Relationship between socio-economic features and health status in elderly hospitalized patients.

We aimed at investigating the relationship between socioeconomic (SES) and health status in the context of an observational multicenter study of elderly hospitalized patients. Our series consisted of 473 patients aged 70 years or more. K-means cluster analysis was used to generate 3 clusters on the basis of age, gender, education, perception of personal economic situation, difficulty to reach health services, need for formal or informal support, family arrangement, and population density of residence municipality. Logistic regression analysis was used to identify correlates of "negative" SES. Correlates of "negative" SES cluster were older age (odds ratio=OR=5.19, 95% Cl=2.28-11.8), cognitive impairment (OR=6.36, 95%CI=3.11-13.0), emergency hospital admission (OR=3.11; 95%CI=1.52-6.35), and dependency in at least 1 BADL (OR=4.36, 95%CI=1.53-12.4). In conclusion, "negative" SES is associated with age and selected indices of frailty in elderly hospitalized patients. The evaluation of socio-economic problems should be routinely addressed in elderly hospitalized patients in order to tailor appropriately post-discharge use of health care resources.

Serum magnesium levels and cognitive impairment in hospitalized hypertensive patients.

We performed this cross-sectional case control study to investigate the association between low serum magnesium levels and cognitive impairment in hypertensive hospitalized patients. The study was carried out in general medical care units at 81 hospitals participating in the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) study throughout Italy, and a total of 1058 patients with diagnoses of hypertension at the discharge were studied. The occurrence of cognitive impairment at discharge was the primary outcome of our study. Cognitive impairment was ascertained using the Hodkinson Abbreviated Mental Test (HAMT). Sociodemographic variables, body mass index, laboratory parameters, comorbidity, use of antihypertensive drugs and number of drugs were considered as potential confounders. Twenty-nine percent of the selected hypertensive patients were classified as having cognitive impairment. In univariate analysis, older age, female sex, and low educational level showed a significant trend for association to cognitive impairment. Moreover the proportion of subjects with cognitive impairment decreased with increasing alcohol consumption, and the prevalence of ex smokers and smokers was significantly lower in patients with cognitive impairment. The lower tertiles for serum albumin and creatinine clearance were more frequent among patients with cognitive impairment, and the lower tertile for serum magnesium levels was significantly more frequent in these patients. Number of drugs was slightly lower in cognitively impaired patients, while number of diagnoses and length of hospital stay were higher in these subjects. In the multivariate logistic regression analysis cognitive impairment decreased with increasing education level (highest education: OR 0.11; 95 per cent CI 0.05-0.25). The lower tertile for serum albumin (< 3.5 g/dl) was significantly associated to cognitive impairment (OR 2.14; 95 per cent CI 1.31-3.49), as well as the lower tertiles for serum magnesium (0.74-0.86 mmol/L: OR 1.54; 95 per cent CI 1.06-2.22; < 0.74 mmol/L: OR 1.75; 95 per cent CI 1.13-2.72]. Our results demonstrate the existence of a significant association between magnesium imbalance and cognitive impairment. These data suggest that the assessment of magnesium status may be of some relevance in hypertensive subjects with cognitive disorders.