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Article: Poverty and Influenza/Pneumococcus Vaccinations in Older People: Data from The Survey of Health, Ageing and Retirement in Europe (SHARE) Study.

Veronese, Nicola / Zambon, Nancy / Noale, Marianna / Maggi, Stefania

2023 Volume 11, Issue 9

Abstract: Vaccine acceptance seems to be lower in poor people. The determinants of the lower vaccine coverage in poor people are not established. Therefore, we aimed to explore the association between poverty and influenza/pneumococcus vaccinations and the factors ...

Abstract	Vaccine acceptance seems to be lower in poor people. The determinants of the lower vaccine coverage in poor people are not established. Therefore, we aimed to explore the association between poverty and influenza/pneumococcus vaccinations and the factors potentially associated with vaccination's coverage in poor people. The data of the Survey of Health, Ageing and Retirement in Europe (SHARE), an ongoing longitudinal, multi-disciplinary, and cross-national European study where used. Poverty was defined using information on income and household size. Among 47,370 participants initially included in the SHARE study, 12,442 were considered poor. In the multivariable logistic regression analysis, "Household size" was associated with a significantly lower vaccination probability, meanwhile "Age", "Years of education", "Regularly taking prescription drugs", and the level of income were significantly associated with higher probabilities of both influenza and pneumonia vaccinations. The "Number of illnesses/health conditions" was significantly associated with a higher probability of getting vaccination against influenza and against pneumococcus. In conclusion, among poor older people, several specific factors could be identified as barriers for the vaccinations against influenza or pneumococcus that are unique to this segment of the population, such as living with the family and having a job.
Language	English
Publishing date	2023-08-27
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2703319-3
ISSN	2076-393X
ISSN	2076-393X
DOI	10.3390/vaccines11091422
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Poverty and Influenza/Pneumococcus Vaccinations in Older People

Nicola Veronese / Nancy Zambon / Marianna Noale / Stefania Maggi

Vaccines, Vol 11, Iss 1422, p

Data from The Survey of Health, Ageing and Retirement in Europe (SHARE) Study

2023 Volume 1422

Abstract	Vaccine acceptance seems to be lower in poor people. The determinants of the lower vaccine coverage in poor people are not established. Therefore, we aimed to explore the association between poverty and influenza/pneumococcus vaccinations and the factors potentially associated with vaccination’s coverage in poor people. The data of the Survey of Health, Ageing and Retirement in Europe (SHARE), an ongoing longitudinal, multi-disciplinary, and cross-national European study where used. Poverty was defined using information on income and household size. Among 47,370 participants initially included in the SHARE study, 12,442 were considered poor. In the multivariable logistic regression analysis, “Household size” was associated with a significantly lower vaccination probability, meanwhile “Age”, “Years of education”, “Regularly taking prescription drugs”, and the level of income were significantly associated with higher probabilities of both influenza and pneumonia vaccinations. The “Number of illnesses/health conditions” was significantly associated with a higher probability of getting vaccination against influenza and against pneumococcus. In conclusion, among poor older people, several specific factors could be identified as barriers for the vaccinations against influenza or pneumococcus that are unique to this segment of the population, such as living with the family and having a job.
Keywords	vaccination ; poverty ; risk factors ; SHARE ; Medicine ; R
Subject code	300
Language	English
Publishing date	2023-08-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
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Article ; Online: The role of nutrition and the Mediterranean diet on the trajectories of cognitive decline.

Maggi, Stefania / Ticinesi, Andrea / Limongi, Federica / Noale, Marianna / Ecarnot, Fiona

Experimental gerontology

2023 Volume 173, Page(s) 112110

Abstract: The worldwide burden of dementia is immense, and set to increase to unprecedented levels in the coming decades, due to population aging. In the absence of disease-modifying treatment, there is therefore a strong rationale to support the assumption that ... ...

Abstract	The worldwide burden of dementia is immense, and set to increase to unprecedented levels in the coming decades, due to population aging. In the absence of disease-modifying treatment, there is therefore a strong rationale to support the assumption that acting on modifiable risk factors, especially in midlife, is a good strategy for reducing the burden of dementia. Among these risk factors, nutrition is key, as it is fundamental to healthy aging, and has interrelated benefits on a number of organ systems, metabolic processes and health states that can all contribute to modifying the risk of dementia. In this paper, we review the methodological challenges of comparing studies of dietary interventions. We then discuss the effect of genetics and the environment on brain health, and review in particular the literature data on the effect of nutrition on cognition. We summarize the body of data reporting the largely beneficial effects of the Mediterranean diet on brain health, and the possible mechanisms that mediate these effects. Finally, we discuss future perspectives for further research in the field, notably the "gut-brain axis", thought to be a key mediator of the effect of nutrition on brain health.
MeSH term(s)	Humans ; Diet, Mediterranean ; Nutritional Status ; Cognitive Dysfunction/prevention & control ; Aging ; Cognition ; Dementia/psychology ; Diet
Language	English
Publishing date	2023-02-02
Publishing country	England
Document type	Review ; Journal Article
ZDB-ID	390992-x
ISSN	1873-6815 ; 0531-5565
ISSN (online)	1873-6815
ISSN	0531-5565
DOI	10.1016/j.exger.2023.112110
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Article ; Online: The role of nutrition and the Mediterranean diet on the trajectories of cognitive decline

Stefania Maggi / Andrea Ticinesi / Federica Limongi / Marianna Noale / Fiona Ecarnot

Experimental Gerontology, Vol 173, Iss , Pp 112110- (2023)

2023

Abstract	The worldwide burden of dementia is immense, and set to increase to unprecedented levels in the coming decades, due to population aging. In the absence of disease-modifying treatment, there is therefore a strong rationale to support the assumption that acting on modifiable risk factors, especially in midlife, is a good strategy for reducing the burden of dementia. Among these risk factors, nutrition is key, as it is fundamental to healthy aging, and has interrelated benefits on a number of organ systems, metabolic processes and health states that can all contribute to modifying the risk of dementia. In this paper, we review the methodological challenges of comparing studies of dietary interventions. We then discuss the effect of genetics and the environment on brain health, and review in particular the literature data on the effect of nutrition on cognition. We summarize the body of data reporting the largely beneficial effects of the Mediterranean diet on brain health, and the possible mechanisms that mediate these effects. Finally, we discuss future perspectives for further research in the field, notably the “gut-brain axis”, thought to be a key mediator of the effect of nutrition on brain health.
Keywords	Nutrition ; Diet ; Cognition ; Dementia ; Mediterranean diet ; Medicine ; R ; Biology (General) ; QH301-705.5
Subject code	360
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
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Article ; Online: Hospital length of stay and 30-day readmissions in older people: their association in a 20-year cohort study in Italy.

Trevisan, Caterina / Noale, Marianna / Zatti, Giancarlo / Vetrano, Davide Liborio / Maggi, Stefania / Sergi, Giuseppe

BMC geriatrics

2023 Volume 23, Issue 1, Page(s) 154

Abstract: Background: There are conflicting data on whether hospital length of stay (LOS) reduction affects readmission rates in older adults. We explored 20-year trends of hospital LOS and 30-day rehospitalizations in a cohort of Italian older people, and ... ...

Abstract	Background: There are conflicting data on whether hospital length of stay (LOS) reduction affects readmission rates in older adults. We explored 20-year trends of hospital LOS and 30-day rehospitalizations in a cohort of Italian older people, and investigated their association. Methods: Participants in the Pro.V.A. project (n = 3099) were followed-up from 1996 to 2018. LOS and 30-day rehospitalizations, i.e. new hospitalizations within 30 days from a previous discharge, were obtained from personal interviews and regional registers. Rehospitalizations in the 6 months before death were also assessed. Linear regressions evaluated the associations between LOS and the frequency of 30-day rehospitalizations, adjusting for the mean age of the cohort within each year. Results: Over 20 years, 2320 (74.9%) participants were hospitalized. Mean LOS gradually decreased from 17.3 days in 1996 to 11.3 days in 2018, while 30-day rehospitalization rates increased from 6.6% in 1996 to 13.6% in 2018. LOS was inversely associated with 30-day rehospitalizations frequency over time (β = -2.33, p = 0.01), similarly in men and women. A total of 1506 individuals was hospitalized within 6 months before death. The frequency of 30-day readmissions at the end of life increased from 1.4% in 1997 to 8.3% in 2017 and was associated with mean LOS (β = -1.17, p = 0.03). Conclusions: The gradual LOS reduction observed in the latter decades is associated with higher 30-day readmission rates in older patients in Italy. This suggests that a careful pre-discharge assessment is warranted in older people, and that community healthcare services should be improved to reduce the risk of readmission.
MeSH term(s)	Male ; Humans ; Female ; Aged ; Patient Readmission ; Length of Stay ; Cohort Studies ; Italy/epidemiology ; Hospitals ; Retrospective Studies
Language	English
Publishing date	2023-03-21
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2059865-8
ISSN	1471-2318 ; 1471-2318
ISSN (online)	1471-2318
ISSN	1471-2318
DOI	10.1186/s12877-023-03884-4
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Article: Health-Related Predictors of Changes in Cognitive Status in Community-Dwelling Older Individuals.

Trevisan, Caterina / Siviero, Paola / Limongi, Federica / Noale, Marianna / Maggi, Stefania

Frontiers in aging neuroscience

2022 Volume 14, Page(s) 876359

Abstract: Given the rising numbers of older people living with dementia, this study focuses on identifying modifiable health-related factors associated with changes in cognitive status. The predictors of 1-year conversion from Preserved Cognitive Health (PCH) and ... ...

Abstract	Given the rising numbers of older people living with dementia, this study focuses on identifying modifiable health-related factors associated with changes in cognitive status. The predictors of 1-year conversion from Preserved Cognitive Health (PCH) and Mild Cognitive Impairment (MCI) in older adults were evaluated. Two logistic regression models were performed on data from an Italian multicenter population-based study; both included sociodemographic factors, family history of dementia (FHD), risk behaviors, and depressive symptoms. The first model considered also disease clusters, while the second one included diseases' number and biochemical parameters. The sample involved 459 participants (61.4% women, median age 75 years). Of the 80 PCH individuals at baseline, after 1 year 35 (43.8%) were stable, 44 (55.0%) progressed to MCI, none to dementia, and one to unclassified status. Of the 379 MCI participants at baseline, after 1 year 281 (74.1%) remained stable, 38 (10.0%) reverted to PCH, 15 (4.0%) progressed to dementia, and 45 (11.9%) become unclassifiable. Hypertension/bone and joint diseases cluster was the only predictor of PCH progression to MCI; age and depression were associated with MCI progression to dementia; FHD was associated with MCI reversion to PCH. More diseases and fewer white blood cells were associated with MCI progression to dementia; more diseases and lower platelets were associated with the transition from MCI to unclassifiable; higher Na and lower TSH levels were associated with MCI reversion. The treatment or management of some chronic conditions and electrolyte imbalances may help attenuate cognitive deterioration in older adults with no or MCI.
Language	English
Publishing date	2022-06-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2558898-9
ISSN	1663-4365
ISSN	1663-4365
DOI	10.3389/fnagi.2022.876359
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Article ; Online: Long-term beneficial impact of the randomised trial 'Train the Brain', a motor/cognitive intervention in mild cognitive impairment people: effects at the 14-month follow-up.

Sale, Alessandro / Noale, Marianna / Cintoli, Simona / Tognoni, Gloria / Braschi, Chiara / Berardi, Nicoletta / Maggi, Stefania / Maffei, Lamberto

Age and ageing

2023 Volume 52, Issue 5

Abstract: No treatment options are currently available to counteract cognitive deficits and/or delay progression towards dementia in older people with mild cognitive impairment (MCI). The 'Train the Brain' programme is a combined motor and cognitive intervention ... ...

Abstract	No treatment options are currently available to counteract cognitive deficits and/or delay progression towards dementia in older people with mild cognitive impairment (MCI). The 'Train the Brain' programme is a combined motor and cognitive intervention previously shown to markedly improve cognitive functions in MCI individuals compared to non-trained MCI controls, as assessed at the end of the 7-month intervention. Here, we extended the previous analyses to include the long-term effects of the intervention and performed a data disaggregation by gender, education and age of the enrolled participants. We report that the beneficial impact on cognitive functions was preserved at the 14-month follow-up, with greater effects in low-educated compared to high-educated individuals, and in women than in men.
MeSH term(s)	Male ; Female ; Humans ; Aged ; Dementia/psychology ; Follow-Up Studies ; Cognitive Dysfunction/diagnosis ; Cognitive Dysfunction/therapy ; Cognitive Dysfunction/psychology ; Brain ; Cognition
Language	English
Publishing date	2023-05-09
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	186788-x
ISSN	1468-2834 ; 0002-0729
ISSN (online)	1468-2834
ISSN	0002-0729
DOI	10.1093/ageing/afad067
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Article ; Online: Prevalence and impact of polypharmacy in older patients with type 2 diabetes.

Remelli, Francesca / Ceresini, Maria Giorgia / Trevisan, Caterina / Noale, Marianna / Volpato, Stefano

Aging clinical and experimental research

2022 Volume 34, Issue 9, Page(s) 1969–1983

Abstract: Background: Polypharmacy is a prevalent condition in older adults, especially those with multiple chronic diseases, and has been largely associated with adverse outcomes, including disability, hospitalizations, and death.: Aims: This systematic ... ...

Abstract	Background: Polypharmacy is a prevalent condition in older adults, especially those with multiple chronic diseases, and has been largely associated with adverse outcomes, including disability, hospitalizations, and death. Aims: This systematic review focused on diabetes and aimed to investigate the prevalence and impact of polypharmacy in older adults affected by such disease. Methods: Observational (either cross-sectional or longitudinal) or experimental studies investigating the frequency and impact of polypharmacy in older adults with diabetes were identified from scientific databases and grey literature until August 2021. The prevalence and the 95% Confidence Interval (95% CI) of polypharmacy in older people with diabetes were summarized by a random-effects meta-analysis. Results: From a total of 1465 records, 9 were selected for the qualitative synthesis, and 8 for the quantitative synthesis. Most studies defined polypharmacy using a cut-off for the minimum number of medications ranging from 4 to 6 drugs/day. The pooled prevalence of polypharmacy in older people with diabetes was 64% (95% CI 45-80%). Considering studies that used the same definition of polypharmacy (i.e. ≥ 5 drugs/day), the pooled prevalence was 50% (95% CI 37-63%). The between-studies heterogeneity was high. Across the selected studies, polypharmacy seemed to negatively influence both diabetes-specific (poor glycemic control and risk of hypoglycemia) and health-related (risk of incident falls, syncope, hospitalization, and death) outcomes. Conclusion: This systematic review confirms the high prevalence of polypharmacy in older people with diabetes and its strong impact on several health-related outcomes, including mortality. These results strengthen the need to improve care strategies for management of these patients.
MeSH term(s)	Aged ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/epidemiology ; Hospitalization ; Humans ; Observational Studies as Topic ; Polypharmacy ; Prevalence
Language	English
Publishing date	2022-06-20
Publishing country	Germany
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID	2104785-6
ISSN	1720-8319 ; 1594-0667
ISSN (online)	1720-8319
ISSN	1594-0667
DOI	10.1007/s40520-022-02165-1
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Article ; Online: Somatically evoked cough responses help to identify patients with difficult-to-treat chronic cough: a six-month observational cohort study.

Lavorini, Federico / Bernacchi, Guja / Fumagalli, Carlo / Noale, Marianna / Maggi, Stefania / Mutolo, Donatella / Cinelli, Eliana / Fontana, Giovanni A

EClinicalMedicine

2023 Volume 57, Page(s) 101869

Abstract: Background: Recently we identified in patients with chronic cough a sensory dysregulation via which the urge-to-cough (UTC) or coughing are evoked mechanically from "somatic points for cough" (SPCs) in the neck and upper trunk. We investigated the ... ...

Abstract	Background: Recently we identified in patients with chronic cough a sensory dysregulation via which the urge-to-cough (UTC) or coughing are evoked mechanically from "somatic points for cough" (SPCs) in the neck and upper trunk. We investigated the prevalence and the clinical relevance of SPCs in an unselected population of patients with chronic cough. Methods: From 2018 to 2021, symptoms of 317 consecutive patients with chronic cough (233 females) were collected on four visits (V1-V4) 2 months apart at the Cough Clinic of the University Hospital in Florence (I). Participants rated the disturbance caused by the cough (0-9 modified Borg Scale). We attempted to evoke coughing and/or UTC using mechanical actions in all participants who were subsequently categorised as responsive (somatic point for cough positive, SPC+) or unresponsive (SPC-) to these actions. An association was established between chronic cough and its commonest causes; treatments were administered accordingly. Findings: 169 patients were SPC+ and had a higher baseline cough score (p < 0.01). In most of the patients, the treatments reduced (p < 0.01) cough-associated symptoms. All patients reported a decrease (p < 0.01) in cough score at V2 (from 5.70 ± 1.4 to 3.43 ± 1.9 and from 5.01 ± 1.5 to 2.74 ± 1.7 for SPC+ and SPC- patients respectively). However, whilst in SPC- patients the cough score continued to decrease indicating virtually complete cough disappearance at V4 (0.97 ± 0.8), in SPC+ patients this variable remained close to V2 values during the entire follow-up. Interpretation: Our study suggests that the assessment of SPCs may identify patients whose cough is unresponsive and are eligible for specific treatments. Funding: This work was funded by an unrestricted grant from Merck (Italy).
Language	English
Publishing date	2023-02-20
Publishing country	England
Document type	Journal Article
ISSN	2589-5370
ISSN (online)	2589-5370
DOI	10.1016/j.eclinm.2023.101869
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Article ; Online: Sleep disorders during the COVID-19 pandemic: Results from the second phase of web-based EPICOVID19 study.

Trevisan, Caterina / De Vincentis, Antonio / Noale, Marianna / Maggi, Stefania / Antonelli Incalzi, Raffaele / Pedone, Claudio / Prinelli, Federica / Giacomelli, Andrea / Fortunato, Loredana / Molinaro, Sabrina / Cori, Liliana / Adorni, Fulvio

Stress and health : journal of the International Society for the Investigation of Stress

2024

Abstract: The COVID-19 pandemic has induced significant impairments, including sleep disturbances. The present study aimed to explore the impact of fear in relation to stress on sleep disorders among Italian adults and older participants in the second phase of the ...

Abstract	The COVID-19 pandemic has induced significant impairments, including sleep disturbances. The present study aimed to explore the impact of fear in relation to stress on sleep disorders among Italian adults and older participants in the second phase of the EPICOVID19 web-based survey (January-February 2021). Sleep disturbances during the pandemic were evaluated using the Jenkins Sleep Scale, perceived stress through the 10-item Perceived Stress Scale and fear of contagion and about economic and job situation with four ad hoc items. The strength of the pathways between stress, sleep disturbances and fear was explored using structural equation modelling, hypothesising that stress was related to sleep disturbances and that fear was associated with both stress and sleep problems. Out of 41,473 participants (74.7% women; mean age 49.7 ± 13.1 years), 8.1% reported sleep disturbances and were more frequently women, employed in a work category at risk of infection or unemployed, and showed higher deprivation scores. Considering an a priori hypotheses model defining sleep and stress scores as endogenous variables and fear as an exogenous variable, we found that fear was associated with sleep problems and stress, and stress was associated with sleep problems; almost half of the total impact of fear on sleep quality was mediated by stress. The impact of stress on sleep quality was more evident in the younger age group, among individuals with a lower socioeconomic status and healthcare workers. Fear related to COVID-19 seem to be associated with sleep disturbances directly and indirectly through stress.
Language	English
Publishing date	2024-01-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2042041-9
ISSN	1532-2998 ; 1532-3005
ISSN (online)	1532-2998
ISSN	1532-3005
DOI	10.1002/smi.3369
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