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BACKGROUND: Several indexes based on clinical and laboratory tests to identify frailty and to predict mortality have been produced. Only two studies, mixing clinical and laboratory parameters were made about a frailty index made of laboratory tests (FI-Lab) and mortality in older patients hospitalized for COVID-19. The aim of this study was to explore the accuracy and precision of an FI-Lab constructed with some common bio-humoral tests and mortality in a cohort of patients hospitalized for COVID-19. METHODS: The FI-Lab was constructed using 40 different bio-humoral tests during the first four days of hospitalization, with a score from 0 to 1. The association between FI-Lab and mortality was assessed using a multivariate Cox's regression analysis, reported as hazard ratios (HRs) and 95% confidence intervals (CIs). The accuracy of the FI-Lab was reported as area under the curve (AUC) and the precision with the C-Index. RESULTS: 376 patients (mean age: 65 years; 53.7% males) were initially included. During the follow-up period, 41 deceased. After adjusting for five different factors, an FI-Lab value >0.54, the median value of our cohort, was associated with a relative risk about five times greater than lower values. Modeling FI-LAB as a continous variable, each increase in 0.01 points was associated with an increased risk in mortality of 8.4% (HR=1.084; 95%CI: 1.039-2.044). The FI-Lab was highly accurate (AUC=0.91; 95%CI: 0.87-0.95) and precise (C-Index=0.81) in predicting death. CONCLUSIONS: A simple index based on common laboratory tests can be used to predict mortality among older people hospitalized for COVID-19.
Subject(s)
COVID-19 , Frailty , Hospitalization , Humans , COVID-19/mortality , COVID-19/diagnosis , COVID-19/epidemiology , Aged , Female , Male , Frailty/diagnosis , Frailty/epidemiology , Prognosis , Hospitalization/statistics & numerical data , Geriatric Assessment/methods , Frail Elderly/statistics & numerical data , Aged, 80 and over , SARS-CoV-2 , Middle AgedABSTRACT
^{140}Ce(n,γ) is a key reaction for slow neutron-capture (s-process) nucleosynthesis due to being a bottleneck in the reaction flow. For this reason, it was measured with high accuracy (uncertainty ≈5%) at the n_TOF facility, with an unprecedented combination of a high purity sample and low neutron-sensitivity detectors. The measured Maxwellian averaged cross section is up to 40% higher than previously accepted values. Stellar model calculations indicate a reduction around 20% of the s-process contribution to the Galactic cerium abundance and smaller sizeable differences for most of the heavier elements. No variations are found in the nucleosynthesis from massive stars.
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OBJECTIVES: Public health messaging during disasters help to provide knowledge and guidance for preventative behaviours and risk reduction. The aim of this review is to explore how public health messages are currently being provided during disasters and identify what influencing factors contribute to the effectiveness of these messages. STUDY DESIGN: Scoping review. METHODS: A scoping review was conducted using guidance from Joanna Briggs Methodology for Scoping Reviews. A narrative synthesis was utilised due to the heterogeneity of findings. The review included seventeen sources, addressing a variety of disasters around the globe over the past two decades. RESULTS: Three key influencing factors were identified and are illustrated in a concept model called the Audience, Information, Messenger and Mode (AIMM) Public Health Messaging Scale. This conceptual model depicts considerations such as the quantity, quality, and framing of information, the human and technological sources used for delivery and the audience needs and capabilities required for optimal message impact and effectiveness. CONCLUSIONS: Public health messages do influence prevention behaviours during disasters, but they must be carefully tailored and delivered to ensure adequate reach, comprehension, and compliance.
Subject(s)
Disasters , Public Health , Humans , NarrationABSTRACT
Neutron capture reaction cross sections on 74 Ge are of importance to determine 74 Ge production during the astrophysical slow neutron capture process. We present new resonance data on 74 Ge( n , γ ) reactions below 70 keV neutron energy. We calculate Maxwellian averaged cross sections, combining our data below 70 keV with evaluated cross sections at higher neutron energies. Our stellar cross sections are in agreement with a previous activation measurement performed at Forschungszentrum Karlsruhe by Marganiec et al., once their data has been re-normalised to account for an update in the reference cross section used in that experiment.
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OBJECTIVE: This is a review on clinical presentation, diagnosis, and treatment of reported cases of Bickerstaff brain encephalitis. MATERIALS AND METHODS: Cases of pediatric Bickerstaff's brainstem encephalitis collected from PubMed, Cochrane Library and Scopus Web of Science databases were reviewed. The inclusion criteria of the cases were based on age ≤ 18 years and the clinical characteristics of the disorder. RESULTS: Twenty-seven articles on Bickerstaff's brainstem encephalitis, including 236 children from a total of 42 from January 1990 to January 2020, were selected. The phenotype of the pediatric cases confirmed those described in the previously published articles. Almost half of the cases demonstrated the positivity of anti-GQ1b antibody titers, but the antibodies' presence was not linked to longer healing time. However, it was found that individuals with neuroimaging changes needed a longer time to recovery. Overall, patients treated with any type of immunotherapy (intravenous immunoglobulins, steroid or plasmapheresis) demonstrated faster resolution of symptoms than supportive care. CONCLUSIONS: Bickerstaff's brainstem encephalitis is an uncommon disorder, the short-term and long-term prognoses depend on the clinical presentation of the disorder, co-morbidity, instrumental investigations, and precocity of treatment.
Subject(s)
Brain Stem/metabolism , Encephalitis , Child , Encephalitis/diagnosis , Encephalitis/metabolism , Encephalitis/therapy , Humans , Immunotherapy , PrognosisABSTRACT
The neutron capture cross sections of several unstable nuclides acting as branching points in the s process are crucial for stellar nucleosynthesis studies. The unstable ^{171}Tm (t_{1/2}=1.92 yr) is part of the branching around mass Aâ¼170 but its neutron capture cross section as a function of the neutron energy is not known to date. In this work, following the production for the first time of more than 5 mg of ^{171}Tm at the high-flux reactor Institut Laue-Langevin in France, a sample was produced at the Paul Scherrer Institute in Switzerland. Two complementary experiments were carried out at the neutron time-of-flight facility (n_TOF) at CERN in Switzerland and at the SARAF liquid lithium target facility at Soreq Nuclear Research Center in Israel by time of flight and activation, respectively. The result of the time-of-flight experiment consists of the first ever set of resonance parameters and the corresponding average resonance parameters, allowing us to make an estimation of the Maxwellian-averaged cross sections (MACS) by extrapolation. The activation measurement provides a direct and more precise measurement of the MACS at 30 keV: 384(40) mb, with which the estimation from the n_TOF data agree at the limit of 1 standard deviation. This value is 2.6 times lower than the JEFF-3.3 and ENDF/B-VIII evaluations, 25% lower than that of the Bao et al. compilation, and 1.6 times larger than the value recommended in the KADoNiS (v1) database, based on the only previous experiment. Our result affects the nucleosynthesis at the Aâ¼170 branching, namely, the ^{171}Yb abundance increases in the material lost by asymptotic giant branch stars, providing a better match to the available pre-solar SiC grain measurements compared to the calculations based on the current JEFF-3.3 model-based evaluation.
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During the menopause women may experience increased oxidative stress and decreased antioxidant capacity and, together with the decline of neurosteroids, this represents a risk factor for Alzheimer's disease. The aim of the present study was to test a functional food (FPP-ORI, Osato Research Institute, Gifu, Japan) on redox and mitochondrial efficiency in post-menopausal women. The study population consisting of 69 untreated post-menopausal women were given supplements as follows: Group A was given a multivitamin (MV) 1c 2 times a day, and group B was given FPP 4.5 g 2 times a day. Group C consisted of 23 fertile premenopausal women as the control group. The tests carried out on entry, and at 3 and 6 months were erythrocyte redox parameters, plasma oxidated proteins, brain-derived neurotrophic factor (BDNF) and peripheral blood mononuclear cell (PBMC) mitochondria cytochrome c oxidase Vmax activity. Menopausal women showed an increased malondialdehyde (MDA) (p<0.05 vs control) which was normalized by both treatments (p<0.05), but MV failed to do so in the BMI ≥26 subgroup (p<0.05). All other redox enzymes and BDNF were significantly lower in menopausal women and they responded only to FPP (p<0.05). Carbonyl protein level was higher in "BMI ≥ 26" subgroup (p<0.05) and reduced only by FPP (p<0.05). The PBMC cyclooxygenase to citrate synthase activity was reduced (<40%) in the menopausal group (p<0.01) and only FPP caused a significant restoration (p<0.05). Although preliminary, these data confirm the redox and mitochondrial dysfunction occurring in post-menopause and responsive to FPP but very poorly to high dosage antioxidants. This may lead to potential preventive opportunities in menopause-associated neurodegenerative disease.
Subject(s)
Functional Food , Mitochondria/pathology , Neurodegenerative Diseases/epidemiology , Postmenopause , Antioxidants/physiology , Brain-Derived Neurotrophic Factor/metabolism , Electron Transport Complex IV/metabolism , Female , Humans , Japan , Leukocytes, Mononuclear , Malondialdehyde/metabolism , Oxidation-Reduction , Oxidative Stress , Pilot Projects , Risk FactorsABSTRACT
BACKGROUND: Elderly people are exposed to an increased load of stressful events and neuro-hormonal stimulation is a key finding in metabolic syndrome and its related disorders. AIMS: To determine the role of cortisol in elderly subjects, with or without metabolic syndrome (MetS), by means of a national multicentre observational study, AGICO (AGIng and Cortisol). METHODS: From 2012 to 2017, the AGICO study enrolled n.339 subjects (aged > 65), after obtaining their informed consent. The investigators assessed a cardio-metabolic panel (including electrocardiogram, carotid ultrasonography and echocardiography), the presence of MetS (on Adult Treatment Panel III criteria), a neurological examination (including brain imaging), and cortisol activity (using a consecutive collection of diurnal and nocturnal urine). RESULTS: In the patients presenting with MetS, the standardized diurnal and nocturnal cortisol excretion rates were 210.7 ± 145.5 and 173.7 ± 118.1 (mean ± standard deviation) µg/g creatinine/12 h; in those without MetS, the standardized diurnal and nocturnal cortisol excretion rates were 188.7 ± 92.7 and 144.1 ± 82.3 µg/g creatinine/12 h, respectively (nocturnal urinary cortisol in patients with MetS versus those without MetS p = 0.05, female patients with MetS vs female patients without MetS, p < 0.025). A significant positive correlation was found between the CRP levels and both the diurnal and nocturnal urinary cortisol levels with r = 0.187 (p < 0.025) and r = 0.411 (p < 0.00000001), respectively. DISCUSSION: The elderly patients with MetS showed a trend towards increased standardized nocturnal cortisol excretions, with particular regard to the female subjects. CONCLUSION: The positive correlation between cortisol excretion and low-grade inflammation suggests a common mechanism driving both hormonal and inflammatory changes.
Subject(s)
Hydrocortisone/metabolism , Inflammation/metabolism , Metabolic Syndrome/metabolism , Aged , Aged, 80 and over , Echocardiography , Female , Humans , Inflammation/complications , Male , Metabolic Syndrome/complicationsABSTRACT
We report on the measurement of the ^{7}Be(n,p)^{7}Li cross section from thermal to approximately 325 keV neutron energy, performed in the high-flux experimental area (EAR2) of the n_TOF facility at CERN. This reaction plays a key role in the lithium yield of the big bang nucleosynthesis (BBN) for standard cosmology. The only two previous time-of-flight measurements performed on this reaction did not cover the energy window of interest for BBN, and they showed a large discrepancy between each other. The measurement was performed with a Si telescope and a high-purity sample produced by implantation of a ^{7}Be ion beam at the ISOLDE facility at CERN. While a significantly higher cross section is found at low energy, relative to current evaluations, in the region of BBN interest, the present results are consistent with the values inferred from the time-reversal ^{7}Li(p,n)^{7}Be reaction, thus yielding only a relatively minor improvement on the so-called cosmological lithium problem. The relevance of these results on the near-threshold neutron production in the p+^{7}Li reaction is also discussed.
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Idiopathic intracranial hypertension (IIH) is a disorder of unknown origin, which is characterized by elevated intracranial pressure (ICP) without underlying etiological evidence of neurological disease. The purpose of the current study was to evaluate epidemiological features, clinical presentation, diagnostic findings and treatment of sixteen children (7 males and 9 females) with IIH. Medical records of the patients were obtained from the University Paediatric Hospital of Catania, Italy. Clinical features, investigations and treatment approaches were retrieved. The mean age of the sixteen children at onset of symptoms was 9 years (range: 4 to 16 years). Most of the patients were classified as pre-pubertal. Mean BMI was 28.9 kg/m2. In 93.75% of patients headache was the presenting clinical symptom; and in the same percentage papilledema was detected as the accompanied sign during diagnostic flow-chart. The mean lumbar puncture opening pressure (LPOP) was 350 mm H2O. Fifty percent of the cases had normal brain imaging, while 12.5% showed enlarged optic nerve diameter and one patient had an intraocular protrusion of the optic nerve on MRI. Two patients (12.5%) had venous sinus stenosis, and one case showed an abnormal spinal MRI. With regard to therapeutic approaches, 93.75% of the cases were successfully treated with Acetazolamide. None of the patients required surgical procedures, and all neuroimaging findings disappeared after receiving treatment. In the present study we investigated the association of IIH with venous sinus stenosis. We also found ocular ultrasound to be a useful non-invasive alternative method for determining papilledema in paediatric IIH, specifically in an emergency.
Subject(s)
Constriction, Pathologic/diagnostic imaging , Headache/diagnostic imaging , Intracranial Hypertension/diagnostic imaging , Papilledema/diagnostic imaging , Acetazolamide/therapeutic use , Adolescent , Anticonvulsants/therapeutic use , Child , Child, Preschool , Constriction, Pathologic/drug therapy , Constriction, Pathologic/epidemiology , Constriction, Pathologic/pathology , Cranial Sinuses/diagnostic imaging , Cranial Sinuses/drug effects , Cranial Sinuses/pathology , Female , Headache/drug therapy , Headache/epidemiology , Headache/pathology , Humans , Intracranial Hypertension/drug therapy , Intracranial Hypertension/epidemiology , Intracranial Hypertension/pathology , Magnetic Resonance Imaging , Male , Neuroimaging , Optic Nerve/diagnostic imaging , Optic Nerve/drug effects , Optic Nerve/pathology , Papilledema/drug therapy , Papilledema/epidemiology , Papilledema/pathology , Retrospective Studies , Spinal Puncture , Treatment OutcomeABSTRACT
The energy-dependent cross section of the ^{7}Be(n,α)^{4}He reaction, of interest for the so-called cosmological lithium problem in big bang nucleosynthesis, has been measured for the first time from 10 meV to 10 keV neutron energy. The challenges posed by the short half-life of ^{7}Be and by the low reaction cross section have been overcome at n_TOF thanks to an unprecedented combination of the extremely high luminosity and good resolution of the neutron beam in the new experimental area (EAR2) of the n_TOF facility at CERN, the availability of a sufficient amount of chemically pure ^{7}Be, and a specifically designed experimental setup. Coincidences between the two alpha particles have been recorded in two Si-^{7}Be-Si arrays placed directly in the neutron beam. The present results are consistent, at thermal neutron energy, with the only previous measurement performed in the 1960s at a nuclear reactor. The energy dependence reported here clearly indicates the inadequacy of the cross section estimates currently used in BBN calculations. Although new measurements at higher neutron energy may still be needed, the n_TOF results hint at a minor role of this reaction in BBN, leaving the long-standing cosmological lithium problem unsolved.
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Although higher dietary intakes of magnesium (Mg) seem to correspond to lower diabetes incidence, research concerning Mg supplementation in people with or at risk of diabetes is limited. Thus, we aimed to investigate the effect of oral Mg supplementation on glucose and insulin-sensitivity parameters in participants with diabetes or at high risk of diabetes compared with placebo. A literature search in PubMed, EMBASE, SCOPUS, Cochrane Central Register of Controlled Trials and Clinicaltrials.gov without language restriction, was undertaken. Eligible studies were randomized controlled trials (RCTs) investigating the effect of oral Mg supplementation vs placebo in patients with diabetes or at high risk of diabetes. Standardized mean differences (SMD) and 95% confidence intervals (CIs) were used for summarizing outcomes with at least two studies; other outcomes were summarized descriptively. Eighteen RCTs (12 in people with diabetes and 6 in people at high risk of diabetes) were included. Compared with placebo (n=334), Mg treatment (n=336) reduced fasting plasma glucose (studies=9; SMD=-0.40; 95% CI: -0.80 to -0.00; I2=77%) in people with diabetes. In conditions in people at high risk of diabetes (Mg: 226; placebo=227 participants), Mg supplementation significantly improved plasma glucose levels after a 2 h oral glucose tolerance test (three studies; SMD=-0.35; 95% CI: -0.62 to -0.07; I2=0%) and demonstrated trend level reductions in HOMA-IR (homeostatic model assessment-insulin resistance; five studies; SMD=-0.57; 95% CI: -1.17 to 0.03; I2=88%). Mg supplementation appears to have a beneficial role and improves glucose parameters in people with diabetes and also improves insulin-sensitivity parameters in those at high risk of diabetes.
Subject(s)
Blood Glucose/metabolism , Diabetes Mellitus/therapy , Dietary Supplements , Magnesium/therapeutic use , Adult , Aged , Blood Glucose/analysis , Diabetes Mellitus/blood , Diabetes Mellitus/etiology , Double-Blind Method , Fasting/blood , Female , Glucose Tolerance Test , Humans , Male , Middle Aged , Randomized Controlled Trials as TopicABSTRACT
Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society, in collaboration with the International Association of Gerontology and Geriatrics for the European Region, the European Union of Medical Specialists, and the International Osteoporosis Foundation-European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people.
Subject(s)
Fractures, Bone/prevention & control , Accidental Falls/prevention & control , Aged , Bone Density , European Union , Humans , Primary Prevention , Secondary PreventionABSTRACT
Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society (EUGMS), in collaboration with the International Association of Gerontology and Geriatrics for the European Region (IAGG-ER), the European Union of Medical Specialists (EUMS), the International Osteoporosis Foundation - European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people.
Subject(s)
Accidental Falls/prevention & control , Fractures, Bone/prevention & control , Osteoporosis/etiology , Aged , Aged, 80 and over , European Union , Geriatrics , HumansABSTRACT
Congenital Muscular Dystrophies (CMDs) can be considered as a heterogeneous group of diseases characterized by marked weakness, generalized hypotonia and joint contractures. They are divided into pure and classical forms, without ocular and cerebral involvement, and complex forms, which are associated with cerebral abnormalities. Seizures have rarely been described in the pure forms while they seem to occur more frequently in complex forms. The aim of our study was to evaluate the incidence of seizure in CMD. Herein, the authors describe 16 cases of congenital muscular dystrophy (CMD) associated with different kinds of epileptic events, in order to study the pathogenic connection between the two clinical manifestations. In all described patients we reviewed the clinical, neurophysiologic, and neuroimaging data to determine any associations with epilepsy. The patients were divided into two groups: 14 cases with merosin positive CMD in one group and 2 patients with Walker Warburg syndrome (WWS) in the second group. In our study we found that in the first group, one benign myoclonic epilepsy (BME), one benign febrile convulsions had occurred. Also in one patient, the EEG revealed a moderately high voltage slow background with diffuse sharp waves reaching 300mV in amplitude with no clinical signs. In the merosin positive CMD patients, the presence of two different epileptic diseases, benign myoclonic epilepsy (BME) in one and febrile convulsion with tonic clinic seizures, may represent a new expression of merosine-positive congenital muscular disease (PCMD) in which the deficiency of an undiscovered muscular protein with a cerebral isoform may be the cause of epileptic events in this group of patients.
Subject(s)
Muscular Dystrophies/complications , Seizures/epidemiology , Seizures/etiology , Child , Child, Preschool , Electroencephalography , Female , Humans , Incidence , Infant , Magnetic Resonance Imaging , MaleABSTRACT
During 2014, the second experimental area (EAR2) was completed at the n-TOF neutron beam facility at CERN (n-TOF indicates neutron beam measurements by means of time of flight technique). The neutrons are produced via spallation, by means of a high-intensity 20 GeV pulsed proton beam impinging on a thick target. The resulting neutron beam covers the energy range from thermal to several GeV. In this paper, we describe two beam diagnostic devices, both exploiting silicon detectors coupled with neutron converter foils containing (6)Li. The first one is based on four silicon pads and allows monitoring of the neutron beam flux as a function of the neutron energy. The second one, in beam and based on position sensitive silicon detectors, is intended for the reconstruction of the beam profile, again as a function of the neutron energy. Several electronic setups have been explored in order to overcome the issues related to the gamma flash, namely, a huge pulse present at the start of each neutron bunch which may blind the detectors for some time. The two devices were characterized with radioactive sources and also tested at the n-TOF facility at CERN. The wide energy and intensity range they proved capable of sustaining made them attractive and suitable to be used in both EAR1 and EAR2 n-TOF experimental areas, where they became immediately operational.
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UNLABELLED: Malnutrition occurs frequently in the elderly with important clinical and functional consequences. Moreover, the treatment of malnutrition in the elderly may be effective if clinical and nutritional interventions are performed in the early stages. Therefore the early identification of the risk of malnutrition using validated and handy tools plays a pivotal role in terms of clinical outcome. Mini Nutritional Assessment (MNA) was validated for this purpose since many years but it is still ongoing the debate over whether the use of different items in certain clinical conditions can be effective without affecting the validity of the nutritional status evaluation. The aim of this study was to assess the agreement between different versions of MNA in the evaluation of nutritional risk in elderly subjects. METHODS: 522 subjects, 345 women and 177 men, were recruited from nursing homes or were free living in three different regions in Italy. All subjects underwent a multidimensional geriatric evaluation, addressed especially to nutritional status. We compared three different versions of MNA: the "original" version; a "proportional" MNA (MNA- P) in which the total MNA score was replaced by the ratio between the maximum score that each subject could obtain without including the body mass index (BMI) and the total original MNA score; and a third version in which calf circumference (CC) and mid- upper arm circumference (MAC) were used instead of BMI. RESULTS: According to the original MNA, a high prevalence of malnutrition was found out in both genders (26% of women and 16.3% of men); both the versions of MNA, in which BMI was not considered, showed a good predictive value compared to original MNA. In particular, the MNA- P. showed an overall efficiency equal to 89,1% with specificity and positive predictive value respectively equal to 97.5% and 95.2%. MNA- CC- MAC showed even better results in terms of overall efficiency (91.4%), sensitivity (81.1%), specificity (97.1%), positive and negative predictive values (94.2% and 94.4%, respectively). CONCLUSION: The different versions of MNA gave similar results in the classifications of subjects and in comparison with nutritional and biochemical parameters. Moreover MNA versions that did not considered BMI seem to be more effective in singling out subjects with risk factors related to malnutrition (disability, reduced strength and calf circumference, anaemia).
Subject(s)
Homes for the Aged , Malnutrition/diagnosis , Malnutrition/epidemiology , Nursing Homes , Nutrition Assessment , Aged , Aged, 80 and over , Body Mass Index , Female , Geriatric Assessment , Humans , Italy/epidemiology , Male , Nutritional Status , Prevalence , Risk Assessment , Risk Factors , Sensitivity and Specificity , Surveys and QuestionnairesABSTRACT
The 63Ni(n,γ) cross section has been measured for the first time at the neutron time-of-flight facility n_TOF at CERN from thermal neutron energies up to 200 keV. In total, capture kernels of 12 (new) resonances were determined. Maxwellian averaged cross sections were calculated for thermal energies from kT=5-100 keV with uncertainties around 20%. Stellar model calculations for a 25Mâ star show that the new data have a significant effect on the s-process production of 63Cu, 64Ni, and 64Zn in massive stars, allowing stronger constraints on the Cu yields from explosive nucleosynthesis in the subsequent supernova.
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BACKGROUND: Loss of the sense of taste is common among older people. Morbidities and polypharmacy may contribute to the age-related decline in gustatory function. The aims of the present study were to investigate taste perception in elderly hospitalized patients by comparing their taste recognition thresholds with those of healthy, free-living elderly individuals and to identify potential determinants of taste loss. METHODS: The participants in this observational study were 55 elderly patients hospitalized in the acute geriatric section of the Department of Medical and Surgical Sciences at Padova University and 41 free-living individuals aged older than 65 years, randomly recruited from elderly people attending mild fitness programs at public gymnasiums in Padova. Data were collected on nutrition, health, cognitive, and functional status for all participants. Gustatory capabilities were assessed using aqueous solutions of sucrose, sodium chloride, citric acid, and quinine hydrochloride (representing sweet, salty, sour, and bitter stimuli, respectively), and taste recognition thresholds were measured in both groups. RESULTS: In comparison with the free-living elderly subjects, those in hospital were significantly less able to recognize the taste of citric acid (P < 0.05). Low citric acid sensitivity was independently associated with advanced age (≥75 years; odds ratio [OR] 3.01, 95% confidence interval [CI] 1.01-9.82), polypharmacy (number of prescribed drugs ≥ 4; OR 2.74, 95% CI 1.01-7.72), and poor nutritional status (as assessed by Mini Nutritional Assessment score < 23.5; OR 5.08, 95% CI 1.76-14.6). CONCLUSION: Because gustatory impairment may reduce a person's appetite and lead to inadequate dietary intake, compensatory nutritional measures, such as the use of flavor-enhanced foods, should be strongly encouraged, particularly in the hospital setting.