Association of chronic non-steroidal anti-inflammatory drugs use and cognitive decline in non-demented elderly patients admitted to a geriatric evaluation and rehabilitation unit.

In a geriatric evaluation and rehabilitation unit (GERU), 258 elderly patients (M: 71, F: 187; mean age 77.4 +/- 7.5) scoring 22 or more at Mini-Mental State Examination (MMSE) consecutively admitted were assessed in order to evaluate the effects of non-steroidal anti-inflammatory drugs (NSAID) chronic treatment on cognitive status in non-demented elderly patients. Sixty-six patients (25.6%) were considered chronic NSAID users. Patients chronically assuming NSAADs showed a significantly higher MMSE score than non-users (26.9+/-2.1 vs 25.7+/-2.5, P<0.0005 ). After controlling for potential confounders in a multivariate model, chronic NSAID use remained independently associated with MMSE score. The results support a positive association between chronic NSAID use and cognitive function in non-demented elderly patients. Randomized controlled trials will be needed to definitively prove this beneficial effect.

3He spin-dependent cross sections and sum rules.

We present a measurement of the spin-dependent cross sections for the 3He over -->(e over -->,e')X reaction in the quasielastic and resonance regions at a four-momentum transfer 0.1< or =Q2< or =0.9 GeV2. The spin-structure functions have been extracted and used to evaluate the nuclear Burkhardt-Cottingham and extended Gerasimov-Drell-Hearn sum rules for the first time. The data are also compared to an impulse approximation calculation and an exact three-body Faddeev calculation in the quasielastic region.

[Comparative methodological contribution and critical observations on the interpretation of blood group determinations of mummies and skeletal remains]. / Vergleichend-methodologischer Beitrag und kritische Bemerkungen zur Interpretation von Blutgruppen-bestimmungen an Mumienrelikten und Skelettfunden.

Bone samples from autopsies, recent and subfossile samples as well as skin and muscle material from non-preserved local mummies were investigated. The material was evaluated morphologically and serologically in parallel by means of the well-known absorption-test, the agglutinin-cohesion technique with deionized concentrated EDTA extracts according to Borgognini, the absorption-elution technique according to Kind with the modification proposed by Kirst & Landes, and the immunofluorescence-histology according to Lengyel. With the latter method no specific results could be obtained at all; with the absorption and the absorption-elution tests the blood-group status of autoptic compacta material could always be estimated correctly, and also with recent bone samples an acceptable phenotype distribution was found. On the contrary, with the old-historic material consisting of 39 skeletons a reverse proportionality between the morphological preservation state and the serological results was found: the more advanced the decay of the organic matrix, the more frequent was the finding of blood-group A or B; the better preserved the bony substance, the more frequent negative (= 0 ?) results were obtained. By analogy with the findings in mummy tissue, where the tracing of A and B bloodgroup substances also prevailed in cases of extensive saprophyte contamination, the postmortal infiltration of microbiological blood-group active foreign material is discussed as a possible cause of erroneous diagnoses for bones, too. The compared methods yielded different results on the same bone in some cases, and also with the, according to our experiences, most suitable absorption-elution method contradictory blood-group findings were achieved with different bones of the same skeleton occasionally. In light of these results it seems possible to detect blood-group substances of the ABO system in bone material only under protective storage conditions, as tomb funeral, ossuaries, or reliquaries after centuries and with acceptable error quote; serological findings on subfossile materials must be valued with greatest reservation, and critical restraint should be recommended especially against the method of approach.

Mood improvement in elderly women after in-hospital physical rehabilitation.

OBJECTIVE: To evaluate the relationship between change in depressive symptoms and in-hospital physical rehabilitation in elderly women. DESIGN: Longitudinal study. SETTING: Hospital facility (geriatric evaluation and rehabilitation unit). PATIENTS: One hundred twenty-three elderly inpatient women (mean age: 78.4+/-6.9 years, range 60 to 93) with good cognitive status (Mini Mental State Examination: 23.1+/-5.1) consecutively admitted over a 7-month period. INTERVENTION: Physical therapy tailored to individual needs (five sessions a week of 30 to 45 minutes each). MAIN OUTCOMES MEASURES: On admission: cognition (MMSE), depressive symptoms (Geriatric Depression Scale [GDS]), functional status (basic and instrumental activities of daily living [BADL, IADL], Tinetti scale), and somatic health. On discharge: depressive symptoms and gait and balance performances (Tinetti scale). RESULTS: Seventy-five patients (61%) did not show changes on Tinetti scale over the hospitalization period and 48(39%) had a change of 3 or more points. Nonresponders had no change of GDS over the hospitalization period for all levels of physical disability on admission, whereas responders had relevant improvement of depressive symptoms when markedly disabled on admission, and progressively smaller improvements of depressive symptoms with increasing function on admission. CONCLUSIONS: The study provides evidence that mood status changes synchronically with disability.

Factors related to length of stay in a geriatric evaluation and rehabilitation unit.

Factors related to length of stay were examined in 295 elderly patients (mean age = 79.0 +/- 7.3, range 65-94; males = 75, females = 220), consecutively admitted to a Geriatric Evaluation and Rehabilitation Unit (GERU, P. Richiedei Hospital, Gussago, Brescia, Italy) over a twelve-month period (November 1, 1993-October 31, 1994). Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Basic Activities of Daily Living (BADL), Instrumental Activities of Daily Living (IADL), Tinetti Scale, Prognostic Nutritional Index (PNI), number of diseases and number of administered drugs were evaluated. An index of Disease Severity (IDS) was utilized to estimate the level of comorbidity severity. Three comorbidity classes were thus defined: I) patients with no disease of relevant severity; II) patients with only one disease of relevant severity accompanied by clinically significant comorbidity; and III) patients with two or more relevant diseases. The variables associated with the length of stay proved to be classes of comorbidity, MMSE, dependence in BADL and IADL, Tinetti scale, and PNI. The association of longer length of stay with greater comorbidity was enhanced by impairment in gait and balance (Tinetti < 18) and malnutrition (PNI > 45). These data suggest that the length of stay in hospital is related to comorbidity in patients with conditions of physical and biomedical frailty.

Assessment of functional ability with the bed rise difficulty scale in a group of elderly patients.

The aim of the study (part of the Progetto Longitudinale Gussago) was to evaluate the variables related to the difficulty in rising from a bed in 2 groups of elderly patients: nursing home residents, and patients admitted to a geriatric evaluation and management unit. Functional ability was tested through the bed rise difficulty scale (BRD). The version used in this study considered only those 7 items (out of 12) found to be of value. Only those patients who were able to rise from bed without help were selected in order to achieve the aim of the study (33 males, 113 females; mean age 79.6 +/- 7.3 years). Although the 146 patients assessed were considered as having a good functional level (Tinetti score 18.8 +/- 6.9, ADL Katz score 1.6 +/- 1.4), most of them had high scores on the BRD scale, indicating the ability of this scale to detect early, mild disability. The total score of the BRD scale was significantly related to the ADL Katz (r = 0.29, p = 0.000), Tinetti scale (r = -0.39, p = 0.000) and physical performance test (PTT; r = -0.47, p = 0.000). Similar results were obtained for the correlation between BRD time and ADL Katz (r = 0.033, p = 0.000), Tinetti scale (r = -0.30, p = 0.000) and PPT-(r = -0.46, p = 0.000). In a logistic regression analysis the items of the PPT scale considering upper extremity function and Tinetti balance score were significantly associated with the total bed rise time and score.

The effect of chronic diseases on physical function. Comparison between activities of daily living scales and the Physical Performance Test.

AIM: to verify the capacity of basic and instrumental activities of daily living (BADL and IADL) disability scales and of a performance-based test (Physical Performance Test; PPT) to detect the effect on the functional capacity of several common chronic conditions in elderly people. METHOD: a cross-sectional survey of the entire population aged 70 and over, living in Ospitaletto (Brescia, northern Italy)-549 subjects; 89.6% of the eligible population; 179 males and 370 females-was carried out in 1992. A multi-dimensional questionnaire administered at the subject's home was used to collect information on demographics, presence of several common chronic diseases and BADL and IADL. Objective physical capacity was assessed using the PPT. RESULTS: only cognitive deterioration and depression were independently associated with disability, as detected by BADL or IADL scales. Cognitive deterioration, stroke, parkinsonism, heart disease and hearing and visual loss were independently associated with PPT. The performance at PPT remained statistically associated with most of the same diseases when the analysis was restricted to subjects with no BADL or IADL disability. CONCLUSION: a performance-based measure, such as PPT, may detect a functional limitation before it becomes measurable by traditional self-reported BADL and IADL scales.

Q2 evolution of the neutron spin structure moments using a 3He target.

We have measured the spin structure functions g(1) and g(2) of 3He in a double-spin experiment by inclusively scattering polarized electrons at energies ranging from 0.862 to 5.058 GeV off a polarized 3He target at a 15.5 degrees scattering angle. Excitation energies covered the resonance and the onset of the deep inelastic regions. We have determined for the first time the Q2 evolution of Gamma(1)(Q2)= integral (1)(0)g(1)(x,Q2)dx, Gamma(2)(Q2)= integral (1)(0)g(2)(x,Q2)dx, and d(2)(Q2)= integral (1)(0)x(2)[2g(1)(x,Q2)+3g(2)(x,Q2)]dx for the neutron in the range 0.1< or =Q2< or =0.9 GeV2 with good precision. Gamma(1)(Q2) displays a smooth variation from high to low Q2. The Burkhardt-Cottingham sum rule holds within uncertainties and d(2) is nonzero over the measured range.