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1.
Compr Psychiatry ; 132: 152481, 2024 07.
Artigo em Inglês | MEDLINE | ID: mdl-38552348

RESUMO

INTRODUCTION: Recent reclassifications have expanded the understanding of Obsessive-Compulsive Disorders (OCDs), now incorporated into a broader category known as Obsessive-Compulsive Disorder and Related Disorders (OCRDs). This study sought to assess obsessive-compulsive symptoms and body uneasiness among outpatients seeking treatment for Eating Disorders (ED). Additionally, we aimed to explore associations and potential mediation effects between obsessive-compulsive symptoms and body uneasiness. This investigation extended beyond concerns related solely to body shape and weight, encompassing fears associated with specific body components (such as facial features, abdominal region, and limbs) or functions (including sweating, blushing, emitting noises, and releasing odors). METHODS: Psychometric assessments included the Obsessive-Compulsive Inventory-Revised (OCI-R) and the Body Uneasiness Test (BUT). Statistical analyses involved bivariate correlations, linear regression, and mediation analysis to explore the associations and potential mediation effects between obsessive-compulsive symptoms and different manifestations of body uneasiness. RESULTS: The sample (N = 210) demonstrated substantial obsessive-compulsive symptoms and notable body discomfort. OCI-R scores positively correlated with various dimensions of body dissatisfaction, including shape, weight, and specific body components or functions. Linear regression revealed significant associations between OCI-R scores and overall body uneasiness (BUT-A) as well as concerns about body components or functions (BUTB). Mediation analysis indicated that BUT-A mediated the relationship between obsessive-compulsive symptoms and BUTB. CONCLUSION: This study offers new insights into the comprehensive landscape of OCRDs. It specifically emphasizes the association between obsessive-compulsive symptoms and body uneasiness, embracing not only concerns about body shape and weight but also extending to body components and functions.


Assuntos
Imagem Corporal , Medo , Transtorno Obsessivo-Compulsivo , Humanos , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno Obsessivo-Compulsivo/diagnóstico , Adulto , Feminino , Imagem Corporal/psicologia , Masculino , Medo/psicologia , Adulto Jovem , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Adolescente , Psicometria/instrumentação , Psicometria/métodos , Pessoa de Meia-Idade , Transtornos Dismórficos Corporais/psicologia , Transtornos Dismórficos Corporais/diagnóstico
3.
Eat Weight Disord ; 26(8): 2531-2544, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33544361

RESUMO

PURPOSE: The term orthorexia nervosa (ON) was coined to describe altered thoughts and behaviours related to healthy eating. The prevalence of ON was found to scale up to almost 90% among high-risk populations (ballet dancers, athletes, and health workers). ON seem to share psychopathological aspects with both Eating Disorders (ED) and Obsessive-Compulsive Disorder (OCD). The aim of the study was to analyse the frequency and intensity of ON symptoms among subjects diagnosed with OCD, hypothesising that they would be higher than in two control groups (subjects with anxiety-depressive disorders and general population). METHODS: We conducted a multi-centre, observational, controlled study. Subjects filled in a socio-demographic questionnaire including questions related to life-style and two psychometric instruments: ORTO-15, for ON symptoms, and OCI-R, for OCD symptoms. Post hoc analysis of the dataset was performed using the revised version of ORTO-15, the ORTO-R. RESULTS: In the final sample of 328 subjects, the overall prevalence of ORTO-15-ON was 59.5%, mean score 37.9 ± 4.2. The mean score at the ORTO-R was 16.6 ± 4.6. No statistically significant differences were found in the prevalence of ON or in the mean ORTO-15 score among OCD patients and the two control groups, and this was confirmed by the multiple regression analysis. At the ORTO-R re-scoring, OCD patients scored significantly lower than the two clinical subgroups (p = .0005) and a lower ORTO-R score was associated to positivity at the OCI-R, confirming the initial hypothesis of the study. CONCLUSIONS: ON symptoms do seem to be more prevalent among subjects suffering from OCD. The psychometric properties of tools available to calculate ON symptoms, namely ORTO-15 vs. ORTO-R, play a relevant role in explaining such finding. ORTO-R seems to be a valid alternative able to overcome such difficulties, though further studies are needed to confirm this.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Transtorno Obsessivo-Compulsivo , Comportamento Alimentar , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Comportamentos Relacionados com a Saúde , Humanos , Transtorno Obsessivo-Compulsivo/epidemiologia , Psicometria , Inquéritos e Questionários
4.
Clin Ter ; 169(3): e135-e139, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29938746

RESUMO

INTRODUCTION: The uncertainty regarding the scientific status of psychiatry arises from psychiatry's involvement with some unsolved problems, or put in another way, from its enmeshment in certain points of transition of contemporary science. There is, in primis, the unsolved problem of the relationship between the mind and the body and, moreo- ver, the intricate relationship of connection/disjunction among biology, social science, anthropology, philosophy, etc. To speak about what psychopathology can expect from philosophy is, above all, to immerse oneself in a debate about the conditions of possibility of psychiatry as a science. This debate is especially concerned with the models of knowledge that have, until now, been proposed to psychiatry. Those models oscillate between the Dilthey's paradigms of the "Science of Nature" and the "Science of Spirit". METHODS: It is certain that psychopathology, as already indicated by Jaspers, is a discipline which is among the most involved regard- ing the use of the two different cognitive strategies. The first strategy concerns the concept of "explanation" and its rigid approach to the objective and ultimate cause of the phenomenon. The second strategy is the "comprehensive" approach. This model, which the hermeneutic thought defines "interpretative", theorizes the provisional character, the subjectiveness and the finiteness of every cognitive project. RESULTS: The interest of the authors is orientated towards the hermeneutic side (comprehensive-interpretative) of psychiatry, that which deals with the specificity of every clinical history, with the continuity of sense, and with intrinsic narrative intelligibility of every human event, psychopathological or not. CONCLUSIONS: This approach to psychopathology is based on the statement: "a clinical history is a text which must be interpreted". From this perspective, every clinical history should be perceived as a text to decipher but, above all, as a "text" to listen to, in the persevering expectation that it could disclose its particular "project of world". When speaking about psychiatry, we always face a problem which dominates all the others: the unsolved problem of the relation- ship between typicalness and singularity of subjective events. B.B. Mandelbrot, theorist of "fractals", sums this dilemma up clearly. He suggests that the innumerable variety of the configurations of Nature is a challenge to investigate the morphology of that which is "irregu- lar" in order to discover in it, as far as possible, a rule.


Assuntos
Filosofia , Psiquiatria , Psicopatologia , Humanos , Conhecimento
5.
Clin Ter ; 168(2): e120-e127, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28383623

RESUMO

AIM: The aim of this work was to validate the Italian version of GAI (GAI-It) and its short form (GAI-It SF) in an over 65-population. METHODS: In 3 recruitment areas across Italy, two raters reciprocally blind to results assessed eligible subjects; a semi-structured diagnostic clinical interview was performed by a psychiatrist. RESULTS: Among the 76 enrolled subjects (mean age 72.7±6.8 years), anxiety symptoms were very common: 69.7% (moderate/ severe HADS-Anxiety), 76.3% (moderate/severe STAI-state), 71.0% (moderate/severe STAI-trait), 61.8% (GAI), 55.3% (GAI-SF). Sensitivity, specificity and positive predictive value of GAI confirmed a good reliability of the Italian version, with Cronbach's Alpha equal to 0.93 for GAI-It and to 0.77 for GAI-It SF, indicating a very good and good construct validity, respectively, of the scales. The Pearson correlation index demonstrated a moderately positive correlation among GAI, GAI-SF and STAI. CONCLUSIONS: Our data confirm the validity of GAI-It as a valuable instrument to assess anxiety in an elderly population, for clinical and research purposes.


Assuntos
Ansiedade/diagnóstico , Escalas de Graduação Psiquiátrica , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Itália , Idioma , Masculino , Psicometria , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
6.
Int J Soc Psychiatry ; 62(3): 252-61, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26896027

RESUMO

AIMS: This article aims to (1) explore the levels of perceived insecurity in a sample of patients with mood or anxiety disorders and (2) assess whether living in 'big cities' can influence the levels of patients' perceived insecurity and social contacts compared to living in a non-urbanized context. METHODS: A total of 24 Italian mental health centers (MHCs) have been invited to participate. Twenty patients consecutively accessing the MHC have been recruited. All patients have been assessed using validated assessment tools. RESULTS: The sample consisted of 426 patients, mostly female, with a mean age of 45 years. Globally, 52.2% of patients had a diagnosis of mood disorders, and 37.8% had anxiety disorders. Half of the sample declared that the main feeling toward life is uncertainty; higher levels of pessimistic views toward life have been detected in patients living in urban areas. A positive association between negative attitudes toward life and higher levels of depressive and anxiety symptoms, poor social functioning and higher levels of perceived psychological distress has been found. CONCLUSION: Our findings confirm the presence of a common sense of perceived uncertainty among our sample. Such attitude toward life can have a detrimental impact on patients' psychological and physical well-being, contributing to high levels of distress.


Assuntos
Transtornos de Ansiedade/epidemiologia , Saúde Mental , Transtornos do Humor/epidemiologia , Incerteza , Urbanização/tendências , Adulto , Feminino , Hospitais Psiquiátricos , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Percepção , Escalas de Graduação Psiquiátrica , Qualidade de Vida/psicologia , Inquéritos e Questionários , Saúde da População Urbana
7.
Drug Saf Case Rep ; 2(1): 3, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27747715

RESUMO

A 71-year-old man developed coma with severe respiratory failure, hypotension, and tachycardia induced by the intentional ingestion of quetiapine fumarate extended release (XR) 20 g. At the time, he had been treated for bipolar depression with venlafaxine 75 mg/day, lamotrigine 100 mg/day, pregabalin 75 mg/day, and quetiapine XR 400 mg/day for approximately 1 year. Comorbidities were hypertension treated with metoprolol, diabetes mellitus type 2 treated with metformin, and benign prostatic hyperplasia treated with silodosin. In the emergency room, about 4 h after ingestion of quetiapine fumarate XR, the presenting symptomatology was characterized by coma (Glasgow Coma Scale score 3), hypotension (blood pressure [BP] 90/60 mmHg), tachycardia (electrocardiogram [ECG] showed sinus tachycardia with heart rate 120 beats per minute and a QTc of 499 ms). A gastric lavage was performed and activated charcoal 50 g and magnesium sulfate 30 g was administered. About 6 h after ingestion, he developed marked desaturation and underwent mechanical ventilation; 13 h after ingestion, a severe hypotensive episode followed (BP 70/40), which was treated with an infusion of ringer lactate 500 cc. On the 3rd day after intentional overdose, an episode of agitation occurred; 4 days after ingestion, the quetiapine plasma level was found to be 42 ng/ml (within therapeutic range). At 5 days after ingestion, the patient developed septicemia caused by staphylococci (probably originating from the central vein catheter), which was treated with antibiotic therapy. On days 10 and 18 after the suicide attempt, two episodes of paroxysmal supraventricular tachycardia (PSVT) occurred and were successfully treated with intravenous adenosine triphosphate. The patient recovered completely without residual symptoms. In line with literature data, in this case report, symptoms of quetiapine overdose were tachycardia, agitation, hypotension, QT interval prolongation, and coma. A causal relationship between PSVT and quetiapine intoxication seems quite unlikely due to the drug level.

8.
9.
Int Psychogeriatr ; 26(1): 19-37, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24103643

RESUMO

BACKGROUND: In clinical practice, Second Generation Antipsychotics (SGAs) are often used as first-line treatment for the Behavioral and Psychological Symptoms of Dementia (BPSD) in older adults due to their fewer neurological adverse events and similar effectiveness compared with First Generation Antipsychotics (FGAs). SGAs, however, are associated with more severe metabolic side effects (weight gain, hyperglycemia, diabetes risk, and hyperlipidemia) than FGAs are. In general, older patients, especially those affected by dementia, are at increased risk for malnutrition, and tend to have lower basal metabolism and reduced liver and kidney function. However, little is known about the metabolic side effects of antipsychotic drugs in this population. METHODS: A comprehensive review of the literature published between January 1996 and December 2012 investigating the metabolic side effects related to FGAs and SGAs use in old patients affected by dementia. RESULTS: Antipsychotic drugs currently used to treat BPSD in subjects with mild to moderate dementia are associated with weight gain. Currently, there are insufficient data to support a causal relationship between the use of FGAs and SGAs and changes in glucose homeostasis or lipid metabolism in older persons affected by severe dementia (MMSE <14). CONCLUSION: A possible association between antipsychotic drugs use and weight gain might exist, in particular in subjects with mild to moderate dementia whereas no significant effects are demonstrated regarding glucose homeostasis and lipid metabolism. The antipsychotic drugs potential for causing metabolic abnormalities in older patients requires further specifically designed studies. Clinicians must be aware of this possibility even if the shorter periods of treatment administered in late-life might not be as harmful as it is in younger individuals.


Assuntos
Antipsicóticos/efeitos adversos , Demência/tratamento farmacológico , Metabolismo dos Lipídeos/efeitos dos fármacos , Doenças Metabólicas/induzido quimicamente , Idoso , Antipsicóticos/uso terapêutico , Demência/metabolismo , Transtornos do Metabolismo de Glucose/induzido quimicamente , Homeostase/efeitos dos fármacos , Humanos , Lipídeos/sangue , Metabolismo/efeitos dos fármacos , Aumento de Peso/efeitos dos fármacos
10.
Psychol Med ; 44(5): 937-47, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23842200

RESUMO

BACKGROUND: There is substantial variability in the degree of cognitive impairment among older depressed persons. Inconsistencies in previous findings may be due to differences in clinical and demographic characteristics across study samples. We assessed the influence of unipolar depression and severity of depression on cognitive performance in a population-based sample of elderly persons aged ⩾60 years. METHOD: Eighty-nine persons fulfilled ICD-10 criteria for unipolar depression (mild, n = 48; moderate, n = 38; severe, n = 3) after thorough screening for dementia (DSM-IV criteria), psychiatric co-morbidities and antidepressant pharmacotherapy. Participants (n = 2486) were administered an extensive cognitive test battery. RESULTS: Moderate/severe unipolar depression was associated with poorer performance on tasks assessing processing speed, attention, executive function, verbal fluency, episodic memory and vocabulary. Mild depression was associated with poorer performance in processing speed, and few differences between mild and moderate/severe depression were observed. No association between depression and short-term memory, general knowledge or spatial ability was observed. Increasing age did not exacerbate the depression-related cognitive deficits, and the deficits remained largely unchanged after excluding persons in a preclinical phase of dementia. Furthermore, depression-related cognitive deficits were not associated with other pharmacological treatments that may affect cognitive performance. CONCLUSIONS: Cognitive deficits in unipolar old-age depression involve a range of domains and the cognitive deficits seem to follow the spectrum of depression severity. The finding that mild depression was also associated with poorer cognitive functioning underscores the importance of detecting mild depression in elderly persons.


Assuntos
Transtornos Cognitivos/epidemiologia , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Suécia/epidemiologia
11.
J Psychiatr Res ; 47(6): 762-73, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23369337

RESUMO

OBJECTIVE: The aim of this literature review was to assess the effects of Animal-Assisted Interventions (AAI) on elderly patients with dementia or various psychiatric disorders. METHODS: We conducted a comprehensive literature search using the online PubMed network of the US National Library of Medicine & National Institutes of Health, Embase, PsycINFO, with the purpose of investigating AAI effects on cognitive functions, mood, and behaviour. RESULTS: A total of 18 articles on dementia and 5 on psychiatric disorders were included in the present review. AAI were found to have positive influences on demented patients by reducing degree of agitation and by improving degree and quality of social interaction. Few studies have assessed the effects of AAI on mood, and even fewer have assessed its consequences on cognitive functions. The results that are available indicate a positive effect on communication and coping ability, but none on cognitive performance. A substitute pet robot yielded encouraging results, but its use requires further investigation. The few studies conducted for elderly patients presenting a variety of psychiatric diagnoses produced controversial findings. CONCLUSIONS: In spite of the encouraging results of AAI, much more research examining the issue of optimal AAI duration, frequency of sessions, and suitable target group is needed.


Assuntos
Terapia Assistida com Animais/métodos , Demência/terapia , Transtornos Mentais/terapia , Idoso , Terapia Assistida com Animais/normas , Terapia Assistida com Animais/tendências , Animais , Humanos
12.
Neurology ; 76(18): 1568-74, 2011 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-21536637

RESUMO

OBJECTIVE: The relation of overweight to dementia is controversial. We aimed to examine the association of midlife overweight and obesity with dementia, Alzheimer disease (AD), and vascular dementia (VaD) in late life, and to verify the hypothesis that genetic and early-life environmental factors contribute to the observed association. METHODS: From the Swedish Twin Registry, 8,534 twin individuals aged ≥65 (mean age 74.4) were assessed to detect dementia cases (DSM-IV criteria). Height and weight at midlife (mean age 43.4) were available in the Registry. Data were analyzed as follows: 1) unmatched case-control analysis for all twins using generalized estimating equation (GEE) models and 2) cotwin matched case-control approach for dementia-discordant twin pairs by conditional logistic regression taking into account lifespan vascular disorders and diabetes. RESULTS: Among all participants, dementia was diagnosed in 350 subjects, and 114 persons had questionable dementia. Overweight (body mass index [BMI] >25-30) and obesity (BMI >30) at midlife were present in 2,541 (29.8%) individuals. In fully adjusted GEE models, compared with normal BMI (20-25), overweight and obesity at midlife were related to dementia with odds ratios (ORs) (95% CIs) of 1.71 (1.30-2.25) and 3.88 (2.12-7.11), respectively. Conditional logistic regression analysis in 137 dementia-discordant twin pairs led to an attenuated midlife BMI-dementia association. The difference in ORs from the GEE and the matched case-control analysis was statistically significant (p = 0.019). CONCLUSIONS: Both overweight and obesity at midlife independently increase the risk of dementia, AD, and VaD. Genetic and early-life environmental factors may contribute to the midlife high adiposity-dementia association.


Assuntos
Demência/etiologia , Obesidade/complicações , Sobrepeso/complicações , Idoso , Idoso de 80 Anos ou mais , Demência/diagnóstico , Diabetes Mellitus Tipo 2/complicações , Doenças em Gêmeos , Feminino , Humanos , Modelos Logísticos , Masculino , Razão de Chances , Sistema de Registros , Risco , Suécia , Gêmeos
13.
J Psychiatr Res ; 41(8): 686-93, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16600299

RESUMO

Some cytokines have been involved in the pathogenesis of late onset Alzheimer's disease (LOAD). A possible increase in plasma cytokines levels has been reported in LOAD and vascular dementia (VD), but the results of previous studies are conflicting. We evaluated the plasma levels of IL-6, TNF-alpha, IL-1beta, and IL-10 in four groups of older individuals: 60 patients with LOAD, 80 patients with VD, 40 subjects with cerebrovascular disease but without dementia (CDND), and 42 controls (C). By analysis of covariance (adjustment for age, gender, coronary heart disease, diabetes, hypertension, smoking, and alcohol consumption) we found that: *IL-1beta was higher in VD, LOAD, and CDND compared with controls (p<0.005). *TNF-alpha was higher in VD and LOAD compared to C (p<0.05), and in VD compared to LOAD (p<0.03). *IL-6 was higher in VD compared with LOAD (p<0.03). No differences in IL-10 values were found (Kruskal-Wallis, Asymp. Sig. 0.14). By logistic regression analysis, we demonstrated that high levels (defined as above the median) of IL-1beta and TNF-alpha, but not of IL-6, were associated with increased likelihood of having VD and LOAD compared to C, while high IL-6 levels were associated with a increased probability of having VD, compared with LOAD. Our study support the notion of a low-grade systemic inflammation in older patients with LOAD or VD, characterized by an increase in plasma IL-1beta and TNF-alpha levels. The high IL-6 levels found in VD might be not a specific finding, as it might come from several conditions including atherosclerosis and related vascular risk factors, comorbidity, and frailty.


Assuntos
Doença de Alzheimer/imunologia , Citocinas/sangue , Demência Vascular/imunologia , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/psicologia , Transtornos Cerebrovasculares/diagnóstico , Transtornos Cerebrovasculares/imunologia , Transtornos Cerebrovasculares/psicologia , Demência Vascular/diagnóstico , Demência Vascular/psicologia , Feminino , Humanos , Inflamação/diagnóstico , Inflamação/imunologia , Interleucina-10/sangue , Interleucina-1beta/sangue , Interleucina-6/sangue , Funções Verossimilhança , Modelos Logísticos , Masculino , Entrevista Psiquiátrica Padronizada , Valores de Referência , Fatores de Risco , Fator de Necrose Tumoral alfa/metabolismo
14.
Int J Geriatr Psychiatry ; 22(4): 305-11, 2007 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17022108

RESUMO

In older individuals, inflammatory mechanisms have been linked to the pathogenesis of both dementia and functional impairment. In this cross-sectional study we have investigated the possible association between some markers of systemic inflammation and functional status, in a sample of one hundred and forty older demented patients including 60 patients with late onset Alzheimer's disease (LOAD) and 80 with vascular dementia (VD). Functional status was evaluated by Barthel Index (BI); the total score ranged from 0 (total dependency) to 20 (total autonomy). Interleukin-1beta, Tumor Necrosis Factor-alpha, Interleukin- 6, Interleukin- 8, and Transforming Grow Factor beta were quantified by ELISA. Among the cytokines evaluated, only IL-6 was correlated with the BI (r: -0.32, p < 0.001). The mean levels of IL-6 progressively decreased from I (9.50 pg/mL), to II (6.40 pg/mL), to III BI tertile (4.80 pg/mL) (p < 0.02). At multiple regression analysis, IL-6 was associated with BI in the whole sample and in VD, but not in LOAD, independent of age, gender, smoking, alcohol consumption, hypertension, diabetes, coronary heart disease, previous stroke, and mini mental state examination score. Our study suggests the existence of an independent and negative relationship between IL-6 plasma levels and functional status in older individuals with vascular dementia. This finding might contribute to explain the 'excess of disability' phenomenon described in older demented patients.


Assuntos
Demência Vascular/sangue , Avaliação da Deficiência , Avaliação Geriátrica , Interleucina-6/sangue , Atividades Cotidianas/classificação , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/sangue , Doença de Alzheimer/diagnóstico , Biomarcadores/sangue , Demência Vascular/diagnóstico , Feminino , Humanos , Inflamação/sangue , Interleucina-1beta/sangue , Interleucina-8/sangue , Masculino , Estatística como Assunto , Fator de Crescimento Transformador beta/sangue , Fator de Necrose Tumoral alfa/sangue
15.
J Nutr Health Aging ; 10(1): 31-5, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16453055

RESUMO

BACKGROUND: Leukoaraiosis (LA) is a common finding in older persons, and might be associated with reduced cognitive performance, gait abnormalities, and functional impairment. Although LA is more frequent in persons affected by dementia, scant data are available about its clinical consequences in this group of patients. OBJECTIVE: To study the association between presence of LA and functional performance in basic activities of daily living in a sample of older persons affected by dementia. DESIGN: We conducted a cross-sectional study on 214 patients; 77 affected by late onset Alzheimer's disease (LOAD), and 137 by vascular dementia (VD). Functional status was assessed using Barthel Index (BI). LA was assessed using computed tomography. RESULTS: In LOAD patients, LA (OR: 7.87; 1.26-48.94), and MMSE score (OR: 0.83; 0.71-0.98) were associated with the risk of severe disability, independent of age, gender, diabetes, hypertension, coronary heart disease, left ventricular hypertrophy, atrial fibrillation, and brain atrophy. In VD patients, MMSE score (OR: 0.77; 0.64-0.93), and CHD (OR: 7.41; 1.09-50.21), but not LA (OR: 2.07; 0.45-9.45) were associated with a severe functional impairment after multivariate adjustment. CONCLUSIONS: Our study suggests that LA might be associated with a worse functional status in basic activities of daily living in patients affected by LOAD but not VD. LA might act synergistically with cognitive and behavioural disturbances to the onset and progression of disability of these patients.


Assuntos
Doença de Alzheimer/patologia , Demência Vascular/patologia , Leucoaraiose/complicações , Leucoaraiose/patologia , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Encéfalo/diagnóstico por imagem , Estudos Transversais , Feminino , Humanos , Leucoaraiose/fisiopatologia , Modelos Logísticos , Masculino , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X
16.
Arch Gerontol Geriatr Suppl ; (9): 393-402, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15207438

RESUMO

Dementia is one of the most pressing public health problems with social and economic implication. The form called cognitive impairment non-dementia (CIND)represents a subclinical phase of dementia. Different studies have shown a possible effect of micro- and macro-nutrients on cognitive function. Trace elements, being involved in metabolic processes and redox reactions in the central nervous system (CNS), could influence the cognitive functions. This study evaluated the presence of an eventual correlation between serum trace element concentrations and cognitive function in a group of subjects with CIND and manifest dementia (Alzheimer dementia = AD, and vascular dementia = VaD), and compared them with a control group. Thirty -five patients were enrolled in this study. Each patient underwent a clinical and biochemical examination. We also performed a neuropsychological and functional assessment (the Milan overall dementia assessment = MODA, activities of daily living = ADL, and instrumental activities of daily living = IADL), and a computerized tomographic (CT) cerebral scan. Patients were than divided in 4 groups according to the obtained diagnosis (Controls, CIND, AD, VaD). The presence of any acute or chronic conditions, affecting cognitive functions, was considered as exclusion criteria. A blood sample was collected to determine iron (Fe), zinc (Zn), manganese (Mn), selenium (Se), cobalt (Co), chromium (Cr), copper (Cu),molybdenum (Mo) and aluminium (Al) serum concentrations (chromatographic,spectrophotometric methods). In our cohort we found a positive correlation between cognitive function, expressed as the MODA score, and Se, Cr, Co and Fe serum levels,while a negative correlation was observed between MODA score, Cu and Al serum levels.Moreover, some statistically significant differences in Se, Cr, Co, Cu and Al concentrations were found among the groups. According to these results, we may suppose that Se, Cr and Co protect cognitive function, Cu influences the evolution of cognitive impairment, while Al contributes to the pathogenesis of AD.


Assuntos
Transtornos Cognitivos/metabolismo , Demência/metabolismo , Oligoelementos/metabolismo , Atividades Cotidianas , Idoso , Albuminas/metabolismo , Encéfalo/diagnóstico por imagem , Colesterol/sangue , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/fisiopatologia , Estudos de Coortes , Demência/diagnóstico , Demência/fisiopatologia , Feminino , Ácido Fólico/sangue , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Masculino , Testes Neuropsicológicos , Oxirredução , Índice de Gravidade de Doença , Tireotropina/sangue , Tomografia Computadorizada por Raios X , Oligoelementos/sangue , Oligoelementos/classificação , Triglicerídeos/sangue , Vitamina B 12/sangue
17.
Ann Chim ; 91(5-6): 265-75, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11507830

RESUMO

To estimate the presence of metal and non-metal micro-pollutants in the soils of the Lecce and Brindisi districts, an analytical study has been carried out on samples of surface soils taken from agricultural areas. The research has concerned the determination of the following micro-pollutants: Cu, Ni, Cr, Zn, Pb, Be, Cd, As, Hg, Sb e Tl. Statistical techniques, such as Principal Component Analysis and Clustering Analysis, have been utilised to examine the correlations among the different parameters and to define contamination areas. The results show that the amount of micro-pollutants in the superficial stratum of the examined soils is in the range permitted by the regulations in force, with the exception of arsenic and thallium. Arsenic concentrations are near to the maximum admissible value, while thallium concentrations are in 56% of the samples higher than the admissible value both in the soil and underground. The most significant parameter from a toxicological point of view is thallium, which has its maximum concentration in the soils located near the industrial area of Brindisi.


Assuntos
Metais Pesados/análise , Poluentes do Solo/análise , Agricultura , Monitoramento Ambiental , Indústrias , Itália
19.
Acta Neurol Scand ; 103(5): 304-8, 2001 May.
Artigo em Inglês | MEDLINE | ID: mdl-11328206

RESUMO

OBJECTIVES: Paraoxonase, angiotensin-converting enzyme (ACE), methylenetetrahydrofolate reductase (MTHFR), and apo E gene polymorphisms were evaluated in older patients with vascular dementia (VD) or late-onset Alzheimer's disease (LOAD). MATERIAL AND METHODS: Sixty patients with VD, 45 patients with LOAD, and 54 non-demented controls were compared. RESULTS: No differences in the distribution of paraoxonase, ACE, and MTHFR polymorphisms were found. The overall frequency of apo E epsilon4 allele was "low"; epsilon4 allele was more frequent in LOAD (17.5%) and VD (13.3%) compared with controls (9.2%), but the difference was not statistically significant. CONCLUSION: Paraoxonase, ACE, and MTHFR polymorphisms were not associated with VD or LOAD; these common polymorphisms might have a marginal role in the pathogenesis of dementia in older subjects. In spite of a "low" frequency of the apo E epsilon4 allele in our sample, the frequency of epsilon4 allele was about double in LOAD compared with controls.


Assuntos
Doença de Alzheimer/genética , Demência Vascular/genética , Polimorfismo Genético , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Apolipoproteínas E/genética , Arildialquilfosfatase , Esterases/genética , Feminino , Humanos , Masculino , Metilenotetra-Hidrofolato Redutase (NADPH2) , Oxirredutases atuantes sobre Doadores de Grupo CH-NH/genética , Peptidil Dipeptidase A/genética
20.
Ann Chim ; 91(1-2): 73-80, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11329771

RESUMO

In the present work, a study of a physico-chemical characterisation of underground waters, utilised for agriculture and human use in the Lecce district (Southern Italy) has been reported. The aim of the work has been to define the quality of underground waters in the different areas and to value salt contamination due to seawater intrusion. Statistical techniques, such as Principal Component Analysis (PCA) and Cluster Analysis (CA), have been utilised to examine the correlations among the different parameters and to define contamination areas. The results have shown a high salt contamination in artesian wells of the Ionian Sea coast.


Assuntos
Água Doce/química , Água do Mar , Cloreto de Sódio/análise , Fenômenos Químicos , Físico-Química , Cromatografia por Troca Iônica , Análise por Conglomerados , Itália , Análise Multivariada , Espectrofotometria Atômica
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