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Artikel: Incidence of young-onset dementia in Italy: The Brescia register study.

Alzheimer's & dementia (Amsterdam, Netherlands)

2024 Band 16, Heft 1, Seite(n) e12544

Abstract: Introduction: The goal of the present work was to assess the incidence of dementia with onset before the age of 65 years (i.e., young-onset dementia [YOD]) and define the frequencies of young-onset Alzheimer's disease (AD), frontotemporal lobar ... ...

Abstract	Introduction: The goal of the present work was to assess the incidence of dementia with onset before the age of 65 years (i.e., young-onset dementia [YOD]) and define the frequencies of young-onset Alzheimer's disease (AD), frontotemporal lobar degeneration (FTLD), and dementia with Lewy bodies (DLB) in the general population. Methods: The study was conducted from January 1, 2019 to December 31, 2019 in Brescia province (population: 1,268,455). During the study period, all new YOD cases (incident YOD) were counted, and all patients' records reviewed. The incidence was standardized to the Italian general population in 2019. Results: A total of 29 YOD patients were diagnosed. The age-sex standardized incidence rate was 4.58 (95% confidence interval, 3.07-6.58) per 100,000 person-years. No difference in incidence rate between YOD due to AD or FTLD ( Discussion: Presenting neurodegenerative YOD phenotypes encompasses both AD and FTLD. Improved knowledge on YOD epidemiology is essential to adequately plan and organize health services.
Sprache	Englisch
Erscheinungsdatum	2024-02-29
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	2832898-X
ISSN	2352-8729
ISSN	2352-8729
DOI	10.1002/dad2.12544
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Nutritional intervention in special care units for dementia.

Boffelli, Stefano / Rozzini, Renzo / Trabucchi, Marco

Journal of the American Geriatrics Society

2004 Band 52, Heft 7, Seite(n) 1216–1217

Mesh-Begriff(e)	Aged ; Aged, 80 and over ; Body Weight ; Comprehensive Health Care ; Dementia/complications ; Dementia/diet therapy ; Dietary Services ; Female ; Humans ; Italy/epidemiology ; Long-Term Care ; Male ; Malnutrition/epidemiology ; Malnutrition/prevention & control ; Nutritional Status ; Outcome Assessment (Health Care) ; Prospective Studies ; Survival Rate ; Time Factors ; Weight Loss
Sprache	Englisch
Erscheinungsdatum	2004-07
Erscheinungsland	United States
Dokumenttyp	Comment ; Letter
ZDB-ID	80363-7
ISSN	1532-5415 ; 0002-8614
ISSN (online)	1532-5415
ISSN	0002-8614
DOI	10.1111/j.1532-5415.2004.52327_1.x
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Changes in characteristics of Alzheimer patients at first visit to centers for dementia: a 10-year follow-up study.

Rozzini, Luca / Vicini Chilovi, Barbara / Riva, Maddalena / Rozzini, Renzo / Boffelli, Stefano / Trabucchi, Marco / Padovani, Alessandro

Aging clinical and experimental research

2011 Band 23, Heft 2, Seite(n) 159–161

Abstract: Background and aims: The Cronos Project is an observational study on Alzheimer's disease (AD), created by Italy's Ministry of Public Health in 2000. The aim of our study was to evaluate whether the clinical characteristics of patients at their first ... ...

Abstract	Background and aims: The Cronos Project is an observational study on Alzheimer's disease (AD), created by Italy's Ministry of Public Health in 2000. The aim of our study was to evaluate whether the clinical characteristics of patients at their first visit to the Alzheimer Evaluation Unit (UVA) changed from September 2000 to December 2009, and to examine possible reasons for changes noted. Methods: 1532 consecutive patients were enrolled in two UVAs (September 2000 to December 2009) in a retrospective, descriptive study, with medical records as the primary source of data. Results: Patients' age at the first visit was not different throughout the period of observation. No differences were observed with regard to education or functional characteristics. However, a reduction in the severity of cognitive impairment was found during the period of evaluation: patients consecutively recruited in the first years were more cognitively, functionally, and psycho- behaviorally compromised than patients recruited in the following years. Conclusions: Data show changes in characteristics at the first visit in patients affected by cognitive deterioration during the years of observation. This finding indicates new clinical needs of patients, requiring changes in pharmacological treatment and in general of the clinical approach.
Mesh-Begriff(e)	Aged ; Aged, 80 and over ; Alzheimer Disease/diagnosis ; Alzheimer Disease/psychology ; Alzheimer Disease/therapy ; Female ; Follow-Up Studies ; Humans ; Italy ; Male ; Mental Status Schedule ; Middle Aged ; Retrospective Studies ; Time Factors
Sprache	Englisch
Erscheinungsdatum	2011-04
Erscheinungsland	Germany
Dokumenttyp	Journal Article
ZDB-ID	2104785-6
ISSN	1720-8319 ; 1594-0667
ISSN (online)	1720-8319
ISSN	1594-0667
DOI	10.3275/6969
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: The impact of COVID-19 on health status of home-dwelling elderly patients with dementia in East Lombardy, Italy: results from COVIDEM network.

Caratozzolo, Salvatore / Zucchelli, Alberto / Turla, Marinella / Cotelli, Maria Sofia / Fascendini, Sara / Zanni, Mara / Bianchetti, Angelo / Psy, Matteo Peli / Rozzini, Renzo / Boffelli, Stefano / Cappuccio, Melania / Psy, Federica Gottardi / Psy, Chiara Vecchi / Bellandi, Daniele / Caminati, Claudia / Gentile, Simona / Psy, Elena Lucchi / Di Fazio, Ignazio / Psy, Marina Zanetti /

Vezzadini, Giuliana / Psy, Chiara Forlani / Psy, Maura Cosseddu / Psy, Rosanna Turrone / Psy, Silvia Pelizzari / Scalvini, Andrea / Di Cesare, Marco / Psy, Marta Grigolo / Falanga, Lina / Medici, Nives / Palamini, Nives / Psy, Elisa Zanacchi / Psy, Eleonora Grossi / Bellelli, Giuseppe / Marengoni, Alessandra / Trabucchi, Marco / Padovani, Alessandro

Aging clinical and experimental research

2020 Band 32, Heft 10, Seite(n) 2133–2140

Abstract: Background: COVID-19 outbreak has led to severe health burden in the elderly. Age, morbidity and dementia have been associated with adverse outcome.: Aims: To evaluate the impact of COVID-19 on health status in home-dwelling patients.: Methods: ... ...

Abstract	Background: COVID-19 outbreak has led to severe health burden in the elderly. Age, morbidity and dementia have been associated with adverse outcome. Aims: To evaluate the impact of COVID-19 on health status in home-dwelling patients. Methods: 848 home-dwelling outpatients with dementia contacted from April 27 to 30 and evaluated by a semi-structured interview to evaluate possible health complication due to COVID-19 from February 21 to April 30. Age, sex, education, clinical characteristics (including diagnosis of dementia) and flu vaccination history were obtained from previous medical records. Items regarding change in health status and outcome since the onset of the outbreak were collected. COVID-19 was diagnosed in patients who developed symptoms according to WHO criteria or tested positive at nasal/throat swab if hospitalized. Unplanned hospitalization, institutionalization and mortality were recorded. Results: Patients were 79.7 years old (SD 7.1) and 63.1% were females. Ninety-five (11.2%) patients developed COVID-19-like symptoms. Non COVID-19 and COVID-19 patients differed for frequency of diabetes (18.5% vs. 37.9%, p < 0.001), COPD (7.3% vs. 18.9%, p < 0.001), and previous flu vaccination (56.7% vs. 37.9%, p < 0.001). Diabetes and COPD were positively associated with COVID-19, whereas higher dementia severity and flu vaccination showed an inverse association. Among COVID-19 patients, 42 (44.2%) were hospitalized while 32 (33.7%) died. Non COVID-19 patients' hospitalization and mortality rate were 1.9% and 1.2%, respectively. COVID-19 and COPD were significantly associated with the rate of mortality. Discussion/conclusions: A high proportion of adverse outcome related to COVID-19 was observed in home-dwelling elderly patients with dementia. Active monitoring though telehealth programs would be useful particularly for those at highest risk of developing COVID-19 and its adverse outcomes.
Mesh-Begriff(e)	Aged ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/mortality ; Dementia/epidemiology ; Dementia/mortality ; Female ; Health Status ; Hospitalization/statistics & numerical data ; Humans ; Italy/epidemiology ; Male ; Pandemics ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/mortality ; SARS-CoV-2
Schlagwörter	covid19
Sprache	Englisch
Erscheinungsdatum	2020-09-12
Erscheinungsland	Germany
Dokumenttyp	Journal Article
ZDB-ID	2104785-6
ISSN	1720-8319 ; 1594-0667
ISSN (online)	1720-8319
ISSN	1594-0667
DOI	10.1007/s40520-020-01676-z
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Delirium in a sub-intensive care unit for the elderly: occurrence and risk factors.

Ranhoff, Anette Hylen / Rozzini, Renzo / Sabatini, Tony / Cassinadri, Angela / Boffelli, Stefano / Trabucchi, Marco

Aging clinical and experimental research

2006 Band 18, Heft 5, Seite(n) 440–445

Abstract: Background and aims: The objective was to study occurrence and risk factors of delirium in a new model of care, the Sub-Intensive Care Unit for the elderly (SICU), which is a level of care between that offered by ordinary wards and intensive care.: ... ...

Abstract	Background and aims: The objective was to study occurrence and risk factors of delirium in a new model of care, the Sub-Intensive Care Unit for the elderly (SICU), which is a level of care between that offered by ordinary wards and intensive care. Methods: A prospective observational study of 401 consecutively admitted patients, 60+ years, in a four-bed SICU in the geriatric ward of a general hospital. Delirium was detected by the Confusion Assessment Method (CAM) at admission (prevalent) and during SICU stay (incident). Impaired function (Barthel Index) and/or IADL two weeks prior to admission identified disability, and additional Mini-Mental State Examination (MMSE) <18 at discharge identified probable dementia. Results: Delirium was detected in 117 patients (29.2%). Of these 62 (15.5%) had delirium at admission and a further 55 developed delirium during their time in the SICU. Delirium occurred in 19 (11.4%) of the "robust" (no dementia or disability), 28 (24.1%) of the disabled and 70 (58.4%) of the demented patients (p<0.001). Prevalent delirium was found in 8 (4.8%), 11 (9.5%) and 43 (36.1%) (p<0.001) and incident in 11 (6.6%), 17 (14.7%) and 27 (22.7%) (p<0.001) of the robust, disabled, and demented patients respectively. Heavy alcohol use, maximum intake of 7 or more drugs, and the use of a bladder catheter were independently associated with delirium. Conclusions: Delirium was common in the SICU, and patients with probable dementia had the highest risk. They tended to have delirium at admission, whereas patients without dementia, although less at risk, were more prone to developing delirium during their stay in the SICU.
Mesh-Begriff(e)	Aged ; Aged, 80 and over ; Alcohol Drinking/adverse effects ; Cohort Studies ; Delirium/epidemiology ; Delirium/etiology ; Dementia/complications ; Disabled Persons/psychology ; Female ; Geriatric Assessment ; Humans ; Incidence ; Intensive Care Units/classification ; Intensive Care Units/statistics & numerical data ; Male ; Middle Aged ; Prospective Studies ; Psychoses, Substance-Induced/complications ; Risk Factors ; Subacute Care/statistics & numerical data ; Urinary Catheterization/adverse effects
Sprache	Englisch
Erscheinungsdatum	2006-12-13
Erscheinungsland	Germany
Dokumenttyp	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2104785-6
ISSN	1720-8319 ; 1594-0667
ISSN (online)	1720-8319
ISSN	1594-0667
DOI	10.1007/bf03324841
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: The impact of COVID-19 on health status of home-dwelling elderly patients with dementia in East Lombardy, Italy: results from COVIDEM network

Aging clin. exp. res

Abstract: BACKGROUND: COVID-19 outbreak has led to severe health burden in the elderly. Age, morbidity and dementia have been associated with adverse outcome. AIMS: To evaluate the impact of COVID-19 on health status in home-dwelling patients. METHODS: 848 home- ... ...

Abstract	BACKGROUND: COVID-19 outbreak has led to severe health burden in the elderly. Age, morbidity and dementia have been associated with adverse outcome. AIMS: To evaluate the impact of COVID-19 on health status in home-dwelling patients. METHODS: 848 home-dwelling outpatients with dementia contacted from April 27 to 30 and evaluated by a semi-structured interview to evaluate possible health complication due to COVID-19 from February 21 to April 30. Age, sex, education, clinical characteristics (including diagnosis of dementia) and flu vaccination history were obtained from previous medical records. Items regarding change in health status and outcome since the onset of the outbreak were collected. COVID-19 was diagnosed in patients who developed symptoms according to WHO criteria or tested positive at nasal/throat swab if hospitalized. Unplanned hospitalization, institutionalization and mortality were recorded. RESULTS: Patients were 79.7 years old (SD 7.1) and 63.1% were females. Ninety-five (11.2%) patients developed COVID-19-like symptoms. Non COVID-19 and COVID-19 patients differed for frequency of diabetes (18.5% vs. 37.9%, p < 0.001), COPD (7.3% vs. 18.9%, p < 0.001), and previous flu vaccination (56.7% vs. 37.9%, p < 0.001). Diabetes and COPD were positively associated with COVID-19, whereas higher dementia severity and flu vaccination showed an inverse association. Among COVID-19 patients, 42 (44.2%) were hospitalized while 32 (33.7%) died. Non COVID-19 patients' hospitalization and mortality rate were 1.9% and 1.2%, respectively. COVID-19 and COPD were significantly associated with the rate of mortality. DISCUSSION/CONCLUSIONS: A high proportion of adverse outcome related to COVID-19 was observed in home-dwelling elderly patients with dementia. Active monitoring though telehealth programs would be useful particularly for those at highest risk of developing COVID-19 and its adverse outcomes.
Schlagwörter	covid19
Verlag	WHO
Dokumenttyp	Artikel
Anmerkung	WHO #Covidence: #754121
Datenquelle	COVID19

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Artikel ; Online: The impact of COVID-19 on health status of home-dwelling elderly patients with dementia in East Lombardy, Italy

Aging Clinical and Experimental Research ; ISSN 1720-8319

results from COVIDEM network

2020

Abstract: Abstract Background COVID-19 outbreak has led to severe health burden in the elderly. Age, morbidity and dementia have been associated with adverse outcome. Aims To evaluate the impact of COVID-19 on health status in home-dwelling patients. Methods 848 ... ...

Abstract	Abstract Background COVID-19 outbreak has led to severe health burden in the elderly. Age, morbidity and dementia have been associated with adverse outcome. Aims To evaluate the impact of COVID-19 on health status in home-dwelling patients. Methods 848 home-dwelling outpatients with dementia contacted from April 27 to 30 and evaluated by a semi-structured interview to evaluate possible health complication due to COVID-19 from February 21 to April 30. Age, sex, education, clinical characteristics (including diagnosis of dementia) and flu vaccination history were obtained from previous medical records. Items regarding change in health status and outcome since the onset of the outbreak were collected. COVID-19 was diagnosed in patients who developed symptoms according to WHO criteria or tested positive at nasal/throat swab if hospitalized. Unplanned hospitalization, institutionalization and mortality were recorded. Results Patients were 79.7 years old (SD 7.1) and 63.1% were females. Ninety-five (11.2%) patients developed COVID-19-like symptoms. Non COVID-19 and COVID-19 patients differed for frequency of diabetes (18.5% vs. 37.9%, p < 0.001), COPD (7.3% vs. 18.9%, p < 0.001), and previous flu vaccination (56.7% vs. 37.9%, p < 0.001). Diabetes and COPD were positively associated with COVID-19, whereas higher dementia severity and flu vaccination showed an inverse association. Among COVID-19 patients, 42 (44.2%) were hospitalized while 32 (33.7%) died. Non COVID-19 patients’ hospitalization and mortality rate were 1.9% and 1.2%, respectively. COVID-19 and COPD were significantly associated with the rate of mortality. Discussion/conclusions A high proportion of adverse outcome related to COVID-19 was observed in home-dwelling elderly patients with dementia. Active monitoring though telehealth programs would be useful particularly for those at highest risk of developing COVID-19 and its adverse outcomes.
Schlagwörter	Ageing ; Geriatrics and Gerontology ; covid19
Sprache	Englisch
Verlag	Springer Science and Business Media LLC
Erscheinungsland	us
Dokumenttyp	Artikel ; Online
DOI	10.1007/s40520-020-01676-z
Datenquelle	BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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Artikel: Relationship between functional loss before hospital admission and mortality in elderly persons with medical illness.

Rozzini, Renzo / Sabatini, Tony / Cassinadri, Angela / Boffelli, Stefano / Ferri, Marco / Barbisoni, Piera / Frisoni, Giovanni B / Trabucchi, Marco

The journals of gerontology. Series A, Biological sciences and medical sciences

2005 Band 60, Heft 9, Seite(n) 1180–1183

Abstract: Objective: This hospital-based prospective study tests the hypothesis that, in a large group of hospitalized elderly patients, those who report functional decline between pre-illness baseline and hospital admission have a higher risk of death.: ... ...

Abstract	Objective: This hospital-based prospective study tests the hypothesis that, in a large group of hospitalized elderly patients, those who report functional decline between pre-illness baseline and hospital admission have a higher risk of death. Methods: Nine hundred fifty elderly ambulant patients (F = 69.3%; mean age 78.3 +/- 8.5 years) were consecutively admitted to a geriatric ward (Poliambulanza Hospital, Brescia, Italy) during a 15-month period. Number and severity of somatic diseases, Charlson Index score, APACHE II score, level of serum albumin, cognitive status (by Mini-Mental State Examination), and depression score (by Geriatric Depression Scale), were assessed on admission and evaluated as potential prognostic factors. Functional status (by Barthel Index) was assessed by self-report on admission. Preadmission function was also assessed by self-report at the time of admission. Impairment of function due to an acute event is measured as the difference between performances on admission and 2 weeks before the acute event. Six-month survival was the main outcome variable. Results: Factors related to mortality in bivariate analysis were: male sex, age over 80, cancer, congestive heart failure, pulmonary diseases, elevated Charlson Index score, and (independently) dementia (Mini-Mental State Examination < 18), APACHE-Acute Physiology Score , albumin level <3.5 g/dL, and anemia. After controlling for these variables and for Barthel Index score 2 weeks before the acute event, change in function due to the acute disease is independently related to 6-month mortality (minor functional change [<30 Barthel Index Point] relative risk: 1.3, 95% confidence interval, 0.6-3.0 and major functional change [major functional decrement] relative risk: 2.8, 95% confidence interval, 1.3-5.7). Conclusions: Disease-induced disability may reflect a condition of biological inability to react to acute diseases (i.e., frailty), and should be assessed as a relevant prognostic indicator.
Mesh-Begriff(e)	Activities of Daily Living ; Aged ; Aged, 80 and over ; Disability Evaluation ; Female ; Frail Elderly ; Hospital Mortality/trends ; Humans ; Male ; Middle Aged ; Patient Admission/statistics & numerical data ; Retrospective Studies ; Risk Factors ; Survival Rate/trends
Sprache	Englisch
Erscheinungsdatum	2005-08-12
Erscheinungsland	United States
Dokumenttyp	Comparative Study ; Journal Article
ZDB-ID	1223643-3
ISSN	1758-535X ; 1079-5006
ISSN (online)	1758-535X
ISSN	1079-5006
DOI	10.1093/gerona/60.9.1180
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Subintensive care unit for the elderly: a new model of care for critically ill frail elderly medical patients.

Ranhoff, Anette Hylen / Rozzini, Renzo / Sabatini, Tony / Cassinadri, Angela / Boffelli, Stefano / Ferri, Marco / Travaglini, Nicola / Ricci, Antonella / Morandi, Alessandro / Trabucchi, Marco

Internal and emergency medicine

2006 Band 1, Heft 3, Seite(n) 197–203

Abstract: Objective: An increasing number of elderly patients are admitted to the hospital for critical diseases and the gap between supply and demand of intensive care resources is a growing problem. To meet this challenge, 4 beds in a 24-bed acute care for the ... ...

Abstract	Objective: An increasing number of elderly patients are admitted to the hospital for critical diseases and the gap between supply and demand of intensive care resources is a growing problem. To meet this challenge, 4 beds in a 24-bed acute care for the elderly (ACE) medical unit were dedicated to a subintensive care unit (SICU). Severely ill elderly medical patients, requiring a higher level of care than provided in ordinary wards, are admitted. The aim of the study was to describe the characteristics of the setting and to discuss its usefulness based on data obtained after the first period of implementation. Methods: This article describes the development, management, economics and patient characteristics of the SICU. Patient care combines the ACE model with a highly specialised medical care. Patients admitted to the SICU are compared with patients treated in the ordinary ACE unit before the SICU opened. All patients received a multidimensional evaluation, including demographics, main diagnosis, number of chronic somatic diseases, Charlson index, APACHE II score, APACHE-APS subscore, number of currently administered drugs, serum albumin, cognitive status (Mini-Mental State Examination), depression (Geriatric Depression Scale) and functional status (basic and instrumental activities of daily living). Ward physicians performed assessment and collection of data. Results: During the first 16 months, 489 patients were admitted, 401 according to the selection criteria (60 +/- years and APACHE II score > or =5 and/or APACHE-APS score > or =3). Mean age was 78.1 years, mean APACHE II score 14.5 (moderate severity) and non-invasive mechanical ventilation was received by 87 (21.7%). The most common diagnoses were respiratory failure, cardiac disease and stroke. Mean length of stay in the SICU was 61.8 h, and 6.0 days in the hospital. Compared with ACE-unit patients admitted during 2002 (n=1380), SICU patients were obviously more seriously ill (APACHE II score 14.5 vs 6.7). When comparing patients of same illness severity (APACHE-APS score > or =3) (n=125), patients treated in the SICU had lower in-hospital mortality than those treated in the ordinary ACE ward (12.5 vs 19.2%). Only a few patients (3.5%) were transferred to the intensive care unit as a consequence of increased severity of illness. Conclusions: The SICU is an innovative method to treat frail elderly patients with more severe conditions. Low hospital mortality compared with that of severe patients in the ACE unit supports the usefulness of this model. It could be implemented in medical units of large hospitals in order to give optimal care and advanced interventions to the frail elderly and to avoid intensive care unit overcrowding.
Mesh-Begriff(e)	APACHE ; Aged ; Aged, 80 and over ; Critical Care ; Critical Illness/therapy ; Female ; Frail Elderly ; Humans ; Intensive Care Units/organization & administration ; Male ; Models, Theoretical ; Practice Guidelines as Topic
Sprache	Englisch
Erscheinungsdatum	2006-11-17
Erscheinungsland	Italy
Dokumenttyp	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2454173-4
ISSN	1970-9366 ; 1828-0447
ISSN (online)	1970-9366
ISSN	1828-0447
DOI	10.1007/bf02934737
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Assessment of the Incremental Diagnostic Value of Florbetapir F 18 Imaging in Patients With Cognitive Impairment: The Incremental Diagnostic Value of Amyloid PET With [18F]-Florbetapir (INDIA-FBP) Study.

Boccardi, Marina / Altomare, Daniele / Ferrari, Clarissa / Festari, Cristina / Guerra, Ugo Paolo / Paghera, Barbara / Pizzocaro, Claudio / Lussignoli, Giulia / Geroldi, Cristina / Zanetti, Orazio / Cotelli, Maria Sofia / Turla, Marinella / Borroni, Barbara / Rozzini, Luca / Mirabile, Dario / Defanti, Carlo / Gennuso, Michele / Prelle, Alessandro / Gentile, Simona /

Morandi, Alessandro / Vollaro, Stefano / Volta, Giorgio Dalla / Bianchetti, Angelo / Conti, Marta Zaffira / Cappuccio, Melania / Carbone, Pasqualina / Bellandi, Daniele / Abruzzi, Luciano / Bettoni, Luigi / Villani, Daniele / Raimondi, Maria Clara / Lanari, Alessia / Ciccone, Alfonso / Facchi, Emanuela / Di Fazio, Ignazio / Rozzini, Renzo / Boffelli, Stefano / Manzoni, Laura / Salvi, Giovanni Pietro / Cavaliere, Sabina / Belotti, Gloria / Avanzi, Stefano / Pasqualetti, Patrizio / Muscio, Cristina / Padovani, Alessandro / Frisoni, Giovanni B

JAMA neurology

2016 Band 73, Heft 12, Seite(n) 1417–1424

Abstract: Importance: Cerebral amyloidosis is a key abnormality in Alzheimer disease (AD) and can be detected in vivo with positron emission tomography (PET) ligands. Although amyloid PET has clearly demonstrated analytical validity, its clinical utility is ... ...

Abstract	Importance: Cerebral amyloidosis is a key abnormality in Alzheimer disease (AD) and can be detected in vivo with positron emission tomography (PET) ligands. Although amyloid PET has clearly demonstrated analytical validity, its clinical utility is debated. Objective: To evaluate the incremental diagnostic value of amyloid PET with florbetapir F 18 in addition to the routine clinical diagnostic assessment of patients evaluated for cognitive impairment. Design, setting, and participants: The Incremental Diagnostic Value of Amyloid PET With [18F]-Florbetapir (INDIA-FBP) Study is a multicenter study involving 18 AD evaluation units from eastern Lombardy, Northern Italy, 228 consecutive adults with cognitive impairment were evaluated for AD and other causes of cognitive decline, with a prescan diagnostic confidence of AD between 15% and 85%. Participants underwent routine clinical and instrumental diagnostic assessment. A prescan diagnosis was made, diagnostic confidence was estimated, and drug treatment was provided. At the time of this workup, an amyloid PET/computed tomographic scan was performed, and the result was communicated to physicians after workup completion. Physicians were asked to review the diagnosis, diagnostic confidence, and treatment after the scan. The study was conducted from August 5, 2013, to December 31, 2014. Main outcomes and measures: Primary outcomes were prescan to postscan changes of diagnosis, diagnostic confidence, and treatment. Results: Of the 228 participants, 107 (46%) were male; mean (SD) age was 70.5 (7) years. Diagnostic change occurred in 46 patients (79%) having both a previous diagnosis of AD and an amyloid-negative scan (P < .001) and in 16 (53%) of those with non-AD diagnoses and an amyloid-positive scan (P < .001). Diagnostic confidence in AD diagnosis increased by 15.2% in amyloid-positive (P < .001; effect size Cohen d = 1.04) and decreased by 29.9% in amyloid-negative (P < .001; d = -1.19) scans. Acetylcholinesterase inhibitors and memantine hydrochloride were introduced in 61 (65.6%) patients with positive scan results who had not previously received those drugs, and the use of the drugs was discontinued in 6 (33.3%) patients with negative scan results who were receiving those drugs (P < .001). Conclusions and relevance: Amyloid PET in addition to routine assessment in patients with cognitive impairment has a significant effect on diagnosis, diagnostic confidence, and drug treatment. The effect on health outcomes, such as morbidity and mortality, remains to be assessed.
Mesh-Begriff(e)	Aged ; Aged, 80 and over ; Alzheimer Disease/diagnosis ; Alzheimer Disease/diagnostic imaging ; Alzheimer Disease/metabolism ; Amyloid beta-Peptides/metabolism ; Aniline Compounds ; Cognitive Dysfunction/diagnosis ; Cognitive Dysfunction/diagnostic imaging ; Cognitive Dysfunction/metabolism ; Ethylene Glycols ; Female ; Humans ; Male ; Positron-Emission Tomography/methods ; Positron-Emission Tomography/standards ; Predictive Value of Tests
Chemische Substanzen	Amyloid beta-Peptides ; Aniline Compounds ; Ethylene Glycols ; florbetapir (6867Q6IKOD)
Sprache	Englisch
Erscheinungsdatum	2016-10-17
Erscheinungsland	United States
Dokumenttyp	Journal Article ; Multicenter Study
ZDB-ID	2702023-X
ISSN	2168-6157 ; 2168-6149
ISSN (online)	2168-6157
ISSN	2168-6149
DOI	10.1001/jamaneurol.2016.3751
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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