Societá

Attivitá SIGG

Giornale di Gerontologia

Numero 1, Febbraio 2007 - Volume LV

Copertina

Sommario

Frontespizio, sommario e norme per la preparazione dei manoscritti

Editoriale

Vivere piú a lungo, lavorare piú a lungo?

A. ROSINA
Professore associato di Demografia all´Universitá Cattolica di Milano

G GERONTOL 2007;55:1-2

Si riaccende, con l´avvicinarsi della finanziaria, il dibattito sull´innalzamento dell´etá pensionabile. Vari studi mettono in evidenza come una risposta alle conseguenze dell´allungamento della durata di vita sulla spesa previdenziale debba passare soprattutto attraverso un aumento dell´occupazione dopo i 50 anni. Un recente rapporto OCSE, ripreso da molti studiosi, propone la formula: ″live longer, work longer″. Ma ″work longer″ significa, soprattutto per l´Italia, anche un accesso meno tardivo al primo impiego.

Articoli originali

La tolleranza allo sforzo nel paziente anziano affetto da BPCO in fase stabile

S. COSSI, V. PINELLI, A. MARENGONI, G. ROMANELLI
I Medicina-Geriatria Acuti, Spedali Civili (Brescia), Fondazione ″Richiedei″ (Gussago), Dipartimento di Scienze Mediche e Chirurgiche, Universitá di Brescia

G GERONTOL 2007;55:3-10

Objective: chronic obstructive pulmonary disease (COPD) is often associated with disability, especially in the old age. The functional status is worsened by a poor exercise endurance. The objective of the present study was to identify which factors were associated with indicators of the exercise endurace in old COPD patients.

Methods: 38 out-patients (> 64 years) affected by stable COPD underwent the following examinations: spirometry, 6-minute walking test, evaluation of dyspnoea with a visual-analogue scale, and multidimensional assessment comprehensive of quality of life questionnairs.

Results: the forced expiratory volume (FEV1), the inspiratory capacity (IC) and the geriatric depression scale score (GDS) were correlated with several indicators of the exercise endurance (dyspnoea during exercise, post-exercise, and the item physical activity of the SF-36 questionnair).

Conclusions: among with the respiratory function, the GDS score is a good indicator of exercise endurance perception in COPD old patients.

Key words: COPD - Dyspnoea - Exercise endurance - Old age

Test delle matrici: velocitá e accuratezza della ricerca visiva nel corso dell´invecchiamento

C. ABBATE*, C. LUZZATTI**, C. VERGANI***
* Universitá di Milano e Fondazione I.R.C.C.S, Ospedale Maggiore Policlinico, ″Mangiagalli, e Regina Elena″, Milano, Divisione di Geriatria;
** Universitá di Milano-Bicocca, Dipartimento di Psicologia;
*** Cattedra di Geriatria e Gerontologia, Universitá di Milano e Fondazione I.R.C.C.S., Ospedale Maggiore Policlinico ″Mangiagalli, e Regina Elena″, Milano, Divisione di Geriatria

G GERONTOL 2007;55:11-20

Objective: the objective of the study was to assess the accuracy and speed of matrix test performance, in aging.

Methods: we tested a sample of 227 subjects, referring to the Geriatric Unit of Ospedale Policlinico of Milan. Subjects were 159 female and 68 male, aged from 58 to 94 years, with 3 to 18 years of education. We excluded patients with acute or chronic neurological disease, sensorial impairment and alcoholism. Data recorded were accuracy and speed of test performance according to new measures introduced.

Results: the results show significant correlation between execution time and age, especially in second and third matrix. There is not significant correlation between the new accuracy measures of the three test matrix and age.

Conclusions: we conclude that speed of matrix test performance decreases with aging, while the accuracy of execution remains stable. The study supports the hypothesis that visual attention is preserved in aging, and confirms a senile slowing. Normative data for the new measures of accuracy and speed of the matrix test performance are presented.

Key words: Selective attention - Visual search - Neuropsychological test - Aging

Articoli speciali

Il cavo orale

E. FERRARI, P. SALVIOLI*, C. MUSSI
Cattedra di Geriatria e Gerontologia, Universitá di Modena e Reggio Emilia;
* Dottore in Odontoiatria e Protesi dentaria, Libero Professionista

G GERONTOL 2007;55:21-38

According to WHO the health of the mouth, teeth and associated structures and their functional viability should be improved in the old people; oral conditions can have serious, disabling effects. Dental status is associated with high overall mortality.
A more in depth attention to oral status and pathologies should be reccomended in older people; in particular infections, xerostomia, swallowing disorders should be avoided or prevented with appropriated and some time omitted intervention. The problems are more important in nursing homes.

Key words: Oral cavity - Parodontopathies - Xerostomia - Swallowing - Ab ingestis

La valutazione antropometrica e il fabbisogno calorico nell´anziano nei diversi setting curativi ed assistenziali: sono indispensabili nella pratica clinica?

M. FORONI, M. LUCA, C. PIFFERI, C. MUSSI
Cattedra di Geriatria e Gerontologia, Universitá di Modena e Reggio Emilia, Unitá Operativa di Geriatria, Nuovo Ospedale Civile ″S. Agostino-Estense″, Baggiovara di Modena

G GERONTOL 2007;55:39-44

In this review we considered the everyday problems that doctors and nurses have to face to achieve a correct nutritional intake for old people and elderly patients living in different settings (home, nursing home, hospital). The low improvement in the evaluation of weight, height, waist and arm circumferences can be one of the causes of the high prevalence of malnutrition in the old population. Specific nurse´s procedures are recommended to collect more correctly the basic antropometric parameters which must be reported in clinical and nursing records.

Atti Congresso

Acidi grassi poliinsaturi (PUFA n-3)

L. DEI CAS, S. NODARI, A. MANERBA
Cattedra di Cardiologia, Universitá di Brescia

G GERONTOL 2007;55:45-57

Nowadays, several observational and experimental studies, especially clinical randomized trials, have been proved polyunsaturated fatty acids n-3 (n-3 PUFAs) benefical effects. The ipolipidic effect was the first detected, so at first these drugs had been used for the treatment of dislipidemic disorders, while the antiinflammatory, antithrombotic, antiatherosclerotic and antiarrhythmogenic effects have been found later. GISSI-Prevenzione trial was the first which demonstrated the efficacy and tolerability of n-3 PUFAs in post-myocardial infarction patients. According to the evidence in literature, today n-3 PUFAs are indicated for the primary and secondary prevention of ischaemic cardiopathy and sudden cardiac death (SCD). Besides, as recently demonstrated, n-3 PUFAs could be indicated not only in patients affected by heart failure or with implantable cardioverter defibrillators, but also in patients at high risk for SCD and for the prevention of Atrial Fibrillation after coronary artery bypass surgery.
The latest studies underline the important role of n-3 PUFAs on the normal brain development, therefore n-3 PUFAs could be used both in the prevention and in the treatment of mental and cognitive diseases. As a matter of fact, n-3 PUFAs benefical effects on the vascular system can be extended also to cerebral system, where the defects of microcirculation are associated with decreased cognitive capacity and the progression of dementia, often present in the elderly patients. Lower n-3 PUFAs concentration in eritrocytes have been observed in patients affected by depression and the concentration have also been correlated with the severity of this psychiatric disease.
In conclusion, increased intake of n-3 PUFAs, both with a diet and a pharmacological therapy, could be indicated not only in the prevention and treatment of cardiovascular diseases but also in neurological and psychiatric diseases, expecially in the elderly patients who usually present more comorbilities.

Key words: Polyunsaturated fatty acids n-3 (n3-PUFAs) - Arrhythmias - Ischemic disease - Sudden cardiac death - Primary and secondary prevention