Patrizia Rinaldi

Plasma antioxidants are similarly depleted in mild cognitive impairment and in Alzheimer's disease

In order to assess peripheral levels and activities of a broad spectrum of non-enzymatic and enzymatic antioxidants in elderly subjects with mild cognitive impairment (MCI) and Alzheimers disease (AD), plasma levels of water-soluble (Vitamin C and uric acid) and of lipophilic (Vitamin A, Vitamin E and carotenoids including lutein, zeaxanthin, beta-cryptoxanthin, lycopene, alpha- and beta-carotene) antioxidant micronutrients as well as activities of plasma and red blood cell (RBC) superoxide dismutase (SOD) and of plasma glutathione peroxidase (GPx) were measured in 25 patients with MCI, 63 AD patients and 53 controls. Peripheral levels and activities of antioxidants were similarly lower in MCI and AD patients as compared to controls. As MCI may represent a prodromal stage of AD, and oxidative damage appears to occur as one of the earliest pathophysiological events in AD, an increased intake of antioxidants in patients with MCI could be helpful in lowering the risk of conversion to dementia.

Validation of the Five‐Item Geriatric Depression Scale in Elderly Subjects in Three Different Settings

OBJECTIVES: To test the effectiveness of a five‐item version of the Geriatric Depression Scale (GDS) for the screening of depression in community‐dwelling older subjects, hospitalized older patients, and nursing home residents.

Conversion of MCI to dementia: Role of proton magnetic resonance spectroscopy

Mild cognitive impairment (MCI) represents a heterogeneous group of cognitive disturbances at high risk of dementia. The amnestic subtype (aMCI) might be a prodromal state of Alzheimers disease (AD). The aim of this study is the identification, by proton magnetic resonance spectroscopy (1H MRS), of modifications in brain metabolites able to detect subjects with aMCI at risk of conversion towards AD. Twenty-five subjects with aMCI and 29 normal elderly were enrolled; they underwent a comprehensive clinical and instrumental assessment, a cerebral 1H MRS scan to measure N-acetyl aspartate (NAA), choline (Cho), myo-inositol (mI) and creatine (Cr) in the paratrigonal white matter, bilaterally. After 1 year, 5 MCI subjects became demented (progressive MCI, pMCI). Their baseline levels of metabolites were compared with those evaluated in stable MCI (sMCI) and in controls. We observed a significant difference of the NAA/Cr ratio between pMCI (1.48+/-0.08) and sMCI (1.65+/-0.12) and between pMCI and controls (1.63+/-0.16) in the left hemisphere, suggesting that this metabolic alteration can be detected before the clinical appearance of dementia.

Impact of the earthquake of September 26, 1997 in Umbria, Italy on the socioenvironmental and psychophysical conditions of an elderly population

The consequences of natural disasters on the social and health status of older people have not been deeply considered. The aim of this study was to evaluate the socioenvironmental and psychophysical conditions of an elderly population after a devastating earthquake. A randomly se-lected group of 332 older people (≥64 years) was selected among 1548 eligible subjects living in the city of Nocera Umbra four months after an earthquake of 5.6 magnitude on the Richter scale. Three geriatricians evaluated the study subjects by means of a structured interview, and standardized scales, which considered physical and mental status, mood and anxiety, and self-perception of well-being, as well as the characteristics of family composition and social interactions. Of the study subjects, 11.1% lived alone, and 33.4% with the spouse only. Most were self-sufficient in the basic activities of daily life. Musculoskeletal diseases and hypertension were the most frequently observed pathologies in this geriatric population. In addition, 47.9% of the subjects lived in temporary houses; this group more frequently suffered from hypertension, and had a higher score of comorbidity as measured by Cumulative Illness Rating Scale (CIRS) compared to people who remained at home. People living in the pre-fabricated huts also showed a higher score on the Geriatric Depression Scale and the Hamilton scale for anxiety, and complained more often of their health status, evaluated as self-perception of well-being, when compared to the home dwellers. Although all the studied subjects suffered from the discomforts caused by the earthquake, the precariousness of living in temporary houses, whose structural characteristics do not take the needs of elderly subjects into account, could justify the higher distress experienced by persons housed in the huts. These observations suggest that, after natural disasters, emergency programs should be more adapted to elderly people, whose needs and expectations are often different from those of young adults.

P4-042: Plasma levels of vitamin E isoforms and of coenzyme Q10 in cognitively normal, mild cognitive impairment and Alzheimer's disease elderly subjects: Preliminary results from the addneuromed project

etiology of this relationship is not well understood. The goal of this study is to evaluate the association of coronary artery calcification (CAC), a subclinical measurement of CAD, with cognitive performance. Methods: A total of 116 non-demented community dwelling subjects over the age of 60 in Philadelphia were recruited. 103 of these subjects received a cognitive battery, a vascular disease risk factor assessment, and an Electron Beam Computerized Tomography (CT) scan. The Agatston score, which measures the amount of calcium at each coronary artery lesion scaled by an attenuation factor, and summed over all lesions, was used to measure CAC. In our analyses, we treated CAC dichotomously, using a standard cut-off point of 100. We also stratified our cognitive performance battery by age greater than or equal to 75, or less than 75. We used a linear regression analysis to evaluate the association of CAC on cognitive performance in specific domains and controlled for age, race, gender, education and low density lipoprotein cholesterol (LDL-C). Results: In tests of executive function, CAC greater than 100 was found to be independently associated with lower performance (p 0.05) on the Digit Symbol Substitution (DSS) test and the Stroop Color-Word Test in subjects greater than 75 years of age. An interaction term for age and CAC score was significant for both the DSS and Stroop Tests. CAC greater than 100 in adults over age 75 was also significant for lower performance scores on the total learning and recall score of the Rey Auditory Verbal Learning Test (RAVLT). CAC greater than 100 was almost significantly negatively associated (p 0.07) with performance on the Biber free recall test for visual memory. Conclusions: A CAC score greater than 100, independent of LDL-C, was negatively associated with lower performance in verbal and visual short-term memory, and for executive function in adults older than age 75. Further research is needed to understand the relationship of CAC with other vascular markers of cognitive impairment.