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The assistance to older community-dwellers provided by family caregivers is crucial for the maintenance of an acceptable quality of life, especially when dementia is present. The caregiver burden may be extremely high, but few data are available on what patient domains mainly affect the caregiver. The aim of this cross-sectional study, performed in older outpatients, was to examine the impact of cognitive, physical and nutritional status of elderly community-dwellers on the caregiver burden, as evaluated by the Caregiver Burden Inventory (CBI). A group of 406 elderly outpatients (161 M, 245 F, mean age of 83.20 ± 6.40) was enrolled. A significant correlation was observed between Mini Nutritional Assessment Instrument-Short Form (MNA-SF) and CBI (r = −0.34; p < 0.001), suggesting that a poor nutritional status is significantly associated with the caregiver burden. There was also a significant correlation between CBI and Short Physical Performance Battery score (r = −0.29; p < 0.001), hand grip strength (r = −0.25; p < 0.001), Mini-Mental State Examination score (r = −0.39; p < 0.001), Geriatric Depression Scale (r = 0.23; p < 0.001), Body Mass Index (BMI) (r = 0.01; p = 0.03), Activities of Daily Living and Instrumental Activities of Daily Living (ADL/IADL) (r = −0.61 and −0.62, respectively; p < 0.001), and with the 4-m walking speed (r = −0.42; p < 0.001). In the multivariate analysis, only the relationships of the CBI (in particular the physical subcomponent) with ADL, IADL and MNA-SF remained statistically significant (β ± SE −0.89 ± 0.20, p < 0.001; −0.58 ± 0.15, p < 0.001 and −0.25 ± 0.11, p = 0.02, respectively). The relationship between CBI and BMI remained statistically significant only for the physical subcomponent (β ± SE 0.14 ± 0.05; p = 0.006). Thus, in this study, we confirmed that the impairment in the activities of daily living is associated with a significant impact on the caregiver burden, and we found also that a poor nutritional status of the older outpatient is independently more associated with the caregiver burden than cognitive and physical disability. The combined evaluation of both patients and caregivers can improve the knowledge and assistance to the elderly subjects.
Claudio Tana; Fulvio Lauretani; Andrea Ticinesi; Luciano Gionti; Antonio Nouvenne; Beatrice Prati; Tiziana Meschi; Marcello Maggio. Impact of Nutritional Status on Caregiver Burden of Elderly Outpatients. A Cross-Sectional Study. Nutrients 2019, 11, 281 .
AMA StyleClaudio Tana, Fulvio Lauretani, Andrea Ticinesi, Luciano Gionti, Antonio Nouvenne, Beatrice Prati, Tiziana Meschi, Marcello Maggio. Impact of Nutritional Status on Caregiver Burden of Elderly Outpatients. A Cross-Sectional Study. Nutrients. 2019; 11 (2):281.
Chicago/Turabian StyleClaudio Tana; Fulvio Lauretani; Andrea Ticinesi; Luciano Gionti; Antonio Nouvenne; Beatrice Prati; Tiziana Meschi; Marcello Maggio. 2019. "Impact of Nutritional Status on Caregiver Burden of Elderly Outpatients. A Cross-Sectional Study." Nutrients 11, no. 2: 281.
Inadequate nutrition and physical inactivity are the mainstays of primary sarcopenia–physiopathology in older individuals. Gut microbiota composition is strongly dependent on both of these elements, and conversely, can also influence the host physiology by modulating systemic inflammation, anabolism, insulin sensitivity, and energy production. The bacterial metabolism of nutrients theoretically influences skeletal muscle cell functionality through producing mediators that drive all of these systemic effects. In this study, we review the scientific literature supporting the concept of the involvement of gut microbiota in primary sarcopenia physiopathology. First, we examine studies associating fecal microbiota alterations with physical frailty, i.e., the loss of muscle performance and normal muscle mass. Then, we consider studies exploring the effects of exercise on gut microbiota composition. Finally, we examine studies demonstrating the possible effects of mediators produced by gut microbiota on skeletal muscle, and intervention studies considering the effects of prebiotic or probiotic administration on muscle function. Even if there is no evidence of a distinct gut microbiota composition in older sarcopenic patients, we conclude that the literature supports the possible presence of a “gut–muscle axis”, whereby gut microbiota may act as the mediator of the effects of nutrition on muscle cells.
Andrea Ticinesi; Fulvio Lauretani; Christian Milani; Antonio Nouvenne; Claudio Tana; Daniele Del Rio; Marcello Maggio; Marco Ventura; Tiziana Meschi. Aging Gut Microbiota at the Cross-Road between Nutrition, Physical Frailty, and Sarcopenia: Is There a Gut–Muscle Axis? Nutrients 2017, 9, 1303 .
AMA StyleAndrea Ticinesi, Fulvio Lauretani, Christian Milani, Antonio Nouvenne, Claudio Tana, Daniele Del Rio, Marcello Maggio, Marco Ventura, Tiziana Meschi. Aging Gut Microbiota at the Cross-Road between Nutrition, Physical Frailty, and Sarcopenia: Is There a Gut–Muscle Axis? Nutrients. 2017; 9 (12):1303.
Chicago/Turabian StyleAndrea Ticinesi; Fulvio Lauretani; Christian Milani; Antonio Nouvenne; Claudio Tana; Daniele Del Rio; Marcello Maggio; Marco Ventura; Tiziana Meschi. 2017. "Aging Gut Microbiota at the Cross-Road between Nutrition, Physical Frailty, and Sarcopenia: Is There a Gut–Muscle Axis?" Nutrients 9, no. 12: 1303.
A precise quantitative measurement of skeletal muscle mass is fundamental for diagnosing sarcopenia in older individuals. The current techniques of assessment, including dual-energy x-ray absorptiometry (DXA), bioimpedance analysis (BIA), and magnetic resonance imaging (MRI) are either difficult to perform in everyday clinical practice or biased by concurrent clinical confounders. B-mode muscle ultrasound can be helpful in assessing muscle mass and architecture, and thus possibly useful for diagnosing or screening sarcopenia. A literature search of published articles on muscle ultrasound and sarcopenia in older individuals as of July 31, 2016, was made on PubMed and Scopus. Manual search and cross-referencing from reviews and original articles was also performed. Most of the existing studies were carried out on healthy well-fit subjects, with a low prevalence of sarcopenia. The main parameters that can be assessed through muscle ultrasound are muscle thickness, cross-sectional area, echo intensity, and, for pennate muscles, fascicle length and pennation angle. In older subjects, all these parameters show some degree of alteration compared to young adults, particularly in lower limb muscles with antigravitary function, such as the quadriceps femoris and gastrocnemius medialis. Each of these parameters may be theoretically useful for detecting the loss of muscle mass and functionality in geriatric patients. They are also poorly influenced by the presence of acute and chronic diseases and fluid balance, unlike DXA and BIA, but a high degree of standardization in ultrasound protocols is necessary. Frontier applications of ultrasound in the assessment of sarcopenia may include contrast-enhanced and diaphragm ultrasound. The current literature does not allow to make conclusive recommendations about the use of muscle ultrasound in geriatric practice. However, this technique is very promising, and further studies should validate its applications in the context of sarcopenia assessment.
Andrea Ticinesi; Tiziana Meschi; Marco V. Narici; Fulvio Lauretani; Marcello Maggio. Muscle Ultrasound and Sarcopenia in Older Individuals: A Clinical Perspective. Journal of the American Medical Directors Association 2017, 18, 290 -300.
AMA StyleAndrea Ticinesi, Tiziana Meschi, Marco V. Narici, Fulvio Lauretani, Marcello Maggio. Muscle Ultrasound and Sarcopenia in Older Individuals: A Clinical Perspective. Journal of the American Medical Directors Association. 2017; 18 (4):290-300.
Chicago/Turabian StyleAndrea Ticinesi; Tiziana Meschi; Marco V. Narici; Fulvio Lauretani; Marcello Maggio. 2017. "Muscle Ultrasound and Sarcopenia in Older Individuals: A Clinical Perspective." Journal of the American Medical Directors Association 18, no. 4: 290-300.
Graziano Onder; Matteo Cesari; Marcello Maggio; Katie Palmer. Defining a care pathway for patients with multimorbidity or frailty. European Journal of Internal Medicine 2017, 38, 1 -2.
AMA StyleGraziano Onder, Matteo Cesari, Marcello Maggio, Katie Palmer. Defining a care pathway for patients with multimorbidity or frailty. European Journal of Internal Medicine. 2017; 38 ():1-2.
Chicago/Turabian StyleGraziano Onder; Matteo Cesari; Marcello Maggio; Katie Palmer. 2017. "Defining a care pathway for patients with multimorbidity or frailty." European Journal of Internal Medicine 38, no. : 1-2.
The role of serum uric acid (SUA), an inflammatory agent and potential mediator of cardiovascular diseases, in endothelial function (EF) has been tested only in middle-aged subjects affected by specific diseases. Our aim was to assess the relationship between SUA and measures of EF in a cohort of elderly community-dwellers. This study involved 424 males and 426 females aged 70 years from the Prospective Study of the Vasculature in Uppsala Seniors (PIVUS), having complete data on SUA and EF assessed by flow-mediated vasodilation (FMD) and by intra-arterial infusion of acetylcholine (endothelium-dependent vasodilation, EDV) and sodium nitroprusside (endothelium-independent vasodilation, EIDV). Univariate and multivariate regression models obtained by backward selection from initial fully-adjusted models were built to assess the relationship between SUA and measures of EF in both genders. Cardiovascular risk factors, serum hormonal and metabolic mediators, and body composition were considered as potential confounders. In the univariate model, SUA was inversely associated in both genders with log(EDV) (β ± SE males − 0.39 ± 0.17, p = 0.03; females − 0.57 ± 0.19, p = 0.003) and log(EIDV) (males − 0.23 ± 0.12, p = 0.05; females − 0.49 ± 0.15, p = 0.002), but not with log(FMD). After adjustment for BMI, only the association between SUA and log(EIDV) in females persisted, though attenuated (− 0.32 ± 0.16, p = 0.049), and was no longer significant in the fully-adjusted multivariate model including waist/hip ratio. In conclusion, in older subjects, especially women, SUA is associated with EF not independently of a list of confounders including BMI and trunk fat mass, suggesting a role as surrogate metabolic marker rather than an active player in EF.
Andrea Ticinesi; Fulvio Lauretani; Gian Paolo Ceda; Carmelinda Ruggiero; Luigi Ferrucci; Rosalia Aloe; Anders Larsson; Tommy Cederholm; Lars Lind; Tiziana Meschi; Marcello Maggio. Uric acid and endothelial function in elderly community-dwelling subjects. Experimental Gerontology 2017, 89, 57 -63.
AMA StyleAndrea Ticinesi, Fulvio Lauretani, Gian Paolo Ceda, Carmelinda Ruggiero, Luigi Ferrucci, Rosalia Aloe, Anders Larsson, Tommy Cederholm, Lars Lind, Tiziana Meschi, Marcello Maggio. Uric acid and endothelial function in elderly community-dwelling subjects. Experimental Gerontology. 2017; 89 ():57-63.
Chicago/Turabian StyleAndrea Ticinesi; Fulvio Lauretani; Gian Paolo Ceda; Carmelinda Ruggiero; Luigi Ferrucci; Rosalia Aloe; Anders Larsson; Tommy Cederholm; Lars Lind; Tiziana Meschi; Marcello Maggio. 2017. "Uric acid and endothelial function in elderly community-dwelling subjects." Experimental Gerontology 89, no. : 57-63.
Manual measurement of 4-meter gait speed by a stopwatch is the gold standard test for functional assessment in older adults. However, the accuracy of this technique may be biased by several factors, including intra- and inter-operator variability. Instrumental techniques of measurement using accelerometers may have a higher accuracy. Studies addressing the concordance between these two techniques are missing. The aim of the present community-based observational study was to compare manual and instrumental measurements of 4-meter gait speed in older individuals and to assess their relationship with other indicators of physical performance. One-hundred seventy-two (69 men, 103 women) non-disabled community-dwellers aged ≥65 years were enrolled. They underwent a comprehensive geriatric assessment including physical function by Short Physical Performance Battery (SPPB), hand grip strength, and 6-minute walking test (6MWT). Timed usual walking speed on a 4-meter course was assessed by using both a stopwatch (4-meter manual measurement, 4-MM) and a tri-axial accelerometer (4-meter automatic measurement, 4-MA). Correlations between these performance measures were evaluated separately in men and women by partial correlation coefficients. In both genders, 4-MA was associated with 4-MM (men r = 0.62, p<0.001; women r = 0.73, p<0.001), handgrip strength (men r = 0.40, p = 0.005; women r = 0.29, p = 0.001) and 6MWT (men r = 0.50, p = 0.0004; women r = 0.22, p = 0.048). 4-MM was associated with handgrip strength and 6MWT in both men and women. Considering gait speed <0.6 m/s as diagnostic of dismobility syndrome, the two methods of assessment disagreed, with a different categorization of subjects, in 19% of men and 23% of women. The use of accelerometer resulted in 29 (13 M, 16 F) additional diagnoses of dismobility, compared with the 4-MM. In an older population, the concordance of gait speeds manually or instrumentally assessed is not optimal. The results suggest that manual measures might lead to misclassification of a substantial number of subjects. However, longitudinal studies using standardized and validated procedures aimed at the comparison of different techniques are needed before recommending the use of accelerometers in comprehensive geriatric assessment.
Marcello Maggio; Gian Paolo Ceda; Andrea Ticinesi; Francesca De Vita; Giovanni Gelmini; Cosimo Costantino; Tiziana Meschi; Reto W. Kressig; Matteo Cesari; Massimo Fabi; Fulvio Lauretani. Instrumental and Non-Instrumental Evaluation of 4-Meter Walking Speed in Older Individuals. PLoS ONE 2016, 11, e0153583 -e0153583.
AMA StyleMarcello Maggio, Gian Paolo Ceda, Andrea Ticinesi, Francesca De Vita, Giovanni Gelmini, Cosimo Costantino, Tiziana Meschi, Reto W. Kressig, Matteo Cesari, Massimo Fabi, Fulvio Lauretani. Instrumental and Non-Instrumental Evaluation of 4-Meter Walking Speed in Older Individuals. PLoS ONE. 2016; 11 (4):e0153583-e0153583.
Chicago/Turabian StyleMarcello Maggio; Gian Paolo Ceda; Andrea Ticinesi; Francesca De Vita; Giovanni Gelmini; Cosimo Costantino; Tiziana Meschi; Reto W. Kressig; Matteo Cesari; Massimo Fabi; Fulvio Lauretani. 2016. "Instrumental and Non-Instrumental Evaluation of 4-Meter Walking Speed in Older Individuals." PLoS ONE 11, no. 4: e0153583-e0153583.
Chronic activation of the inflammatory response, defined as inflammaging, is the key physio-pathological substrate for anabolic resistance, sarcopenia and frailty in older individuals. Nutrients can theoretically modulate this phenomenon. The underlying molecular mechanisms reducing the synthesis of pro-inflammatory mediators have been elucidated, particularly for vitamin D, n-3 polyunsaturated fatty acids (PUFA) and whey proteins. In this paper, we review the current evidence emerging from observational and intervention studies, performed in older individuals, either community-dwelling or hospitalized with acute disease, and evaluating the effects of intake of vitamin D, n-3 PUFA and whey proteins on inflammatory markers, such as C-Reactive Protein (CRP), interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α). After the analysis, we conclude that there is sufficient evidence for an anti-inflammatory effect in aging only for n-3 PUFA intake, while the few existing intervention studies do not support a similar activity for vitamin D and whey supplements. There is need in the future of large, high-quality studies testing the effects of combined dietary interventions including the above mentioned nutrients on inflammation and health-related outcomes.
Andrea Ticinesi; Tiziana Meschi; Fulvio Lauretani; Giovanna Felis; Fabrizio Franchi; Carlo Pedrolli; Michela Barichella; Giuseppe Benati; Sergio Di Nuzzo; Gian Paolo Ceda; Marcello Maggio. Nutrition and Inflammation in Older Individuals: Focus on Vitamin D, n-3 Polyunsaturated Fatty Acids and Whey Proteins. Nutrients 2016, 8, 186 .
AMA StyleAndrea Ticinesi, Tiziana Meschi, Fulvio Lauretani, Giovanna Felis, Fabrizio Franchi, Carlo Pedrolli, Michela Barichella, Giuseppe Benati, Sergio Di Nuzzo, Gian Paolo Ceda, Marcello Maggio. Nutrition and Inflammation in Older Individuals: Focus on Vitamin D, n-3 Polyunsaturated Fatty Acids and Whey Proteins. Nutrients. 2016; 8 (4):186.
Chicago/Turabian StyleAndrea Ticinesi; Tiziana Meschi; Fulvio Lauretani; Giovanna Felis; Fabrizio Franchi; Carlo Pedrolli; Michela Barichella; Giuseppe Benati; Sergio Di Nuzzo; Gian Paolo Ceda; Marcello Maggio. 2016. "Nutrition and Inflammation in Older Individuals: Focus on Vitamin D, n-3 Polyunsaturated Fatty Acids and Whey Proteins." Nutrients 8, no. 4: 186.
We aimed at evaluating the relationship between the circadian blood pressure rhythm and UA level in young patients (30-40 years old) with newly diagnosed essential hypertension.
Francesco Giallauria; Pasquale Predotti; Antonio Casciello; Alessandra Grieco; Angelo Russo; Anna Viggiano; Rodolfo Citro; Amelia Ravera; Maurizio Ciardo; Michele Guglielmi; Marcello Maggio; Carlo Vigorito. Serum uric acid is associated with non-dipping circadian pattern in young patients (30–40 years old) with newly diagnosed essential hypertension. Clinical and Experimental Hypertension 2016, 38, 233 -237.
AMA StyleFrancesco Giallauria, Pasquale Predotti, Antonio Casciello, Alessandra Grieco, Angelo Russo, Anna Viggiano, Rodolfo Citro, Amelia Ravera, Maurizio Ciardo, Michele Guglielmi, Marcello Maggio, Carlo Vigorito. Serum uric acid is associated with non-dipping circadian pattern in young patients (30–40 years old) with newly diagnosed essential hypertension. Clinical and Experimental Hypertension. 2016; 38 (2):233-237.
Chicago/Turabian StyleFrancesco Giallauria; Pasquale Predotti; Antonio Casciello; Alessandra Grieco; Angelo Russo; Anna Viggiano; Rodolfo Citro; Amelia Ravera; Maurizio Ciardo; Michele Guglielmi; Marcello Maggio; Carlo Vigorito. 2016. "Serum uric acid is associated with non-dipping circadian pattern in young patients (30–40 years old) with newly diagnosed essential hypertension." Clinical and Experimental Hypertension 38, no. 2: 233-237.
Serum procalcitonin and high-sensitivity C-reactive protein (hs-CRP) elevations have been associated with pneumonia in adults. Our aim was to establish their diagnostic usefulness in a cohort of hospitalized multimorbid patients ≥65 years old admitted to hospital with acute respiratory symptoms. With a retrospective cohort study design, all multimorbid patients ≥65 years-old with acute respiratory symptoms admitted to an internal medicine hospital ward in Italy from January to August 2013 were evaluated. Pneumonia diagnosis, comorbidities expressed through Cumulative Illness Rating Scale (CIRS), setting of living, length of stay, serum hs-CRP and procalcitonin at admission were collected for each patient. Data were analyzed with Mann-Whitney’s U test and multivariate Cox logistic regression analysis. A Receiver Operating Characteristic (ROC) curve was used to verify each biomarker’s association with pneumonia diagnosis. Four hundred fifty five patients (227 M) were included in the study, of whom 239 with pneumonia (138 M, mean age 80 ± 13) and 216 without pneumonia (89 M, mean age 80 ± 14). After adjustment for age and sex, median levels of hs-CRP were significantly higher in patients with pneumonia (116 mg/L, IQR 46.5–179.0, vs 22.5 mg/dl, IQR 6.9–84.4, p < 0.0001), while procalcitonin median levels were not (0.22 ng/ml IQR 0.12–0.87, vs 0.15 ng/ml, IQR 0.10–0.35, p = 0.08). The ROC analysis showed that, unlike procalcitonin, hs-CRP values were predictive of pneumonia (AUC 0.76, 95 % CI 0.72–0.79, p < 0.0001, cut-off value 61 mg/L), even after adjustment for possible confounders including nursing home residence and dementia. Serum hs-CRP levels >61 mg/L were independently associated with a 3.59-fold increased risk of pneumonia (OR 3.59, 95 % CI 2.35–5.48, p < 0.0001). In elderly multimorbid patients who require hospital admission for respiratory symptoms, serum hs-CRP testing seems to be more useful than procalcitonin for guiding the diagnostic process when clinical suspicion of pneumonia is present. Procalcitonin testing might hence be not recommended in this setting.
Antonio Nouvenne; Andrea Ticinesi; Giuseppina Folesani; Nicoletta Cerundolo; Beatrice Prati; Ilaria Morelli; Loredana Guida; Fulvio Lauretani; Marcello Maggio; Rosalia Aloe; Giuseppe Lippi; Tiziana Meschi. The association of serum procalcitonin and high-sensitivity C-reactive protein with pneumonia in elderly multimorbid patients with respiratory symptoms: retrospective cohort study. BMC Geriatrics 2016, 16, 1 -8.
AMA StyleAntonio Nouvenne, Andrea Ticinesi, Giuseppina Folesani, Nicoletta Cerundolo, Beatrice Prati, Ilaria Morelli, Loredana Guida, Fulvio Lauretani, Marcello Maggio, Rosalia Aloe, Giuseppe Lippi, Tiziana Meschi. The association of serum procalcitonin and high-sensitivity C-reactive protein with pneumonia in elderly multimorbid patients with respiratory symptoms: retrospective cohort study. BMC Geriatrics. 2016; 16 (1):1-8.
Chicago/Turabian StyleAntonio Nouvenne; Andrea Ticinesi; Giuseppina Folesani; Nicoletta Cerundolo; Beatrice Prati; Ilaria Morelli; Loredana Guida; Fulvio Lauretani; Marcello Maggio; Rosalia Aloe; Giuseppe Lippi; Tiziana Meschi. 2016. "The association of serum procalcitonin and high-sensitivity C-reactive protein with pneumonia in elderly multimorbid patients with respiratory symptoms: retrospective cohort study." BMC Geriatrics 16, no. 1: 1-8.
Anemia is a multifactorial condition whose prevalence increases in both sexes after the fifth decade of life. It is a highly represented phenomenon in older adults and in one-third of cases is “unexplained.” Ageing process is also characterized by a “multiple hormonal dysregulation” with disruption in gonadal, adrenal, and somatotropic axes. Experimental studies suggest that anabolic hormones such as testosterone, IGF-1, and thyroid hormones are able to increase erythroid mass, erythropoietin synthesis, and iron bioavailability, underlining a potential role of multiple hormonal changes in the anemia of aging. Epidemiological data more consistently support an association between lower testosterone and anemia in adult-older individuals. Low IGF-1 has been especially associated with anemia in the pediatric population and in a wide range of disorders. There is also evidence of an association between thyroid hormones and abnormalities in hematological parameters under overt thyroid and euthyroid conditions, with limited data on subclinical statuses. Although RCTs have shown beneficial effects, stronger for testosterone and the GH-IGF-1 axis and less evident for thyroid hormones, in improving different hematological parameters, there is no clear evidence for the usefulness of hormonal treatment in improving anemia in older subjects. Thus, more clinical and research efforts are needed to investigate the hormonal contribution to anemia in the older individuals.
Marcello Maggio; Francesca De Vita; Alberto Fisichella; Fulvio Lauretani; Andrea Ticinesi; Graziano Ceresini; Anne Cappola; Luigi Ferrucci; Gian Paolo Ceda. The Role of the Multiple Hormonal Dysregulation in the Onset of “Anemia of Aging”: Focus on Testosterone, IGF-1, and Thyroid Hormones. International Journal of Endocrinology 2015, 2015, 1 -22.
AMA StyleMarcello Maggio, Francesca De Vita, Alberto Fisichella, Fulvio Lauretani, Andrea Ticinesi, Graziano Ceresini, Anne Cappola, Luigi Ferrucci, Gian Paolo Ceda. The Role of the Multiple Hormonal Dysregulation in the Onset of “Anemia of Aging”: Focus on Testosterone, IGF-1, and Thyroid Hormones. International Journal of Endocrinology. 2015; 2015 ():1-22.
Chicago/Turabian StyleMarcello Maggio; Francesca De Vita; Alberto Fisichella; Fulvio Lauretani; Andrea Ticinesi; Graziano Ceresini; Anne Cappola; Luigi Ferrucci; Gian Paolo Ceda. 2015. "The Role of the Multiple Hormonal Dysregulation in the Onset of “Anemia of Aging”: Focus on Testosterone, IGF-1, and Thyroid Hormones." International Journal of Endocrinology 2015, no. : 1-22.
Objective: Recent studies indicate a role for the age-related decline of anabolic hormones, especially testosterone, in the onset of “anemia of aging.” Some of testosterone's erythropoietic activities are mediated by insulin-like growth factor (IGF)-1, which also seems to have independent erythropoietic effects. However, the associations among IGF-1, anemia, and hemoglobin (Hb) have not been adequately investigated in older populations. Methods: We used data from a representative sample of 953 subjects ≥65 years who participated in the InCHIANTI (Invecchiare in Chianti) Study and were not on growth hormone (GH) or erythropoietin therapy and were not diagnosed with hematologic malignancies or other cancers. Anemia was defined according to the World Health Organization (WHO) criteria by Hb level ≤13 g/dL in males and ≤12 g/dL in females. Backward multiple regression analyses including age, IGF binding protein (IGFBP)-3, testosterone, comorbidities, inflammatory markers, and anemia-related measures were used to address the relationship between IGF-1 and Hb and between IGF-1 and anemia in both sexes. Results: We found that 46/410 (11.2%) males and 71/543 (13.0%) females were defined as anemic. After adjustment for age, anemic males (100 ± 54 vs. 130 ± 56, P<.001) and females (89.1 ± 48 vs. 110 ± 52, P = .001) exhibited lower IGF-1 levels than their nonanemic counterparts. IGF-1 levels were independently and negatively associated with anemia in males (β ± SE = −0.0005 ± 0.0002, P = .04) but not in females (β ± SE = −0.0002 ± 0.0002, P = .40). In both males (β ± SE = 0.002 ± 0.001, P = .03) and females (β ± SE = 0.002 ± 0.0009, P = .03), IGF-1 levels were independently and positively associated with Hb levels. Conclusion: In older males but not in females, IGF-1 levels are negatively associated with anemia. IGF-1 levels are independent and positive determinants of Hb concentration in both sexes. Abbreviations: BMI = body mass index CRP = C-reactive protein CV = coefficient of variation GH = growth hormone Hb = hemoglobin IGF-1 = insulin-like growth factor-1 IGFBP-3 = insulin-like growth factor binding protein-3 IL-6 = interleukin-6 InCHIANTI = Invecchiare in Chianti MDC = minimum detectable concentration sTfr = soluble transferrin receptor WHO = World Health Organization
Francesca De Vita; Marcello Maggio; Fulvio Lauretani; Lara Crucitti; Stefania Bandinelli; Federica Mammarella; Francesco Landi; Luigi Ferrucci; Gian Paolo Ceda. Insulin-Like Growth Factor-1 and Anemia in Older Subjects: The Inchianti Study. Endocrine Practice 2015, 21, 1211 -1218.
AMA StyleFrancesca De Vita, Marcello Maggio, Fulvio Lauretani, Lara Crucitti, Stefania Bandinelli, Federica Mammarella, Francesco Landi, Luigi Ferrucci, Gian Paolo Ceda. Insulin-Like Growth Factor-1 and Anemia in Older Subjects: The Inchianti Study. Endocrine Practice. 2015; 21 (11):1211-1218.
Chicago/Turabian StyleFrancesca De Vita; Marcello Maggio; Fulvio Lauretani; Lara Crucitti; Stefania Bandinelli; Federica Mammarella; Francesco Landi; Luigi Ferrucci; Gian Paolo Ceda. 2015. "Insulin-Like Growth Factor-1 and Anemia in Older Subjects: The Inchianti Study." Endocrine Practice 21, no. 11: 1211-1218.
Background. In vitro evidence suggests anti-estrogenic properties for retinol and carotenoids, supporting a chemo-preventive role of these phytochemicals in estrogen-dependent cancers. During aging there are significant reductions in retinol and carotenoid concentrations, whereas estradiol levels decline during menopause and progressively increase from the age of 65. We aimed to investigate the hypothesis of a potential relationship between circulating levels of retinol, carotenoids, and estradiol (E2) in a cohort of late post-menopausal women. Methods. We examined 512 women ≥ 65 years from the InCHIANTI study. Retinol, α-caroten, β-caroten, β-criptoxantin, lutein, zeaxanthin, and lycopene levels were assayed at enrollment (1998–2000) by High-Performance Liquid Chromatography. Estradiol and testosterone (T) levels were assessed by Radioimmunometry (RIA) and testosterone-to-estradiol ratio (T/E2), as a proxy of aromatase activity, was also calculated. General linear models adjusted for age (Model 1) and further adjusted for other confounders including Body Mass Index (BMI) BMI, smoking, intake of energy, lipids, and vitamin A; C-Reactive Protein, insulin, total cholesterol, liver function, and testosterone (Model 2) were used to investigate the relationship between retinol, carotenoids, and E2 levels. To address the independent relationship between carotenoids and E2 levels, factors significantly associated with E2 in Model 2 were also included in a fully adjusted Model 3. Results. After adjustment for age, α-carotene (β ± SE = −0.01 ± 0.004, p = 0.02) and β-carotene (β ± SE = −0.07 ± 0.02, p = 0.0007) were significantly and inversely associated with E2 levels. α-Carotene was also significantly and positively associated with T/E2 ratio (β ± SE = 0.07 ± 0.03, p = 0.01). After adjustment for other confounders (Model 2), the inverse relationship between α-carotene (β ± SE = −1.59 ± 0.61, p = 0.01), β-carotene (β ± SE = −0.29 ± 0.08, p = 0.0009), and E2 persisted whereas the relationship between α-carotene and T/E2 ratio was attenuated (β ± SE = 0.22 ± 0.12, p = 0.07). In a fully adjusted model (Model 3), only β-carotene (β ± SE = −0.05 ± 0.02, p = 0.03) was significantly and inversely associated with E2 levels independent of α-carotene. No association was found between retinol, total non-pro-vitamin A carotenoids, lutein, zeaxanthin, and lycopene, and E2 levels. Conclusions: In older women, β-carotene levels are independently and inversely associated with E2.
Marcello Maggio; Francesca De Vita; Fulvio Lauretani; Stefania Bandinelli; Richard D. Semba; Benedetta Bartali; Antonio Cherubini; Anne R. Cappola; Gian Paolo Ceda; Luigi Ferrucci. Relationship between Carotenoids, Retinol, and Estradiol Levels in Older Women. Nutrients 2015, 7, 6506 -6519.
AMA StyleMarcello Maggio, Francesca De Vita, Fulvio Lauretani, Stefania Bandinelli, Richard D. Semba, Benedetta Bartali, Antonio Cherubini, Anne R. Cappola, Gian Paolo Ceda, Luigi Ferrucci. Relationship between Carotenoids, Retinol, and Estradiol Levels in Older Women. Nutrients. 2015; 7 (8):6506-6519.
Chicago/Turabian StyleMarcello Maggio; Francesca De Vita; Fulvio Lauretani; Stefania Bandinelli; Richard D. Semba; Benedetta Bartali; Antonio Cherubini; Anne R. Cappola; Gian Paolo Ceda; Luigi Ferrucci. 2015. "Relationship between Carotenoids, Retinol, and Estradiol Levels in Older Women." Nutrients 7, no. 8: 6506-6519.
In the last 2 decades, it was observed a widely increased use of proton pump inhibitors (PPIs) especially in older populations. Despite the fact that PPIs are superior to histamine receptor antagonists in treating gastroesophageal reflux disease (GERD) and peptic ulcers, the chronic use of PPIs has been associated with adverse clinical outcomes including higher risk of fractures and Clostridium difficile infections. In vitro studies have shown that PPIs negatively modulate the bioactivity of insulin-like growth factor-1 (IGF-1), anabolic hormone and nutritional marker. However, whether or not PPIs use has negative influence on survival and independence of activities of daily living (ADL) and the mechanisms underlying these hypothesized associations are still poorly known. The aims of the study were to test the relationship between the use of PPIs and adverse clinical outcomes (mortality and rehospitalization, loss of ADL) and the association between use of PPIs and cortical and trabecular bone mineral density, IGF-1 bioactivity in older patients of 2 different populations. In 491 patients (mean age 80.1 ± 5.9 years), categorized as PPI users and non users, discharged from 11 acute care medical wards and 3 long-term care/rehabilitation units, we tested the relationship between use of PPIs and 1- year mortality or combined end-point mortality and rehospitalization and incident dependency by using time-dependent Cox proportional hazard regression models and after propensity score matching. The association between use of PPIs, IGF-1 and bone mineral density was estimated by multivariate regression model adjusted for multiple confounders in 938 subjects (413 men and 525 women) aged ≥ 65 years, from the InCHIANTI Study, with complete information on tibial pQCT, IGF-1, IGF-binding protein-1 (IGFBP-1) and medications. In the hospitalized population the use of PPIs was independently associated with mortality (hazard ratio, 1.51 [95% CI, 1.03–2.77]) but not with the combined end point (1.49 [0.98–2.17]). An increased risk of mortality was observed among patients exposed to high-dose PPIs vs none (hazard ratio, 2.59 [95% CI, 1.22–7.16]). Use of PPIs was significantly associated with functional decline either before (OR = 1.75; 95% CI = 1.17–2.60) and after propensity score matching (OR = 2.44; 95% CI = 1.36–4.41). In the InCHIANTI population, PPI users showed age- and sex-adjusted lower vBMDt than nonusers (180.5 ± 54.8 vs. 207.9 ± 59.4, P = 0.001). The inverse association between PPI use and vBMDt remained almost unchanged after adjustment for multiple confounders. There was no statistically significant difference in vBMDc between PPI users and nonusers. PPI users had lower IGF-1 levels (81,9 [61,1-113,8]) than non-users (110 [77,8–148,6]), P = 0.02. After further adjustment for BMI, liver function, number of medications, caloric intake and IGFBP-1, the relationship between use of PPI and IGF-1 remained statistically significant (β...
M. Maggio; A. Corsonello. Use of proton pump inhibitors in older subjects: Risk of adverse clinical outcomes and potential mechanisms. European Geriatric Medicine 2015, 6, 94 .
AMA StyleM. Maggio, A. Corsonello. Use of proton pump inhibitors in older subjects: Risk of adverse clinical outcomes and potential mechanisms. European Geriatric Medicine. 2015; 6 (1):94.
Chicago/Turabian StyleM. Maggio; A. Corsonello. 2015. "Use of proton pump inhibitors in older subjects: Risk of adverse clinical outcomes and potential mechanisms." European Geriatric Medicine 6, no. 1: 94.
Objective: During the male aging process, testosterone (T) levels progressively fall and inflammatory biomarkers increase. Although a relationship between these 2 phenomena has been tested in previous clinical trials, there is inconclusive evidence about the potential anti-inflammatory action of T. Methods: A total of 108 healthy males >65 years with serum T concentration <475 ng/dL were recruited by direct mailings to alumni of the University of Pennsylvania and Temple University and randomized to 60-cm2 T or a placebo patch for 36 months. Ninety-six subjects completed the trial. Information and stored serum specimens from this trial were used to test the hypothesis of the inhibitory effect of T on inflammation. We evaluated 70 males (42 in the T group) who had banked specimens from multiple time points available for assays of T, C-reactive protein (CRP), tumor necrosis factor (TNF)-α, soluble TNF-α receptor-1 (TNFR1), interleukin-6 (IL-6), and soluble IL-6 receptors (sIL6r and sgp130). Results: The mean age ± SD at baseline was 71.8 ± 4.9 years. Testosterone replacement therapy for 36 months did not induce significant decreases in inflammatory markers. A trend toward a significant increase was observed in the placebo group for TNF-α (P = .03) and sgp130 (P = .01). Significant differences in estimated means of TNFR1 (but not other inflammatory markers), with lower levels in the T group, were observed at the 36-month time point. In T-treated subjects we found an almost significant treatment x time interaction term TNFR1 (P = .02) independent of total body fat content as assessed by dual energy X-ray absorptiometry (DXA). No serious adverse effect was observed. Conclusions: Transdermal T treatment of older males for 36 months is not associated with significant changes in inflammatory markers.
Marcello Maggio; Peter J. Snyder; Francesca De Vita; Gian Paolo Ceda; Yuri Milaneschi; Fulvio Lauretani; Michele Luci; Chiara Cattabiani; Helen Peachey; Giorgio Valenti; Anne R. Cappola; Dan L. Longo; Luigi Ferrucci. Effects of Transdermal Testosterone Tretment on Inflammatory Markers in Elderly Males. Endocrine Practice 2014, 20, 1170 -1177.
AMA StyleMarcello Maggio, Peter J. Snyder, Francesca De Vita, Gian Paolo Ceda, Yuri Milaneschi, Fulvio Lauretani, Michele Luci, Chiara Cattabiani, Helen Peachey, Giorgio Valenti, Anne R. Cappola, Dan L. Longo, Luigi Ferrucci. Effects of Transdermal Testosterone Tretment on Inflammatory Markers in Elderly Males. Endocrine Practice. 2014; 20 (11):1170-1177.
Chicago/Turabian StyleMarcello Maggio; Peter J. Snyder; Francesca De Vita; Gian Paolo Ceda; Yuri Milaneschi; Fulvio Lauretani; Michele Luci; Chiara Cattabiani; Helen Peachey; Giorgio Valenti; Anne R. Cappola; Dan L. Longo; Luigi Ferrucci. 2014. "Effects of Transdermal Testosterone Tretment on Inflammatory Markers in Elderly Males." Endocrine Practice 20, no. 11: 1170-1177.
Vitamin D plays a role in a wide range of extraskeletal processes, including vascular function. Endothelial dysfunction is a predictor of cardiovascular disease, especially in older subjects. However, the relationship between vitamin D levels and indexes of endothelial vasodilation has never been fully addressed in older individuals. The objective of this study was to examine the association between vitamin D and endothelial function in a large community-based sample of older subjects. This cross-sectional study involved 852 community-dwelling men and women aged 70 years from the Prospective Study of the Vasculature in Uppsala Seniors (PIVUS), with complete data on vascular function and 25-hydroxyvitamin D. We evaluated endothelium-dependent vasodilation by an invasive forearm technique with acetylcholine, endothelium-independent vasodilation by sodium nitroprussiate, flow-mediated vasodilation, and the pulse wave analysis (reflectance index). Vitamin D levels were measured by chemiluminescence. We used multivariate regression models adjusted for body mass index (model 1) and for multiple confounders (high-sensitivity C-reactive protein, insulin, total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, smoking, sex hormones, season of blood collection, hypertension, diabetes, cardiovascular medications and diseases, statin usage, plasma calcium and calcium intake, PTH, physical exercise, liver and kidney function tests, albumin; model 2). In women, but not in men, vitamin D levels were positively associated with endothelium-independent vasodilation in both model 1 (β ± SE = 1.41 ± 0.54; P = .001), and model 2 (β ± SE = 2.01 ± 0.68; P = .003).We found no significant relationship between vitamin D levels and endothelium-dependent vasodilation, flow-mediated vasodilation, and reflectance index in both sexes. In older women, but not in men, vitamin D is positively and independently associated with EIDV.
Marcello Maggio; Francesca De Vita; Fulvio Lauretani; Gian Paolo Ceda; Elena Volpi; Francesco Giallauria; Giuseppe De Cicco; Chiara Cattabiani; Håkan Melhus; Karl Michaëlsson; Tommy Cederholm; Lars Lind. Vitamin D and Endothelial Vasodilation in Older Individuals: Data From the PIVUS Study. The Journal of Clinical Endocrinology & Metabolism 2014, 99, 3382 -3389.
AMA StyleMarcello Maggio, Francesca De Vita, Fulvio Lauretani, Gian Paolo Ceda, Elena Volpi, Francesco Giallauria, Giuseppe De Cicco, Chiara Cattabiani, Håkan Melhus, Karl Michaëlsson, Tommy Cederholm, Lars Lind. Vitamin D and Endothelial Vasodilation in Older Individuals: Data From the PIVUS Study. The Journal of Clinical Endocrinology & Metabolism. 2014; 99 (9):3382-3389.
Chicago/Turabian StyleMarcello Maggio; Francesca De Vita; Fulvio Lauretani; Gian Paolo Ceda; Elena Volpi; Francesco Giallauria; Giuseppe De Cicco; Chiara Cattabiani; Håkan Melhus; Karl Michaëlsson; Tommy Cederholm; Lars Lind. 2014. "Vitamin D and Endothelial Vasodilation in Older Individuals: Data From the PIVUS Study." The Journal of Clinical Endocrinology & Metabolism 99, no. 9: 3382-3389.
In older persons, vitamin D insufficiency and a subclinical chronic inflammatory status frequently coexist. Vitamin D has immune-modulatory and in vitro anti-inflammatory properties. However, there is inconclusive evidence about the anti-inflammatory role of vitamin D in older subjects. Thus, we investigated the hypothesis of an inverse relationship between 25-hydroxyvitamin D (25(OH)D) and inflammatory markers in a population-based study of older individuals. After excluding participants with high-sensitivity C-reactive protein (hsCRP) ≥ 10 mg/dl and those who were on chronic anti-inflammatory treatment, we evaluated 867 older adults ≥65 years from the InCHIANTI Study. Participants had complete data on serum concentrations of 25(OH)D, hsCRP, tumor necrosis factor (TNF)-α, soluble TNF-α receptors 1 and 2, interleukin (IL)-1β, IL-1 receptor antagonist, IL-10, IL-18, IL-6, and soluble IL-6 receptors (sIL6r and sgp130). Two general linear models were fit (model 1—adjusted for age, sex, and parathyroid hormone (PTH); model 2—including covariates of model 1 plus dietary and smoking habits, physical activity, ADL disability, season, osteoporosis, depressive status, and comorbidities). The mean age was 75.1 ± 17.1 years ± SD. In model 1, log(25OH-D) was significantly and inversely associated with log(IL-6) (β ± SE = −0.11 ± 0.03, p = <0.0001) and log (hsCRP) (β ± SE = −0.04 ± 0.02, p = 0.04) and positively associated with log(sIL6r) (β ± SE = 0.11 ± 0.04, p = 0.003) but not with other inflammatory markers. In model 2, log (25OH-D) remained negatively associated with log (IL-6) (β ± SE = −0.10 ± 0.03, p = 0.0001) and positively associated with log(sIL6r) (β ± SE = 0.11 ± 0.03, p = 0.004) but not with log(hsCRP) (β ± SE = −0.01 ± 0.03, p = 0.07). 25(OH)D is independently and inversely associated with IL-6 and positively with sIL6r, suggesting a potential anti-inflammatory role for vitamin D in older individuals.
Francesca De Vita; Fulvio Lauretani; Juergen Bauer; Ivan Bautmans; Michelle Shardell; Antonio Cherubini; Giuliana Bondi; Giovanni Zuliani; Stefania Bandinelli; Mario Pedrazzoni; Elisabetta Dall’Aglio; Gian Paolo Ceda; Marcello Maggio. Relationship between vitamin D and inflammatory markers in older individuals. AGE 2014, 36, 9694 .
AMA StyleFrancesca De Vita, Fulvio Lauretani, Juergen Bauer, Ivan Bautmans, Michelle Shardell, Antonio Cherubini, Giuliana Bondi, Giovanni Zuliani, Stefania Bandinelli, Mario Pedrazzoni, Elisabetta Dall’Aglio, Gian Paolo Ceda, Marcello Maggio. Relationship between vitamin D and inflammatory markers in older individuals. AGE. 2014; 36 (4):9694.
Chicago/Turabian StyleFrancesca De Vita; Fulvio Lauretani; Juergen Bauer; Ivan Bautmans; Michelle Shardell; Antonio Cherubini; Giuliana Bondi; Giovanni Zuliani; Stefania Bandinelli; Mario Pedrazzoni; Elisabetta Dall’Aglio; Gian Paolo Ceda; Marcello Maggio. 2014. "Relationship between vitamin D and inflammatory markers in older individuals." AGE 36, no. 4: 9694.
Mobility-disability is a common condition in older individuals. Many factors, including the age-related hormonal dysregulation, may concur to the development of disability in the elderly. In fact, during the aging process it is observed an imbalance between anabolic hormones that decrease (testosterone, dehydroepiandrosterone sulphate (DHEAS), estradiol, insulin like growth factor-1 (IGF-1) and Vitamin D) and catabolic hormones (cortisol, thyroid hormones) that increase. We start this review focusing on the mechanisms by which anabolic and catabolic hormones may affect physical performance and mobility. To address the role of the hormonal dysregulation to mobility-disability, we start to discuss the contribution of the single hormonal derangement. The studies used in this review were selected according to the period of time of publication, ranging from 2002 to 2013, and the age of the participants (≥65 years). We devoted particular attention to the effects of anabolic hormones (DHEAS, testosterone, estradiol, Vitamin D and IGF-1) on both skeletal muscle mass and strength, as well as other objective indicators of physical performance. We also analyzed the reasons beyond the inconclusive data coming from RCTs using sex hormones, thyroid hormones, and vitamin D (dosage, duration of treatment, baseline hormonal values and reached hormonal levels). We finally hypothesized that the parallel decline of anabolic hormones has a higher impact than a single hormonal derangement on adverse mobility outcomes in older population. Given the multifactorial origin of low mobility, we underlined the need of future synergistic optional treatments (micronutrients and exercise) to improve the effectiveness of hormonal treatment and to safely ameliorate the anabolic hormonal status and mobility in older individuals.
Marcello Maggio; Fulvio Lauretani; Francesca Vita; Shehzad Basaria; Giuseppe Lippi; Valeria Butto; Michele Luci; Chiara Cattabiani; Graziano Ceresini; Ignazio Verzicco; Luigi Ferrucci; Gian Paolo Ceda. Multiple Hormonal Dysregulation as Determinant of Low Physical Performance and Mobility in Older Persons. Current Pharmaceutical Design 2014, 20, 3119 -3148.
AMA StyleMarcello Maggio, Fulvio Lauretani, Francesca Vita, Shehzad Basaria, Giuseppe Lippi, Valeria Butto, Michele Luci, Chiara Cattabiani, Graziano Ceresini, Ignazio Verzicco, Luigi Ferrucci, Gian Paolo Ceda. Multiple Hormonal Dysregulation as Determinant of Low Physical Performance and Mobility in Older Persons. Current Pharmaceutical Design. 2014; 20 (19):3119-3148.
Chicago/Turabian StyleMarcello Maggio; Fulvio Lauretani; Francesca Vita; Shehzad Basaria; Giuseppe Lippi; Valeria Butto; Michele Luci; Chiara Cattabiani; Graziano Ceresini; Ignazio Verzicco; Luigi Ferrucci; Gian Paolo Ceda. 2014. "Multiple Hormonal Dysregulation as Determinant of Low Physical Performance and Mobility in Older Persons." Current Pharmaceutical Design 20, no. 19: 3119-3148.
Gian Paolo Ceda And Fulvio Lauretani Marcello Maggio; Gian Paolo Ceda; Fulvio Lauretani. Editorial (Thematic Issue: The Multidomain Mobility Lab in Older Persons: From Bench to Bedside). Current Pharmaceutical Design 2014, 20, 3093 -3094.
AMA StyleGian Paolo Ceda And Fulvio Lauretani Marcello Maggio, Gian Paolo Ceda, Fulvio Lauretani. Editorial (Thematic Issue: The Multidomain Mobility Lab in Older Persons: From Bench to Bedside). Current Pharmaceutical Design. 2014; 20 (19):3093-3094.
Chicago/Turabian StyleGian Paolo Ceda And Fulvio Lauretani Marcello Maggio; Gian Paolo Ceda; Fulvio Lauretani. 2014. "Editorial (Thematic Issue: The Multidomain Mobility Lab in Older Persons: From Bench to Bedside)." Current Pharmaceutical Design 20, no. 19: 3093-3094.
The adrenal prohormone dehydroepiandrosterone (DHEA) and its sulphate conjugate (DHEAS) steadily decrease with age by 10% per decade reaching a nadir after the age of 80. Both DHEA and DHEAS (DHEA/S) exert many biological activities in different tissues and organs. In particular, DHEA and DHEAS are produced de novo in the brain, hence their classification as neurosteroids. In humans, the brain-to-plasma ratios for DHEA and DHEAS are 4–6.5 and 8.5, respectively, indicating a specific neuroendocrine role for these hormones. DHEA/S stimulates neurite growth, neurogenesis and neuronal survival, apoptosis, catecholamine synthesis and secretion. Together with antioxidant, anti-inflammatory and anti-glucocorticoid properties, it has been hypothesized a neuroprotective effect for DHEA/S. We conducted an accurate research of the literature using PubMed. In the period of time between 1994 and 2013, we selected the observational human studies testing the relationship between DHEA/S and cognitive function in both sexes. The studies are presented according to the cross-sectional and longitudinal design and to the positive or neutral effects on different domains of cognitive function. We also analysed the Clinical Trials, available in the literature, having cognitive domains as the main or secondary outcome. Although the cross-sectional evidence of a positive association between DHEA/S and cognitive function, longitudinal studies and RCTs using DHEA oral treatment (50 mg/day) in normal or demented adult–older subjects, have produced conflicting and inconsistent results. In summary, the current data do not provide clear evidence for the usefulness of DHEA treatment to improve cognitive function in adult–older subjects. This article is part of a Special Issue entitled ‘Essential role of DHEA’.
Marcello Maggio; Francesca De Vita; Alberto Fisichella; Elena Colizzi; Sandra Provenzano; Fulvio Lauretani; Michele Luci; Graziano Ceresini; Elisabetta Dall’Aglio; Paolo Caffarra; Giorgio Valenti; Gian Paolo Ceda. DHEA and cognitive function in the elderly. The Journal of Steroid Biochemistry and Molecular Biology 2014, 145, 281 -292.
AMA StyleMarcello Maggio, Francesca De Vita, Alberto Fisichella, Elena Colizzi, Sandra Provenzano, Fulvio Lauretani, Michele Luci, Graziano Ceresini, Elisabetta Dall’Aglio, Paolo Caffarra, Giorgio Valenti, Gian Paolo Ceda. DHEA and cognitive function in the elderly. The Journal of Steroid Biochemistry and Molecular Biology. 2014; 145 ():281-292.
Chicago/Turabian StyleMarcello Maggio; Francesca De Vita; Alberto Fisichella; Elena Colizzi; Sandra Provenzano; Fulvio Lauretani; Michele Luci; Graziano Ceresini; Elisabetta Dall’Aglio; Paolo Caffarra; Giorgio Valenti; Gian Paolo Ceda. 2014. "DHEA and cognitive function in the elderly." The Journal of Steroid Biochemistry and Molecular Biology 145, no. : 281-292.
To investigate the effects of proton pump inhibitors (PPIs) on the insulin-like-growth factor 1(IGF-1) system in the elderly. cross-sectional. InCHIANTI study. 938 older subjects (536 women, 402 men, mean age 75.7±7.4 years). complete data on age, sex, BMI, liver function, medications, dietary intake, IGF-1, IGF-binding protein-1 and -3 (IGFBP-1, IGFBP-3). Participants were categorized by PPI use, identifying 903 PPI non users and 35 users. After adjusting for age, male PPI users (107.0 ± 69.6 vs. 127.1 ± 55.8, p<0.001) and female PPI users (87.6 ± 29.1 vs. 107.6 ± 52.3, p=0.03) had lower IGF-1 levels than non-users. IGFBP-1 levels were similar in the two groups in both sexes. In whole population, after adjustment for age and sex, PPI users had lower IGF-1 levels 81.9 [61.1-113.8] than non-users 110 [77.8-148.6], p=0.02. After further adjustment for BMI, albumin, liver function, C-reactive protein, Interleukin-6, number of medications, ACE-inhibitors use, caloric intake, protein intake, physical activity, glycemia, and IGFBP-1, the use of PPIs remained significantly and negatively associated with IGF-1 levels (β±SE = -19.60±9.83, p=0.045). Use of PPIs was independently and negatively associated with IGF-1 levels.
Marcello Maggio; Fulvio Lauretani; F. De Vita; V. Buttò; C. Cattabiani; S. Masoni; E. Sutti; G. Bondi; E. Dall’Aglio; S. Bandinelli; A. Corsonello; A. M. Abbatecola; F. Lattanzio; L. Ferrucci; Gian Paolo Ceda. Relationship between use of proton pump inhibitors and IGF system in older subjects. The journal of nutrition, health & aging 2013, 18, 420 -3.
AMA StyleMarcello Maggio, Fulvio Lauretani, F. De Vita, V. Buttò, C. Cattabiani, S. Masoni, E. Sutti, G. Bondi, E. Dall’Aglio, S. Bandinelli, A. Corsonello, A. M. Abbatecola, F. Lattanzio, L. Ferrucci, Gian Paolo Ceda. Relationship between use of proton pump inhibitors and IGF system in older subjects. The journal of nutrition, health & aging. 2013; 18 (4):420-3.
Chicago/Turabian StyleMarcello Maggio; Fulvio Lauretani; F. De Vita; V. Buttò; C. Cattabiani; S. Masoni; E. Sutti; G. Bondi; E. Dall’Aglio; S. Bandinelli; A. Corsonello; A. M. Abbatecola; F. Lattanzio; L. Ferrucci; Gian Paolo Ceda. 2013. "Relationship between use of proton pump inhibitors and IGF system in older subjects." The journal of nutrition, health & aging 18, no. 4: 420-3.