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4. All-cause mortality and antipsychotic use among elderly persons with high baseline cardiovascular and cerebrovascular risk: a multi-center retrospective cohort study in Italy

Author

Sultana J., Giorgianni F., REA, FEDERICO, Lucenteforte E., Lombardi N., Mugelli A., Vannacci A., Liperoti R., Kirchmayer U., Vitale C., Chinellato A., Roberto G., Corrao G., Trifiro G., Agabiti N., Bartolini C., Bernabei R., Bettiol A., Bonassi S., Caputi A. P., Cascini S., Cipriani F., Davoli M., Fini M., Gini R., Lapi F., Onder G., Sorge C., Tari M., Vetrano D. L., Sultana, J, Giorgianni, F, Rea, F, Lucenteforte, E, Lombardi, N, Mugelli, A, Vannacci, A, Liperoti, R, Kirchmayer, U, Vitale, C, Chinellato, A, Roberto, G, Corrao, G, Trifiro, G, Agabiti, N, Bartolini, C, Bernabei, R, Bettiol, A, Bonassi, S, Caputi, A, Cascini, S, Cipriani, F, Davoli, M, Fini, M, Gini, R, Lapi, F, Onder, G, Sorge, C, Tari, M, and Vetrano, D

Subjects
Male, Pediatrics, medicine.medical_treatment, Toxicology, 030226 pharmacology & pharmacy, Cohort Studies, Antipsychotic, 0302 clinical medicine, Retrospective Studie, Risk Factors, Cardiovascular Disease, 80 and over, Antipsychotics, Medicine, Drug Interactions, Aged, 80 and over, Incidence, Incidence (epidemiology), General Medicine, Italy, Cardiovascular Diseases, 030220 oncology & carcinogenesis, Cerebrovascular Disorder, Female, cohort study, drug interactions, elderly, mortality, Antipsychotic Agents, Human, Cohort study, medicine.medical_specialty, 03 medical and health sciences, Elderly persons, Humans, Cerebrovascular risk, Proportional Hazards Models, Retrospective Studies, Aged, Pharmacology, drug interaction, urogenital system, business.industry, Proportional hazards model, Settore MED/09 - MEDICINA INTERNA, Retrospective cohort study, equipment and supplies, Cerebrovascular Disorders, Antipsychotic Agent, Proportional Hazards Model, Cohort Studie, business, All cause mortality
Abstract

Background: Little is known about the comparative risk of death with atypical or conventional antipsychotics (APs) among persons with cardiovascular or cerebrovascular disease (CCD). Research design and methods: A cohort study was conducted using five Italian claims databases. New atypical AP users with CCD aged ≥65 (reference) were matched to new conventional AP users. Mortality per 100 person-years (PYs) and hazard ratios (HR), estimated using Cox models, were reported. Incidence and risk of death were estimated for persons having drug–drug interactions. Outcome occurrence was evaluated 180 days after AP initiation. Results: Overall 24,711 and 27,051 elderly new conventional and atypical AP users were identified. The mortality rate was 51.3 and 38.5 deaths per 100 PYs for conventional and atypical AP users. Mortality risk was 1.33 (95%CI: 1.27–1.39) for conventional APs. There was no increased mortality risk with single drug–drug interactions (DDIs) vs. no DDI. AP users with ≥1 DDI had a 29% higher mortality risk compared to no DDI in the first 90 days of treatment (HR: 1.29 (95% CI: 1.00–1.67)). Conclusions: Conventional APs had a higher risk of death than atypical APs among elderly persons with CCD. Having ≥1 DDI was associated with an increased risk of death.

Published
2019

5. All-cause mortality and antipsychotic use among elderly persons with high baseline cardiovascular and cerebrovascular risk: a multi-center retrospective cohort study in Italy

Author

Sultana, J, Giorgianni, F, Rea, F, Lucenteforte, E, Lombardi, N, Mugelli, A, Vannacci, A, Liperoti, R, Kirchmayer, U, Vitale, C, Chinellato, A, Roberto, G, Corrao, G, Trifiro, G, Agabiti, N, Bartolini, C, Bernabei, R, Bettiol, A, Bonassi, S, Caputi, A, Cascini, S, Cipriani, F, Davoli, M, Fini, M, Gini, R, Lapi, F, Onder, G, Sorge, C, Tari, M, Vetrano, D, Sultana J., Giorgianni F., REA, FEDERICO, Lucenteforte E., Lombardi N., Mugelli A., Vannacci A., Liperoti R., Kirchmayer U., Vitale C., Chinellato A., Roberto G., Corrao G., Trifiro G., Agabiti N., Bartolini C., Bernabei R., Bettiol A., Bonassi S., Caputi A. P., Cascini S., Cipriani F., Davoli M., Fini M., Gini R., Lapi F., Onder G., Sorge C., Tari M., Vetrano D. L., Sultana, J, Giorgianni, F, Rea, F, Lucenteforte, E, Lombardi, N, Mugelli, A, Vannacci, A, Liperoti, R, Kirchmayer, U, Vitale, C, Chinellato, A, Roberto, G, Corrao, G, Trifiro, G, Agabiti, N, Bartolini, C, Bernabei, R, Bettiol, A, Bonassi, S, Caputi, A, Cascini, S, Cipriani, F, Davoli, M, Fini, M, Gini, R, Lapi, F, Onder, G, Sorge, C, Tari, M, Vetrano, D, Sultana J., Giorgianni F., REA, FEDERICO, Lucenteforte E., Lombardi N., Mugelli A., Vannacci A., Liperoti R., Kirchmayer U., Vitale C., Chinellato A., Roberto G., Corrao G., Trifiro G., Agabiti N., Bartolini C., Bernabei R., Bettiol A., Bonassi S., Caputi A. P., Cascini S., Cipriani F., Davoli M., Fini M., Gini R., Lapi F., Onder G., Sorge C., Tari M., and Vetrano D. L.

Abstract

Background: Little is known about the comparative risk of death with atypical or conventional antipsychotics (APs) among persons with cardiovascular or cerebrovascular disease (CCD). Research design and methods: A cohort study was conducted using five Italian claims databases. New atypical AP users with CCD aged ≥65 (reference) were matched to new conventional AP users. Mortality per 100 person-years (PYs) and hazard ratios (HR), estimated using Cox models, were reported. Incidence and risk of death were estimated for persons having drug–drug interactions. Outcome occurrence was evaluated 180 days after AP initiation. Results: Overall 24,711 and 27,051 elderly new conventional and atypical AP users were identified. The mortality rate was 51.3 and 38.5 deaths per 100 PYs for conventional and atypical AP users. Mortality risk was 1.33 (95%CI: 1.27–1.39) for conventional APs. There was no increased mortality risk with single drug–drug interactions (DDIs) vs. no DDI. AP users with ≥1 DDI had a 29% higher mortality risk compared to no DDI in the first 90 days of treatment (HR: 1.29 (95% CI: 1.00–1.67)). Conclusions: Conventional APs had a higher risk of death than atypical APs among elderly persons with CCD. Having ≥1 DDI was associated with an increased risk of death.

Published
2019

7. Association between frailty and ischemic heart disease: a systematic review and meta-analysis

Author

Liperoti, Rosa, Vetrano, Dl, Palmer, K, Targowski, T, Cipriani, Maria Camilla, Lo Monaco, Maria Rita, Giovannini, Silvia, Acampora, N, Villani, Emanuele Rocco, Bernabei, Roberto, Onder, Graziano, ADVANTAGE JA WP4, Group., Liperoti R (ORCID:0000-0003-3740-1687), Cipriani MC, Lo Monaco MR (ORCID:0000-0002-1457-7981), Giovannini S (ORCID:0000-0001-9125-752X), Villani ER, Bernabei R (ORCID:0000-0002-9197-004X), Onder G (ORCID:0000-0003-3400-4491), Liperoti, Rosa, Vetrano, Dl, Palmer, K, Targowski, T, Cipriani, Maria Camilla, Lo Monaco, Maria Rita, Giovannini, Silvia, Acampora, N, Villani, Emanuele Rocco, Bernabei, Roberto, Onder, Graziano, ADVANTAGE JA WP4, Group., Liperoti R (ORCID:0000-0003-3740-1687), Cipriani MC, Lo Monaco MR (ORCID:0000-0002-1457-7981), Giovannini S (ORCID:0000-0001-9125-752X), Villani ER, Bernabei R (ORCID:0000-0002-9197-004X), and Onder G (ORCID:0000-0003-3400-4491)

Abstract

Background: Frailty is increasingly reported among older adults with cardiovascular diseases and it has been demonstrated to increase negative health outcomes and mortality. To date, no systematic review of the evidence is available regarding the association between frailty and ischemic heart disease (IHD). We performed a systematic review of literature and a meta-analysis to assess the association between frailty and IHD. Methods: We selected all the studies that provided information on the association between frailty and IHD, regardless of the study setting, study design, or definition of IHD and frailty. PubMed, Web of Science and Embase were searched for relevant papers. Studies that adopted the Fried definition for frailty were included in the meta-analyses. For each measure of interest (proportions and estimates of associations), a meta-analysis was performed if at least three studies used the same definition of frailty. Pooled estimates were obtained through random effect models and Mantel-Haenszel weighting. Results: Thirty-seven studies were included. Of these, 22 adopted the Fried criteria to define frailty and provided estimates of prevalence and therefore they were included in meta-analyses. The pooled prevalence of IHD in frail individuals was 17% (95% Confidence Interval [95%CI] 11-23%) and the pooled prevalence of frailty in individuals with IHD was 19% (95% CI 15-24%). The prevalence of frailty among IHD patients ranged from 4 to 61%. Insufficient data were found to assess longitudinal association between frailty and IHD. Conclusions: Frailty is quite common in older persons with IHD. The identification of frailty among older adults with IHD should be considered relevant to provide individualized strategies of cardiovascular prevention and care. Further research should specifically explore the association between frailty and IHD and investigate the potential common biological ground.

Published
2021

8. Gender may be related to the side of the motor syndrome and cognition in idiopathic Parkinson's disease

Author

Bentivoglio, Anna Rita, Lo Monaco, Maria Rita, Liperoti, Rosa, Fusco, Domenico, Di Stasio, Enrico, Tondinelli, A., Marzullo, D., Maino, Alessandro, Cipriani, Maria Camilla, Silveri, Maria Caterina, Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Liperoti R. (ORCID:0000-0003-3740-1687), Fusco D., Di Stasio E. (ORCID:0000-0003-1047-4261), Maino A., Cipriani M. C., Silveri M. C. (ORCID:0000-0001-5012-0682), Bentivoglio, Anna Rita, Lo Monaco, Maria Rita, Liperoti, Rosa, Fusco, Domenico, Di Stasio, Enrico, Tondinelli, A., Marzullo, D., Maino, Alessandro, Cipriani, Maria Camilla, Silveri, Maria Caterina, Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Liperoti R. (ORCID:0000-0003-3740-1687), Fusco D., Di Stasio E. (ORCID:0000-0003-1047-4261), Maino A., Cipriani M. C., and Silveri M. C. (ORCID:0000-0001-5012-0682)

Abstract

Background: and Sex and cognitive profile may be related to the laterality of motor symptoms in idiopathic Parkinson's disease. Introduction: Parkinson's disease (PD) is well recognised as an inherently asymmetric disease with unilateral onset of motor symptoms. The laterality of motor symptoms may be linked to sex, clinical and demographic variables, and neuropsychological disorders. However, the available data are inconsistent. This study aimed to explore the potential association between the laterality of motor symptoms and clinical and demographic variables and deficits in specific cognitive domains. Material and methods: We retrospectively recruited 97 participants with idiopathic PD without dementia; 60 presented motor symptoms on the left side and 37 on the right side. Both groups were comparable in terms of age, age at disease onset, disease duration, and severity of the neurological deficits according to the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr scale. Results: Participants with left-side motor symptoms scored lower on the Schwab and England Activities of Daily Living scale. Our sample included more men than women (67% vs. 33%). Both sexes were not equally represented in the 2 groups: there were significantly more men than women in the group of patients with left-side motor symptoms (77% vs. 23%), whereas the percentages of men and women in the group of patients with right-side motor symptoms were similar (51% vs. 49%). Both groups performed similarly in all neuropsychological tasks, but women, independently of laterality, performed better than men in the naming task. Conclusion: We found a clear prevalence of men in the group of patients with left-side motor symptoms; this group also scored lower on the Schwab and England Scale. Female sex was predictive of better performance in the naming task. Sex should always be considered in disorders that cause asymmetric involvement of the brain, such as PD.

Published
2021

9. Gender may be related to the side of the motorsyndrome and cognition in idiopathic Parkinson’sdisease

Author

Bentivoglio, Anna Rita, Lo Monaco, Maria Rita, Liperoti, Rosa, Fusco, Domenico, Di Stasio, Enrico, Tondinelli, A, Maino, A, Marzullo, D, Cipriani, Maria Camilla, Silveri, Maria Caterina, Bentivoglio AR (ORCID:0000-0002-9663-095X), Lo Monaco MR (ORCID:0000-0002-1457-7981), Liperoti R (ORCID:0000-0003-3740-1687), Fusco D, Di Stasio E (ORCID:0000-0003-1047-4261), Cipriani MC, Silveri MC (ORCID:0000-0001-5012-0682), Bentivoglio, Anna Rita, Lo Monaco, Maria Rita, Liperoti, Rosa, Fusco, Domenico, Di Stasio, Enrico, Tondinelli, A, Maino, A, Marzullo, D, Cipriani, Maria Camilla, Silveri, Maria Caterina, Bentivoglio AR (ORCID:0000-0002-9663-095X), Lo Monaco MR (ORCID:0000-0002-1457-7981), Liperoti R (ORCID:0000-0003-3740-1687), Fusco D, Di Stasio E (ORCID:0000-0003-1047-4261), Cipriani MC, and Silveri MC (ORCID:0000-0001-5012-0682)

Abstract

Parkinson's disease s a well recognised

Published
2021

10. What about the caregiver? A journey into Parkinson’s disease following the burden tracks

Author

Lo Monaco, Maria Rita, Di Stasio, Enrico, Ricciardi, Diego, Solito, Marcella, Petracca, Martina, Fusco, Domenico, Onder, Graziano, Landi, Giovanni, Zuccala', Giuseppe, Liperoti, Rosa, Cipriani, Maria Camilla, Brisi, C., Bernabei, Roberto, Silveri, Maria Caterina, Bentivoglio, Anna Rita, Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Di Stasio E. (ORCID:0000-0003-1047-4261), Ricciardi D., Solito M., Petracca M., Fusco D., Onder G. (ORCID:0000-0003-3400-4491), Landi G., Zuccala' G. (ORCID:0000-0002-2567-2220), Liperoti R. (ORCID:0000-0003-3740-1687), Cipriani M. C., Bernabei R. (ORCID:0000-0002-9197-004X), Silveri M. C. (ORCID:0000-0001-5012-0682), Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Lo Monaco, Maria Rita, Di Stasio, Enrico, Ricciardi, Diego, Solito, Marcella, Petracca, Martina, Fusco, Domenico, Onder, Graziano, Landi, Giovanni, Zuccala', Giuseppe, Liperoti, Rosa, Cipriani, Maria Camilla, Brisi, C., Bernabei, Roberto, Silveri, Maria Caterina, Bentivoglio, Anna Rita, Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Di Stasio E. (ORCID:0000-0003-1047-4261), Ricciardi D., Solito M., Petracca M., Fusco D., Onder G. (ORCID:0000-0003-3400-4491), Landi G., Zuccala' G. (ORCID:0000-0002-2567-2220), Liperoti R. (ORCID:0000-0003-3740-1687), Cipriani M. C., Bernabei R. (ORCID:0000-0002-9197-004X), Silveri M. C. (ORCID:0000-0001-5012-0682), and Bentivoglio A. R. (ORCID:0000-0002-9663-095X)

Abstract

Objectives: To investigate caregivers and patients characteristics related to different dimensions of burden in Parkinson’s disease (PD). Methods: 55 pairs of PD patients and caregivers were recruited. The burden was evaluated with the Caregiver Burden Inventory (CBI). Multivariate analysis was applied to evaluate the impact of caregivers’ and patients’ characteristics on the varying aspects of burden. Results: ADL score was the dominant predictor for the total score and all dimensions of CBI, except for the social burden, which is strongly predicted by the motor severity of PD. As one can easily imagine, the Total CBI decreases as the ADL score increases. Discussion: An increased appreciation for characteristics of caregiver burden is a fundamental aspect of the patient’s global evaluation. Clinicians may need to directly probe for these factors in the caregiver as they may not be elicited routinely.

Published
2021

12. Baricitinib as rescue therapy in a patient with COVID-19 with no complete response to sarilumab

Author

Cingolani, A., Tummolo, A. M., Montemurro, G., Gremese, E., Larosa, L., Cipriani, M. C., Pasciuto, G., Liperoti, R., Murri, R., Pirronti, T., Cauda, R., Fantoni, M., Bellieni, A., Brandi, V., Calabrese, A., Calvello, M. R., Ciccullo, A., Corbo, G., Falsiroli, C., Intini, E., Landi, G., Leone, P. M., Macagno, F., Martis, I., Pais, C., Potenza, A., Salini, S., Simonetti, J., Taddei, E., Tosato, M., Varone, F., Ventura, G., and Siciliano, M.

Subjects
0301 basic medicine, Male, Baricitinib, medicine.medical_treatment, Azithromycin, Lopinavir, 0302 clinical medicine, Respiratory function, 030212 general & internal medicine, Sulfonamides, Brief Report, General Medicine, Drug Combinations, Infectious Diseases, Treatment Outcome, Radiological weapon, Anesthesia, Acute Disease, Immunotherapy, Coronavirus Infections, Respiratory Insufficiency, medicine.drug, Hydroxychloroquine, Microbiology (medical), Coronavirus disease 2019 (COVID-19), 030106 microbiology, Pneumonia, Viral, Antibodies, Monoclonal, Humanized, Antiviral Agents, 03 medical and health sciences, Betacoronavirus, medicine, Humans, Pandemics, Aged, Ritonavir, business.industry, SARS-CoV-2, Sarilumab, Drug Repositioning, COVID-19, Respiratory failure, Purines, Azetidines, Pyrazoles, business
Abstract

A patient with COVID-19-related severe respiratory failure, with insufficient response to an antiretroviral therapy, hydroxychloroquine and Interleukin-6 (IL-6) antagonist therapy, presented a prompt resolution of the respiratory function and improvement in the radiological picture after baricitinib at an oral dose of 4 mg per day for 2 weeks.

Published
2020

13. The “development of metabolic and functional markers of dementia in older people” (ODINO) study: Rationale, design and methods

Author

Picca, A., Ronconi, D., Coelho-Junior, H. J., Calvani, Riccardo, Marini, F., Biancolillo, A., Gervasoni, Jacopo, Primiano, A., Pais, C., Meloni, E., Fusco, Domenico, Lo Monaco, Maria Rita, Bernabei, Roberto, Camilla Cipriani, M., Marzetti, Emanuele, Liperoti, Rosa, Calvani R. (ORCID:0000-0001-5472-2365), Gervasoni J., Fusco D., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Bernabei R. (ORCID:0000-0002-9197-004X), Marzetti E. (ORCID:0000-0001-9567-6983), Liperoti R. (ORCID:0000-0003-3740-1687), Picca, A., Ronconi, D., Coelho-Junior, H. J., Calvani, Riccardo, Marini, F., Biancolillo, A., Gervasoni, Jacopo, Primiano, A., Pais, C., Meloni, E., Fusco, Domenico, Lo Monaco, Maria Rita, Bernabei, Roberto, Camilla Cipriani, M., Marzetti, Emanuele, Liperoti, Rosa, Calvani R. (ORCID:0000-0001-5472-2365), Gervasoni J., Fusco D., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Bernabei R. (ORCID:0000-0002-9197-004X), Marzetti E. (ORCID:0000-0001-9567-6983), and Liperoti R. (ORCID:0000-0003-3740-1687)

Abstract

Mild cognitive impairment (MCI), also termed mild neurocognitive disorder, includes a heterogeneous group of conditions characterized by declines in one or more cognitive domains greater than that expected during "normal" aging but not severe enough to impair functional abilities. MCI has been associated with an increased risk of developing dementia and even considered an early stage of it. Therefore, noninvasively accessible biomarkers of MCI are highly sought after for early identification of the condition. Systemic inflammation, metabolic perturbations, and declining physical performance have been described in people with MCI. However, whether biological and functional parameters differ across MCI neuropsychological subtypes is presently debated. Likewise, the predictive value of existing biomarkers toward MCI conversion into dementia is unclear. The "develOpment of metabolic and functional markers of Dementia IN Older people" (ODINO) study was conceived as a multi-dimensional investigation in which multi-marker discovery will be coupled with innovative statistical approaches to characterize patterns of systemic inflammation, metabolic perturbations, and physical performance in older adults with MCI. The ultimate aim of ODINO is to identify potential biomarkers specific for MCI subtypes and predictive of MCI conversion into Alzheimer's disease or other forms of dementia over a three-year follow-up. Here, we describe the rationale, design, and methods of ODINO.

Published
2020

14. Prevalence of Obsessive-Compulsive Symptoms in Elderly Parkinson Disease Patients: A Case-Control Study

Author

Lo Monaco, Maria Rita, Di Stasio, Enrico, Zuccala', Giuseppe, Petracca, Martina, Genovese, Maria Daniela, Fusco, Domenico, Silveri, Maria Caterina, Liperoti, Rosa, Ricciardi, Diego, Cipriani, Maria Camilla, Laudisio, A., Bentivoglio, Anna Rita, Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Di Stasio E. (ORCID:0000-0003-1047-4261), Zuccala G. (ORCID:0000-0002-2567-2220), Petracca M., Genovese D., Fusco D., Silveri M. C. (ORCID:0000-0001-5012-0682), Liperoti R. (ORCID:0000-0003-3740-1687), Ricciardi D., Cipriani M. C., Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Lo Monaco, Maria Rita, Di Stasio, Enrico, Zuccala', Giuseppe, Petracca, Martina, Genovese, Maria Daniela, Fusco, Domenico, Silveri, Maria Caterina, Liperoti, Rosa, Ricciardi, Diego, Cipriani, Maria Camilla, Laudisio, A., Bentivoglio, Anna Rita, Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Di Stasio E. (ORCID:0000-0003-1047-4261), Zuccala G. (ORCID:0000-0002-2567-2220), Petracca M., Genovese D., Fusco D., Silveri M. C. (ORCID:0000-0001-5012-0682), Liperoti R. (ORCID:0000-0003-3740-1687), Ricciardi D., Cipriani M. C., and Bentivoglio A. R. (ORCID:0000-0002-9663-095X)

Abstract

Background: The clinical picture of obsessive-compulsive disorder encompasses a broad range of symptoms that are related to multiple psychological domains, including perception, cognition, emotion, and social relatedness. As obsessive-compulsive symptoms (OCS) frequently have an early onset, there are limited data about OCS in older populations (>= 65 years) and, in particular, in elderly subjects with Parkinson disease (PD). Objective: This study aimed to estimate the prevalence of OCS using a self-report measure (Obsessive-Compulsive Inventory-Revised) and to identify associated sociodemographic and clinical factors in a sample of elderly PD patients compared to a comparison group of similarly aged healthy volunteers. Results: The mean age was 74 +/- 6 years in the PD patients and 73 +/- 7 years in the comparison group. The mean disease duration was 9.6 +/- 5.8 years. Among the PD patients, 30.7% reported at least one OCS or a related disorder compared to 21.1% in the comparison group. Hoarding was significantly more common in PD patients than in the comparison group. Conclusions: Subclinical OCS were present at a high percentage in both PD patients and comparison group. The OCS phenotype in PD may present differently, as hoarding was more common in PD patients.

Published
2020

15. Use of antidepressant medications among older adults in European long-term care facilities: a cross-sectional analysis from the SHELTER study

Author

Giovannini, Silvia, Onder, Graziano, van der Roest, Hg, Topinkova, E, Gindin, J, Cipriani, Maria Camilla, Denkinger, Md, Bernabei, Roberto, Liperoti, Rosa, Giovannini S (ORCID:0000-0001-9125-752X), Onder G (ORCID:0000-0003-3400-4491), Cipriani MC, Bernabei R (ORCID:0000-0002-9197-004X), Liperoti R (ORCID:0000-0003-3740-1687), Giovannini, Silvia, Onder, Graziano, van der Roest, Hg, Topinkova, E, Gindin, J, Cipriani, Maria Camilla, Denkinger, Md, Bernabei, Roberto, Liperoti, Rosa, Giovannini S (ORCID:0000-0001-9125-752X), Onder G (ORCID:0000-0003-3400-4491), Cipriani MC, Bernabei R (ORCID:0000-0002-9197-004X), and Liperoti R (ORCID:0000-0003-3740-1687)

Abstract

Background: Late-life depression is common among older adults living in nursing homes (NHs). Over the last 30 years there has been an increase in the rates of prescription of antidepressant medications across all ages, with the largest rise reported in older adults. This study aimed to describe the pattern of antidepressant medication use among NH residents from 7 European countries and Israel and to examine patient and facilities characteristics that may account for it. Methods: We conducted a cross-sectional analysis of data from the SHELTER study, an observational longitudinal cohort study that collected comprehensive resident data using the interRAI Long-Term Care Facility instrument in 7 European Countries and Israel. Descriptive statistics were used to examine sample characteristics. Potential correlates of antidepressant medication use were identified using multiple logistic regression modeling. Results: Among 4023 residents entering the study, 32% had depressive symptoms and nearly half of these individuals used antidepressants. Antidepressant medication use varied by country, with a prevalence in the overall sample of 35.6% (n = 1431). Among antidepressant users, 59.9% were receiving selective serotonin reuptake inhibitors (SSRI). The strongest correlates of antidepressant use included reported diagnosis of anxiety, depression, bipolar disorder, pain, falls and high level of social engagement. Age over 85 years, living in facilities located in rural areas and a diagnosis of schizophrenia reduced the likelihood of being prescribed with an antidepressant. Conclusions: A large proportion of residents in European long-term care facilities receive antidepressant medications. The decision to prescribe antidepressants to NH residents seems to be influenced by both patient and facility characteristics. Future longitudinal studies should evaluate the efficacy and safety of antidepressant use in NHs thus providing evidence for recommendations for clinical practice.

Published
2020

16. The Geriatrician: The Frontline Specialist in the Treatment of COVID-19 Patients

Author

Landi, Francesco, Barillaro, Christian, Bellieni, Agnese, Brandi, V., Carfi, A., Cipriani, Maria Camilla, D'Angelo, Emanuela, Falsiroli, C., Fusco, Domenico, Landi, G., Liperoti, Rosa, Lo Monaco, Maria Rita, Martone, Anna Maria, Marzetti, Emanuele, Pagano, Francesco Cosimo, Pais, C., Russo, Andrea, Salini, S., Tosasto, M., Tummolo, A. M., Benvenuto, Francesca, Bramato, Giulia, Catalano, L., Ciciarello, Francesca, Martis, I., Rocchi, Sara, Rota, Elisabetta, Salerno, Andrea, Tritto, Marcello, Sgadari, Antonio, Zuccala', Giuseppe, Bernabei, Roberto, Landi F. (ORCID:0000-0002-3472-1389), Barillaro C., Bellieni A., Cipriani M. C., D'Angelo E., Fusco D., Liperoti R. (ORCID:0000-0003-3740-1687), Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Martone A. M., Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F. C., Russo A., Benvenuto F., Bramato G., Ciciarello F., Rocchi S., Rota E., Salerno A., Tritto M., Sgadari A. (ORCID:0000-0002-8296-043X), Zuccala G. (ORCID:0000-0002-2567-2220), Bernabei R. (ORCID:0000-0002-9197-004X), Landi, Francesco, Barillaro, Christian, Bellieni, Agnese, Brandi, V., Carfi, A., Cipriani, Maria Camilla, D'Angelo, Emanuela, Falsiroli, C., Fusco, Domenico, Landi, G., Liperoti, Rosa, Lo Monaco, Maria Rita, Martone, Anna Maria, Marzetti, Emanuele, Pagano, Francesco Cosimo, Pais, C., Russo, Andrea, Salini, S., Tosasto, M., Tummolo, A. M., Benvenuto, Francesca, Bramato, Giulia, Catalano, L., Ciciarello, Francesca, Martis, I., Rocchi, Sara, Rota, Elisabetta, Salerno, Andrea, Tritto, Marcello, Sgadari, Antonio, Zuccala', Giuseppe, Bernabei, Roberto, Landi F. (ORCID:0000-0002-3472-1389), Barillaro C., Bellieni A., Cipriani M. C., D'Angelo E., Fusco D., Liperoti R. (ORCID:0000-0003-3740-1687), Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Martone A. M., Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F. C., Russo A., Benvenuto F., Bramato G., Ciciarello F., Rocchi S., Rota E., Salerno A., Tritto M., Sgadari A. (ORCID:0000-0002-8296-043X), Zuccala G. (ORCID:0000-0002-2567-2220), and Bernabei R. (ORCID:0000-0002-9197-004X)

Abstract

On February 20, 2020, a man living in the north of Italy was admitted to the emergency room with an atypical pneumonia that later proved to be COVID-19. This was the trigger of one of the most serious clusters of COVID-19 in the world, outside of China. Despite aggressive restraint and inhibition efforts, COVID-19 continues to increase, and the total number of infected patients in Italy is growing daily. After 6 weeks, the total number of patients reached 128,948 cases (April 5, 2020), with the higher case-fatality rate (15,887 deaths) dominated by old and very old patients. This sudden health emergency severely challenged the Italian Health System, in particular acute care hospitals and intensive care units. In 1 hospital, geriatric observation units were created, the experience of which can be extremely useful for European countries, the United States, and all countries that in the coming days will face a similar situation.

Published
2020

17. Assessment of neurological manifestations in hospitalized patients with COVID-19

Author

Luigetti, Marco, Iorio, Raffaele, Bentivoglio, Anna Rita, Tricoli, Luca, Riso, Vittorio, Marotta, Jessica, Piano, Carla, Primiano, Guido Alessandro, Zileri Del Verme, L., Lo Monaco, Maria Rita, Calabresi, Paolo, Abbate, V., Acampora, N., Addolorato, G., Agostini, F., Ainora, M. E., Akacha, K., Amato, E., Andreani, F., Andriollo, G., Annetta, Maria Giuseppina, Annicchiarico, B. E., Antonelli, Massimo, Antonucci, G., Anzellotti, G. M., Armuzzi, A., Baldi, F., Barattucci, I., Barillaro, C., Barone, F., Bellantone, R. D. A., Bellieni, A., Bello, G., Benicchi, A., Benvenuto, F., Berardini, L., Berloco, F., Bernabei, R., Bianchi, A., Biasucci, D. G., Biasucci, L. M., Bibbo, S., Bini, A., Bisanti, A., Biscetti, F., Bocci, M. G., Bonadia, N., Bongiovanni, F., Borghetti, A., Bosco, G., Bosello, Silvia Laura, Bove, V., Bramato, G., Brandi, V., Bruni, T., Bruno, C., Bruno, D., Bungaro, M. C., Buonomo, A., Burzo, L., Calabrese, A., Calvello, M. R., Cambieri, A., Cambise, C., Camma, G., Candelli, M., Canistro, G., Cantanale, A., Capalbo, G., Capaldi, L., Capone, E., Capristo, E., Carbone, L., Cardone, S., Carelli, S., Carfi, A., Carnicelli, A., Caruso, C., Casciaro, F. A., Catalano, L., Cauda, R., Cecchini, A. L., Cerrito, L., Cesarano, M., Chiarito, A., Cianci, Rossella, Cicchinelli, S., Ciccullo, A., Cicetti, M., Ciciarello, F., Cingolani, A., Cipriani, M. C., Consalvo, M. L., Coppola, G., Corbo, G. M., Corsello, A., Costante, F., Costanzi, M., Covino, M., Crupi, D., Cutuli, S. L., D'Addio, S., D'Alessandro, A., D'Alfonso, M. E., D'Angelo, E., D'Aversa, F., Damiano, F., De Berardinis, G. M., De Cunzo, T., De Gaetano, D. K., De Luca, G., De Matteis, G., De Pascale, G., De Santis, P., De Siena, M., De Vito, F., Del Gatto, V., Del Giacomo, P., Del Zompo, F., Dell'Anna, A. M., Della, P. D., Di Gialleonardo, L., Di Giambenedetto, S., Di Luca, R., Di Maurizio, L., Di Muro, M., Dusina, A., Eleuteri, D., Esperide, A., Fachechi, D., Faliero, D., Falsiroli, C., Fantoni, M., Fedele, A., Feliciani, D., Ferrante, C., Ferrone, G., Festa, R., Fiore, M. C., Flex, A., Forte, E., Franceschi, Francesco, Francesconi, A., Franza, L., Funaro, B., Fuorlo, M., Fusco, D., Gabrielli, M., Gaetani, E., Galletta, C., Gallo, A., Gambassi, G., Garcovich, M., Gasbarrini, A., Gasparrini, I., Gelli, S., Giampietro, A., Gigante, L., Giuliano, G., Giupponi, B., Gremese, E., Grieco, Domenico Luca, Guerrera, M., Guglielmi, V., Guidone, C., Gulli, A., Iaconelli, A., Iafrati, A., Ianiro, Gianluca, Iaquinta, A., Impagnatiello, M., Inchingolo, R., Intini, E., Iorio, R., Izzi, I. M., Jovanovic, T., Kadhim, C., La Macchia, R., La Milia, D. I., Landi, F., Landi, G., Landi, R., Landolfi, R., Leo, M., Leone, P. M., Levantesi, L., Liguori, A., Liperoti, R., Lizzio, M. M., Lo Monaco Maria, R., Locantore, P., Lombardi, F., Lombardi, G., Lopetuso, L., Loria, V., Losito, A. R., Lucia, M. B. P., Macagno, F., Macerola, N., Maggi, G., Maiuro, G., Mancarella, F., Mangiola, F., Manno, A., Marchesini, D., Maresca, G. M., Marrone, G., Martis, I., Martone, A. M., Marzetti, Emanuele, Mattana, C., Matteo, M. V., Maviglia, R., Mazzarella, A., Memoli, C., Miele, Luca, Migneco, A., Mignini, I., Milani, A., Milardi, D., Montalto, M., Montemurro, G., Monti, F., Montini, Luca, Morena, T. C., Morra, V., Morretta, C., Moschese, D., Murace, C. A., Murdolo, M., Murri, Rita, Napoli, M., Nardella, E., Natalello, G., Natalini, D., Navarra, S. M., Nesci, A., Nicoletti, A., Nicoletti, R., Nicoletti, T. F., Nicolo, R., Nicolotti, N., Nista, E. C., Nuzzo, E., Oggiano, M., Ojetti, V., Pagano, F. C., Paiano, G., Pais, C., Pallavicini, F., Palombo, A., Paolillo, F., Papa, Alfredo, Papanice, D., Papparella, L. G., Paratore, M., Parrinello, G., Pasciuto, G., Pasculli, P., Pecorini, G., Perniola, S., Pero, E., Petricca, L., Petrucci, M., Picarelli, C., Piccioni, A., Piccolo, A., Piervincenzi, E., Pignataro, G., Pignataro, R., Pintaudi, G., Pisapia, L., Pizzoferrato, M., Pizzolante, F., Pola, R., Policola, C., Pompili, M., Pontecorvi, F., Pontecorvi, V., Ponziani, F., Popolla, V., Porceddu, E., Porfidia, A., Porro, L. M., Potenza, A., Pozzana, F., Privitera, G., Pugliese, D., Pulcini, G., Racco, S., Raffaelli, F., Ramunno, V., Rapaccini, G. L., Richeldi, Luca, Rinninella, Emanuele, Rocchi, S., Romano, B., Romano, S., Rosa, F., Rossi, L., Rossi, R., Rossini, E., Rota, E., Rovedi, F., Rubino, C., Rumi, G., Russo, A., Sabia, L., Salerno, A., Salini, S., Salvatore, L., Samori, D., Sandroni, Claudio, Sanguinetti, M., Santarelli, L., Santini, P., Santolamazza, D., Santoliquido, A., Santopaolo, F., Santoro, M. C., Sardeo, F., Sarnari, C., Saviano, A., Saviano, L., Scaldaferri, Franco, Scarascia, R., Schepis, T., Schiavello, F., Scoppettuolo, G., Sedda, D., Sessa, F., Sestito, L., Settanni, C., Siciliano, M., Siciliano, V., Sicuranza, R., Simeoni, B., Simonetti, J., Smargiassi, A., Soave, P. M., Sonnino, C., Staiti, D., Stella, C., Stella, L., Stival, E., Taddei, E., Talerico, R., Tamburello, E., Tamburrini, E., Tanzarella, E. S., Tarascio, E., Tarli, C., Tersali, A., Tilli, P., Timpano, J., Torelli, E., Torrini, F., Tosato, M., Tosoni, A., Tricoli, L., Tritto, M., Tumbarello, M., Tummolo, A. M., Vallecoccia, M. S., Valletta, F., Varone, F., Vassalli, F., Ventura, G., Verardi, L., Vetrone, L., Vetrugno, G., Visconti, E., Visconti, F., Viviani, A., Zaccaria, R., Zaccone, C., Zelano, L., Zileri Dal Verme, L., Zuccala, G., Luigetti M. (ORCID:0000-0001-7539-505X), Iorio R. (ORCID:0000-0002-6270-0956), Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Tricoli L., Riso V., Marotta J., Piano C., Primiano G., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Calabresi P. (ORCID:0000-0003-0326-5509), Annetta M. G. (ORCID:0000-0001-7574-1311), Antonelli M. (ORCID:0000-0003-3007-1670), Bosello S. (ORCID:0000-0002-4837-447X), Cianci R. (ORCID:0000-0001-5378-8442), Franceschi F. (ORCID:0000-0001-6266-445X), Grieco D. L. (ORCID:0000-0002-4557-6308), Ianiro G. (ORCID:0000-0002-8318-0515), Marzetti E. (ORCID:0000-0001-9567-6983), Miele L. (ORCID:0000-0003-3464-0068), Montini L. (ORCID:0000-0003-4602-5134), Murri R. (ORCID:0000-0003-4263-7854), Papa A. (ORCID:0000-0002-4186-7298), Richeldi L. (ORCID:0000-0001-8594-1448), Rinninella E. (ORCID:0000-0002-9165-2367), Sandroni C. (ORCID:0000-0002-8878-2611), Scaldaferri F. (ORCID:0000-0001-8334-7541), Luigetti, Marco, Iorio, Raffaele, Bentivoglio, Anna Rita, Tricoli, Luca, Riso, Vittorio, Marotta, Jessica, Piano, Carla, Primiano, Guido Alessandro, Zileri Del Verme, L., Lo Monaco, Maria Rita, Calabresi, Paolo, Abbate, V., Acampora, N., Addolorato, G., Agostini, F., Ainora, M. E., Akacha, K., Amato, E., Andreani, F., Andriollo, G., Annetta, Maria Giuseppina, Annicchiarico, B. E., Antonelli, Massimo, Antonucci, G., Anzellotti, G. M., Armuzzi, A., Baldi, F., Barattucci, I., Barillaro, C., Barone, F., Bellantone, R. D. A., Bellieni, A., Bello, G., Benicchi, A., Benvenuto, F., Berardini, L., Berloco, F., Bernabei, R., Bianchi, A., Biasucci, D. G., Biasucci, L. M., Bibbo, S., Bini, A., Bisanti, A., Biscetti, F., Bocci, M. G., Bonadia, N., Bongiovanni, F., Borghetti, A., Bosco, G., Bosello, Silvia Laura, Bove, V., Bramato, G., Brandi, V., Bruni, T., Bruno, C., Bruno, D., Bungaro, M. C., Buonomo, A., Burzo, L., Calabrese, A., Calvello, M. R., Cambieri, A., Cambise, C., Camma, G., Candelli, M., Canistro, G., Cantanale, A., Capalbo, G., Capaldi, L., Capone, E., Capristo, E., Carbone, L., Cardone, S., Carelli, S., Carfi, A., Carnicelli, A., Caruso, C., Casciaro, F. A., Catalano, L., Cauda, R., Cecchini, A. L., Cerrito, L., Cesarano, M., Chiarito, A., Cianci, Rossella, Cicchinelli, S., Ciccullo, A., Cicetti, M., Ciciarello, F., Cingolani, A., Cipriani, M. C., Consalvo, M. L., Coppola, G., Corbo, G. M., Corsello, A., Costante, F., Costanzi, M., Covino, M., Crupi, D., Cutuli, S. L., D'Addio, S., D'Alessandro, A., D'Alfonso, M. E., D'Angelo, E., D'Aversa, F., Damiano, F., De Berardinis, G. M., De Cunzo, T., De Gaetano, D. K., De Luca, G., De Matteis, G., De Pascale, G., De Santis, P., De Siena, M., De Vito, F., Del Gatto, V., Del Giacomo, P., Del Zompo, F., Dell'Anna, A. M., Della, P. D., Di Gialleonardo, L., Di Giambenedetto, S., Di Luca, R., Di Maurizio, L., Di Muro, M., Dusina, A., Eleuteri, D., Esperide, A., Fachechi, D., Faliero, D., Falsiroli, C., Fantoni, M., Fedele, A., Feliciani, D., Ferrante, C., Ferrone, G., Festa, R., Fiore, M. C., Flex, A., Forte, E., Franceschi, Francesco, Francesconi, A., Franza, L., Funaro, B., Fuorlo, M., Fusco, D., Gabrielli, M., Gaetani, E., Galletta, C., Gallo, A., Gambassi, G., Garcovich, M., Gasbarrini, A., Gasparrini, I., Gelli, S., Giampietro, A., Gigante, L., Giuliano, G., Giupponi, B., Gremese, E., Grieco, Domenico Luca, Guerrera, M., Guglielmi, V., Guidone, C., Gulli, A., Iaconelli, A., Iafrati, A., Ianiro, Gianluca, Iaquinta, A., Impagnatiello, M., Inchingolo, R., Intini, E., Iorio, R., Izzi, I. M., Jovanovic, T., Kadhim, C., La Macchia, R., La Milia, D. I., Landi, F., Landi, G., Landi, R., Landolfi, R., Leo, M., Leone, P. M., Levantesi, L., Liguori, A., Liperoti, R., Lizzio, M. M., Lo Monaco Maria, R., Locantore, P., Lombardi, F., Lombardi, G., Lopetuso, L., Loria, V., Losito, A. R., Lucia, M. B. P., Macagno, F., Macerola, N., Maggi, G., Maiuro, G., Mancarella, F., Mangiola, F., Manno, A., Marchesini, D., Maresca, G. M., Marrone, G., Martis, I., Martone, A. M., Marzetti, Emanuele, Mattana, C., Matteo, M. V., Maviglia, R., Mazzarella, A., Memoli, C., Miele, Luca, Migneco, A., Mignini, I., Milani, A., Milardi, D., Montalto, M., Montemurro, G., Monti, F., Montini, Luca, Morena, T. C., Morra, V., Morretta, C., Moschese, D., Murace, C. A., Murdolo, M., Murri, Rita, Napoli, M., Nardella, E., Natalello, G., Natalini, D., Navarra, S. M., Nesci, A., Nicoletti, A., Nicoletti, R., Nicoletti, T. F., Nicolo, R., Nicolotti, N., Nista, E. C., Nuzzo, E., Oggiano, M., Ojetti, V., Pagano, F. C., Paiano, G., Pais, C., Pallavicini, F., Palombo, A., Paolillo, F., Papa, Alfredo, Papanice, D., Papparella, L. G., Paratore, M., Parrinello, G., Pasciuto, G., Pasculli, P., Pecorini, G., Perniola, S., Pero, E., Petricca, L., Petrucci, M., Picarelli, C., Piccioni, A., Piccolo, A., Piervincenzi, E., Pignataro, G., Pignataro, R., Pintaudi, G., Pisapia, L., Pizzoferrato, M., Pizzolante, F., Pola, R., Policola, C., Pompili, M., Pontecorvi, F., Pontecorvi, V., Ponziani, F., Popolla, V., Porceddu, E., Porfidia, A., Porro, L. M., Potenza, A., Pozzana, F., Privitera, G., Pugliese, D., Pulcini, G., Racco, S., Raffaelli, F., Ramunno, V., Rapaccini, G. L., Richeldi, Luca, Rinninella, Emanuele, Rocchi, S., Romano, B., Romano, S., Rosa, F., Rossi, L., Rossi, R., Rossini, E., Rota, E., Rovedi, F., Rubino, C., Rumi, G., Russo, A., Sabia, L., Salerno, A., Salini, S., Salvatore, L., Samori, D., Sandroni, Claudio, Sanguinetti, M., Santarelli, L., Santini, P., Santolamazza, D., Santoliquido, A., Santopaolo, F., Santoro, M. C., Sardeo, F., Sarnari, C., Saviano, A., Saviano, L., Scaldaferri, Franco, Scarascia, R., Schepis, T., Schiavello, F., Scoppettuolo, G., Sedda, D., Sessa, F., Sestito, L., Settanni, C., Siciliano, M., Siciliano, V., Sicuranza, R., Simeoni, B., Simonetti, J., Smargiassi, A., Soave, P. M., Sonnino, C., Staiti, D., Stella, C., Stella, L., Stival, E., Taddei, E., Talerico, R., Tamburello, E., Tamburrini, E., Tanzarella, E. S., Tarascio, E., Tarli, C., Tersali, A., Tilli, P., Timpano, J., Torelli, E., Torrini, F., Tosato, M., Tosoni, A., Tricoli, L., Tritto, M., Tumbarello, M., Tummolo, A. M., Vallecoccia, M. S., Valletta, F., Varone, F., Vassalli, F., Ventura, G., Verardi, L., Vetrone, L., Vetrugno, G., Visconti, E., Visconti, F., Viviani, A., Zaccaria, R., Zaccone, C., Zelano, L., Zileri Dal Verme, L., Zuccala, G., Luigetti M. (ORCID:0000-0001-7539-505X), Iorio R. (ORCID:0000-0002-6270-0956), Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Tricoli L., Riso V., Marotta J., Piano C., Primiano G., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Calabresi P. (ORCID:0000-0003-0326-5509), Annetta M. G. (ORCID:0000-0001-7574-1311), Antonelli M. (ORCID:0000-0003-3007-1670), Bosello S. (ORCID:0000-0002-4837-447X), Cianci R. (ORCID:0000-0001-5378-8442), Franceschi F. (ORCID:0000-0001-6266-445X), Grieco D. L. (ORCID:0000-0002-4557-6308), Ianiro G. (ORCID:0000-0002-8318-0515), Marzetti E. (ORCID:0000-0001-9567-6983), Miele L. (ORCID:0000-0003-3464-0068), Montini L. (ORCID:0000-0003-4602-5134), Murri R. (ORCID:0000-0003-4263-7854), Papa A. (ORCID:0000-0002-4186-7298), Richeldi L. (ORCID:0000-0001-8594-1448), Rinninella E. (ORCID:0000-0002-9165-2367), Sandroni C. (ORCID:0000-0002-8878-2611), and Scaldaferri F. (ORCID:0000-0001-8334-7541)

Abstract

Background and purpose: The objective of this study was to assess the neurological manifestations in a series of consecutive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients, comparing their frequency with a population hospitalized in the same period for flu/respiratory symptoms, finally not related to SARS-CoV-2. Methods: Patients with flu/respiratory symptoms admitted to Fondazione Policlinico Gemelli hospital from 14 March 2020 to 20 April 2020 were retrospectively enrolled. The frequency of neurological manifestations of patients with SARS-CoV-2 infection was compared with a control group. Results: In all, 213 patients were found to be positive for SARS-CoV-2, after reverse transcriptase polymerase chain reaction on nasal or throat swabs, whilst 218 patients were found to be negative and were used as a control group. Regarding central nervous system manifestations, in SARS-CoV-2-positive patients a higher frequency of headache, hyposmia and encephalopathy always related to systemic conditions (fever or hypoxia) was observed. Furthermore, muscular involvement was more frequent in SARS-CoV-2 infection. Conclusions: Patients with COVID-19 commonly have neurological manifestations but only hyposmia and muscle involvement seem more frequent compared with other flu diseases.

Published
2020

20. All-cause mortality and antipsychotic use among elderly persons with high baseline cardiovascular and cerebrovascular risk: a multi-center retrospective cohort study in Italy

Author

Sultana, J., Giorgianni, F., Rea, F., Lucenteforte, E., Lombardi, N., Mugelli, A., Vannacci, A., Liperoti, Rosa, Kirchmayer, U., Vitale, C., Chinellato, A., Roberto, G., Corrao, G., Trifiro, G., Agabiti, N., Bartolini, C., Bernabei, Roberto, Bettiol, A., Bonassi, S., Caputi, A. P., Cascini, S., Cipriani, Fabrizio, Davoli, M., Fini, M., Gini, R., Lapi, F., Onder, Graziano, Sorge, C., Tari, M., Vetrano, D. L., Liperoti R. (ORCID:0000-0003-3740-1687), Bernabei R. (ORCID:0000-0002-9197-004X), Cipriani F., Onder G. (ORCID:0000-0003-3400-4491), Sultana, J., Giorgianni, F., Rea, F., Lucenteforte, E., Lombardi, N., Mugelli, A., Vannacci, A., Liperoti, Rosa, Kirchmayer, U., Vitale, C., Chinellato, A., Roberto, G., Corrao, G., Trifiro, G., Agabiti, N., Bartolini, C., Bernabei, Roberto, Bettiol, A., Bonassi, S., Caputi, A. P., Cascini, S., Cipriani, Fabrizio, Davoli, M., Fini, M., Gini, R., Lapi, F., Onder, Graziano, Sorge, C., Tari, M., Vetrano, D. L., Liperoti R. (ORCID:0000-0003-3740-1687), Bernabei R. (ORCID:0000-0002-9197-004X), Cipriani F., and Onder G. (ORCID:0000-0003-3400-4491)

Abstract

Background: Little is known about the comparative risk of death with atypical or conventional antipsychotics (APs) among persons with cardiovascular or cerebrovascular disease (CCD). Research design and methods: A cohort study was conducted using five Italian claims databases. New atypical AP users with CCD aged ≥65 (reference) were matched to new conventional AP users. Mortality per 100 person-years (PYs) and hazard ratios (HR), estimated using Cox models, were reported. Incidence and risk of death were estimated for persons having drug–drug interactions. Outcome occurrence was evaluated 180 days after AP initiation. Results: Overall 24,711 and 27,051 elderly new conventional and atypical AP users were identified. The mortality rate was 51.3 and 38.5 deaths per 100 PYs for conventional and atypical AP users. Mortality risk was 1.33 (95%CI: 1.27–1.39) for conventional APs. There was no increased mortality risk with single drug–drug interactions (DDIs) vs. no DDI. AP users with ≥1 DDI had a 29% higher mortality risk compared to no DDI in the first 90 days of treatment (HR: 1.29 (95% CI: 1.00–1.67)). Conclusions: Conventional APs had a higher risk of death than atypical APs among elderly persons with CCD. Having ≥1 DDI was associated with an increased risk of death.

Published
2019

21. Association of Body Fat With Health-Related Quality of Life and Depression in Nonagenarians: The Mugello Study.

Author

Giovannini, Silvia, Macchi, C, Liperoti, Rosa, Laudisio, A, Coraci, Daniele, Loreti, Claudia, Vannetti, F, Onder, Graziano, Padua, Luca, Giovannini S (ORCID:0000-0001-9125-752X), Liperoti R (ORCID:0000-0003-3740-1687), Coraci D, Loreti C, Onder G (ORCID:0000-0003-3400-4491), Padua L (ORCID:0000-0003-2570-9326), Giovannini, Silvia, Macchi, C, Liperoti, Rosa, Laudisio, A, Coraci, Daniele, Loreti, Claudia, Vannetti, F, Onder, Graziano, Padua, Luca, Giovannini S (ORCID:0000-0001-9125-752X), Liperoti R (ORCID:0000-0003-3740-1687), Coraci D, Loreti C, Onder G (ORCID:0000-0003-3400-4491), and Padua L (ORCID:0000-0003-2570-9326)

Abstract

OBJECTIVES: The association of body fat with health status and depression in the oldest old is still debated. The aim of this cross-sectional study is to investigate the association of body fat with health-related quality of life and depression in a sample of nonagenarians. DESIGN: Data are from the Mugello study, a community-based project conducted in Italian older adults aged 90 years. SETTING AND PARTICIPANTS: Total body fat was assessed by body impedance assessment. Participants were divided into 3 groups according to gender-specific tertiles of body fat percentage (BF%). Self-perceived mental and physical health status were assessed by the Mental Component Summary (MCS) and the Physical Component Summary (PCS) subscales derived from the 12-item Short Form Health Survey. Lower scores of MCS and PCS indicated poorer mental health and physical health status, respectively. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale, and a score ≥5 was used to identify participants with depression. RESULTS: The mean age of 251 study participants was 92.5 years, and 173 (68.9%) were women. Participants were included in the low (n = 83), medium (n = 83), and high (n = 85) BF% groups. In the whole sample, mean scores at PCS progressively declined with the increasing BF% group (P = .004). This association was stronger in women, although no significant interaction was observed between the gender and BF% group (P = .63). No significant association between BF% and MCS was documented. Medium and high BF% were associated with a significantly higher probability of depression as compared with low BF% [odds ratio (OR) 2.15, 95% confidence interval (CI) 1.04-4.44, and OR 2.15, 95% CI 1.06-4.34, respectively]. This association was stronger in women, although no significant interaction was observed between gender and BF% group (P = .70). CONCLUSIONS AND IMPLICATIONS: High BF% is significantly positively associated with poor health-related quality of life and dep

Published
2019

29. Second and third generation assessment instruments: the birth of standardization in geriatric care

Author

Roberto BERNABEI, Landi, F., Onder, G., Liperoti, R., and Gambassi, G.

Subjects
Geriatrics, Health Services for the Aged, Settore MED/09 - MEDICINA INTERNA, Activities of Daily Living, Humans, Reference Standards, Geriatric Assessment, Home Care Services, Aged, Quality of Health Care
Abstract

The systematic adoption of "second-generation" comprehensive geriatric assessment instruments, initiated with the Minimum Data Set (MDS) implementation in U.S. nursing homes, and continued with the uptake of related MDS instruments internationally, has contributed to the creation of large patient-level data sets. In the present special article, we illustrate the potential of analyses using the MDS data to: (a) identify novel prognostic factors; (b) explore outcomes of interventions in relatively unselected clinical populations; (c) monitor quality of care; and (d) conduct comparisons of case mix, outcomes, and quality of care. To illustrate these applications, we use a sample of elderly patients admitted to home care in 11 European Home Health Agencies that participated in the AgeD in HOme Care (AD-HOC) project, sponsored by the European Union. The participants were assessed by trained staff using the MDS for Home Care, 2.0 version. We argue that the harmonization by InterRAI of the MDS forms for different health settings, referred to as "the third generation of assessment," has produced the first scientific, standardized methodology in the approach to effective geriatric care.

Published
2008

32. Patterns and correlates of atypical and conventional antipsychotic use in nursing homes

Author

Liperoti, R., Lapane, K., and Mor, V.

Subjects
Health, Seniors
Abstract

Little information exists about the use of atypical antipsychotics in nursing homes. We describe the patterns of atypical and conventional antipsychotic use among nursing home residents. We used the Minimum Data Set (1998-2000) in 6 states. We identified 150,316 residents in 1,834 facilities systematically collecting detailed drag information. Sixty two percent were classified as 'high risk' according to the HCFA antipsychotic use quality indicator. Eighteen percent used antipyschotics, with the majority of use atypical. The most frequently used antipsychotics were risperidone and haloperidol. Overall, resident characteristics of atypical vs. conventional antipsychotic users were similar with the exception of depression (51% vs. 38%, for atypical vs. conventional) and use of antidepressants (50% vs. 37%, for atypical vs. conventional). In a relatively short period of time, atypical antipsychotics have attained a major presence in nursing homes. Given that resident characteristics little explain the choice of antipsychotic used, contextual factors should be evaluated.

Published
2002

44. CLUSTERING OF BEHAVIOURAL AND PSYCHOLOGICAL SYMPTOMS IN DEMENTIA (BPSD): A EUROPEAN ALZHEIMER’S DISEASE CONSORTIUM (EADC) STUDY

Author

Petrovic, M., primary, Hurt, C., additional, Collins, D., additional, Burns, A., additional, Camus, V., additional, Liperoti, R., additional, Marriott, A., additional, Nobili, F., additional, Robert, P., additional, Tsolaki, M., additional, Vellas, B., additional, Verhey, F., additional, and Byrne, E.J., additional

Published
2007
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50. New study looks at whether antipsychotics raise the risk of cerebrovascular events: experts cite need to consider risks-benefits equation before prescribing

Author

Liperoti, R., Gambassi, G., and Lapane, K.L.

Subjects
Dementia -- Drug therapy -- Complications and side effects -- Risk factors, Stroke (Disease) -- Risk factors -- Drug therapy -- Complications and side effects, Antipsychotic drugs -- Dosage and administration -- Complications and side effects, Health, Psychology and mental health, Seniors
Abstract

A typical antipsychotics have become widely used for treating behavioral and psychological symptoms of dementia (BPSD). Their rapid acceptance reflected their 'purported superior profile in terms of motor side effects [...]

Published
2005

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