Thyroid function in healthy centenarians.

Seven thyroid function parameters (total T3, TT3; total T4, TT4; free T3, FT3; free T4, FT4; TSH; anti-thyroglobulin antibodies, TGAb; and anti-microsomal antibodies, TMAb) were studied in a series of 20 healthy centenarians in order to evaluate their thyroid function status. Our results showed that all the parameters were within normal range, with the exception of TT4 values which were reduced in 60% of centenarians examined. Therefore, the authors believe that the production of thyroid hormones seems to decrease in advanced years, but that this may not solely depend on thyroid parenchyma involution, but also on a lower demand by the hormone sensitive tissues. Centenarians seem to be adapted euthyroid subjects who present low, nonetheless adequate, levels of circulating thyroid hormone (T4).

Cognitive and affective assessment and multiple pathologies in institutionalized elderly.

Studies were carried out using the mini mental state examination (MMSE) and the geriatric depression scale (GDS) in 71 elderly patients, in order to establish eventual correlations between cognitive deficit, depression and multiple pathologies. This examination was part of a multidimensional evaluation involving patients over 65 years of age hospitalized in the Department of Clinical Medicine. The patients were divided into 5 grades on the basis of the extent ot functional impairments (from Grade 0 to Grade IV) (British Columbia Classification). Mean MMSE and GDS scores, as well as the mean of the multiple pathologies were calculated in each group. As all the MMSE items could not always be applied, we used a score obtained by dividing the maximum score accomplished by the maximum score applicable. No MMSb impairment was present in 94.11% of the Grade 0 patients, in 57.14% of the Grade I, in 37.5% of the Grade II, and in 40% of the Grade III patients. However, impairment was present in all the Grade IV patients. GDS analysis revealed no depression in 82.35% of Grade 0 patients, in 21.43% Grade I, in 50% Grade II, in 16% Grade III patients. However, some degree of depression was present in all Grade IV patients. The occurrence of patients affected by multiple pathologies was as follows: 1-2 pathologies were recorded in 47.06% of Grade 0 patients, in 57.14% Grade I, in 37.5% Grade II, in 36% Grade III, and in 57.14% of Grade IV patients.

Lipoprotein(a) levels in centenarians.

In elderly subjects (above 65 years), cardio- and cerebrovascular diseases are known to contribute to the death rate. Serum lipoprotein(a) = Lp(a), a low density lipoprotein, is involved in the atherogenic processes, as confirmed by several clinical trials. We evaluated serum Lp(a) levels in a group of centenarians (15 females and 7 males, mean age 102.81 +/- 2.5 years) compared to 25 healthy control subjects (10 males and 15 females, mean age 51.12 +/- 15.34 years). In all subjects Lp(a) serum levels were determined by ELISA method (EIA mod. 2550 reader). Statistical analysis of the results was performed by using the Student's t test. In centenarians the mean Lp(a) level increased (39.6 +/- 23.53 mg/dl) compared to that of the control group (16.78 +/- 16.24 mg/dl) (p < 0.005). The elevated Lp(a) values observed in centenarians may be attributed to the presence of low molecular weight lipoprotein isoforms which are known to be associated with cardio-cerebrovascular risk. Therefore, it seems that elevated Lp(a) levels alone are not risk factors for the onset of acute acute vascular accidents and do not influence longevity.

Multiple pathologies and drug consumption in a group of centenarians from Eastern Sicily.

Multiple pathologies are characteristic for the elderly. We evaluated the prevalence of multiple pathologies in 28 randomly selected centenarians living in Eastern Sicily and compared the data with those obtained in another random group of 28 control subjects over 80 years of age. It has been revealed that 25% of the centenarians suffered from 0-3 pathologies, while the remaining 75% displayed more than 3 pathologies. The control subjects had 0-3 pathologies in 50% of over 80 years, while 50% were affected by more than 3 pathologies. In centenarians the most prevalent pathologies involved the sensorial apparatus (sight and hearing), followed by the digestive, urogenital and cardiovascular systems. In the control group the rank of occurrence was as follows: cardiovascular system, osteoarticular and respiratory apparatuses, and sensorium. We compared drug consumption in the two age groups. In the centenarians, 71.43% took 0-3 drugs, while 28.57% took more than 3 drugs. In the control group, 53.57% took 0-3 drugs, whereas 46.43% took more than 3 drugs.

Functional evaluation of a group of centenarians in Eastern Sicily by means of the activity of daily living scale.

A random sample of 28 centenarians was studied (32.56% of all centenarians in Eastern Sicily) within the framework of the Italian Multicenter Study on Centenarians. The activity of daily living (ADL) scale was applied to evaluate their capacity to perform everyday tasks autonomously. The study sample consisted of 8 males (28.57%) and 20 females (71.43%), overall mean age was 102.57 +/- 2.1 years. The patients fell into 3 groups according to their ADL scores independent group (with score A) 5 persons, 17.86% (2 males and 3 females); partially independent group (with scores B and C) 5 persons, 17.86% (1 male and 4 females); dependent group (with scores D-E-F-G and other) 18 persons, 64.29% (5 males and 13 females). We compared the results with a control study sample of 28 elderly patients (8 males, 20 females) over 85 years of age resident in a small village in Eastern Sicily (Graniti) and observed that the centenarians presented greater independence, especially the women.

Laboratory blood parameters in a group of centenarians.

Several laboratory blood parameters in a group of healthy centenarians (7 males and 15 females) living in Eastern Sicily were studied and compared with those recorded in a group of healthy elderly subjects (5 males and 12 females) from 80 to 87 years of age. Almost all the laboratory test parameters analyzed were within the range considered to be normal for adult subjects. The exceptions were some renal function markers such as azotemia and creatinine, which were higher in the centenarians, and total cholesterol levels, which were significantly lower in the male centenarians as compared to the elderly male subjects. The conclusion is drawn, therefore, that laboratory tests reflect the health conditions rather than the age of an individual.

Sense of smell in centenarians from Eastern Sicily.

The sense of smell was studied in a group of centenarians from Eastern Sicily, displaying a mini mental state examination score larger than 19. Analysis of the data demonstrated that centenarians retain the capacity to perceive olfactory stimuli. However, as compared to the results obtained in groups of young and elderly subjects, a statistically significant quantitative reduction (p < 0.001) in the sense of smell was revealed in the centenarians.

Study on the sense of taste in a group of Sicilian centenarians.

The sense of taste was studied in a group of 20 centenarians from Eastern Sicily, displaying a mini mental state examination (MMSE) score higher than 19. Control subjects were 20 adult (mean age 27.7 +/- 3.2 years) and 20 elderly subjects (mean age 71.3 +/- 5.5 years). Although it has been revealed that centenarians retain considerably the capacity to perceive tastes, they displayed statistically significant reductions (p < 0.001) in taste functions for sweet, sour, salty and bitter, as compared to both the adult and elderly controls.

Life conditions of Sicilian centenarians.

Aim of the study was at furnishing a description of the socio-economic reality of Sicilian centenarians. Informations were taken from the records of Italian Multicentric Study on Centenarians. Randomly selected 28 centenarians (8 males, 20 females), in the age range 100-108 years from Eastern Sicily were examined. The following average socioeconomic profile of the centenarians was established: they are widows or widowers with 4 children; have primary education, mediocre socioeconomic conditions, have worked in the fields or had been housewives; their hobbies were before gardening or embroidering and sewing and now is watching TV; they live in their own salubrious 4 roomed house in small center in the hills. These observations reveal that the social and intellectual quality of life is better in cases of centenarian subjects living at home, in their family environment, surrounded by their children and grandchildren as they receive greater affection and physical care than those living in old peoples' homes.

[Centenarians: health status and life conditions]. / Centenari: stato di salute e condizioni di vita.

The progressive lengthening of the average life span and the expanding elderly population high-light the phenomenon of "centenarianism" or extreme longevity in Italy. A large number of Italian Geriatric and Gerontology Centers throughout Italy have joined in the Italian Multicenter Study on Centenarians which evaluates the clinical and biological conditions of centenarians. A census of centenarians in Italy as of December 31, 1993 is presently in course. Preliminary data indicate that about 6000 subjects were alive on that day. Interesting epidemiological and biological information is also being processed. Scores based on the mini mental state, the index of independence in activities of daily living, the instrumental activities of daily living, and the geriatric depression scale, as well as laboratory tests, and case histories have evidenced a number of particular characteristics of centenarians: their longevity is familiar; centenarians live in a familiar and comfortable environment; they have been hard workers, and they have a good degree of mental self-sufficiency; they have never presented the classic risk factors, have always followed a balanced diet based on natural foods; they maintain a well-conserved immune system and especially natural killer activity; they have a normal lipidic balance and no symptomatic hyperglycemia. Mobility and morbidity rates are high. Further studies and interdisciplinary research should enable us to gain better understanding of the aging process and of life "over 100".

Treatment of nonresectable hepatocellular carcinoma: review of the literature and meta-analysis.

Many doubts surround the numerous forms of nonsurgical treatment of nonresectable hepatocellular carcinoma (HCC). Our study aimed to reach reliable conclusions on the actual efficacy of these treatments. We examined 85 studies involving a total of 6746 patients: 6113 were treated; the remaining 633 were not. We applied the Mantel-Haenszel-Peto method to the extrapolated data, based on the reported 1- and 3-year survival rates. The results confirm that percutaneous ethanol injection achieved survival exceeding 5 years in many cases of HCC characterized by small nodules (diameter < 3 cm). The most efficacious nonsurgical treatment options were transcatheter arterial embolization and transcatheter arterial chemoembolization. Systemic chemotherapy and hepatic intra-arterial chemotherapy were not very effective.

Alterations of blood and plasma viscosity and erythrocyte filtration in senile osteoporosis.

Blood and plasma viscosity, as well as erythrocyte filtration rates were studied in 44 osteopenic (20 men and 24 women) and in 40 non-osteopenic (20 men and 20 women) patients, all over 65 years of age. Pathological hemorheological parameters were observed only in 12 subject of the osteopenic group, and 10 controls. The results indicate that although the hemorheological parameters do not show a direct correlation with the osteopenia, it is worthwhile following these parameters, among others, in order to optimize the treatment with anti-osteoporotic drugs which are able to regulate them.

Diabetes in the elderly: remarks from an epidemiological study carried out in a town in south-eastern Sicily (Militello V.C.).

Longer mean life span and life expectancy of diabetics and increased factors that favor onset of type II diabetes have determined greater prevalence of diabetes in the elderly population. According to HANES II, it is 17% in the elderly in U.S.A. We carried out an epidemiological study on the over 65 year olds in Militello V.C. and examined 910 elderly subjects (72.05% of the total elderly population). All were tested for peripheral fasting blood glucose, body weight and height and filled out a questionnaire with general and diabetological questions. The values recommended by the NDDG were used to diagnose diabetes. One hundred and sixty-one diabetics (25 newly diagnosed) were observed (17.69%). Onset had occurred before age 65 (aged diabetics) in 72 cases and after 65 in 89 (senile diabetics). Mean blood glucose was 152.91 +/- 55.56 mg/dl. Our results indicated that sulfonylureas and/or biguanides are first choice treatment. By grouping the diabetics on the basis of age at onset and duration of disease, a fall in the number of cases treated with diet alone and hypoglycemic drugs and an increase in patients on insulin were seen in aged diabetics as the disease evolves. On the contrary, there was a rise in the number of senile diabetics on hypoglycemic drugs.