Correlation of physical and cognitive impairment in diabetic and hypertensive frail older adults

Background: Diabetes and hypertension are common in older adults and represent established risk factors for frailty. Frailty is a multidimensional condition due to reserve loss and susceptibility to stressors with a high risk of death, hospitalizations, functional and cognitive impairment. Comorbidities such as diabetes and hypertension play a key role in increasing the risk of mortality, hospitalization, and disability. Moreover, frail patients with diabetes and hypertension are known to have an increased risk of cognitive and physical impairment. Nevertheless, no study assessed the correlation between physical and cognitive impairment in frail older adults with diabetes and hypertension. Methods: We evaluated consecutive frail older patients with diabetes and hypertension who presented at ASL (local health unit of the Italian Ministry of Health) Avellino, Italy, from March 2021 to October 2021. The inclusion criteria were: a previous diagnosis of diabetes and hypertension with no evidence of secondary causes; age > 65 years; a frailty status; Montreal Cognitive Assessment (MoCA) score < 26. Results: 179 patients successfully completed the study. We found a strong and significant correlation between MoCA score and 5-m gait speed test (r: 0.877; p < 0.001). To further verify our results, we performed a linear multivariate analysis adjusting for potential confounding factors, with MoCA score as dependent variable, which confirmed the significant association with glycemia (p < 0.001). Conclusions: This is the first study showing a significant correlation between 5-m gait speed test and MoCA score in frail diabetic and hypertensive older adults

Physical decline and cognitive impairment in frail hypertensive elders during COVID-19

Background: Hypertension is common in older adults and its incidence increases with age. We investigated the correlation between physical and cognitive impairment in older adults with frailty and hypertension. Methods: We recruited frail hypertensive older adults during the COVID-19 pandemic, between March 2021 and December 2021. Global cognitive function was assessed through the Montreal Cognitive Assessment (MoCA), physical frailty assessment was performed following the Fried criteria, and all patients underwent physical evaluation through 5-meter gait speed test. Results: We enrolled 203 frail hypertensive older adults and we found a significant correlation between MoCA score and gait speed test (r: 0.495; p<0.001) in our population. To evaluate the impact of comorbidities and other factors on our results, we applied a linear regression analysis with MoCA score as a dependent variable, observing a significant association with age, diabetes, chronic obstructive pulmonary disease (COPD), and gait speed test. Conclusions: Our study revealed for the first time a significant correlation between physical and cognitive impairment in frail hypertensive elderly subjects

Convegno \u201cCampi elettromagnetici e salute: le risposte della Scienza\u201d, Venezia, 1 ottobre 2005

Questo volume contiene gli Atti del Convegno promosso da Elettra 2000 \u201cCampi elettromagnetici e salute: le risposte della Scienza\u201d, che si \ue8 svolto a Venezia il 1 ottobre 2005. Il contenuto di questo libro intende fornire una panoramica sulle attuali conoscenze scientifiche in materia di esposizione ai campi elettromagnetici, al fine di costruire un dialogo sul tema e prevenire l\u2019insorgere di allarmismi ingiustificati

Secondo Convegno \u201cElettrosmog\u201d: quali risposte? Campi elettromagnetici e salute: le risposte della scienza, della societ\ue0, della comunicazione. Roma, 11 ottobre 2007

Questo volume contiene gli Atti del Secondo Convegno \u201cElettrosmog:quali risposte? Campi elettromagnetici e salute: le risposte della Scienza,della Societ\ue0, della Comunicazione\u201d, tenutosi a Roma l\u201911 ottobre 2007. Il Convegno \ue8 stato promosso da Elettra 2000 con lo scopo di fare il punto su quali sono stati gli sviluppi delle ricerche scientifiche negli ultimi anni, con un\u2019ampia e aggiornata panoramica sugli studi recenti affidata ai pi\uf9 qualificati esperti della Scienza del settore. Una seconda sessione \ue8 stata dedicata alla discussione degli aspetti sociali e di comunicazione, in modo da offrire un\u2019occasione di incontro tra mondo politico, mondo accademico e cittadini, a sottolineare come in questi anni la via dei processi partecipati sia stata quella di maggior successo per la diminuzione dei conflitti, che dalle origini ad oggi hanno caratterizzato la gestione del problema \u201ccampi elettromagnetici\u201d

SGLT2 Inhibition via Empagliflozin Improves Endothelial Function and Reduces Mitochondrial Oxidative Stress: Insights from Frail Hypertensive and Diabetic Patients

Background: Frailty is a multidimensional condition often diagnosed in older adults with hypertension and diabetes, and both these conditions are associated with endothelial dysfunction and oxidative stress. We investigated the functional role of the SGLT2 (sodium glucose cotransporter 2) inhibitor empagliflozin in frail diabetic and hypertensive older adults. Methods: We studied the effects of empagliflozin in consecutive hypertensive and diabetic older patients with frailty presenting at the ASL (local health unit of the Italian Ministry of Health) of Avellino, Italy, from March 2021 to January 2022. Moreover, we performed in vitro experiments in human endothelial cells to measure cell viability, permeability, mitochondrial Ca2+, and oxidative stress. Results: We evaluated 407 patients; 325 frail elders with diabetes successfully completed the study. We propensity-score matched 75 patients treated with empagliflozin and 75 with no empagliflozin. We observed a correlation between glycemia and Montreal Cognitive Assessment (MoCA) score and between glycemia and 5-meter gait speed (5mGS). At 3-month follow-up, we detected a significant improvement in the MoCA score and in the 5mGS in patients receiving empagliflozin compared with non-treated subjects. Mechanistically, we demonstrate that empagliflozin significantly reduces mitochondrial Ca2+overload and reactive oxygen species production triggered by high glucose in human endothelial cells, attenuates cellular permeability, and improves cell viability in response to oxidative stress. Conclusions: Taken together, our data indicate that empagliflozin reduces frailty in diabetic and hypertensive patients, most likely by decreasing the mitochondrial generation of reactive oxygen species in endothelial cells

Occupational exposure assessment to static magnetic field in MRI environment

The aim of the present study is the evaluation of occupational exposure to static magnetic field in MRI environment, through direct measurements and relevant dosimetric parameters calculation

Empagliflozin Improves Cognitive Impairment in Frail Older Adults With Type 2 Diabetes and Heart Failure With Preserved Ejection Fraction

OBJECTIVE: To assess whether the sodium-glucose cotransporter 2 (SGLT2) inhibitor empagliflozin improves cognitive impairment in frail older adults with diabetes and heart failure with preserved ejection fraction (HFpEF). RESEARCH DESIGN AND METHODS: We designed a prospective study to assess cognitive and physical function in consecutive frail older adults with diabetes and HFpEF, comparing the effects of empagliflozin, metformin, and insulin. RESULTS: A total of 162 frail older adults with HFpEF and diabetes successfully completed the study. Montreal Cognitive Assessment scores at baseline and after 1 month were 19.80 ± 3.77 vs. 22.25 ± 3.27 (P < 0.001) in the empagliflozin group, 19.95 ± 3.81 vs. 20.71 ± 3.56 (P = 0.26) in the metformin group, and 19.00 ± 3.71 vs. 19.1 ± 3.56 (P = 0.81) in the insulin group. A multivariable regression analysis confirmed the beneficial effects of empagliflozin. Additionally, we observed a marked amelioration of physical impairment, assessed by the 5-m gait speed test, in the empagliflozin and metformin groups but not in the insulin group. CONCLUSIONS: This study is the first to show significant beneficial effects of the SGLT2 inhibitor empagliflozin on cognitive and physical impairment in frail older adults with diabetes and HFpEF