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1. Antibiotic use and associated factors in a large sample of hospitalised older people

Author

Ardoino, I, Mannucci, Pm, Nobili, A, Franchi, C, Tettamanti, M, Pasina, L, Corrao, S, Marengoni, A, Salerno, F, Cesari, M, Perticone, F, Licata, G, Violi, F, Corazza, Gr, Prisco, D, Silvestri, E, Emmi, G, Bettiol, A, Caterina, C, Biolo, G, Zanetti, M, Guadagni, M, Zaccari, M, Chiuch, M, Vanoli, M, Grignani, G, Pulixi, Ea, Bernardi, M, Bassi, Sl, Santi, L, Zaccherini, G, Lupattelli, G, Mannarino, E, Bianconi, V, Paciullo, F, Alcidi, R, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Girelli, D, Busti, F, Marchi, G, Barbagallo, M, Dominguez, L, Cocita, F, Beneduce, V, Plances, L, Natoli, G, Mularo, S, Raspanti, M, Cavallaro, F, Zoli, M, Lazzari, I, Brunori, M, Fabbri, E, Magalotti, D, Arn?, R, Pasini, Fl, Capecchi, Pl, Palasciano, G, Modeo, Me, Di Gennaro, C, Cappellini, Md, Maira, D, Di Stefano, V, Fabio, G, Seghezzi, S, Mancarella, M, De Amicis, Mm, De Luca, G, Scaramellini, N, Rossi, Pd, Damanti, S, Clerici, M, Conti, F, Bonini, G, Ottolini, Bb, Di Sabatino, A, Miceli, E, Lenti, Mv, Pisati, M, Dominioni, Cc, Murialdo, G, Marra, A, Cattaneo, F, Pontremoli, R, Beccati, V, Nobili, G, Secchi, Mb, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Cipollone, F, Guagnano, Mt, Valeriani, E, Rossi, I, Mancuso, G, Calipari, D, Bartone, M, Delitala, G, Berria, M, Pes, C, Delitala, A, Muscaritoli, M, Molfino, A, Petrillo, E, Zuccal?, G, D'Aurizio, G, Romanelli, G, Zucchelli, A, Manzoni, F, Volpini, A, Picardi, A, Gentilucci, Uv, Gallo, P, Dell'Unto, C, Annoni, G, Corsi, M, Bellelli, G, Zazzetta, S, Mazzola, P, Szabo, H, Bonfanti, A, Arturi, F, Succurro, E, Rubino, M, Tassone, B, Sesti, G, Serra, Mg, Bleve, Ma, Gasbarrone, L, Sajeva, Mr, Brucato, A, Ghidoni, S, Fabris, F, Bertozzi, I, Bogoni, G, Rabuini, Mv, Cosi, E, Scarinzi, P, Amabile, A, Omenetto, E, Prandini, T, Manfredini, R, Fabbian, F, Boari, B, De Giorgi, A, Tiseo, R, De Giorgio, R, Paolisso, G, Rizzo, Mr, Borghi, C, Strocchi, E, Ianniello, E, Soldati, M, Sabb?, C, Vella, Fs, Suppressa, P, Agosti, P, Schilardi, A, Loparco, F, De Vincenzo, Gm, Comitangelo, A, Amoruso, E, Fenoglio, L, Falcetta, A, Bracco, C, Fracanzani, Al, Fargion, S, Tiraboschi, S, Cespiati, A, Oberti, G, Sigon, G, Peyvandi, F, Rossio, R, Ferrari, B, Colombo, G, Monzani, V, Savojardo, V, Folli, C, Ceriani, G, Pallini, G, Dallegri, F, Ottonello, L, Liberale, L, Caserza, L, Salam, K, Liberato, Nl, Tognin, T, Bianchi, Gb, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Spazzini, E, Ferrandina, C, Montrucchio, G, Petitti, P, Peasso, P, Favale, E, Poletto, C, Salmi, R, Gaudenzi, P, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Campiotti, L, Grossi, A, Bertolotti, M, Mussi, C, Lancellotti, G, Libbra, Mv, Dondi, G, Pellegrini, E, Carulli, L, Galassi, M, Grassi, Y, Perticone, M, Battaglia, R, Filice, M, Maio, R, Stanghellini, V, Ruggeri, E, del Vecchio, S, Salvi, A, Leonardi, R, Damiani, G, Capeci, W, Gabrielli, A, Mattioli, M, Martino, Gp, Biondi, L, Pettinari, P, Ghio, R, Dal Col, A, Minisola, S, Colangelo, L, Cilli, M, Labbadia, G, Afeltra, A, Marigliano, B, Pipita, Me, Castellino, P, Zanoli, L, Pignataro, S, Gennaro, A, Blanco, J, Saracco, V, Fogliati, M, Bussolino, C, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Marra, Am, Sirico, D, Moreo, G, Gasparini, F, Prolo, S, Pina, G, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, Mc, Graziella, B, Baldassarre, S, Fragapani, S, Gruden, G, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffr?, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Passariello, N, Rinaldi, L, Berti, F, Famularo, G, Tarsitani, P, Castello, R, Pasino, M, Ceda, Gp, Maggio, Mg, Morganti, S, Artoni, A, Del Giacco, S, Firinu, D, Losa, F, Paoletti, G, Costanzo, G, Montalto, G, Licata, A, Malerba, V, Montalto, Fa, Lasco, A, Basile, G, Catalano, A, Malatino, L, Stancanelli, B, Terranova, V, Di Marca, S, Di Quattro, R, La Malfa, L, Caruso, R, Mecocci, P, Ruggiero, C, Boccardi, V, Meschi, T, Lauretani, F, Ticinesi, A, Nouvenne, A, Minuz, P, Fondrieschi, L, Pirisi, M, Fra, Gp, Sola, D, Porta, M, Riva, P, Quadri, R, Larovere, E, Novelli, M, Scanzi, G, Mengoli, C, Provini, S, Ricevuti, L, Simeone, E, Scurti, R, Tolloso, F, Tarquini, R, Valoriani, A, Dolenti, S, Vannini, G, Tedeschi, A, Trotta, L, Volpi, R, Bocchi, P, Vignali, A, Harari, S, Lonati, C, Cattaneo, M, Nieves, Rd, Alberto, Mm, Pedro, Ar, Vanessa, Lp, Lara, T, Xavier, Cv, Francesc, F, Jesus, Dm, Esperanza, Bt, Esther, Dcb, Maria, Sp, Romero, M, Blanca, Pl, Cristina, Lgc, Victoria, Vgm, Saez, L, Bosco, J, Susana, Sb, Marta, Ag, Concepcion, Gb, Antonio, Fm, Hernandez, Mg, Borrego, Mp, Raquel, Pc, Florencia, Pr, Beatriz, Go, Sara, Cg, Alfonso, Gcc, Marta, Pm, Alberto, Rc, Antonio, Aa, Montserrat, Gg, Angel, Brm, Manuel, Mj, Ignacio, Nv, Lucia, As, Alfonso, L, David, Rb, Iniguez, Vi, Monica, Rp, Ardoino I., Mannucci P.M., Nobili A., Franchi C., Tettamanti M., Pasina L., Corrao S., Marengoni A., Salerno F., Cesari M., Perticone F., Licata G., Violi F., Corazza G.R., Ardoino, I, Mannucci, P M, Nobili, A, Franchi, C, and Rinaldi, Luca

Subjects
Registrie, Male, 0301 basic medicine, Antibiotics, Logistic regression, 0302 clinical medicine, Drug Prescription, 80 and over, Prevalence, Immunology and Allergy, LS4_4, Hospital Mortality, Registries, 030212 general & internal medicine, Multivariate Analysi, Respiratory Tract Infections, Aged, 80 and over, Anti-Bacterial Agents, Hospitalization, Italy, Antibiotic use, Female, Human, Microbiology (medical), medicine.medical_specialty, Logistic Model, Internal medicine ward, medicine.drug_class, 030106 microbiology, Immunology, Socio-culturale, Drug Prescriptions, Microbiology, Odds, 03 medical and health sciences, Antibiotic resistance, Anti-Bacterial Agent, medicine, Older people, Aged, Geriatric Assessment, Humans, Logistic Models, Multivariate Analysis, Medical prescription, business.industry, Confidence interval, Antibiotic use, Internal medicine ward, Older people, Emergency medicine, business
Abstract

Objectives: The aims of this study were to assess (i) the prevalence of antibiotic use, (ii) factors associated with their use and (iii) the association with in-hospital mortality in a large sample of hospitalised older people in Italy.Methods: Data were obtained from the 2010-2017 REPOSI register held in more than 100 internal medicine and geriatric wards in Italy. Patients aged >= 65 years with at least one antibiotic prescription during their hospitalisation were selected. Multivariable logistic regression models were used to determine factors associated with antibiotic use.Results: A total of 5442 older patients were included in the analysis, of whom 2786 (51.2%) were prescribed antibiotics during their hospitalisation. The most frequently prescribed antibiotic class was beta-lactams, accounting for 50% of the total prescriptions. Poor physical independence, corticosteroid use and being hospitalised in Northern Italy were factors associated with a higher likelihood of being prescribed antibiotics. Antibiotic use was associated with an increased risk of in-hospital mortality (odds ratio = 2.52, 95% confidence interval 1.82-3.48) also when accounting for factors associated with their use.Conclusion: Hospitalised older people are often prescribed antibiotics. Factors related to poor physical independence and corticosteroid use are associated with increased antibiotic use. Being prescribed antibiotics is also associated with an increased risk of in-hospital death. These results demand the implementation of specific stewardship programmes to improve the correct use of antibiotics in hospital settings and to reduce the risk of antimicrobial resistance. (C) 2019 International Society for Antimicrobial Chemotherapy. Published by Elsevier Ltd. All rights reserved.

Published
2019

2. Muscle strength is related to mental and physical quality of life in the oldest old

Author

Laudisio, A, Giovannini, Silvia, Finamore, P, Loreti, Claudia, Vannetti, F, Coraci, Daniele, Incalzi, Ra, Zuccal, G, Macchi, C, Padua, Luca, Giovannini S (ORCID:0000-0001-9125-752X), Loreti C, Coraci D, Padua L (ORCID:0000-0003-2570-9326), Laudisio, A, Giovannini, Silvia, Finamore, P, Loreti, Claudia, Vannetti, F, Coraci, Daniele, Incalzi, Ra, Zuccal, G, Macchi, C, Padua, Luca, Giovannini S (ORCID:0000-0001-9125-752X), Loreti C, Coraci D, and Padua L (ORCID:0000-0003-2570-9326)

Abstract

Purpose of the study: Quality of life represents the principal outcome of health interventions for the oldest old. However, little is known about the determinants of quality of life in this population stratum. We evaluated the association between health-related quality of life (HRQoL) and handgrip strength in a cohort of 331 participants aged 90+ with a living in the Mugello area (Tuscany, Italy). Design and methods: HRQoL was assessed using the Medical Outcomes Study Short Form 12 (SF12), considering the Physical Composite Score (PCS) and the Mental Composite Score (MCS) of the SF-12. Muscle strength was tested by hand grip dynamometry. Results: The median MCS was 46.9, while the median PCS was 43.0. According to logistic regression, muscle strength was associated with increased probability of better PCS (OR = 1.05; 95 % CI = 1.01-1.10, P = .042), and better MCS (OR = 1.05; 95 % CI = 1.01-1.10, P = .036), after adjusting. Implication: Muscle strength is associated with both physical and mental HRQoL among nonagenarians. Further studies are needed to explore the subsystems involved in this association, and whether improving muscle performance might improve global mental and physical quality of life in the most advanced age.

Published
2020

3. Drug–drug interactions involving CYP3A4 and p-glycoprotein in hospitalized elderly patients

Author

Gallo, P, De Vincentis, A, Pedone, C, Nobili, A, Tettamanti, M, Gentilucci, Uv, Picardi, A, Mannucci, Pm, Incalzi, Ra, Prisco, D, Silvestri, E, Emmi, G, Bettiol, A, Caterina, C, Biolo, G, Zanetti, M, Guadagni, M, Zaccari, M, Chiuch, M, Vanoli, M, Grignani, G, Pulixi, Ea, Bernardi, M, Bassi, Sl, Santi, L, Zaccherini, G, Lupattelli, G, Mannarino, E, Bianconi, V, Paciullo, F, Alcidi, R, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Girelli, D, Busti, F, Marchi, G, Barbagallo, M, Dominguez, L, Cocita, F, Beneduce, V, Plances, L, Corrao, S, Natoli, G, Mularo, S, Raspanti, M, Cavallaro, F, Zoli, M, Lazzari, I, Brunori, M, Fabbri, E, Magalotti, D, Arn?, R, Pasini, Fl, Capecchi, Pl, Palasciano, G, Modeo, Me, Di Gennaro, C, Cappellini, Md, Maira, D, Di Stefano, V, Fabio, G, Seghezzi, S, Mancarella, M, De Amicis MM, De Luca, G, Scaramellini, N, Cesari, M, Rossi, Pd, Damanti, S, Clerici, M, Conti, F, Bonini, G, Ottolini, Bb, Di Sabatino, A, Miceli, E, Lenti, Mv, Pisati, M, Dominioni, Cc, Murialdo, G, Marra, A, Cattaneo, F, Pontremoli, R, Beccati, V, Nobili, G, Secchi, Mb, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Cipollone, F, Guagnano, Mt, Valeriani, E, Rossi, I, Mancuso, G, Calipari, D, Bartone, M, Delitala, G, Berria, M, Pes, C, Delitala, A, Muscaritoli, M, Molfino, A, Petrillo, E, Zuccal?, G, D'Aurizio, G, Romanelli, G, Marengoni, A, Zucchelli, A, Manzoni, F, Volpini, A, Dell'Unto, C, Annoni, G, Corsi, M, Bellelli, G, Zazzetta, S, Mazzola, P, Szabo, H, Bonfanti, A, Arturi, F, Succurro, E, Rubino, M, Tassone, B, Sesti, G, Serra, Mg, Bleve, Ma, Gasbarrone, L, Sajeva, Mr, Brucato, A, Ghidoni, S, Fabris, F, Bertozzi, I, Bogoni, G, Rabuini, Mv, Cosi, E, Scarinzi, P, Amabile, A, Omenetto, E, Prandini, T, Manfredini, R, Fabbian, F, Boari, B, De Giorgi, A, Tiseo, R, De Giorgio, R, Paolisso, G, Rizzo, Mr, Borghi, C, Strocchi, E, Ianniello, E, Soldati, M, Sabb?, C, Vella, Fs, Suppressa, P, Agosti, P, Schilardi, A, Loparco, F, De Vincenzo GM, Comitangelo, A, Amoruso, E, Fenoglio, L, Falcetta, A, Bracco, C, Fracanzani, Al, Fargion, S, Tiraboschi, S, Cespiati, A, Oberti, G, Sigon, G, Peyvandi, F, Rossio, R, Ferrari, B, Colombo, G, Monzani, V, Savojardo, V, Folli, C, Ceriani, G, Salerno, F, Pallini, G, Dallegri, F, Ottonello, L, Liberale, L, Caserza, L, Salam, K, Liberato, Nl, Tognin, T, Bianchi, Gb, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Spazzini, E, Ferrandina, C, Montrucchio, G, Petitti, P, Peasso, P, Favale, E, Poletto, C, Salmi, R, Gaudenzi, P, Violi, F, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Campiotti, L, Grossi, A, Bertolotti, M, Mussi, C, Lancellotti, G, Libbra, Mv, Dondi, G, Pellegrini, E, Carulli, L, Galassi, M, Grassi, Y, Perticone, F, Perticone, M, Battaglia, R, Filice, M, Maio, R, Stanghellini, V, Ruggeri, E, del Vecchio, S, Salvi, A, Leonardi, R, Damiani, G, Capeci, W, Gabrielli, A, Mattioli, M, Martino, Gp, Biondi, L, Pettinari, P, Ghio, R, Dal Col, A, Minisola, S, Colangelo, L, Cilli, M, Labbadia, G, Afeltra, A, Marigliano, B, Pipita, Me, Castellino, P, Zanoli, L, Pignataro, S, Gennaro, A, Blanco, J, Saracco, V, Fogliati, M, Bussolino, C, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Marra, Am, Sirico, D, Moreo, G, Gasparini, F, Prolo, S, Pina, G, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, Mc, Graziella, B, Baldassarre, S, Fragapani, S, Gruden, G, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffr?, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Passariello, N, Rinaldi, L, Berti, F, Famularo, G, Tarsitani, P, Castello, R, Pasino, M, Ceda, Gp, Maggio, Mg, Morganti, S, Artoni, A, Del Giacco, S, Firinu, D, Losa, F, Paoletti, G, Costanzo, G, Montalto, G, Licata, A, Malerba, V, Montalto, Fa, Lasco, A, Basile, G, Catalano, A, Malatino, L, Stancanelli, B, Terranova, V, Di Marca, S, Di Quattro, R, La Malfa, L, Caruso, R, Mecocci, P, Ruggiero, C, Boccardi, V, Meschi, T, Lauretani, F, Ticinesi, A, Nouvenne, A, Minuz, P, Fondrieschi, L, Pirisi, M, Fra, Gp, Sola, D, Porta, M, Riva, P, Quadri, R, Larovere, E, Novelli, M, Scanzi, G, Mengoli, C, Provini, S, Ricevuti, L, Simeone, E, Scurti, R, Tolloso, F, Tarquini, R, Valoriani, A, Dolenti, S, Vannini, G, Tedeschi, A, Trotta, L, Volpi, R, Bocchi, P, Vignali, A, Harari, S, Lonati, C, Cattaneo, M., Gallo, P., De Vincentis A., Pedone C., Nobili A., Tettamanti M., Gentilucci U. V., Picardi A., Mannucci P. M., Incalzi R. A., and Rinaldi, L

Subjects
Male, Databases, Factual, Cytochrome P450, 030204 cardiovascular system & hematology, 0302 clinical medicine, Risk Factors, Inherent risk, Older in-patients, 80 and over, Prevalence, Cytochrome P-450 CYP3A, 030212 general & internal medicine, P-glycoprotein, media_common, Aged, 80 and over, biology, Hospitalization, Older in-patient, Subfamily B, Italy, Cohort, Female, Human, Drug, medicine.medical_specialty, Member 1, Drug-Related Side Effects and Adverse Reactions, media_common.quotation_subject, ATP Binding Cassette Transporter, Drug interaction, Adverse drug reaction, Socio-culturale, Adverse drug reactions, Appropriate use, Drug interactions, 03 medical and health sciences, Databases, Internal medicine, Internal Medicine, medicine, Humans, ATP Binding Cassette Transporter, Subfamily B, Member 1, Adverse effect, Factual, Aged, Polypharmacy, CYP3A4, business.industry, Risk Factor, Settore MED/09 - MEDICINA INTERNA, biology.protein, Adverse drug reactions, Cytochrome P450, Drug interactions, Older in-patients, P-glycoprotein, business, Drug-Related Side Effects and Adverse Reaction
Abstract

Polypharmacy is very common in older patients and may be associated with drug-drug interactions. Hepatic cytochrome P450 (notably 3A4 subtype, CYP3A4) is a key enzyme which metabolizes most drugs; P-glycoprotein (P-gp) is a transporter which significantly influences distribution and bioavailability of many drugs. In this study, we assess the prevalence and patterns of potential interactions observed in an hospitalized older cohort (Registro Politerapia Societa Italiana di Medicina Interna) exposed to at least two interacting drugs involving CYP3A4 and P-gp at admission, during hospitalization and at discharge. Individuals aged 65 and older (N-4039; mean age 79.2; male 48.1%), hospitalized between 2010 and 2016, were selected. The most common combinations of interacting drugs (relative frequency > 5%) and socio-demographic and clinical factors associated with the interactions were reported. The prevalence of interactions for CYP3A4 was 7.9% on admission, 10.3% during the stay and 10.7% at discharge; the corresponding figures for P-gp interactions were 2.2%, 3.8% and 3.8%. The most frequent interactions were amiodarone-statin for CYP3A4 and atorvastatin-verapamil-diltiazem for P-gp. The prevalence of some interactions, mainly those involving cardiovascular drugs, decreased at discharge, whereas that of others, e.g. those involving neuropsychiatric drugs, increased. The strongest factor associated with interactions was polypharmacy (OR 6.7, 95% CI 5.0–9.2). In conclusion, hospital admission is associated with an increased prevalence, but also a changing pattern of interactions concerning CYP3A4 and P-gp in elderly. Educational strategies and appropriate use of dedicated software seem desirable to limit drug interactions and the inherent risk of adverse events in older patients.

Published
2019

4. Living alone as an independent predictor of prolonged length of hospital stay and non-home discharge in older patients

Author

Agosti, P, Tettamanti, M, Vella, Fs, Suppressa, P, Pasina, L, Franchi, C, Nobili, A, Mannucci, Pm, Sabba, C, Prisco, D, Silvestri, E, Emmi, G, Bettiol, A, Caterina, C, Biolo, G, Zanetti, M, Guadagni, M, Zaccari, M, Chiuch, M, Vanoli, M, Grignani, G, Pulixi, Ea, Bernardi, M, Bassi, Sl, Santi, L, Zaccherini, G, Lupattelli, G, Mannarino, E, Bianconi, V, Paciullo, F, Alcidi, R, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Girelli, D, Busti, F, Marchi, G, Barbagallo, M, Dominguez, L, Cocita, F, Beneduce, V, Plances, L, Corrao, S, Natoli, G, Mularo, S, Raspanti, M, Cavallaro, F, Zoli, M, Lazzari, I, Brunori, M, Fabbri, E, Magalotti, D, Arn?, R, Pasini, Fl, Capecchi, Pl, Palasciano, G, Modeo, Me, Di Gennaro, C, Cappellini, Md, Maira, D, Di Stefano, V, Fabio, G, Seghezzi, S, Mancarella, M, De Amicis MM, De Luca, G, Scaramellini, N, Cesari, M, Rossi, Pd, Damanti, S, Clerici, M, Conti, F, Bonini, G, Ottolini, Bb, Di Sabatino, A, Miceli, E, Lenti, Mv, Pisati, M, Dominioni, Cc, Murialdo, G, Marra, A, Cattaneo, F, Pontremoli, R, Beccati, V, Nobili, G, Secchi, Mb, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Cipollone, F, Guagnano, Mt, Valeriani, E, Rossi, I, Mancuso, G, Calipari, D, Bartone, M, Delitala, G, Berria, M, Pes, C, Delitala, A, Muscaritoli, M, Molfino, A, Petrillo, E, Zuccal?, G, D'Aurizio, G, Romanelli, G, Marengoni, A, Zucchelli, A, Manzoni, F, Volpini, A, Picardi, A, Gentilucci, Uv, Gallo, P, Dell'Unto, C, Annoni, G, Corsi, M, Bellelli, G, Zazzetta, S, Mazzola, P, Szabo, H, Bonfanti, A, Arturi, F, Succurro, E, Rubino, M, Tassone, B, Sesti, G, Serra, Mg, Bleve, Ma, Gasbarrone, L, Sajeva, Mr, Brucato, A, Ghidoni, S, Fabris, F, Bertozzi, I, Bogoni, G, Rabuini, Mv, Cosi, E, Scarinzi, P, Amabile, A, Omenetto, E, Prandini, T, Manfredini, R, Fabbian, F, Boari, B, De Giorgi, A, Tiseo, R, De Giorgio, R, Paolisso, G, Rizzo, Mr, Borghi, C, Strocchi, E, Ianniello, E, Soldati, M, Sabb?, C, Schilardi, A, Loparco, F, De Vincenzo GM, Comitangelo, A, Amoruso, E, Fenoglio, L, Falcetta, A, Bracco, C, Fracanzani, Al, Fargion, S, Tiraboschi, S, Cespiati, A, Oberti, G, Sigon, G, Peyvandi, F, Rossio, R, Ferrari, B, Colombo, G, Monzani, V, Savojardo, V, Folli, C, Ceriani, G, Salerno, F, Pallini, G, Dallegri, F, Ottonello, L, Liberale, L, Caserza, L, Salam, K, Liberato, Nl, Tognin, T, Bianchi, Gb, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Spazzini, E, Ferrandina, C, Montrucchio, G, Petitti, P, Peasso, P, Favale, E, Poletto, C, Salmi, R, Gaudenzi, P, Violi, F, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Campiotti, L, Grossi, A, Bertolotti, M, Mussi, C, Lancellotti, G, Libbra, Mv, Dondi, G, Pellegrini, E, Carulli, L, Galassi, M, Grassi, Y, Perticone, F, Perticone, M, Battaglia, R, Filice, M, Maio, R, Stanghellini, V, Ruggeri, E, del Vecchio, S, Salvi, A, Leonardi, R, Damiani, G, Capeci, W, Gabrielli, A, Mattioli, M, Martino, Gp, Biondi, L, Pettinari, P, Ghio, R, Dal Col, A, Minisola, S, Colangelo, L, Cilli, M, Labbadia, G, Afeltra, A, Marigliano, B, Pipita, Me, Castellino, P, Zanoli, L, Pignataro, S, Gennaro, A, Blanco, J, Saracco, V, Fogliati, M, Bussolino, C, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Marra, Am, Sirico, D, Moreo, G, Gasparini, F, Prolo, S, Pina, G, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, Mc, Graziella, B, Baldassarre, S, Fragapani, S, Gruden, G, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffr?, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Passariello, N, Rinaldi, L, Berti, F, Famularo, G, Tarsitani, P, Castello, R, Pasino, M, Ceda, Gp, Maggio, Mg, Morganti, S, Artoni, A, Del Giacco, S, Firinu, D, Losa, F, Paoletti, G, Costanzo, G, Montalto, G, Licata, A, Malerba, V, Montalto, Fa, Lasco, A, Basile, G, Catalano, A, Malatino, L, Stancanelli, B, Terranova, V, Di Marca, S, Di Quattro, R, La Malfa, L, Caruso, R, Mecocci, P, Ruggiero, C, Boccardi, V, Meschi, T, Lauretani, F, Ticinesi, A, Nouvenne, A, Minuz, P, Fondrieschi, L, Pirisi, M, Fra, Gp, Sola, D, Porta, M, Riva, P, Quadri, R, Larovere, E, Novelli, M, Scanzi, G, Mengoli, C, Provini, S, Ricevuti, L, Simeone, E, Scurti, R, Tolloso, F, Tarquini, R, Valoriani, A, Dolenti, S, Vannini, G, Tedeschi, A, Trotta, L, Volpi, R, Bocchi, P, Vignali, A, Harari, S, Lonati, C, Cattaneo, M, Nieves, Rd, Alberto, Mm, Pedro, Ar, Vanessa, Lp, Lara, T, Xavier, Cv, Francesc, F, Jesus, Dm, Esperanza, Bt, Esther, Dcb, Maria, Sp, Romero, M, Blanca, Pl, Cristina, Lgc, Victoria, Vgm, Saez, L, Bosco, J, Susana, Sb, Marta, Ag, Concepcion, Gb, Antonio, Fm, Hernandez, Mg, Borrego, Mp, Raquel, Pc, Florencia, Pr, Beatriz, Go, Sara, Cg, Alfonso, Gcc, Marta, Pm, Alberto, Rc, Antonio, Aa, Montserrat, Gg, Angel, Brm, Manuel, Mj, Ignacio, Nv, Lucia, As, Alfonso, L, David, Rb, Iniguez, Vi, Monica, Rp., Agosti, P, Tettamanti, M, Vella, F S, Suppressa, P, Pasina, L, Franchi, C, Nobili, A, Mannucci, P M, Sabbà, C, Marra, Alberto Maria, Vella, F, Mannucci, P, Sabba, C, Corrao, S, Marengoni, A, Marcucci, M, Salerno, F, Perticone, F, Licata, G, Violi, F, Corazza, G, Cortesi, L, Ardoino, I, Prisco, D, Silvestri, E, Cenci, C, Emmi, G, Biolo, G, Zanetti, M, Guadagni, M, Zaccari, M, Vanoli, M, Grignani, G, Pulixi, E, Bernardi, M, Bassi, S, Santi, L, Zaccherini, G, Mannarino, E, Lupattelli, G, Bianconi, V, Paciullo, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Olivieri, O, Girelli, D, Matteazzi, T, Barbagallo, M, Dominguez, L, Cocita, F, Beneduce, V, Plances, L, Zoli, M, Lazzari, I, Brunori, M, Pasini, F, Capecchi, P, Palasciano, G, Modeo, M, Di Gennaro, C, Cappellini, M, Maira, D, Di Stefano, V, Fabio, G, Seghezzi, S, Mancarella, M, Cesari, M, Rossi, P, Damanti, S, Clerici, M, Conti, F, Miceli, E, Lenti, M, Pisati, M, Dominioni, C, Murialdo, G, Marra, A, Cattaneo, F, Secchi, M, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Cipollone, F, Guagnano, M, Angelucci, E, Valeriani, E, Mancuso, G, Calipari, D, Bartone, M, Delitala, G, Berria, M, Muscaritoli, M, Molfino, A, Petrillo, E, Zuccala, G, D'Aurizio, G, Romanelli, G, Zucchelli, A, Picardi, A, Gentilucci, U, Gallo, P, Dell'Unto, C, Annoni, G, Corsi, M, Bellelli, G, Zazzetta, S, Mazzola, P, Szabo, H, Bonfanti, A, Arturi, F, Succurro, E, Rubino, M, Serra, M, Bleve, M, Gasbarrone, L, Sajeva, M, Brucato, A, Ghidoni, S, Fabris, F, Bertozzi, I, Bogoni, G, Rabuini, M, Cosi, E, Manfredini, R, Fabbian, F, Boari, B, De Giorgi, A, Tiseo, R, Paolisso, G, Rizzo, M, Borghi, C, Strocchi, E, De Sando, V, Pareo, I, Schilardi, A, Loparco, F, Fenoglio, L, Bracco, C, Giraudo, A, Fargion, S, Periti, G, Porzio, M, Tiraboschi, S, Peyvandi, F, Rossio, R, Ferrari, B, Colombo, G, Monzani, V, Savojardo, V, Folli, C, Ceriani, G, Pallini, G, Dallegri, F, Ottonello, L, Liberale, L, Caserza, L, Salam, K, Liberato, N, Tognin, T, Bianchi, G, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Spazzini, E, Ferrandina, C, Montrucchio, G, Petitti, P, Salmi, R, Gaudenzi, P, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Molaro, M, Grossi, A, Bertolotti, M, Mussi, C, Libbra, M, Dondi, G, Pellegrini, E, Carulli, L, Colangelo, L, Falbo, T, Stanghellini, V, De Giorgio, R, Ruggeri, E, Del Vecchio, S, Salvi, A, Leonardi, R, Damiani, G, Gabrielli, A, Capeci, W, Mattioli, M, Martino, G, Biondi, L, Pettinari, P, Ghio, R, Dal Col, A, Minisola, S, Afeltra, A, Marigliano, B, Pipita, M, Castellino, P, Blanco, J, Zanoli, L, Pignataro, S, Saracco, V, Fogliati, M, Bussolino, C, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Sirico, D, Moreo, G, Gasparini, F, Prolo, S, Pina, G, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, M, Graziella, B, Baldassarre, S, Fragapani, S, Gruden, G, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffre, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Passariello, N, Rinaldi, L, Berti, F, Famularo, G, Patrizia, T, Castello, R, Pasino, M, Ceda, G, Maggio, M, Morganti, S, Artoni, A, Del Giacco, S, Firinu, D, Losa, F, Paoletti, G, Montalto, G, Licata, A, Malerba, V, Antonino, L, Basile, G, Catalano, A, Malatino, L, Stancanelli, B, Terranova, V, Di Marca, S, Mecocci, P, Ruggiero, C, Boccardi, V, Meschi, T, Lauretani, F, Ticinesi, A, Minuz, P, Fondrieschi, L, Pirisi, M, Fra, G, Sola, D, Porta, M, Riva, P, Quadri, R, Scanzi, G, Mengoli, C, Provini, S, Ricevuti, L, Simeone, E, Scurti, R, Tolloso, F, Tarquini, R, Valoriani, A, Dolenti, S, Vannini, G, Tedeschi, A, Trotta, L, Volpi, R, Bocchi, P, Vignali, A, Harari, S, Lonati, C, Cattaneo, M, Nieves, R, Alberto, M, Pedro, A, Vanessa, L, Lara, T, Xavier, C, Francesc, F, Jesus, D, Esperanza, B, Esther, D, Maria, S, Romero, M, Blanca, P, Cristina, L, Victoria, V, Saez, L, Bosco, J, Susana, S, Marta, A, Concepcion, G, Antonio, F, Hernandez, M, Borrego, M, Raquel, P, Florencia, P, Beatriz, G, Sara, C, Alfonso, G, Marta, P, Garcia, S, Alberto, R, Antonio, A, Montserrat, G, Angel, B, Manuel, M, Ignacio, N, Lucia, A, Alfonso, L, David, R, Iria, I, and Monica, R

Subjects
Male, Activities of daily living, vulnerability, 030204 cardiovascular system & hematology, older adult, 0302 clinical medicine, Older patients, Activities of Daily Living, 80 and over, real-time prediction: of-stay, 030212 general & internal medicine, Registries, Hospital Mortality, Social isolation, risk, Aged, 80 and over, Patient discharge, validation, length hospitalization, multidimensional prognostic index, adverse clinical events, elderly persons, mortality, care, readmission, living alone, Patients, General Surgery, Frail patients, Patient Discharge, Italy, Social Isolation, Female, medicine.symptom, Aged, Humans, Length of Stay, Logistic Models, Frail patients, medicine.medical_specialty, Patients, MEDLINE, Socio-culturale, predictor, Hospital mortality, Independent predictor, 03 medical and health sciences, Internal Medicine, medicine, business.industry, General Surgery, Emergency medicine, business, Hospital stay
Published
2018

5. Hippocampal atrophy in people with memory deficits: results from the population-based IPREA study

Author

Ferrarini L, van Lew B, Reiber JH, Gandin C, Galluzzo L, Scafato E, FrisoniGB, Milles J, Pievani M, IPREA Working Group: Scafato E, Farchi G, Giampaoli S, Mariotti S, Ghirini S, Martire S, Di Pasquale L, Maggi S, Crepaldi G, Enzi G, Gallina P, Inzitari D, Baldereschi M, Di Carlo A, Frisoni GB, Galluzzi S, Gandolfo C, Conti M, Postacchini D, Cruciani G, Giuli C, Capurso A, Solfrizzi V, Panza F, Rengo F, ABETE, PASQUALE, Motta M, Negrini R, Forti P, Tabanelli P, Cocchi A, Zuccal G, Cacciatore F, Calabrese C, Sica G, Estraneo A, Foundation SM, Consoli D, Naso F, Torcasio G, Valentia V, Mecocci P, Rinaldi P, Serafini V, Senin U., Ferrarini, L, van Lew, B, Reiber, Jh, Gandin, C, Galluzzo, L, Scafato, E, Frisonigb, Milles, J, Pievani, M, IPREA Working Group: Scafato, E, Farchi, G, Giampaoli, S, Mariotti, S, Ghirini, S, Martire, S, Di Pasquale, L, Maggi, S, Crepaldi, G, Enzi, G, Gallina, P, Inzitari, D, Baldereschi, M, Di Carlo, A, Frisoni, Gb, Galluzzi, S, Gandolfo, C, Conti, M, Postacchini, D, Cruciani, G, Giuli, C, Capurso, A, Solfrizzi, V, Panza, F, Rengo, F, Abete, Pasquale, Motta, M, Negrini, R, Forti, P, Tabanelli, P, Cocchi, A, Zuccal, G, Cacciatore, F, Calabrese, C, Sica, G, Estraneo, A, Foundation, Sm, Consoli, D, Naso, F, Torcasio, G, Valentia, V, Mecocci, P, Rinaldi, P, Serafini, V, and Senin, U.

Subjects
medicine.medical_specialty, education.field_of_study, business.industry, Population, Not Otherwise Specified, Hippocampus, Audiology, Hippocampal formation, medicine.disease, population-based, memory, Psychiatry and Mental health, Clinical Psychology, Atrophy, hippocampal atrophy, medicine, Dementia, Memory impairment, Geriatrics and Gerontology, Alzheimer's disease, business, education, Gerontology, MRI
Abstract

Background:Clinical studies have shown that hippocampal atrophy is present before dementia in people with memory deficits and can predict dementia development. The question remains whether this association holds in the general population. This is of interest for the possible use of hippocampal atrophy to screen population for preventive interventions. The aim of this study was to assess hippocampal volume and shape abnormalities in elderly adults with memory deficits in a cross-sectional population-based study.Methods:We included individuals participating in the Italian Project on the Epidemiology of Alzheimer Disease (IPREA) study: 75 cognitively normal individuals (HC), 31 individuals with memory deficits (MEM), and 31 individuals with memory deficits not otherwise specified (MEMnos). Hippocampal volumes and shape were extracted through manual tracing and the growing and adaptive meshes (GAMEs) shape-modeling algorithm. We investigated between-group differences in hippocampal volume and shape, and correlations with memory deficits.Results:In MEM participants, hippocampal volumes were significantly smaller than in HC and were mildly associated with worse memory scores. Memory-associated shape changes mapped to the anterior hippocampus. Shape-based analysis detected no significant difference between MEM and HC, while MEMnos showed shape changes in the posterior hippocampus compared with HC and MEM groups.Conclusions:These findings support the discriminant validity of hippocampal volumetry as a biomarker of memory impairment in the general population. The detection of shape changes in MEMnos but not in MEM participants suggests that shape-based biomarkers might lack sensitivity to detect Alzheimer's-like pathology in the general population.

Published
2014

6. Therapeutic Duplicates in a Cohort of Hospitalized Elderly Patients: Results from the REPOSI Study

Author

Pasina, L, Astuto, S, Cortesi, L, Tettamanti, M, Franchi, C, Marengoni, A, Mannucci, Pm, Nobili, A, Prisco, D, Silvestri, E, Emmi, G, Bettiol, A, Caterina, C, Biolo, G, Zanetti, M, Guadagni, M, Zaccari, M, Chiuch, M, Vanoli, M, Grignani, G, Pulixi, Ea, Bernardi, M, Bassi, Sl, Santi, L, Zaccherini, G, Lupattelli, G, Mannarino, E, Bianconi, V, Paciullo, F, Alcidi, R, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Girelli, D, Busti, F, Marchi, G, Barbagallo, M, Dominguez, L, Cocita, F, Beneduce, V, Plances, L, Corrao, S, Natoli, G, Mularo, S, Raspanti, M, Cavallaro, F, Zoli, M, Lazzari, I, Brunori, M, Fabbri, E, Magalotti, D, Arn?, R, Pasini, Fl, Capecchi, Pl, Palasciano, G, Modeo, Me, Di Gennaro, C, Cappellini, Md, Maira, D, Di Stefano, V, Fabio, G, Seghezzi, S, Mancarella, M, De Amicis, Mm, De Luca, G, Scaramellini, N, Cesari, M, Rossi, Pd, Damanti, S, Clerici, M, Conti, F, Bonini, G, Ottolini, Bb, Di Sabatino, A, Miceli, E, Lenti, Mv, Pisati, M, Dominioni, Cc, Murialdo, G, Marra, A, Cattaneo, F, Pontremoli, R, Beccati, V, Nobili, G, Secchi, Mb, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Cipollone, F, Guagnano, Mt, Valeriani, E, Rossi, I, Mancuso, G, Calipari, D, Bartone, M, Delitala, G, Berria, M, Pes, C, Delitala, A, Muscaritoli, M, Molfino, A, Petrillo, E, Zuccal?, G, D'Aurizio, G, Romanelli, G, Zucchelli, A, Manzoni, F, Volpini, A, Picardi, A, Gentilucci, Uv, Gallo, P, Dell'Unto, C, Annoni, G, Corsi, M, Bellelli, G, Zazzetta, S, Mazzola, P, Szabo, H, Bonfanti, A, Arturi, F, Succurro, E, Rubino, M, Tassone, B, Sesti, G, Serra, Mg, Bleve, Ma, Gasbarrone, L, Sajeva, Mr, Brucato, A, Ghidoni, S, Fabris, F, Bertozzi, I, Bogoni, G, Rabuini, Mv, Cosi, E, Scarinzi, P, Amabile, A, Omenetto, E, Prandini, T, Manfredini, R, Fabbian, F, Boari, B, De Giorgi, A, Tiseo, R, De Giorgio, R, Paolisso, G, Rizzo, Mr, Borghi, C, Strocchi, E, Ianniello, E, Soldati, M, Sabb?, C, Vella, Fs, Suppressa, P, Agosti, P, Schilardi, A, Loparco, F, De Vincenzo, Gm, Comitangelo, A, Amoruso, E, Fenoglio, L, Falcetta, A, Bracco, C, Fracanzani, Al, Fargion, S, Tiraboschi, S, Cespiati, A, Oberti, G, Sigon, G, Peyvandi, F, Rossio, R, Ferrari, B, Colombo, G, Monzani, V, Savojardo, V, Folli, C, Ceriani, G, Salerno, F, Pallini, G, Dallegri, F, Ottonello, L, Liberale, L, Caserza, L, Salam, K, Liberato, Nl, Tognin, T, Bianchi, Gb, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Spazzini, E, Ferrandina, C, Montrucchio, G, Petitti, P, Peasso, P, Favale, E, Poletto, C, Salmi, R, Gaudenzi, P, Violi, F, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Campiotti, L, Grossi, A, Bertolotti, M, Mussi, C, Lancellotti, G, Libbra, Mv, Dondi, G, Pellegrini, E, Carulli, L, Galassi, M, Grassi, Y, Perticone, F, Perticone, M, Battaglia, R, Filice, M, Maio, R, Stanghellini, V, Ruggeri, E, del Vecchio, S, Salvi, A, Leonardi, R, Damiani, G, Capeci, W, Gabrielli, A, Mattioli, M, Martino, Gp, Biondi, L, Pettinari, P, Ghio, R, Dal Col, A, Minisola, S, Colangelo, L, Cilli, M, Labbadia, G, Afeltra, A, Marigliano, B, Pipita, Me, Castellino, P, Zanoli, L, Pignataro, S, Gennaro, A, Blanco, J, Saracco, V, Fogliati, M, Bussolino, C, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Marra, Am, Sirico, D, Moreo, G, Gasparini, F, Prolo, S, Pina, G, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, Mc, Graziella, B, Baldassarre, S, Fragapani, S, Gruden, G, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffr?, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Passariello, N, Rinaldi, L, Berti, F, Famularo, G, Tarsitani, P, Castello, R, Pasino, M, Ceda, Gp, Maggio, Mg, Morganti, S, Artoni, A, Del Giacco, S, Firinu, D, Losa, F, Paoletti, G, Costanzo, G, Montalto, G, Licata, A, Malerba, V, Montalto, Fa, Lasco, A, Basile, G, Catalano, A, Malatino, L, Stancanelli, B, Terranova, V, Di Marca, S, Di Quattro, R, La Malfa, L, Caruso, R, Mecocci, P, Ruggiero, C, Boccardi, V, Meschi, T, Lauretani, F, Ticinesi, A, Nouvenne, A, Minuz, P, Fondrieschi, L, Pirisi, M, Fra, Gp, Sola, D, Porta, M, Riva, P, Quadri, R, Larovere, E, Novelli, M, Scanzi, G, Mengoli, C, Provini, S, Ricevuti, L, Simeone, E, Scurti, R, Tolloso, F, Tarquini, R, Valoriani, A, Dolenti, S, Vannini, G, Tedeschi, A, Trotta, L, Volpi, R, Bocchi, P, Vignali, A, Harari, S, Lonati, C, Cattaneo, M, Nieves, Rd, Alberto, Mm, Pedro, Ar, Vanessa, Lp, Lara, T, Xavier, Cv, Francesc, F, Jesus, Dm, Esperanza, Bt, Esther, Dcb, Maria, Sp, Romero, M, Blanca, Pl, Cristina, Lgc, Victoria, Vgm, Saez, L, Bosco, J, Susana, Sb, Marta, Ag, Concepcion, Gb, Antonio, Fm, Hernandez, Mg, Borrego, Mp, Raquel, Pc, Florencia, Pr, Beatriz, Go, Sara, Cg, Alfonso, Gcc, Marta, Pm, Alberto, Rc, Antonio, Aa, Montserrat, Gg, Angel, Brm, Manuel, Mj, Ignacio, Nv, Lucia, As, Alfonso, L, David, Rb, Iniguez, Vi, and Monica, Rp

Subjects
Drug, Male, Risk, Pediatrics, medicine.medical_specialty, Drug-Related Side Effects and Adverse Reactions, Cross-sectional study, media_common.quotation_subject, Hospital Departments, Socio-culturale, Inappropriate Prescribing, 030204 cardiovascular system & hematology, Drug Prescriptions, Geriatrics and Gerontology, Pharmacology (medical), 03 medical and health sciences, 0302 clinical medicine, Pharmacotherapy, 80 and over, Prevalence, Medicine, Humans, Drug Interactions, 030212 general & internal medicine, Prospective Studies, Medical prescription, Prospective cohort study, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Hospitalization, Italy, Patient Discharge, Polypharmacy, media_common, business.industry, Inappropriate Prescriptions, Drug class, Emergency medicine, business
Abstract

Explicit criteria for potentially inappropriate prescriptions in the elderly are recommended to avoid prescriptions of duplicate drug classes and to optimize monotherapy within a single drug class before a new agent is considered. Duplicate drug class prescription (or therapeutic duplicates) puts the patient at increased risk of adverse drug reactions with no additional therapeutic benefits. To our knowledge, the prevalence of elderly inpatients receiving therapeutic duplicates has never been studied. Our objective was to assess the prevalence of therapeutic duplicates at admission, discharge, and 3-month follow-up of hospitalized elderly patients. This cross-sectional prospective study was conducted in 97 Italian internal medicine and geriatric wards. Therapeutic duplicates were defined as at least two drugs of the same therapeutic class prescribed simultaneously to a patient. A patient’s drug therapy at admission relates to prescriptions from general practitioners, whereas prescriptions at discharge are those from hospital internists or geriatricians. The study sample comprised 5821 admitted and 4983 discharged patients. In all, 143 therapeutic duplicates were found at admission and 170 at discharge. The prevalence of patients exposed to at least one therapeutic duplicate rose significantly from hospital admission (2.5 %) to discharge (3.4 %; p = 0.0032). Psychotropic drugs and drugs for peptic ulcer or gastroesophageal reflux disease were the most frequently involved. A total of 86.8 % of patients discharged with at least one therapeutic duplicate were still receiving them at 3-month follow-up. Hospitalization and drugs prescribed by internists and geriatricians are both factors associated with a small but definite increase in overall therapeutic duplicates in elderly patients admitted to internal medicine and geriatric wards. More attention should be paid to the indications for each drug prescribed, because therapeutic duplicates are not supported by evidence and increase both the risk of adverse drug reactions and costs. Identification of unnecessary therapeutic duplicates is essential for the optimization of polypharmacy.

Published
2016

9. Muscle strength is related to mental and physical quality of life in the oldest old.

Author

Laudisio A, Giovannini S, Finamore P, Loreti C, Vannetti F, Coraci D, Incalzi RA, Zuccal G, Macchi C, and Padua L

Subjects
Aged, 80 and over, Cohort Studies, Humans, Italy epidemiology, Surveys and Questionnaires, Hand Strength, Muscle Strength, Quality of Life
Abstract

Purpose of the Study: Quality of life represents the principal outcome of health interventions for the oldest old. However, little is known about the determinants of quality of life in this population stratum. We evaluated the association between health-related quality of life (HRQoL) and handgrip strength in a cohort of 331 participants aged 90+ with a living in the Mugello area (Tuscany, Italy)., Design and Methods: HRQoL was assessed using the Medical Outcomes Study Short Form 12 (SF12), considering the Physical Composite Score (PCS) and the Mental Composite Score (MCS) of the SF-12. Muscle strength was tested by hand grip dynamometry., Results: The median MCS was 46.9, while the median PCS was 43.0. According to logistic regression, muscle strength was associated with increased probability of better PCS (OR = 1.05; 95 % CI = 1.01-1.10, P = .042), and better MCS (OR = 1.05; 95 % CI = 1.01-1.10, P = .036), after adjusting., Implication: Muscle strength is associated with both physical and mental HRQoL among nonagenarians. Further studies are needed to explore the subsystems involved in this association, and whether improving muscle performance might improve global mental and physical quality of life in the most advanced age., Competing Interests: Declaration of Competing Interest All authors declare to have no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Published
2020
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