Search PubMed⌕ Search

Biomedical subjects

M Trabucchi

Publications and source records attributed to M Trabucchi.

At least 145 records · Page 8Linked to original sources
PubMed1996

The Mini-Mental State Examination in Alzheimer's disease and multi-infarct dementia.

The aim of this study was to compare the performances on each item of the Mini-Mental State Examination (MMSE) of patients with Alzheimer's disease (AD) and multi-infarct dementia (MID). In order to identify the items that could better distinguish the two groups of patients, 70 AD and 31 MID patients matched for disease severity, age, and education were evaluated. The scores of the 101 patients on each of the MMSE items were entered into a principal component factor analysis using varimax rotation, and two main components were derived. Component 1 was probably representative of recently acquired information, whereas component 2 represented educational level. A score summing the items that loaded on component 1 and the recall item was calculated to generate a measure of episodic memory. Performing analysis of variance and covarying for age and education revealed that this score was statistically different in the two groups, with AD patients having lower values. The data suggest that the MMSE may demonstrate a pattern of impairment of memory that differs between AD and MID. Possible explanations of this finding should take into account the different neuroanatomical impairments and the different degrees of motivation, due to depression or attentional deficits, toward external stimuli.

Aged↗
PubMed1996

Napping in the elderly and its association with night sleep and psychological status.

The aim of this study was to assess the prevalence of daytime napping and its psychic, night sleep, and functional correlates in Italian community-dwelling elderly persons. A cross-sectional survey of community-dwelling elderly subjects was conducted with a multidimensional quality-of-life questionnaire administered by interviewers at the subjects' own homes. Participants were 223 community-dwelling elderly subjects, aged 75 and over, with a Mini-Mental State Examination score of 18 or more, living in Brescia, Italy. Statistical analysis was performed with logistic regression for estimates of the bivariate and multivariate associations of continuous independent variables with a dichotomous dependent variable (napping). Beta coefficients with 95% and 99% confidence interval (CI), and p values at Wald statistics, were computed. Napping once or more per week was reported by 23.8% of the sample. Napping was found to be independently and positively associated with obsessive-compulsive symptoms (beta = .86, 95% CI 0.25 to 1.47, p = .005) and with the night sleep symptom of not feeling rested in the morning (beta = .17, 95% CI 0.00 to 0.35, p = .048). No association was found with instrumental activities of daily living (beta = .18, 95% CI -0.04 to 0.40, p = .113). It is concluded that napping in the elderly is partly related to personality characteristics and partly a consequence of night sleep disturbance.

Activities of Daily Living↗
PubMed1996

Functional impairment in protein kinase C by RACK1 (receptor for activated C kinase 1) deficiency in aged rat brain cortex.

Several laboratories have reported a lack of protein kinase C (PKC) activation in response to various stimuli in the brain of aged rats. It has been suggested that changes in lipid membrane composition could be related to this functional deficit. However, recent evidence has indicated that the translocation of PKC to the different subcellular compartments is controlled by protein-protein interactions. Recently, a class of proteins, termed receptors for activated C kinase (RACKs), have been described that bind PKC. The present study was conducted to determine whether alterations in RACK1, the best-characterized member of RACKs, were associated with changes in translocation and expression of PKC. Quantitative immunoblotting revealed that RACK1 content was decreased by approximately 50% in aged rat brain cortex, compared with that in adult and middle-aged animals. The levels of calcium-independent PKC delta and epsilon, interacting with RACK1, and related calcium-independent PKC activity were not modified by the aging process. By comparison, phorbol ester-stimulated translocation of this activity and of PKC delta and epsilon immunoreactivity was absent in cortex from aged animals, as well as the translocation of the calcium-dependent PKC beta, also known to interact with RACK1. These results indicate that a deficit in RACK1 may contribute to the functional impairment in PKC activation observed in aged rat brain.

Aging↗
PubMed1996

Effects of sensory aids on the quality of life and mortality of elderly people: a multivariate analysis.

The present study aimed at clarifying the relationships between the use of sensory aids and the quality of life (QOL) and mortality of elderly people suffering from sensory deprivation. We carried out a cross-sectional survey on the QOL and the sensory status of an elderly cohort and a 6-year longitudinal follow-up of mortality rates among 1192 non-institutionalized people aged 70-75 years in a North Italian town. We classified respondents into three groups: those with functionally adequate visual and hearing acuity (n = 275); those with sensory impairment, corrected by the use of sensory aids (n = 680), and those with uncorrected sensory impairment (n = 245). In the whole sample, multiple logistic regression analyses showed that an uncorrected sensory deprivation was associated with a significant and independent impairment of mood, self-sufficiency in instrumental activities of daily living and social relationships. Such impairments were not apparent in the subjects with sensory impairments who were using sensory aids. In men with uncorrected sensory impairment the unadjusted 6-year mortality rate was almost twice that of the other two groups, which did not differ from each other. No corresponding differences were detected in women. Multivariate analysis showed that the effect of the sensory aid status on mortality was indirect and mediated through the global physical health status and the social relationships. We conclude that our cross-sectional data demonstrate an association between uncorrected sensory deprivation and a low QOL; such an association was not present in subjects with corrected sensory deprivation.

Activities of Daily Living↗
PubMed1996

Dementia care.

Explore the source record for details and available documents.

Aged↗
PubMed1996

Good nutritional oral intake is associated with equal survival in demented and nondemented very old patients.

OBJECTIVE: To evaluate the association of oral food intake with survival in very old demented nursing home patients. DESIGN: A prospective cohort study. SETTING: A nursing home in northern Italy. MEASUREMENTS: Anthropometric and laboratory nutritional indicators and nutrient intake were assessed in 33 demented (age 85.7 +/- 5.7 years) and 25 nondemented (age 84.9 +/- 5.7 years) patients. Mortality data were collected over a 28-month follow-up period. Association of survival with dementia was estimated by Kaplan-Meyer analysis and multivariate Cox proportional hazard models. RESULTS: Nutrient intake and nutritional status were good compared with data in the literature and were similar in demented and nondemented patients, except for smaller triceps skinfold thickness in the demented. The cumulative annual death rate was 0.23 deaths per subject per year, similar in the demented (0.23) and the nondemented (0.22). Unadjusted survival by Kaplan-Meyer analysis was similar in the two groups, and correction for-age, gender, cognition, triceps skinfold thickness, and number of drugs in a Cox model did not alter the relationship. CONCLUSIONS: Dementia developing in very old age is not necessarily associated with malnutrition and decreased life expectancy.

Aged↗
PubMed1996

Magnetic resonance and single-photon emission tomography findings in a pair of twins discordant for Alzheimer's disease.

The value of functional and morphological neuroimaging in the early diagnosis of Alzheimer's disease (AD) is still debated. Described here are cerebral perfusion and linear measures of medial temporal lobe atrophy in 2 monozygotic twins discordant for AD who were investigated with technetium 99m-hexamethylpropy-leneamineoxime single-photon emission tomography (SPET) and magnetic resonance (MR) imaging. Both showed pathological cortical perfusion findings on SPET, while medical temporal lobe atrophy was present only in the affected twin. MR measures of medial temporal lobe atrophy have greater agreement with clinical data than do SPET measures of cerebral perfusion. Evaluation of atrophy may be useful in the early diagnosis of AD.

Activities of Daily Living↗
PubMed1996

Executive dysfunction in early Alzheimer's disease.

Twenty five patients with probable mild Alzheimer's disease were assessed for deficits in executive functioning and the impact of these deficits on performance in other neuropsychological domains. The Wisconsin card sorting test, the release from proactive interference paradigm, the verbal fluency test, and the Stroop test were adopted to classify patients with (AD+) and without (AD-) executive deficits. Seven of the patients showed an impairment in executive function (AD+), defined as a performance below the cut off score in at least two of these tests. There were no significant differences in clinical assessments, demographic features, or other cognitive functions between patients. Executive dysfunction may be an early additional feature in a subgroup of patients with mild Alzheimer's disease. Impairment on frontal lobe tests does not seem to be related to the severity or duration of disease, or to a different pattern of impairment in other cognitive domains.

Aged↗
PubMed1996

Brain atrophy in frontotemporal dementia.

OBJECTIVES: To evaluate the pattern of regional brain atrophy in patients with frontotemporal dementia by comparing it with that in patients with Alzheimer's disease and normal controls. METHODS: Fourteen patients with frontotemporal dementia, 13 with moderate, and 33 with mild Alzheimer's disease, and 31 controls were studied. Atrophy was evaluated with linear measures in the anterior brain, medial temporal lobe, and hippocampal formation regions using MRI. RESULTS: Patients with frontotemporal dementia had greater atrophy in the anterior brain regions than patients with Alzheimer's disease or controls. Atrophy of the hippocampal formation, which best discriminates Alzheimer's disease from controls, was present also in patients with frontotemporal dementia. By contrast, atrophy of the medial temporal lobe, which is also present in Alzheimer's disease, was absent in frontotemporal dementia. CONCLUSION: A pattern of atrophy in the frontal lobes and hippocampal formation with sparing of the medial temporal lobe might be distinctive of frontotemporal dementia. Hippocampal involvement might not be specific for Alzheimer's disease and specific patterns of atrophy might be distinctive of some forms of degenerative dementia.

Aged↗
PubMed1996

Time-dependent changes in rat brain neuroactive steroid concentrations and GABAA receptor function after acute stress.

The time courses of changes in rat brain neuroactive steroid concentrations and gamma-aminobutyric acid type A (GABAA) receptor function elicited by acute stress were investigated in animals exposed to CO2 for 1 min, a treatment known to induce stress in rats and panic attacks in humans. Inhalation of CO2 induced increases in cerebral cortical steroid concentrations, the time dependence of which varied with the steroid examined. Thus, progesterone and deoxycorticosterone showed maximal increases (10- and 4-fold, respectively) 10 min after CO2 inhalation and had returned to basal values by 30 and 60 min, respectively. In contrast, pregnenolone and 3alpha-hydroxy-5alpha-pregnan-20-one (allopregnanolone) concentrations showed maximal increases (+174 and + 200%, respectively) at 30 min, were still higher than control at 60 min and returned to control values 120 min after stress. Inhalation of CO2 also resulted in increases in plasma steroid concentrations, most of which peaked at 30 min and had returned to control values by 60 min. A parallel analysis of the stress-induced changes in GABAA receptor function, assessed either biochemically by t-[35S]butylbicyclophosphorothionate ([35S]TBPS) binding to cerebral cortical membranes or behaviorally by the punished responding score in Vogel's test, showed that the effects of CO2 inhalation on both parameters were maximal (+51 and -40%, respectively) after 10 min; the behavioral reaction returned to normal after 60 min, whereas [35S]TBPS binding had returned to control values 120 min after stress. The results show that: (a) the maximal increase in the brain concentrations of allopregnanolone, a potent and efficacious positive modulator of GABAA receptors, occurred at a time (30 min) when both conflict behavior and [35S]TBPS binding begun to decrease, and (b) both allopregnanolone concentrations and [35S]TBPS binding had returned to control values 120 min after CO2 inhalation. The data are thus consistent with a physiological role of neuroactive steroids in restoring GABAergic tone after stress.

Animals↗
PubMed1996

Principal lifetime occupation and sleep quality in the elderly.

Sleep symptoms, cognitive, psychic, and physical health variables were assessed in a sample of 449 community-dwelling elders aged 75 and over. The subjects were in a good cognitive and functional condition. Three night sleep symptoms were evaluated: difficulty falling asleep, waking up frequently in the night, and early morning awakenings. For each symptom, respondents were asked to estimate the frequency of the symptom during the past month on a five-point scale. White-collar workers reported the best, and blue-collar workers the poorest quality of sleep: the difference in the difficulty of falling asleep between the two groups was 0.86, of waking up frequently in the night 0.93, of early morning awakenings 1.01 (corresponding to 3 days/month, 5 days/month, and 3.5 days/month, respectively), and of total sleep symptoms 2.81. These unadjusted differences were reduced, respectively, to 0.57, 0.42, 0.54, and 1.53 after adjustment for other factors. Of these, only waking up frequently in the night was not statistically significant. These data show more frequent sleep symptoms in socially disadvantaged occupational groups, suggesting that social factors can significantly affect the quality of sleep in the elderly.

Aged↗
PubMed1996

Assessment of functional ability with the bed rise difficulty scale in a group of elderly patients.

The aim of the study (part of the Progetto Longitudinale Gussago) was to evaluate the variables related to the difficulty in rising from a bed in 2 groups of elderly patients: nursing home residents, and patients admitted to a geriatric evaluation and management unit. Functional ability was tested through the bed rise difficulty scale (BRD). The version used in this study considered only those 7 items (out of 12) found to be of value. Only those patients who were able to rise from bed without help were selected in order to achieve the aim of the study (33 males, 113 females; mean age 79.6 +/- 7.3 years). Although the 146 patients assessed were considered as having a good functional level (Tinetti score 18.8 +/- 6.9, ADL Katz score 1.6 +/- 1.4), most of them had high scores on the BRD scale, indicating the ability of this scale to detect early, mild disability. The total score of the BRD scale was significantly related to the ADL Katz (r = 0.29, p = 0.000), Tinetti scale (r = -0.39, p = 0.000) and physical performance test (PTT; r = -0.47, p = 0.000). Similar results were obtained for the correlation between BRD time and ADL Katz (r = 0.033, p = 0.000), Tinetti scale (r = -0.30, p = 0.000) and PPT-(r = -0.46, p = 0.000). In a logistic regression analysis the items of the PPT scale considering upper extremity function and Tinetti balance score were significantly associated with the total bed rise time and score.

Aged↗
PubMed1996

Risk of mortality and institutionalization in demented patients with delusions.

Delusions are a common symptom during the course of dementia. Despite their clinical relevance, however, it is still unclear whether they are of prognostic value. This longitudinal study involving, at baseline, 99 demented Alzheimer disease (AD) and multi-infarct dementia (MID) patients, investigates the risk of mortality and institutionalization at 2 years after discharge from a dementia unit in patients with and without delusions at baseline. Results indicate that the presence of delusions is a significant predictor of future institutionalization (odds ratio 3.6, confidence interval 1.3-9.6), even when confounding factors such as age, educational level, and severity of cognitive and functional impairment are statistically controlled. No significant impact on survival was found.

Aged↗