The investigations of the Laboratory have been mainly centered on the study of epidemiology, clinical course and pharmacology (clinical trials and observational studies) of dementia, depression and behavioral disturbances in the elderly and on the assessment of the quality of care and drug use in aged patients. Targeted research concerns also the study of the relationship of various pathologies, particularly anemia, with the health condition of elderly subjects, the determinants of healthy aging, and the assessment of the quality of care of terminally ill patients in hospices. The Laboratory has always been involved in developing and validating instruments and tests able to reliably assess the different aspects characterizing the clinical expression of dementia.
Dementia and cognitive decline in the oldest-old: prospective population-based study
The exclusion from studies of oldest-old inevitably tends to underestimate the overall number of cases with dementia present in the population. Furthermore, the study of the relationship between dementia and age in the most advanced ages allows us to better understand whether dementia is an "age-related" or "aging-related" phenomenon. To remedy this gap, a door-to-door population-based study was initiated on the prevalence, incidence, risk factors and natural history of dementias and cognitive deficits associated with aging in an elderly population aged 80 years and older resident in eight municipalities in the province of Varese (Monzino 80-plus Study). The survey was subsequently extended to all the centenarians residing in the province of Varese.
Successful aging in centenarians: longitudinal studies
We have recently focused our research also on the study of exceptionally long-lived individuals (the centenarians from two population-based studies, the Monzino 80-plus and Centenari a Trieste) not only in order to investigate the relationship between age and cognitive decline and dementia, but also to identify protective factors that could contribute to postpone dementia onset and investigate the determinants of healthy and successful aging. In collaboration with the International Centenarian Consortium-Dementia (ICC-Dementia) that brings together the largest studies on centenarians in the world.
Anemia in the elderly: longitudinal population-based study
A large population-based study in elderly residents of the municipality of Biella (some 9,000 elderly subjects 65 years or older) has been conducted in collaboration with the Local Health Authority of Biella and Registro Tumori Piemonte to estimate the prevalence and incidence of anemia (mild, moderate and severe) and to investigate the association of mild anemia with hospitalization and mortality in the elderly population (Anemia and Health Study). In a large subgroup of elderly subjects also the effects of mild grade anemia on cognitive, functional, mood, and quality of life variables have been investigated.
Longitudinal study on the association between age and myelodysplastic syndromes
In collaboration with the Department Biomedical Sciences of Humanitas University, we have started the study “Aging of hematopoietic stem cells - molecular architecture of marrow dysplasia and clinical contribution of ineffective hematopoiesis to frailty in the elderly”. The definition of the molecular architecture of marrow dysplasia and clinical contribution of ineffective hematopoiesis to frailty in the elderly would allow us to improve the current diagnosis and classification of anemia in the elderly and the definition of individual patient’s risk of disease associated morbidity/mortality. Finally, in patients with marrow dysplasia sequencing is expected to predict the vulnerability of a particular genotype to specific therapeutic interventions, thus providing a basis for optimizing at individual level timing and modality of therapeutic interventions.
Predictors of conversion to dementia in patients with subjective memory complaints or mild cognitive impairment: The Canton Ticino Study
It has been suggested that cognitive decline varies in early-onset and late-onset Alzheimer's disease and therefore that different phenotypes may exist. Evaluating the effect of age on cognitive profiles of patients with subjective memory disorders or mild cognitive impairment will allow us to investigate whether the cognitive profile of younger patients and young-olds is similar or different to that of old-olds and what are the cognitive areas most predictive of conversion to dementia in the various age groups. In collaboration with the Geriatric Division of the Ospedali Regionali of Lugano and Mendrisio, Switzerland.
The evaluation of the quality of care in the terminally ill patient in hospice
In recent years there has been a growing request for assistance for patients with terminal cancer who cannot be assisted at home. In collaboration with the hospice “Via di Natale” di Aviano, the two research studies in patients with advanced cancer, initiated in 2016 are ongoing. The aim of the first study is to investigate whether the use of a set of clinical variables combined with the clinician’s judgment would improve the accuracy in estimate the life expectancy of these patients. In the second study, the nursing staff is involved to monitor the quality of death in the last hours of life on terminally ill oncologic patients in hospice.
International Consensus on Cardiopulmonary Resuscitation.