[Incidence and risk factors for accidental falls among general practice elderly patients in Latina, Central Italy]. / Incidenza e fattori di rischio delle cadute accidentali in un campione di anziani assistiti da MMG nella provincia di Latina.

BACKGROUND: falls incidence in home resident elderly people varies from 30% to 40%. Falls induce loss of self-sufficiency and increase mortality and morbidity. OBJECTIVES: to evaluate falls incidence and risk factors in a group of general practice elderly patients. DESIGN: prospective cohort study with 1 year follow-up. METHODS: 18 practitioners visited their elderly patients (>75 years) for a baseline assessment. Information on current pathologies and previous falls in the last six months was collected. Functional status was evaluated using: Short Portable Mental State Questionnaire, Geriatric Depression Scale, Activities of Daily Living, Instrumental Activities of Daily Living. Total mobility Tinetti score was measured in a subgroup of elderly. Falls were monitored through 2 phone-interviews at 6 and 12 months. Data were analyzed through logistic regression. RESULTS: 1168 elderly were visited and 800 were enrolled in the study. Twenty-eight percent of the elderly fell in the whole period. Sixty percent of falls were not reported to the practitioner. Independent predictors for falls were ADL score (ADL<5: OR 1.90; 95% CI 1.05-3.45), falls occurred in the 6 months previous to the follow-up period (OR 1.62; 95% CI 1.03-2.54) and the interaction term among this factor and the follow-up period (OR 2.39; 95% CI 1.22-4.72). Tinetti score was significantly associated to falls only in univariate analysis. CONCLUSIONS: Practitioners can play a key-role in identifying at-risk subjects and managing prevention interventions. Falls monitoring and a continuous practice of comprehensive geriatric assessment should be encouraged.

[Evolution and current tools of multidimensional assessment in Italy]. / La valutazione multidimensionale in Italia: evoluzione e strumenti in uso.

Evaluation of the health status of elderly patients clearly should take into consideration the older individual's medical (physical and mental health), psychosocial and economical status, and functional capabilities and problems (multidimensional evaluation). This methodology has been used in anglo-saxon countries since over 20 years and is now quite diffuse in Italy as well. This paper reports the results of a study performed by the Epidemiology Unit of Tor Vergata University in Rome (Italy) to verify whether a national project regarding the elderly population (Progetto Obiettivo Anziani), has been put into effect across Italy and, in particular, whether, in the context of this project, Geriatric Evaluation Units have been activated. The study evaluated the structural features of the existing Geriatric Units, as well as the type of employed staff and tools used. The results confirm that multidimensional assessment of the elderly is well established in Italy even though Geriatric Evaluation Units across the country are very diverse with respect to the type of employed staff and their work experience. The number of elderly persons evaluated in the Geriatric Units appears to be low but this is also due to the fact that multidimensional evaluation is only one of the many activities performed by the Units. This fact should be reflected upon however, and may call for a greater investment in this important sector of geriatric care.

[A survey of residential care services for HIV infected individuals]. / Un'indagine sulle case alloggio per persone con HIV.

The aims of this study were to examine the current situation regarding residential care facilities for HIV-infected individuals in Italy and to describe the characteristics of residents of such facilities.