A long-term TNP in ChEIs-treated MCI subjects induces additional cognitive and mood benefits.

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The study analyzes the characteristics of 54 nursing home patients (12 male, 42 female; mean age 81.9 ± 7.9 years) with and without the complaint of the fear of falling, and the association of this fear with falling and functional status. Patients who had a fear of falling at baseline (n = 25) had a lower functional status (Barthel Index) score (69.8 ± 22.3 vs. 79.3 ± 15.4), lower scores for balance (8.4 ± 4.4 vs. 10.6 ± 3.7) and gait (Tinetti; 6.7 ± 3.3 vs. 8.3 ± 2.6) and were taking a higher number of psychotropic drugs (0.8 ± 1.1 vs. 0.2 ± 0.5) than those with no fear (n = 29). At 24 months’ follow-up, 25 subjects were still available for evaluation. Fear of falling at baseline was predictive of a decline in activities of daily living, as measured by the Barthel Index, in a multiple regression model, after controlling for baseline cognitive function and change in cognitive function, age, gender, balance and gait, frequency of psychotropic drug usage, and number of chronic symptoms. The findings of this study suggests that, in mobile patients, the fear of falling can be a clinically important predictor of functional decline.

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Dementia developing in very old age is not necessarily associated with malnutrition and decreased life expectancy.

a b s t r a c tThe aim of the study was to investigate the association between postoperative delirium (POD) and in vivo markers of Alzheimer's disease pathology in nondemented hip fracture surgery patients. POD was assessed with the Confusion Assessment Method. Amyloid load was quantified on 18 F-Flutemetamol positron emission tomography images as standardized uptake value ratio. Secondary outcome measures were gray matter volumes, white matter integrity, and functional connectivity at rest. All the patients with POD (PODþ, N ¼ 5) were amyloid negative (standardized uptake value ratio <0.59), whereas 6 out of 11 patients without POD (PODÀ) showed brain amyloid positivity. PODþ compared to PODÀ displayed: lower gray matter volumes in the amygdala (p ¼ 0.003), in the middle temporal gyrus and in the anterior cingulate cortex (p < 0.001), increased diffusivity in the genu of the corpus callosum and in the anterior corona radiata (p < 0.05), and higher functional connectivity within the default mode network (p < 0.001). POD patients showed altered gray and white matter integrity in the fronto-limbic regions in absence of brain amyloidosis. Based on this preliminary investigation, delirium pathophysiology might be independent of Alzheimer's disease. Future studies on larger samples are needed to confirm this hypothesis.

Food intake is a strong predictor of survival even in moderately diseased elderly patients, suggesting possible low-cost interventions.