Alessandro Ferrari Jacinto

Physical Frailty As a Clinical Marker of Biological Age and Aging

Canadians relative to the 2011 Dietary Reference Intakes: An examination in children and adults with and without supplement use. Am J Clin Nutr 2011;94:128–135. 4. Cameron ID, Gillespie LD, Robertson MC et al. Interventions for preventing falls in older people in care facilities and hospital. Cochrane Database Syst Rev 2012;12:CD005465. 5. Bolland MJ, Grey A, Gamble GD et al. Vitamin D supplementation and falls: A trial sequential meta-analysis. Lancet Diabetes Endocrinol 2014;2:1–8. 6. American Geriatrics Society Workgroup on Vitamin D Supplementation for Older Adults. Recommendations abstracted from the American Geriatrics Society consensus statement on vitamin D for prevention of falls and their consequences. J Am Geriatr Soc 2014;62:147–152. 7. Papaioannou A, Morin S, Cheung AM et al. 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: Summary. Can Med Assoc J 2010;182:1864–1873.

Effectiveness of probiotics on the occurrence of infections in older people: systematic review and meta-analysis

BACKGROUND infectious diseases in older people are associated with higher mortality rates and probiotics have been hypothesised to reduce the occurrence of infection. OBJECTIVES to assess the effectiveness and safety of probiotics in the occurrence of infections in older adults in comparison to placebo. METHODS a systematic review and meta-analysis of randomised placebo-controlled trials were conducted on 30 December 2016 using Medline, Embase, CENTRAL, Web of Science and LILACS databases. Efficacy outcomes were: occurrence of infection, quality of life, mortality and mean duration of infection per episode. Safety outcomes were adverse events. Data were analysed using relative risk ratios with 95% confidence intervals. Relative risk ratios were pooled where more than three estimates were available. RESULTS fifteen articles were included, with a total of 5,916 participants with a mean age of 75.21 years. The effect of probiotics was not significantly different from that reported for placebo on the occurrence of infection, adverse events, mortality or mean duration of infection episodes (relative risk (RR) 0.90, 95% confidence interval (CI) 0.76 to 1.08; RR 1.01, 95% CI 0.91 to 1.12; RR 1.09, 95% CI 0.70 to 1.72; MD -0.35, 95% CI -1.57 to 0.87, respectively). CONCLUSION the current low-quality evidence does not support the use of probiotics for the reduction in the occurrence of infection in older adults, however, the safety outcomes were similar between probiotics and placebo. Further research is required to confirm these findings.PROSPERO: CRD42014013707.

Antipsychotics: Mortality Risk Themselves?

the University of Minnesota, where she coordinated the evaluation of the PACE model and coordinated a study of health and cost outcomes of outpatient geriatric evaluation and management provided by an interdisciplinary team. From 1998 on, she served as an independent consultant on a variety of projects designed to improve care for vulnerable elderly adults. Her caring, passion, and humanism permeated her work. Her programs and projects have helped to define how to best coordinate care for medically complex older populations and advanced the role of interdisciplinary teams. She has published extensively on these topics and presented regularly at the American Geriatrics Society and the Gerontological Society of America. Her final work was a chapter on the PACE model, published in Geriatric Models of Care. Lynne was the exemplar of the interdisciplinary professional in aging who teamed with and befriended many in the field across many disciplines. She received many honors and awards for her work across fields, including Fellow of the University of California at Los Angeles/ University of Southern California Long Term Care Gerontology Center, Outstanding Woman Employee at National Medical Enterprises, Alzheimer’s Association Community Service Award, the Jewish Home for the Aging Award for Geriatric Nursing, and election as Fellow of the Gerontological Society of America. She was a member of the Gerontological Society of America, American Geriatrics Society, American Society of Aging, American Nurse’s Association, Minnesota Nurses Association, and Minnesota Geriatrics Society. Lynne is survived by her husband and son Tom and Jake Amatruda, mother Lois, and sister Leslie and her cherished extended family. Celebrations of Lynne’s life were held Saturday May 7, 2016, 11 a.m.: Breck School Chapel, 123 Ottawa Avenue N, Golden Valley, Minnesota; Thursday May 19, 7:00–9:00 a.m.: Hyatt Hotel, Regency B, Long Beach, California, Nursing Breakfast, American Geriatrics Society Annual Meeting. For further information, please contact: Tom Amatruda (ttamatruda@gmail.com) or Jake Amatruda (jakeamatruda@gmail.com). In lieu of flowers, please consider a donation in Lynne’s name to Planned Parenthood, the American Refugee Committee, or the Health in Aging Foundation of the American Geriatrics Society.

Impact of hospitalization on the functional capacity of the elderly: A cohort study

Universidade Estadual Paulista Julio de Mesquita Filho Faculdade de Medicina Programa de Pos-graduacao em Saude Coletiva

Validity and reliability of the Brazilian Portuguese version of the Australian National University - Alzheimer’s Disease Risk Index (ANU-ADRI)

Abstract The ANU-ADRI is a self-report tool that assesses risk for Alzheimer’s Disease (AD). Objective: To validate an adapted Portuguese version of this instrument and to carry out the reliability Test-Retest of the ANU-ADRI in Brazil. Methods: In this longitudinal study, the sample was formed (n=100) by two groups (A and B): each comprising 50 patients assisted by GPs (general practitioners) or specialists in dementia. All participants were cognitively healthy upon screening using the MMSE. The ANU-ADRI was applied at baseline (Test) and again within 1 week of the test (Retest). Results: There was a correlation between the mean scores of the ANU-ADRI Test and Retest (r=0.918, P<0.001). Group A had higher ANU-ADRI scores than those of group B (P<0.05). There was a moderate negative linear relation between the ANU-ADRI and MMSE scores (r= -0.353, P<0.001). Conclusion: The ANU-ADRI is a valid and reliable instrument to assess whether community-dwelling Brazilians are at greater risk for AD. Low levels of education were associated with higher risk scores on the ANU-ADRI.

Mild cognitive impairment and progression to dementia of Alzheimer's disease

The increase in life expectancy in the Brazilian population raises questions about the preparation of the public health system in identifying elderly patients with signs of cognitive impairment. Currently, as a consequence of the long duration of preclinical phase of Alzheimers disease, efforts of early detection have been emphasized. Clinical dementia presents an important impact on the individuals caregivers, family, society and economy. Identifying individuals who already have some cognitive impairment, despite remaining functional, as well as analyzing associated comorbidities, constitutes an opportunity to analyze possibilities for future interventions. Dementias are clinical conditions that impose a burden on the health system with its high costs, whereas the identification of individuals with cognitive impairment without dementia can aid patients and their families to plan the future and mitigate costs. This narrative revision can provide general practitioners with more information on the subject.

Evaluation of the use of laboratory tests in primary care

Introducao: A avaliacao da utilizacao dos exames laboratoriais na atencao primaria pode melhorar a qualidade do atendimento prestado a populacao. Objetivo: Avaliar a utilizacao de exames laboratoriais pelas unidades de atencao primaria a saude de Botucatu, Sao Paulo, Brasil. Metodos: Foram realizados grupos tutoriais para avaliacao dos laudos de exames laboratoriais solicitados por 15 unidades basicas de saude do municipio de Botucatu, no periodo de 12 meses. As informacoes obtidas foram avaliadas quanto a quantidade de exames solicitados por consulta medica e proporcoes de exames com resultado anormal. Resultados: A taxa de solicitacao de exames laboratoriais nas consultas medicas encontra-se acima das recomendacoes do Ministerio da Saude, permitindo inferir que ha muitas solicitacoes desnecessarias. O exame que se apresentou anormal com maior frequencia foi hemoglobina glicada, indicando um possivel controle inadequado dos pacientes diabeticos. Conclusao: Conhecer e monitorar a atencao laboratorial possibilita aos gestores de unidades de saude maior efetividade e uso racional dos escassos recursos disponiveis.

Teaching medical students about dementia: A brief review

Underdeveloped nations have the largest absolute number of the worlds elderly population. Approximately 10.7% of the Brazilian population comprises aged individuals. Aging populations are associated with a higher incidence of chronic degenerative diseases such as dementia. Demented individuals place a high burden of care on healthcare systems and family members. General practitioners should be able to diagnose the most common elderly diseases such as dementia since they act as gatekeepers to specialized care. In Brazil, many medical students work as general practitioners upon graduating. The present study shows some scenarios of medical schools worldwide, including Brazilian, regarding teaching on dementia.