Biomedical subjects

Benedetta Bartali

Publications and source records attributed to Benedetta Bartali.

29 records · Page 2Linked to original sources

PubMed2004

Vitamin E levels, cognitive impairment and dementia in older persons: the InCHIANTI study.

There is conflicting evidence that antioxidants contribute to maintaining cognitive function in elderly subjects. We investigated whether vitamin E plasma levels are related to the presence of dementia and cognitive impairment in a population-based cohort study conducted in Italy. A total of 1033 participants aged at least 65 years received clinical and neuropsychological examinations, donated blood for vitamin E analysis and had their diets assessed. Participants with plasma vitamin E levels in the bottom tertile had a significantly higher probability of being demented (OR 2.6, 95% CI 1.0-7.1) and also of suffering from cognitive impairment (OR 2.2, 95% CI 1.2-4.2) compared to those in the highest vitamin E tertile after adjustment for age, gender, education, lipid levels, energy intake, vitamin E intake, and smoking. This study supports the notion that higher vitamin E plasma levels might provide significant protection against cognitive impairment and dementia in elderly subjects.

Aged↗

PubMed2004

Bone density and hemoglobin levels in older persons: results from the InCHIANTI study.

Hypoxemia has been recognized as a risk factor for bone loss. The aim of the present study is to investigate the relationship of bone mass and density measures with anemia and hemoglobin levels in a large sample of older community-dwelling persons. The study is based on data from 950 participants enrolled in the "Invecchiare in Chianti" (Aging in the Chianti area, InCHIANTI) study. All the analyses were performed considering continuous hemoglobin levels as well as the dichotomous anemia variable (defined according to WHO criteria as hemoglobin < 12 g/dl in women and < 13 g/dl in men). A peripheral quantitative computerized tomography (pQCT) scan of the right calf was performed in all participants to evaluate total bone density, trabecular bone density, cortical bone density, and the ratio between cortical and total bone area. Linear regression analyses were used to assess the multivariate relationship of pQCT bone measures with anemia and hemoglobin levels after adjustment for demographics, chronic conditions, muscle strength and biological variables. Participants were 75.0 (SD 6.9) years old. In our sample, 101 participants (10.6%) were anemic. In women, coefficients from adjusted linear regression analyses evaluating the association between pQCT bone measures (per SD increase) and hemoglobin levels/anemia showed significant associations of anemia with total bone density (beta = -0.335, SE = 0.163; P = 0.04) and cortical bone density (beta = -0.428, SE = 0.160; P = 0.008). Relationships with borderline significance were found for the associations of anemia with trabecular bone density and the ratio between cortical and total bone area. Significant associations were found between hemoglobin levels and trabecular bone density (beta = 0.112, SE = 0.049; P = 0.02), total bone density (beta = 0.101, SE = 0.046; P = 0.03), cortical bone density (beta = 0.100, SE = 0.046; P = 0.03) and the ratio between cortical bone and total area (beta = 0.092, SE = 0.045; P = 0.04). In men, significant associations were found for hemoglobin levels with total bone density (beta = 0.076, SE = 0.036; P = 0.03) and cortical bone density (beta = 0.095, SE = 0.41; P = 0.02). A borderline significance was reported for the association between anemia and cortical bone density. We concluded that anemia and low hemoglobin levels are negatively and independently associated with bone mass and density. The bone loss associated with hemoglobin levels mainly occurs in the cortical bone. Women with lower hemoglobin levels demonstrate a higher bone loss than male counterparts.

Aged↗

PubMed2004

Neurological examination findings to predict limitations in mobility and falls in older persons without a history of neurological disease.

PURPOSE: To estimate the prevalence of neurological signs and their association with limitations in mobility and falls in a sample of older persons without known neurological disease. METHODS: A neurologist examined 818 participants from the InCHIANTI study who were aged > or =65 years and who did not have cognitive impairment, treatment with neuroleptics, and a history of neurological disease. Mobility was assessed as walking speed and self-reported ability to walk at least 1 km without difficulty. Participants were asked to report falls that had occurred in the previous 12 months. RESULTS: Less than 20% (160/818) of participants had no neurological signs. Neurological signs were more prevalent in older participants and those with impaired mobility. When all neurological signs were included in sex-and age-adjusted multivariate models, 10 were mutually independent correlates of poor mobility. After adjusting for age and sex, the number of neurological signs was associated with progressively slower walking speed (P <0.001), a higher probability of reported inability to walk 1 km (P <0.001), and a history of falls (P <0.05). CONCLUSION: Neurological signs are independent correlates of limitations in mobility and falls in older persons who have no clear history of neurological disease.

Accidental Falls↗

PubMed2004

Antioxidants and physical performance in elderly persons: the Invecchiare in Chianti (InCHIANTI) study.

BACKGROUND: Muscle strength and physical performance in old age might be related to the oxidative damage caused by free radicals. OBJECTIVE: The objective was to assess the correlation of plasma concentrations and daily dietary intakes of antioxidants with skeletal muscle strength and physical performance in elderly persons. DESIGN: This study is part of the Invecchiare in Chianti (InCHIANTI) study, which was conducted in 986 Italians aged > or = 65 y. Physical performance was assessed on the basis of walking speed, ability to rise from a chair, and standing balance. Knee extension strength was assessed with a hand-held dynamometer. The European Prospective Investigation into Cancer and Nutrition (EPIC) questionnaire was used to evaluate the daily dietary intakes of vitamin C, vitamin E, beta-carotene, and retinol. Plasma alpha- and gamma-tocopherol concentrations were measured. Adjusted linear regression analyses were used to calculate regression coefficients per SD increase in plasma concentrations and daily dietary intakes. RESULTS: In adjusted analyses, plasma alpha-tocopherol was significantly correlated with knee extension (beta = 0.566, P = 0.003) and the summary physical performance score (beta = 0.044, P = 0.008). Plasma gamma-tocopherol was associated only with knee extension strength (beta = 0.327, P = 0.04). Of the daily dietary intake measures, vitamin C and beta-carotene were significantly correlated with knee extension strength, and vitamin C was significantly associated with physical performance (beta = 0.029, P = 0.04). CONCLUSIONS: Plasma antioxidant concentrations correlate positively with physical performance and strength. Higher dietary intakes of most antioxidants, especially vitamin C, appear to be associated with higher skeletal muscular strength in elderly persons.

Aged↗

PubMed2003

High-frequency vibration training increases muscle power in postmenopausal women.

OBJECTIVE: To test whether training on a high-frequency (28Hz) vibrating platform improves muscle power and bone characteristics in postmenopausal women. DESIGN: Randomized controlled trial with 6-month follow-up. SETTING: Outpatient clinic in a general hospital in Italy. PARTICIPANTS: Twenty-nine postmenopausal women (intervention group, n=14; matched controls, n=15). INTERVENTION: Participants stood on a ground-based oscillating platform for three 2-minute sessions for a total of 6 minutes per training session, twice weekly for 6 months. The controls did not receive any training. Both groups were evaluated at baseline and after 6 months. MAIN OUTCOME MEASURES: Muscle power, calculated from ground reaction forces produced by landing after jumping as high as possible on a forceplate, cortical bone density, and biomarkers of bone turnover. RESULTS: Over 6 months, muscle power improved by about 5% in women who received the intervention, and it remained unchanged in controls (P=.004). Muscle force remained stable in both the intervention and control groups. No significant changes were observed in bone characteristics. CONCLUSION: Reflex muscular contractions induced by vibration training improve muscle power in postmenopausal women.

Analysis of Variance↗

PubMed2003

The frailty syndrome: a critical issue in geriatric oncology.

Evidence exists that the geriatric intervention guided by Comprehensive Geriatric Assessment (CGA) has positive effects on a number of important health outcomes in frail older patients. Although a number of observational studies, editorials, special articles and clinical reports, suggest that CGA should be used to guide the assessment and clinical decision-making in older cancer patients, there is limited support to this view in the literature. Older patients that are diagnosed with cancer are usually healthier and less problematic than persons of the same age who are randomly sampled from the general population. In these persons, the cancer dominates the clinical picture and, therefore, instruments especially tuned for the frail elderly may provide little information. The concept of the frailty syndrome, characterized by high susceptibility, low functional reserve and unstable homeostasis, has recently received a lot of attention by the geriatric community. A CGA approach, which also evaluates elements of the frailty syndrome, may be of great interest for those oncologists who want to identify older patients likely to develop severe toxicity and severe side effects in response to aggressive treatment. Improvements in the definition of the frailty syndrome may profit from the clinical experience of oncologists.

Adaptation, Physiological↗

PubMed2003

Age and disability affect dietary intake.

The purpose of the study was to provide information on dietary intake in the InCHIANTI study population, a representative sample (n = 1453) of persons living in two towns of Tuscany (Italy), including a large number of old and very old individuals (79.5% >65 y old). We also investigated whether difficulties in nutrition-related activities were associated with inadequate intake of selected nutrients. The percentage of persons with an inadequate intake of nutrients according to Italian Recommended Nutrients Levels (LARN) was higher in the older age groups. Older persons tended to adapt their diets in response to individual functional difficulties, often leading to monotonous food consumption and, as a consequence, to inadequate nutrient intakes. Multiple logistic models were used to evaluate whether inadequate intake of selected nutrients could be predicted by nutrition-related difficulties. Reporting difficulties in three or more nutrition-related activities (chewing, self-feeding, shopping for basic necessities, carrying a shopping bag, cooking a warm meal, using fingers to grasp or handle) significantly increased the risk of inadequate intake of energy [odds ratio (OR) = 3.8, 95% CI = 1.9-7.8) and vitamin C (OR = 2.2, 95% CI = 1.2-4.2, after adjustment for energy intake). More attention to functional problems in the elderly population and the provision of formal or informal help to those who have difficulty in purchasing, processing and eating food may reduce, at least in part, the percentage of older persons with poor nutrition.

Aged↗

PubMed2003

Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia.

Sarcopenia, the reduction of muscle mass and strength that occurs with aging, is widely considered one of the major causes of disability in older persons. Surprisingly, criteria that may help a clinician to identify persons with impaired muscle function are still lacking. Using data from a large representative sample of the general population, we examined how muscle function and calf muscle area change with aging and affect mobility in men and women free of neurological conditions. We tested several putative indicators of sarcopenia, including knee extension isometric torque, handgrip, lower extremity muscle power, and calf muscle area. For each indicator, sarcopenia was considered to be present when the measure was >2 SDs below the mean. For all four measures, the prevalence of sarcopenia increased with age, both in men and women. The age-associated gradient in prevalence was maximum for muscle power and minimum for calf-muscle area. However, lower extremity muscle power was no better than knee-extension torque or handgrip in the early identification of poor mobility, defined either as walking speed <0.8 m/s or inability to walk at least 1 km without difficulty and without developing symptoms. Optimal cutoff values that can be used in the clinical practice to identify older persons with poor mobility were developed. The findings of the study lay the basis for a cost-effective, clinical marker of sarcopenia based on a measure of isometric handgrip strength. Our findings should be verified in a longitudinal study.

Adult↗

PubMed2002

Understanding the physiological and functional consequences of menopause: the PROSALMEN study. PROgetto SALute MENopausa.

BACKGROUND AND AIMS: Women live longer and are more often affected by disability and poor health than men. The mechanism underlying this sex-related "mortality-morbidity" paradox is still unclear but it has been suggested that the physiological and functional changes occurring during the menopausal transition play an important role. The aim of PROSALMEN (PROgetto SALute MENopausa: Health in Menopause Project) is to study in great detail how these changes affect the integrity and function of the physiologic subsystems that are relevant to the maintenance of an active and healthy life-style during the aging process. METHODS: PROSALMEN is a cross-sectional comparison of age-matched pre- and post-menopausal women. Thirty post-menopausal women, aged 48-58 years, were enrolled in the study together with 30 age-matched pre-menopausal controls. A number of clinical, biological and functional parameters were collected assessing the integrity and level of function of the physiological subsystems that are important for mobility. Furthermore, we collected information on risk factors, medical conditions and symptoms that frequently develop or become clinically evident after menopause, including the most important elements of the classical post-menopausal syndrome. CONCLUSIONS: This rich dataset will be used to start dissecting the causal pathway leading from menopause to damages in the musculoskeletal system and, in turn, to reduced physical function. The final goal is to understand how and to what extent changes in health behavior and pharmacological treatments in addition to hormone replacement therapy (HRT) may counteract these processes.

Aging↗

PubMed2002

Changes in anthropometric measures in men and women across the life-span: findings from the InCHIANTI study.

OBJECTIVES: To describe the age distribution of anthropometric parameters in a population-based sample of older persons. METHODS: Cross-sectional survey of a population-based sample of persons over a wide age-range living in the Chianti area, Italy, between 1998 to 2000. Total cohort: 1453 men and women, of whom 424 younger than 65 and 1029 aged 65 years or older. Participation rate: 69.4% in < 65 yrs and 91.6% in > or = 65 yrs. Analytical cohort: anthropometric measures were available for 1266 subjects. RESULTS: Height and weight declined with increasing age in both sexes. In men, Body mass index (BMI) increased with age up to age 45-54 and then it declined. In women, it reached its maximum at age 65-74 and remained higher than in men in each corresponding age group above 65 years of age. Waist-to-hip ratio (WHR) progressively increased in men up to age 55-64 and then slightly declined. In women WHR steadily increased over the entire age range. CONCLUSIONS: Height and weight decline with age, regardless to differences in body size attributable to secular trend. In both sexes, important fat redistribution occurs between 45 and 54 years and in older women the increase in WHR mostly reflects a reduction of fat deposits in the hips. This information may be relevant for a correct interpretation of changes in WHR in older persons. However, these findings were obtained in a cross-sectional study and should be verified in a longitudinal perspective.

Adult↗

PubMedDate not supplied

Dietary intake estimated using different methods in two Italian older populations.

Most of the tools used to assess nutritional intake in large epidemiological studies were originally developed to be used in young and middle-aged subjects and, therefore, their validity and reliability when employed in older subjects remain uncertain. We conducted this study to verify whether the questionnaire developed in the context of the European Prospective Investigation into Cancer and nutrition (EPIC) could be used to assess dietary intake in the participants of InCHIANTI, an epidemiological study of risk factors for disability in late life, performed in 633 men (78% aged, > or =65 years) and 802 women (81% aged, > or =65 years) randomly sampled from the general population. In particular, the aim of this project was to collect preliminary information that could support a future study of concurrent validity. Data on food consumption assessed using the EPIC questionnaire from the InCHIANTI participants were compared with those collected using a 7-day diary in the National Nutritional Investigation into Dietary Behavior (INN-CA), a study conducted in 15 Italian centres aimed at assessing Italian households' and individuals' dietary intake. In spite of different populations and different methods used in data collection, the distributions of dietary intake from the two studies were remarkably similar for most macro- and micro-nutrients, both in men and women and according to age groups. At a population level, a food frequency questionnaire and a costly and time-consuming objective method provided similar estimates of dietary intake. Future study should attempt to generalize these findings at an individual level by collecting data with both instruments in the same subjects.

Aged↗