M. Pau, I. Mulas, V. Putzu, Gesuina Asoni, D. Viale, Irene Mameli, G. Allali
{"title":"Functional mobility in older women with and without motoric cognitive risk syndrome: a quantitative assessment using wearable inertial sensors","authors":"M. Pau, I. Mulas, V. Putzu, Gesuina Asoni, D. Viale, Irene Mameli, G. Allali","doi":"10.36150/2499-6564-n259","DOIUrl":"https://doi.org/10.36150/2499-6564-n259","url":null,"abstract":"Background. The Motoric Cognitive Risk (MCR) syndrome is defined in non-demented older adults by cognitive complaints and slow gait. Individuals with MCR are at higher risk of dementia and other poor clinical outcomes, such as falls. However, no data are available as regards functional mobility alterations associated with MCR. The main purpose of the present study is to quantitatively investigate such an aspect using the instrumented Timed-Up-and-Go (iTUG) test carried out using a wearable inertial measurement unit (IMU). Methods. Fifty-one women aged over 65 years underwent a geriatric and neuropsychologic assessment (which included the Mini Mental State Examination, MMSE and Addenbrooke’s Cognitive Examination Revised, ACE-R), instrumented gait analysis and iTUG performed using an IMU located on the lower back. Based on subjective cognitive complaints and slow gait, they were assigned either to the MCR (n = 24) or non-MCR (n = 27) group. IMU data allowed calculation of overall and sub-phases iTUG times.Results. Women with MCR were characterized by a significantly higher body mass and body mass index, lower normalized handgrip strength, and similar values of MMSE compared to non-MCRs. A trend was observed in terms of lower overall and sub-domain ACE-R score. They also performed iTUG at a significantly slower speed (22.4 s vs 14.1 of the non-MCR group, p < 0.001) and exhibited increased sub-phase times (29 to 31% higher with respect to non-MCRs).Conclusions. The findings of the present study suggest that the MCR syndrome impairs functional mobility, probably due reduced muscular strength and coordination, fear of falling and increased instability. The instrumental evaluation of functional mobility appears useful in the management of women with MCR, particularly in monitoring the progression of the motor impairments, verifying the effectiveness of interventions targeted in alleviating the impact on daily life of mobility limitations associated with MCR and in defining tailored rehabilitation programs.","PeriodicalId":42690,"journal":{"name":"Journal of Gerontology and Geriatrics","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45154770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Geirsdottir, M. Chang, K. Briem, P. Jónsson, I. Thorsdottir, A. Ramel
{"title":"Determinants of physical function in community dwelling old people","authors":"O. Geirsdottir, M. Chang, K. Briem, P. Jónsson, I. Thorsdottir, A. Ramel","doi":"10.36150/2499-6564-n261","DOIUrl":"https://doi.org/10.36150/2499-6564-n261","url":null,"abstract":"","PeriodicalId":42690,"journal":{"name":"Journal of Gerontology and Geriatrics","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48431756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Aksu, Güzin Zeren Öztürk, Memet Taşkın Eğici, C. Ardic
{"title":"Evaluation of the relationship between lower urinary tract symptoms and fall risks in male patients over 65 years old","authors":"S. Aksu, Güzin Zeren Öztürk, Memet Taşkın Eğici, C. Ardic","doi":"10.36150/2499-6564-n359","DOIUrl":"https://doi.org/10.36150/2499-6564-n359","url":null,"abstract":"","PeriodicalId":42690,"journal":{"name":"Journal of Gerontology and Geriatrics","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49529444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cardiac amyloidosis awareness among residents/specialists in Geriatrics: an Italian national survey","authors":"Diana Lelli, C. Pedone, D. Leosco, R. Incalzi","doi":"10.36150/2499-6564-n374","DOIUrl":"https://doi.org/10.36150/2499-6564-n374","url":null,"abstract":"Objective. Cardiac amyloidosis (CA) among older adults is less infrequent than usually considered, and often underdiagnosed. Geriatricians’ awareness and knowledge of CA is unknown. Objectives of the study are to assess actual CA knowledge among residents/specialists in Geriatrics, and their usual clinical practice in managing suspected CA. Methods. In this Nation-wide survey carried out by the Italian Society of Gerontology and Geriatrics in April-August 2020, we administered to residents/specialists in Geriatrics a questionnaire divided in three sections: socio-demographical, procedural and knowledge. Results were stratified by qualification (resident/specialist) and by performance (best/worst performers). Results. 289 residents and 104 specialists participated. The overall proportion of correct answers was 57.9% (58.4% residents, 56.1% specialists); knowledge about clinical (89% of correct answers, 91% residents and 84% specialists, P = 0.062), ECG (72% of correct answers, no differences between groups), and echocardiographic (86% of correct answers, no differences between groups) signs of CA was good. However, only 8% participants knew how to diagnose ATTRwt CA (no differences between groups), and 19% which diuretic is indicated in CA (22% residents, 13% specialists, P = 0.069). Only 25% of the participants knew the natural history of ATTRwt (19% residents, 41% specialists, P < 0.001), and 37% was aware of the target of the ATTR treatment. Prevalence of CA was underestimated by 57% specialists and 37% residents (P = 0.001). Conclusions. Knowledge of CA among residents/specialists in Geriatrics is uncomplete. Education campaigns on this topic are desirable, to improve physicians’ awareness of CA, thus reducing the number of potential misdiagnosis/delay in correct diagnoses.","PeriodicalId":42690,"journal":{"name":"Journal of Gerontology and Geriatrics","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48170964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Management of balance problems in an elderly with multiple system atrophy with predominant cerebellar ataxia (MSA-C) and sick sinus syndrome","authors":"A. Eker, P. Yiğitoğlu, H. Duygu, E. Tan","doi":"10.36150/2499-6564-n262","DOIUrl":"https://doi.org/10.36150/2499-6564-n262","url":null,"abstract":"Multiple system atrophy (MSA) is a late-onset, sporadic, progressive, neurodegenerative disorder clinically characterized by autonomic failure and either poorly levodopa-responsive parkinsonism or cerebellar ataxia. There isn’t any effective treatment on disease progression. Current therapeutic strategies are primarily based on dopamine replacement and improvement of autonomic failure. Clonazepam, propranolol, baclofen, amantadine, gabapentin, buspirone have also been used for symptomatic treatment of ataxia in MSA patients, but their efficacy known modest and transient. Herein we describe a MSA-C patient with disabling ataxia and sick sinus syndrome who showed distinct improvement in her symptoms after amantadine treatment and cardiac pacemaker implantation.","PeriodicalId":42690,"journal":{"name":"Journal of Gerontology and Geriatrics","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43019037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Calabrese, V. Calsolaro, R. Franchi, S. Rogani, D. Guarino, C. Okoye, F. Monzani
{"title":"Dabigatran-induced acute liver injury in older patients: case report and literature review","authors":"A. Calabrese, V. Calsolaro, R. Franchi, S. Rogani, D. Guarino, C. Okoye, F. Monzani","doi":"10.36150/2499-6564-n345","DOIUrl":"https://doi.org/10.36150/2499-6564-n345","url":null,"abstract":"Objective. Dabigatran, a direct inhibitor of thrombin, represents an effective alternative to warfarin. Despite the good tolerance and predictable pharmacokinetic profile, dabigatran may be associated to adverse reactions, including gastrointestinal disorders. Here we report on a case of hepatotoxicity along with an extensive revision of the available literature on dabigatran induced liver injury.Methods & results. An 84 years old man attended the Emergency Department after experiencing fatigue for a few days. He suffered from atrial fibrillation and had been initiated on dabigatran (110 mg bid) in the last four weeks. Clinical examination revealed tachycardia, scleral icterus in the absence of signs of chronic hepatic disease. Blood chemistry showed altered liver function tests: AST 809 IU/L, ALT 1629 IU/L, total bilirubin 2.42 mg/dL, gGT 381 IU/L, ALP 388 IU/L, LDH 552 IU/L. Screening laboratory investigations for infectious, autoimmune or metabolic hepatotoxic pathology were unremarkable. The abdominal ultrasound examination excluded vascular causes, revealing non-homogeneous echo-structure consistent with mild hepatic steatosis. At admission to our Geriatric ward dabigatran was discontinued and fondaparinux was introduced. Resolution of the hepatitis and normalization of blood chemistry was observed within two weeks. Few cases are described regarding hepatotoxicity likely caused by the recent onset of treatment with dabigatran. Conclusions. DOACs associated hepatotoxicity is rare but potentially harmful and should be kept in mind, especially in comorbid patients with unexplained liver injury. The mechanism of liver injury during dabigatran therapy is unknown and, not related to cytochrome P450 enzymes since the drug does not affect CYP450 activity.","PeriodicalId":42690,"journal":{"name":"Journal of Gerontology and Geriatrics","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48308224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Biological diagnosis of Alzheimer’s disease and the issue of stigma","authors":"F. Ronchetto, Martina Ronchetto","doi":"10.36150/2499-6564-n327","DOIUrl":"https://doi.org/10.36150/2499-6564-n327","url":null,"abstract":"Starting from the early years of the 21st century a shift occurred in the conceptualization of Alzheimer’s disease (AD). Thanks to advances in the biomolecular field, new criteria of diagnosis and a new lexicon such as “preclinical AD”, “prodromal AD”, “at risk for AD” have been introduced. The disease has been reconceptualized as a slow and progressive pathological process beginning decades before clinical symptoms of dementia occurrence. Today, due to biomarkers detected in cerebrospinal fluid and on neuroimaging, there is the opportunity of a preclinical diagnosis of dementia in asymptomatic or minimally symptomatic individuals. The key characteristic of biomarkers is that they appear to reflect earlier brain changes eventually leading to clinical dementia. Originally reserved for research purposes, biological diagnosis and new lexicon seem to be now progressively included in clinical practice. If this trend is in line with the most advanced scientific achievements, on the other hand it raises some ethical concerns, mainly linked to stigma and discrimination expected toward people with a diagnosis of pre-dementia and their family caregivers. It is good to keep in mind that there is no currently certainty that asymptomatic will become symptomatic individuals and consequently further studies are needed. The purpose of this article is to offer a historical overview and ethical discussion about the conceptual changes in Alzheimer’s disease, from Alois Alzheimer to current era.","PeriodicalId":42690,"journal":{"name":"Journal of Gerontology and Geriatrics","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42521570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Millarelli, F. Mammarella, A. Loperfido, F. Stella, G. Bellocchi
{"title":"The first case of nasal chondromesenchymal hamartoma in an octogenarian: description and literature review","authors":"S. Millarelli, F. Mammarella, A. Loperfido, F. Stella, G. Bellocchi","doi":"10.36150/2499-6564-n362","DOIUrl":"https://doi.org/10.36150/2499-6564-n362","url":null,"abstract":"Nasal Chondromesenchymal Hamartoma (NCMH) is a rare tumour of the sinonasal tract with a benign clinical behaviour. Locally destructive symptoms may occur. Due to the extreme rarity of this entity, only a few case reports are present in literature and most of them describe paediatric patients, usually under 12 years. Occasionally it may occur in adults. Symptoms are usually due to nasal localization, as nasal obstruction or mass effect or local compression caused by the lesion itself, as visual disturbances or facial pain. Cases described in the adult population are exceedingly rare. We describe the eldest case reported in literature of NCHM with peculiar features: geriatric patient, septal localization and asymptomatic clinic despite its voluminous size. The treatment of choice should be radical surgical resection however the best management strategy should be defined after multidisciplinary assessment of frailty in elderly patients.","PeriodicalId":42690,"journal":{"name":"Journal of Gerontology and Geriatrics","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42419077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}