Laura Tafaro

Fattori di rischio per il decadimento cognitivo

Cognitive impairment is an invalidating condition and its prevalence increases significantly with age. It is very important to identify the risk factors for cognitive impairment. Aside from age, sex, familiary history and educational level, the other major risk factors (hypertension, hypercolesterolemia, diabetes mellitus and tobacco), known to be associated frequently with different cerebrovascular diseases, might also contribute to degenerative forms of cognitive impairment because they might favour cerebral microvascular alterations with hypoperfusion, demyelinization and ischemic lesions of subcortical white matter. Longitudinal epidemiological studies detected that arterial hypertension, hypercolesterolemia and tobacco are frequently associated with degenerative forms of cognitive impairment. Some studies show there is no relationship between cognitive impairment and diabetes mellitus, while other underline its role; light alcohol drinking might protect against cognitive impairment. Other recently identified risk factors might be hyperhomocysteinemia and high C-reactive protein blood levels because they seem to be associated with cognitive impairment.

Stress in centenarians

Everybody is subject to a physical clock, determining the calendar age, and also to a biological clock, the speed of which depends on the interaction between the genetic reserves and the environment. Stress is taken into account more and more as one of the main factors responsible for the acceleration of the biological clock and the dishomogeneity of the aging process. Despite the fact that centenarians are prone to chronic stress due to a progressive loss of self-sufficiency, more than a half of our centenarians were not depressed and had a low trait-anxiety: they showed an emotional tendency to react with a low anxiety-intensity to stressful conditions. Their good physical conditions may be explained by a positive character-disposition and by strong adaptability to the adversities of the life. Personality traits can be reduced to five basic phenomena, the so-called Big Five: extroversion, agreeableness, conscientiousness, openness to experience and emotional stability. In our sample 65.4% were classified as extroverted, 50% as open minded and 34.5% showed good emotional stability. In the centenarians aging of all apparatuses was slowed down by a healthy lifestyle and also by good adaptability that allowed for a positive and effective response to stress throughout their whole lives.

Is it possible to predict one-year survival in centenarians? A neural network study

Background: Human life expectancy is constantly increasing: the challenge for modern geriatric medicine is to identify the means to reach successfully extreme longevity. Objective: To determine which are the survival determinants in centenarians using a neural network. Methods: Sample of 110 centenarians living in Rome, mean age 101.6 years (SD = 1.8) with a sex ratio males:females of 1:3. We administered an extensive health interview (lasting 1–2 h) to each subject. The questionnaire, carried out according to the Geriatric Multidimensional Assessment, is made up of 100 items including a comprehensive health and psychosocial assessment aimed at various topics of general health and well-being and some scales used in geriatric practice. We applied several three-layered feed-forward neural networks by mixing in different ways the most important of the 100 items. Results: The most predicting powered net is the one constructed with 23 variables regarding comorbidity, cardiovascular risk factors, cognitive status, mood, functional status and social interactions, which therefore are strictly related to survival in centenarians. Conclusion: Survival in longevity is a complex biological phenomenon, which is an ideal field for using the neural network as a statistic method. The net shows us that the maintenance of social relationships even in presence of disability is of major importance for survival in the oldest old.