Performance of Edmonton Frail Scale on frailty assessment: its association with multi-dimensional geriatric conditions assessed with specific screening tools.

BACKGROUND: The aim of this study was to evaluate the performance of Edmonton Frail Scale (EFS) on frailty assessment in association with multi-dimensional conditions assessed with specific screening tools and to explore the prevalence of frailty by gender. METHODS: We enrolled 366 hospitalised patients (women\men: 251\115), mean age 81.5 years. The EFS was given to the patients to evaluate their frailty. Then we collected data concerning cognitive status through Mini-Mental State Examination (MMSE), health status (evaluated with the number of diseases), functional independence (Barthel Index and Activities Daily Living; BI, ADL, IADL), use of drugs (counting of drugs taken every day), Mini Nutritional Assessment (MNA), Geriatric Depression Scale (GDS), Skeletal Muscle Index of sarcopenia (SMI), osteoporosis and functionality (Handgrip strength). RESULTS: According with the EFS, the 19.7% of subjects were classified as non frail, 66.4% as apparently vulnerable and 13.9% with severe frailty. The EFS scores were associated with cognition (MMSE: β = 0.980; p < 0.01), functional independence (ADL: β = -0.512; p < 0.00); (IADL: β = -0.338; p < 0.01); use of medications (β = 0.110; p < 0.01); nutrition (MNA: β = -0.413; p < 0.01); mood (GDS: β = -0.324; p < 0.01); functional performance (Handgrip: β = -0.114, p < 0.01) (BI: β = -0.037; p < 0.01), but not with number of comorbidities (β = 0.108; p = 0.052). In osteoporotic patients versus not-osteoporotic patients the mean EFS score did not differ between groups (women: p = 0.365; men: p = 0.088), whereas in Sarcopenic versus not-Sarcopenic patients, there was a significant differences in women: p < 0.05. CONCLUSIONS: This study suggests that measuring frailty with EFS is helpful and performance tool for stratifying the state of fragility in a group of institutionalized elderly. As matter of facts the EFS has been shown to be associated with several geriatric conditions such independence, drugs assumption, mood, mental, functional and nutritional status

Association between the red blood cell distribution width (RDW) and cardiometabolic markers : a cross-sectional study in obese and overweight subjects

Introduction The RDW is hence a measurement of the size variation and an index of the heterogeneity of the erythrocytes, which is calculated by dividing the standard deviation (SD) of RBC volume by the MCV and multiplying by 100 to express the result as a percentage. Several lines of evidences have recently attested that increased RDW is associated with a higher likelihood of a variety of disorders, so that this parameter might become a novel and reliable marker, refl ecting multiple physiological impairments. The main aim of this study is to assess the association of the RDW in cardiometabolic risk. Methods The population of the present study consists on 116 subjects (87 females, 29 males, age: 39.43 \ub1 10.33y). Body composition markers (waist circonference, and BMI) were assessed. Also biochemical parameters, such as arterial pressure, glucose and triglyceride, insulin and HDL Cholesterol were also measured. A linear regression model, adjusted for gender and age, was applied to assess and quantify the associations between RDW and the several cardiovascular and metabolic markers. Results All cardiometabolic markers examinated, except for arterial pressure, glucose and triglyceride, showed highly significant association (P < 0.001) with RDW index. For a unit increase of BMI, increased RWD of 0,16: this effect was very strong. Similar effects were found also for unit increase of waist circonference (b= +0,095), insulin (b=0,068) and cholesterol HDL (b= - 0,028). Conclusions RDW might be effectively considered a metabolic markers involved in cardiovascular and metabolic disease, whose assessment might allow the acquisition of significant diagnostic and prognostic information in patients with cardiovascular risk

Focus on pivotal role of dietary intake (diet and supplement) and blood levels of tocopherols and tocotrienols in obtaining successful aging.

Numerous specific age-related morbidities have been correlated with low intake and serum levels of tocopherols and tocotrienols. We performed a review in order to evaluate the extant evidence regarding: (1) the association between intake and serum levels of tocopherols and tocotrienols and age-related pathologies (osteoporosis, sarcopenia and cognitive impairment); and (2) the optimum diet therapy or supplementation with tocopherols and tocotrienols for the treatment of these abnormalities. This review included 51 eligible studies. The recent literature underlines that, given the detrimental effect of low intake and serum levels of tocopherols and tocotrienols on bone, muscle mass, and cognitive function, a change in the lifestyle must be the cornerstone in the prevention of these specific age-related pathologies related to vitamin E-deficient status. The optimum diet therapy in the elderly for avoiding vitamin E deficiency and its negative correlates, such as high inflammation and oxidation, must aim at achieving specific nutritional goals. These goals must be reached through: accession of the elderly subjects to specific personalized dietary programs aimed at achieving and/or maintaining body weight (avoid malnutrition); increase their intake of food rich in vitamin E, such as derivatives of oily seeds (in particular wheat germ oil), olive oil, hazelnuts, walnuts, almonds, and cereals rich in vitamin E (such as specific rice cultivar rich in tocotrienols) or take vitamin E supplements. In this case, vitamin E can be correctly used in a personalized way either for the outcome from the pathology or to achieve healthy aging and longevity without any adverse effect

Associazione tra insulino-resistenza e stress ossidativo valutato mediante Reactive Oxygen Species : studio osservazionale trasversale condotto in soggetti sovrappeso e obesi

Razionale La "free radical theory of aging" riporta come tra il 2 e il 5% dell'ossigeno consumato ogni giorno dall'organismo sia associato alla produzione di specie reattive dell\u2019ossigeno (ROS), la cui concentrazione \ue8 correlata al metabolismo energetico ma \ue8 inversamente proporzionale all'aspettativa di vita. E' proprio questa marcata produzione di ROS, ad aumentare nei soggetti obesi la prevalenza di co-morbidit\ue0 secondarie all'obesit\ue0. In questo studio sono stati valutati gli effetti dell'insulino-resistenza sulle ROS in soggetti affetti da sovrappeso o obesit\ue0. Materiali e metodi Il campione ha incluso 167 pazienti (90 femmine, 77 maschi), et\ue0 media 39 anni (\uf0b110,3 anni) e con BMI maggiore di 25 kg/m2 ,afferenti all\u2019ambulatorio di endocrinologia dell\u2019Azienda di Servizi alla Persona di Pavia. Sono stati effettuati in tutti i soggetti esami ematochimici per la valutazione del metabolismo glucidico, quali la glicemia e l'insulinemia a digiuno. Inoltre \ue8 stato calcolato l'indice HOMA. Una volta ottenuto l'indice HOMA, inizialmente \ue8 stato applicato un test di correlazione di Perason con la variabile che indicava lo stress ossidativo (ROS) e gli indicatori dell'insulino-resistenza. In un secondo momento \ue8 stato applicato un modello di regressione lineare per valutare gli effetti delle due variabili (insulina e HOMA), aggiustati per sesso ed et\ue0, sull\u2019outcome di stress ossidativo. Risultati Il test di Perason ha evidenziato una correlazione positiva tra ROS e insulina (r= 0.268, P<0.001), glicemia (r= 0.136, P=0.101) e HOMA (r= 0.248, P<0.015). Dall\u2019applicazione del modello di regressione lineare, aggiustando per sesso ed et\ue0, \ue8 emerso che all'aumento di un'unit\ue0 di insulina, c'\ue8 una variazione di 0,353 unit\ue0 delle ROS. Comparando invece l'aumento di un\u2019unit\ue0 dell'indice HOMA, \ue8 stata valutata una variazione delle ROS di 1,5 unit\ue0. Questo effetto \ue8 risultato significativo (P>0.01) Conclusioni L'insulino-resistenza pu\uf2 essere considerata un fattore che incide in modo diretto e negativo nello stress ossidativo del paziente con problematiche di sovrappeso e obesit\ue0. Un corretto controllo metabolico dei fattori di rischio legati all'obesit\ue0 \ue8 da considerarsi un fattore primario nella riduzione dello stress ossidativo