Use of specific serotonin reuptake inhibitors (SSRIs) (Sertraline or Citalopram) in the treatment of depression reduces the cardiovascular risk in the elderly: evidence from a Sicilian population >80 years recovered in the assisted sanitary residences (RSA).

The correlation between depression and cardiovascular pathologies was studied in geriatric age. As a matter of fact, the high comorbidity of depression with the sudden cardiac deaths or other cardiovascular events requires a careful evaluation of these causalities. A total of 110 patients were analyzed, recovered in assisted sanitary residence (from the widely used Italian name: "residenza sanitaria assistita" abbreviated as RSA) during the last 12 months. All patients were above the age of 80 years at the admission (mean age was 83.2+/-2.8 years), and all of them have had a diagnosis of depression according to the DSM IV. All patients were treated with the antidepressive specific serotonin reuptake inhibitor (SSRI) (Citalopram, 20-40mg/day, or Sertraline 50-100mg/day). The patients were divided on the basis of their therapeutic response in two groups: Group A (responders) and Group B (non-responders). After 4, 6 and 12 months of treatment, we observed a reduction of the cardiovascular events (-75%, -83% and -60%, respectively). These findings confirm the existence of a correlation between the level of affectivity and the cardiac functions.

Management and treatment of decubital ulcers of an elderly population in the assisted sanitary residence of Futura-Viagrande (Catania, Sicily, Italy).

Decubital lesions indicate the gravity of the pathologies of the elderly patients, representing a serious cause of disability and of mortality. The present study was aimed at evaluating the decubital lesions during 1 year of treatment in an assisted sanitary residence (abbreviated as RSA from the Italian name), through observations of the assistential and therapeutical outcomes, aimed at improving the quality of life of the recovered elderly patients. We had 131 patients involved from a total of 308 recovered patients in the RSA. Their mean age was 83.4+/-1.3 years (74 women and 57 men). All cases were treated, considering the actual clinical stages, according to the advanced protocols on the basis of the guidelines of the National Pressure Ulcer Advisory Panel (NPUAP). All patients were evaluated by using the Braden-scale at the start and after 30 days for having a risk for the development of decubital ulcers and also for monitoring the modifications during the therapy, while the improvements were evaluated only clinically, establishing the reduction of the stage of the lesions. A precise analysis of the data revealed a higher prevalence of decubital lesions at the entrance to the RSA, particularly the advanced Grades III and IV (84 patients, 27% of all recovered subjects), compared to those with lower gravity Grades I and II (47 cases, 15% of all recovered subjects). Complete healing was observed only in a few cases (18.0%), mainly in the lower grades. Applying the therapeutic methods and protocols of NPUAP, most of the ulcers displayed an improving tendency. We had only a few mortal cases due to the ulcers (3 deaths of 131 patients), nevertheless, numerous death cases for other causes occurred among the patients, having advanced grades of ulcers (12%). Our data confirm the statement that the decubital ulcers represent the marker of severity of the polypathological state of the fragile elderly patients.