155 research outputs found
Cognitive frailty: what is still missing?
No full textIn recent years, the complex relationship between frailty and cognitive functioning has been increasingly investigated. Accordingly, the concept of "cognitive frailty" was recently proposed to describe a clinical condition characterized by the simultaneous occurrence of both physical frailty and cognitive impairment, in absence of overt dementia diagnosis or underlying neurological conditions. This novel construct has several elements of novelty and may delineate a promising target for preventive and therapeutic actions against age-related conditions. In the present paper we discuss the main issues that are still limiting the clinical and research implementation of the cognitive frailty construct. In particular, a) how to operationalize its definition; b) the supporting epidemiological data; and c) the underlying clinical and biological characteristics constitute points that need to be addressed and clarified
The sterile controversy on the amyloid cascade hypothesis
No full textIn these last years, several phase III randomized controlled trials testing promising candidates sharing Aβ depots as target of their action have failed, despite showing some reductions of the brain Aβ charge. The announcements of the negative results have heated the discussion in the field and divided the scientific community between the defenders versus the opponents of the Aβ theory. In the present article, we discuss the limits of these drastic, opposite positions and we propose a novel approach to Alzheimer's disease (AD). In particular, a "one-fits-all" approach where a single biomarker/process is able to explain the clinical manifestation seems inadequate for AD (as for other conditions of old age). Accordingly, there is an urgent need to overcome the traditional paradigms of "standalone-diseases" (requiring unimodal interventions) in favor of more comprehensive and multidimensional approaches. Specifically, promoting biomarker modeling procedures based on multivariate statistical methodologies may have important implications and advantages in the field of AD and other neurodegenerative diseases
Covid-19 e criteri etici per l’accesso alle cure intensive. Un esame critico
No full textQuesto articolo ricostruisce il dibattito etico in merito ai criteri di accesso alle cure intensive in condizioni di saturazione delle risorse disponibili. Tale dibattito si è presentato in tutta la sua drammatica urgenza nel corso della pandemia dovuta al virus SARS-CoV-2. Alcune rilevanti società scientifiche vi hanno preso parte attraverso la pubblicazione di apposite linee-guida. Oltre ad illustrare le diverse opzioni morali, si sosterrà una tesi normativa secondo la quale l’aspettativa di guarigione a breve termine rappresenta il criterio più appropriato nelle decisioni relative all’accesso dei pazienti affetti da COVID-19 nei reparti di terapia intensiva.In this paper, we offer an account of the ethical debate about the criteria to determine patients’ access to intensive care in when available resources approximate saturation. Such a debate has become prominent during the SARS-CoV-2 pandemics. Other than illustrating different moral options and ethical guidelines, we will maintain that short-term recovery is the most appropriate criterion to decide how to allocate COVID-19 patients to intensive care units
Reasoning about frailty in neurology: neurobiological correlates and clinical perspectives
No full textTo date, the frailty syndrome has surprisingly attracted limited attention in the field of neurology and
neuroscience. Nevertheless, several concepts closely related to frailty, such as vulnerability, susceptibility, and
homeostatic reserves, have been increasingly investigated and documented at level of neuronal cells, brain
networks, and functions. Similarly, several aspects commonly assessed in the neurological practice, including
cognitive functioning and emotional/affective status, clearly appear to be major determinants of the individual’s
vulnerability and resiliency to stressors. Therefore, they should be carefully considered in the clinical approach to
frail subjects. Moreover, dysfunctions of these domains, if timely detected, may be suitable to be targeted by
interventions providing beneficial effects to the overall health status of the individual. In the present article, we
discuss the neurobiological processes potentially contributing to frailty. Moreover, we reason about the clinical
manifestations allowing the prompt and easy recognition of frail persons in the neurological practice
Frailty and cognitive decline: how do they relate
No full textPURPOSE OF REVIEW:
To provide a comprehensive review of the recent literature (published over the last 12 months) exploring the relationship between frailty and cognition.
RECENT FINDINGS:
Fourteen studies were retained for the present review. No randomized controlled trial was found. Overall, the main findings of the selected studies appeared to be mainly confirmatory of the previous evidence. In longitudinal studies, physical frailty was found to predict the incidence of cognitive impairment and dementia. Cross-sectional studies showed that frail individuals have lower cognitive performance compared with nonfrail persons. Interestingly, few studies examined the association between frailty and specific cognitive functions and domains, reporting a significant impairment of attention and executive functions Finally, we found several studies including cognitive measures in the operational definitions of frailty.
SUMMARY:
The present findings are suggestive of an almost complete lack
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