Preadmission Functional Decline Predicts Functional Improvement Among Older Patients Admitted to Acute Care Hospital.

Background: Functional decline from preadmission to admission may represent an important predictor of functional trajectories during hospitalization among older patients. Therefore, we aimed at describing the impact of preadmission decline on functional trajectories among older hospitalized patients.

Methods: Our series consisted of 2,011 patients aged 65 years or more consecutively admitted to four acute care wards of Geriatric Medicine participating to a multicenter observational study.

Common polymorphisms in nitric oxide synthase (NOS) genes influence quality of aging and longevity in humans.

Nitric oxide (NO) triggers multiple signal transduction pathways and contributes to the control of numerous cellular functions. Previous studies have shown in model organisms that the alteration of NO production has important effects on aging and lifespan. We studied in a large sample (763 subjects, age range 19-107 years) the variability of the three human genes (NOS1, -2, -3) coding for the three isoforms of the NADPH-dependent enzymes named NO synthases (NOS) which are responsible of NO synthesis.

Urinary incontinence in the elderly and in the oldest old: correlation with frailty and mortality.

Urinary incontinence (UI) is very common in the elderly and has personal and social implications. Many authors have pointed out the necessity to analyze UI in correlation with the overall quality of aging, to better understand this syndrome and define measures for its prevention and treatment. In the present study, we addressed this problem by analyzing the UI correlation with frailty, which has emerged in the last decade as the geriatric syndrome correlated with individual homeostatic capacity and then as the basis of the age-related physical decline.

Prognostic significance of the short physical performance battery in older patients discharged from acute care hospitals.

We investigated the prognostic role of the Short Physical Performance Battery (SPPB) in elderly patients discharged from the acute care hospital. Our series consisted of 506 patients aged 70 years or more enrolled in a multicenter collaborative observational study. We considered three main outcomes: 1-year survival after discharge, functional decline, and hospitalization during follow-up.

Global DNA methylation in old subjects is correlated with frailty.

Epigenetic variations have been widely described to occur during the aging process. To verify if these modifications are correlated with the inter-individual phenotypic variability of elderly people, we searched for a correlation between global DNA methylation levels and frailty. We found that the global DNA methylation levels were correlated to the frailty status in middle/advanced-aged subjects but not with age.

A cross-section analysis of FT3 age-related changes in a group of old and oldest-old subjects, including centenarians' relatives, shows that a down-regulated thyroid function has a familial component and is related to longevity.

Background: several studies suggest that a decreased thyroid activity might be favourable in oldest-old subjects and that subclinical thyroid hyperfunction may be detrimental.

Objectives: to verify whether declining levels of circulating thyroid hormones may contribute to longevity.

Design: cross-sectional observational study.

A novel, population-specific approach to define frailty.

The description of frailty, a syndrome of the elderly due to the decline of homeostatic capacities, has opened new opportunities in the study of the biological basis of human aging. However, the noticeable heterogeneity for this trait in different geographic areas makes it difficult to use standardized methods for measuring the quality of aging in different populations. Consequently, the necessity to carry out population-specific surveys to define tools which are able to highlight groups of subjects with homogeneous aging phenotype within each population has emerged.

To grow old in southern Italy: a comprehensive description of the old and oldest old in Calabria.

Background: The unprecedented growth of the elderly population is posing important social and medical problems as management of this population is highly demanding in terms of assistance and care. Consequently, many studies are focusing on the elderly subjects in order to better understand their needs by identifying various environmental, social, psychological, and genetic factors determining the quality of ageing.

Objectives: Our aim was to carry out a survey of the elderly Calabrian population in order to highlight the social and medical conditions of this continuously growing population group.

Targeting inflammation to slow or delay functional decline: where are we?

The role of inflammation in the pathophysiology of chronic age-related diseases is increasingly recognized, and inflammation could represent the common pathway linking diseases and disability. Thus, targeting inflammation could represent a useful strategy at preventing or delaying functional decline. In this paper we review recent evidence suggesting that selected drugs, such as statins, fibrates, angiotensin converting enzyme-inhibitors and angiotensin receptor blockers, and physical exercise may be able to contrast functional decline by blunting inflammation.

[Role of renal failure in the pathogenesis of adverse drug reactions in the elderly].

The high prevalence of multiple chronic disorders and polypharmacotherapy expose elderly patient to an increased risk of adverse drug reactions. Aging is associated with relevant morphological and functional changes in the kidney, with consequent changes in the pharmacokinetics of hydrosoluble drugs. Changes in renal function are not always clinically evident, and a concealed renal failure can lead to an increased risk of adverse drug reactions to hydrosoluble drugs.

Concealed renal failure and adverse drug reactions in older patients with type 2 diabetes mellitus.

Background: In elderly patients serum creatinine may be normal despite decreased glomerular filtration rate (GFR). The aim of this study was to evaluate the prevalence of this "concealed" renal failure, i.e.

Health status in older hospitalized patients with cancer or non-neoplastic chronic diseases.

Background: Whether cancer is more disabling than other highly prevalent chronic diseases in the elderly is not well understood, and represents the objective of the present study.

Methods: We used data from the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) study, a large collaborative observational study based in community and university hospitals located throughout Italy. Our series consisted of three groups of patients with non-neoplastic chronic disease (congestive heart failure, CHF, N = 832; diabetes mellitus, N = 939; chronic obstructive pulmonary disease, COPD, N = 399), and three groups of patients with cancer (solid tumors without metastasis, N = 813; solid tumors with metastasis, N = 259; leukemia/lymphoma, N = 326).

Seasonal hypertension: a clue to explain the high prevalence of unrecognized hypertension in the elderly? Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA).

Background And Aims: Blood pressure is known to be influenced by the season, particularly in the elderly. The association between cold weather and unrecognized hypertension has not been previously studied. The present study aimed at assessing whether recognition of hypertension in the elderly follows a seasonal pattern.

Identifying older diabetic patients at risk of poor glycemic control.

Background: Optimal glycemic control prevents the onset of diabetes complications. Identifying diabetic patients at risk of poor glycemic control could help promoting dedicated interventions. The purpose of this study was to identify predictors of poor short-term and long-term glycemic control in older diabetic in-patients.