Relation of secondhand smoking to mild cognitive impairment in older inpatients.

Up to now, controversy still exists regarding the role of secondhand smoking (SHS) in developing cognitive impairment. This study aimed to evaluate the prevalence of SHS in hospitalized older patients with cognitive deficit, particularly in those with mild cognitive impairment (MCI). Smoking history was classified into four groups: never smokers, former-active smokers/no SHS, active smokers, and secondhand smokers, and cognitive function into three levels: normal cognition (C), MCI, and dementia. A total of 933 older subjects with diagnoses of MCI (n = 98), dementia (n = 124), or C (n = 711) were enrolled in this cross-sectional study. As expected, patients with dementia had significantly higher frequency of former-active smokers than cognitively normal. Moreover, patients with MCI showed a significantly higher frequency of active and secondhand smokers than patients with dementia or C. A smoking history is very frequent in older patients with dementia. Patients with MCI had even higher rate of exposure to active or secondhand smoking.

Geriatric assessment of a giant splenic artery aneurysm accidentally diagnosed.

Giant splenic artery aneurysms (GSAAs) larger than 8 cm in diameter have rarely been reported, particularly in older people. They are clinically important lesions, often asymptomatic and related to an increased risk of complications such as abrupt rupture, requiring emergency surgical treatment. Comprehensive geriatric assessment (CGA), originally developed for multidimensional clinical evaluation in several geriatric settings, was recently proposed as a fundamental preoperative aid for treatment planning of older patients undergoing elective surgery and preventing adverse post-operative outcomes. We present the first case of an asymptomatic 9-cm partially thrombosed GSAA, accidentally diagnosed during abdominal ultrasound in a 63-year-old woman from the Apulia region in Southern Italy. She successfully underwent aneurysmectomy, highlighting the usefulness of CGA in elective surgical patients.

Nutritional status in hospitalized elderly patients with mild cognitive impairment.

BACKGROUND & AIMS: Malnutrition is prevalent in hospitalized elderly people leading to complications including cognitive deficit. However, the relationship between the nutritional status and the preclinical phase of dementia in the elderly is still unclear. The aim of this study was to evaluate the prevalence of malnutrition in older patients with mild cognitive impairment. METHODS: A total of 623 hospitalized elderly patients underwent the comprehensive geriatric assessment to evaluate medical, cognitive, affective and social aspects. Nutritional status was assessed by using the mini-nutritional assessment. The cognitive function was categorized into three levels -- normal cognition, mild cognitive impairment and dementia -- according to the neuropsychological evaluation. RESULTS: According to the mini-nutritional assessment classification, 18% of the sample study was assessed as well nourished, 58% at risk of malnutrition and 24% as malnourished. Patients with mild cognitive impairment and dementia had significantly lower frequency of well nourished and higher frequency of at risk of malnutrition or malnourished than patients with normal cognition. CONCLUSIONS: Malnutrition is prevalent in hospitalized elderly patients with cognitive deficit, even in those with mild cognitive impairment. It remains to be demonstrated whether improvement in nutritional status may delay progression to dementia in these patients.