A new tool for the evaluation of the rehabilitation outcomes in older persons. a machine learning model to predict functional status 1 year ahead

Purpose To date, the assessment of disability in older people is obtained utilizing a Comprehensive Geriatric Assessment (CGA). However, it is often difficult to understand which areas of CGA are most predictive of the disability. The aim of this study is to evaluate the possibility to early predict—1year ahead—the disability level of a patient using machine leaning models. Methods Community-dwelling older people were enrolled in this study. CGA was made at baseline and at 1year follow-up. After collecting input/independent variables (i.e., age, gender, schooling followed, body mass index, information on smoking, polypharmacy, functional status, cognitive performance, depression, nutritional status), we performed two distinct Support Vector Machine models (SVMs) able to predict functional status 1year ahead. To validate the choice of the model, the results achieved with the SVMs were compared with the output produced by simple linear regression models. Results 218 patients (mean age = 78.01; SD = 7.85; male = 39%) were recruited. The combination of the two SVMs is able to achieve a higher prediction accuracy (exceeding 80% instances correctly classified vs 67% instances correctly classified by the combination of the two linear regression models). Furthermore, SVMs are able to classify both the three categories, self sufficiently, disability risk and disability, while linear regression model separates the population only in two groups (self-sufficiency and disability) without identifying the intermediate category (disability risk) which turns out to be the most critical one. Conclusions The development of such a model can contribute to the early detection of patients at risk of self-sufficiency loss

Montelukast therapy and psychological distress in chronic obstructive pulmonary disease (COPD): a preliminary report

Chronic obstructive pulmonary disease (COPD) is an alteration in which ventilatory function, exercise capacity and health status of patients progressively decline and it is characterized by an increase of inflammatory cytokines such as TNF-a, LTB4, IL-8, etc. In this study we considered twenty patients (15 males and 5 females; mean age: 72.8 6.3) with stable COPD. All patients were performed evaluation of psychological stress at enrollment and were treated with leukotriene receptor antagonists (montelukast tablets) 10 mg/day for 12 months. After 12 months we observed a significant decrease of serum levels of LTB4, IL-8 and also a decrease of the number of outpatient clinic visits, of the number of hospitalizations and of the duration of hospitalizatio

New frontiers of cognitive rehabilitation in geriatric age: the Mozart effect (ME)

The ME was described for the first time in 1993. Subsequently other studies with similar designs were performed. The present study, therefore, proposes: (i) to verify the existence of the benefits of exposure to music in elderly subjects with mild cognitive impairment (MCI), (ii) to explore whether it is possible to find any lasting improvement after training, conducted for a long period of time, with such musical pieces, in the measurable cognitive performances. The study we conducted showed that the ME is present in geriatric patients with MCI; the influence on spatial–temporal abilities remains constant in time if the stimulation is maintained. The continuation of our study will consist of increasing the number of individuals examined and in having them listen to music during the study of ECG rhythms and during the acquisition of cerebral functional magnetic resonance imaging (fMRI), and, at the same time, testing them by neuropsychometric methods

Association between serum vitamin D and metabolic syndrome in middle-aged and older adults and role of supplementation therapy with vitamin D

Objectives. To evaluate i) the correlation between vitamin D (vit. D) serum concentra-tions and metabolic syndrome (MetS); ii) the efficacy of 6 months supplementation therapy with vit. D. Method. 200 patients were enrolled. Blood analyses and anthropometric measurements were carried out. Patients with hypovitaminosis D received an oral supplement therapy. Results. 81% of the sample shows vit. D levels < 30 ng/mL. Rate of MetS was significant-ly higher in vit. D deficiency group than in vit D insufficiency (p = 0.009) and sufficiency (p = 0.002) groups. Vit. D shows a significant negative correlation with both waist circum-ference (WC) (ρ - 0.202 p = 0.004) and glycaemia values (FBG) (ρ -0.185 p = 0.009). After the supplementation therapy in a group of 60 subjects a significant increase in vit. D levels (p = 0.001) and a significant reduction in WC values (p = 0.001) were observed. Conclusions. MetS, WC and FBG appeared to be associated vit. D status and it is well-known that central obesity, with the inflammatory alterations thereto correlated that determine insulin resistance, can be considered the “primum movens” for the develop-ment of MetS

Association between epicardial fat thickness and cognitive function in elderly. A preliminary study

Background: Recent studies suggested that the visceral fat could exert a predictive role in the pathogenesis of dementia. The aims of the present study were to evaluate a) the possible correlation between the epicardial adipose tissue (EAT) thickness and the cognitive impairment; b) the possible predictive role of the EAT levels on cognitive functioning. Methods: 65 community-dwelling subjects were enrolled. The metabolic profile was assessed through the evaluation of the biochemical parameters whereas the EAT thickness was measured through the transthoracic echocardiography. The Mini Mental State Examination (MMSE) was also administered. Results EAT thickness values showed several significant correlations with the variables examined in the study and a strong negative correlation with the MMSE scores (r= -.68; p=.001) was found. The multiple linear regression analysis showed that the EAT thickness levels and the hypertension had a predictive effect on the MMSE scores. Conclusions These preliminary findings support the association between EAT thickness levels and cognitive impairment

An exoskeleton in the rehabilitation of institutionalized elderly patients at high risk of falls. a pilot study

The aim of this study was to evaluate the effects of a physical training with the HBP on gait and balance in the institutionalized elderly at severe risk of falls (Tinetti score &lt;19), evaluated by (1) Tinetti balance and gait evaluation scale (28-point scale: &lt;19 indicates a high risk of falls; 19–24 indicates a moderate risk of falls; (2) short physical performance battery (SPPB), a tool for evaluating lower extremity functioning in the elderly by measuring balance (SPPB balance score), gait speed (SPPB gait score), lower limb strength and endurance (SPPB chair score) [each component was scored from 0 (not possible) to 4 (best performance); total score ranging from 0 to 12]

Mozart Effect and Its Clinical Applications: A Review

Recent research efforts examining the effects on the brain of listening to music have discovered that music, with specific characteristics, is able to improve cognitive and learning capacity. Recent studies have demonstrated that music, in particular some musical compositions (such as those of W. A. Mozart and J. S. Bach), has a notable role not only in cognitive disturbances, but also in the treatment of several syndromes and diseases, either by rehabilitating or by stimulating cerebral synaptic plasticity. The Mozart Effect was described for the first time in 1993. Subsequently, other studies with similar designs were made. This review summarizes the recent scientific literature on the Mozart Effect. More studies are needed, in order to define specific protocols in which music helps clinicians in recuperating patients and in improving their quality of life