Planning and Development, Physical activity, Osteoarthritis, Lower limb, Structural equation modeling, 03 medical and health sciences, 0302 clinical medicine, Older adults, Residence Characteristics, medicine, Environmental factors, Humans, 030212 general & internal medicine, Exercise, Aged, 030505 public health, Mediation Analysis, Public Health, Environmental and Occupational Health, Social environment, SDG 10 - Reduced Inequalities, Social participation, Social engagement, medicine.disease, Social Participation, Environmental factor, Cross-Sectional Studies, Lower Extremity, Osteoarthriti, Female, 0305 other medical science, Psychology
Abstract

Older adults with lower limb osteoarthritis (LLOA) are highly dependent on their physical and social environment for being physically active. Longitudinal data from 2286 older adults (M age = 73.8 years; 50.3% female) in six European countries were analyzed using cross-lagged Structural Equation Modeling (SEM) and multi-group SEM. In cross-sectional analyses, neighborhood resources were associated with physical activity (r = 0.26;p

Published
2021
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9. Association between osteoarthritis and social isolation: data from the EPOSA study

Author

Elaine M. Dennison, Suzan van der Pas, Maria Victoria Castell, Ángel Otero, Sabina Zambon, Florian Herbolsheimer, Richard Peter, Brendon Stubbs, Nancy L. Pedersen, Dorly J. H. Deeg, Mark H. Edwards, Stefania Maggi, Nicola Veronese, Laura A. Schaap, Cyrus Cooper, Erik J. Timmermans, Federica Limongi, Paola Siviero, Michael Denkinger, Toby O. Smith, Natasja M. van Schoor, Epidemiology and Data Science, APH - Aging & Later Life, APH - Health Behaviors & Chronic Diseases, APH - Personalized Medicine, Nutrition and Health, AMS - Musculoskeletal Health, Sociology and Social Gerontology, Siviero, P., Veronese, N., Smith, T., Stubbs, B., Limongi, F., Zambon, S., Dennison, E.M., Edwards, M., Cooper, C., Timmermans, E.J., van Schoor, N.M., van der Pas, S., Schaap, L.A., Denkinger, M.D., Peter, R., Herbolsheimer, F., Otero, Á., Castell, M.V., Pedersen, N.L., Deeg, D.J.H., Maggi, S., and for the EPOSA Research Group

Subjects
Male, medicine.medical_specialty, WOMAC, social isolation, Pain, EPOSA, Comorbidity, Walking, Disease, Article, Osteoarthritis, Hip, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, Epidemiology, medicine, Humans, Cognitive Dysfunction, Prospective Studies, 030212 general & internal medicine, Social isolation, Depression (differential diagnoses), Aged, Aged, 80 and over, 030203 arthritis & rheumatology, Depression, business.industry, Loneliness, SDG 10 - Reduced Inequalities, Middle Aged, Osteoarthritis, Knee, Hand, Social engagement, Europe, osteoarthritis, Socioeconomic Factors, Physical therapy, Osteoarthriti, Female, Observational study, epidemiology, Independent Living, Geriatrics and Gerontology, medicine.symptom, business
Abstract

Objective: To determine whether there is an association between osteoarthritis (OA) and incident social isolation using data from the European Project on OSteoArthritis (EPOSA) study.Design: Prospective, observational study with 12 to 18 months of follow-up.Setting: Community dwelling.Participants: Older people living in six European countries.Measurements: Social isolation was assessed using the Lubben Social Network Scale and the Maastricht Social Participation Profile. Clinical OA of the hip, knee, and hand was assessed according to American College of Rheumatology criteria. Demographic characteristics, including age, sex, multijoint pain, and medical comorbidities, were assessed.Results: Of the 1967 individuals with complete baseline and follow-up data, 382 (19%) were socially isolated and 1585 were nonsocially isolated at baseline; of these individuals, 222 (13.9%) experienced social isolation during follow-up. Using logistic regression analyses, after adjustment for age, sex, and country, four factors were significantly associated with incident social isolation: clinical OA, cognitive impairment, depression, and worse walking time. Compared to those without OA at any site or with only hand OA, clinical OA of the hip and/or knee, combined or not with hand OA, led to a 1.47 times increased risk of social isolation (95% confidence interval = 1.03-2.09).Conclusion: Clinical OA, present in one or two sites of the hip and knee, or in two or three sites of the hip, knee, and hand, increased the risk of social isolation, adjusting for cognitive impairment and depression and worse walking times. Clinicians should be aware that individuals with OA may be at greater risk of social isolation.

Published
2019
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10. Randomized trial on the effects of a combined physical/cognitive training in aged MCI subjects: The Train the Brain study

Author

Chiara Braschi, I. Falorni, Gennaro D'Angelo, Margherita Maffei, Antonella Mercuri, Marco Mainardi, Maria Chiara Scali, L. Gargani, Eugenio Picano, Francesco Stea, Nicoletta Berardi, G. Cartoni, Alessandro Tonacci, Roberto Ceravolo, Matteo Caleo, Claudia Kusmic, Silvestro Micera, M. Di Galante, Tommaso Pizzorusso, Michelangelo Maestri, Loredana Fortunato, Lamberto Maffei, Pietro Pietrini, Luca Cecchetti, L. Mammana, C. Carlesi, Maria Grazia Andreassi, Andrea Borghini, Silverio Sbrana, T. Navarra, Tatjana Begenisic, F. Limongi, Veronica Mariotti, Leda Volpi, F. S. Giorgi, Laura Biagi, Maria Cristina Cenni, Danilo Scelfo, Martina Coscia, Andrea Angelucci, Enrica Bonanni, Rosa Sicari, Ugo Faraguna, S. Del Turco, Lorenza Pratali, Roberta Franco, Marianna Noale, Joyce Bonaccorsi, Alessandro Sale, Sara Palumbo, Sabrina Molinaro, Gloria Tognoni, Rosa Maria Bruno, Rosa Pasquariello, Mario Costa, Laura Baroncelli, Cristina Pagni, S. Turchi, Erika Melissari, Filippo Baldacci, Roberta Narducci, M. Broccardi, M. De Nes, A. Marabotti, Giovanni Cioni, Stefano Taddei, E Di Coscio, Michela Tosetti, R. Iannarella, Simona Cintoli, R. Gargiulo, Francesco Faita, Gabriele Siciliano, Paola D'Ascanio, Giuseppina Rota, Silvia Pellegrini, P. F. Bellinvia, Ubaldo Bonuccelli, L. Carnicelli, A. Fenu, Andrea Poli, Emiliano Ricciardi, Caterina Iofrida, Stefania Maggi, Alessandra Retico, Gaia Scabia, Lorenzo Ghiadoni, N. Di Lascio, Lucia Chico, Maffei, L., Picano, E., Andreassi, M. G., Angelucci, A., Baldacci, Fabio, Baroncelli, L., Begenisic, Tatjana, Bellinvia, P. F., Berardi, N., Biagi, L., Bonaccorsi, Joyce, Bonanni, E., Bonuccelli, U., Borghini, Andrea, Braschi, Chiara, Broccardi, M., Bruno, R. M., Caleo, M., Carlesi, C., Carnicelli, L., Cartoni, G., Cecchetti, L., Cenni, MARIA CRISTINA, Ceravolo, R., Chico, L., Cintoli, S., Cioni, Giovanni, Coscia, M., Costa, M., D'Angelo, Giulia, D’Ascanio, P., Nes, M. De, Turco, S. Del, Coscio, E. Di, Galante, M. Di, Lascio, N. di, Faita, F., Falorni, I., Faraguna, U., Fenu, A., Fortunato, L., Franco, R., Gargani, L., Gargiulo, R., Ghiadoni, L., Giorgi, F. S., Iannarella, R., Iofrida, C., Kusmic, C., Limongi, F., Maestri, M., Maffei, M., Maggi, Stefania, Mainardi, M., Mammana, L., Marabotti, A., Mariotti, V., Melissari, E., Mercuri, A., Micera, Silvestro, Molinaro, S., Narducci, R., Navarra, T., Noale, M., Pagni, C., Palumbo, S., Pasquariello, R., Pellegrini, Silvia, Pietrini, Pietro, Pizzorusso, T., Poli, Andrea, Pratali, L., Retico, A., Ricciardi, E., Rota, G., Sale, A., Sbrana, S., Scabia, G., Scali, M., Scelfo, D., Sicari, R., Siciliano, G., Stea, F., Taddei, S., Tognoni, G., Tonacci, A., Tosetti, M., Turchi, S., and Volpi, LAURA MARINA

Subjects
Male, 0301 basic medicine, medicine.medical_specialty, Settore BIO/09 - FISIOLOGIA, education, ALzheimer's disease, Neuropsychological Tests, Settore BIO/09 - Fisiologia, behavioral disciplines and activities, Article, law.invention, 03 medical and health sciences, mild cognitive impairment, 0302 clinical medicine, Randomized controlled trial, law, mental disorders, neural plasticity, Alzheimer's disease, physical exercise, Humans, Medicine, Cognitive Dysfunction, physical exercise cognitive training social settind MCI RM fMRI, Psychiatry, Physical Therapy Modalities, Aged, Aged, 80 and over, Brain Mapping, Multidisciplinary, Cognitive Behavioral Therapy, business.industry, Brain, cognitive reserve, Magnetic Resonance Imaging, Cognitive training, Treatment Outcome, 030104 developmental biology, Physical therapy, environmental enrichment, Female, brain aging, business, 030217 neurology & neurosurgery
Abstract

Age-related cognitive impairment and dementia are an increasing societal burden. Epidemiological studies indicate that lifestyle factors, e.g. physical, cognitive and social activities, correlate with reduced dementia risk; moreover, positive effects on cognition of physical/cognitive training have been found in cognitively unimpaired elders. Less is known about effectiveness and action mechanisms of physical/cognitive training in elders already suffering from Mild Cognitive Impairment (MCI), a population at high risk for dementia. We assessed in 113 MCI subjects aged 65–89 years, the efficacy of combined physical-cognitive training on cognitive decline, Gray Matter (GM) volume loss and Cerebral Blood Flow (CBF) in hippocampus and parahippocampal areas, and on brain-blood-oxygenation-level-dependent (BOLD) activity elicited by a cognitive task, measured by ADAS-Cog scale, Magnetic Resonance Imaging (MRI), Arterial Spin Labeling (ASL) and fMRI, respectively, before and after 7 months of training vs. usual life. Cognitive status significantly decreased in MCI-no training and significantly increased in MCI-training subjects; training increased parahippocampal CBF, but no effect on GM volume loss was evident; BOLD activity increase, indicative of neural efficiency decline, was found only in MCI-no training subjects. These results show that a non pharmacological, multicomponent intervention improves cognitive status and indicators of brain health in MCI subjects.

Published
2017

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