Risk factors and health determinants in older Italians.
ABSTRACT According to a WHO estimate, 50% of the total burden of diseases in men and 25% in women for the EURO-A group (which includes the highly developed countries of the WHO European Region) are attributable to unhealthy life-styles. The aim of the present study was to analyze anthropometric, biochemical and behavioral risk factors using data from the Italian Longitudinal Study on Aging (ILSA), a population-based study of older Italians initiated in 1992 to study those chronic conditions and attendant risk factors that contribute most substantially to morbidity, disability and mortality.
In this descriptive study, we calculated the means and distribution of risk factors in a sample of 5632 Italian subjects aged 65-84 by gender, age class and geographic area, and identified the proportion of these subgroups at higher risk. Analyses include data from the first (1992-93) and second (1995-96) examinations of this cohort.
Over 64% of older Italian participants were overweight in 1992. More than 70% had blood pressure in the borderline or definitely hypertensive range, and almost one-third had hyperlipidemic serum cholesterol levels, including subjects receiving treatment for these conditions. Based on Body Mass Index, more women than men were obese (27 vs 15%) and more women than men were hyperlipidemic in all age classes (38 vs 23%). Approximately 13% of the sample had glucose levels exceeding the recommended 126 mg/dL. Men were found to consume on average about 41 grams of alcohol daily and women 17 g/d. Lastly, we found that approximately 20% of men and 8% of women were smokers in 1992 but that smoking tended to diminish with age.
As the Italian population rapidly ages, the burden of disease and disability is increasing, necessitating more focused, immediate and effective prevention programs. We have identified a number of critical concerns ripe for intervention. The results of this study can better focus such efforts and help guide long-term health planning and policy.
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ABSTRACT: ObjectivesTo identify the relationship among cognitive status, psychological conditions, anthropometric measurements and life-style in a sample of elderly Italian men and women. MethodsThree hundred and six volunteers for ZINCAGE Project recruited. The sample was made up of healthy older adults living in the Marche Region aged 65 and over. All elderly were given a complete medical, anthropometric assessment, and psycho-social evaluation. ResultsOverall, the participants perceived themselves to be in very good or good (22%) or fair (69%) health; only 9% reported a poor health status. The 46% of the sample fell within the normal body mass index (BMI) range, though 38% were overweight, 12% were obese, and only 4% were underweight. In both sexes, BMI significantly decreased with age (p<0.001). BMI was positively associated with performing sedentary activities (r = 0.188; p < 0.001). Levels of both sedentary (r = 0.221; p < 0.001) and non-sedentary (r = 0.258; p < 0.001) leisure activities were positively associated with education level (p<0.05). It was found that lower scores of physical activity were associated to higher scores of Geriatric Depression Scale (r=−0.425; p<0.01), lower scores of Mini Mental State Examination (r=0.266; p<0.001) and higher score of Perceived Stress Scale (r=−0.131; p<0.05). ConclusionMen and women lead different lifestyles and have a different psychological status, with advancing age consequently stressing the need for healthy lifestyle programmes particularly in the case of overweight and obese elderly people. Key wordsLifestyle-ageing-anthropometric status-ZINCAGE projectThe Journal of Nutrition Health and Aging 08/2010; 14(7):515-522. · 2.66 Impact Factor
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ABSTRACT: The importance of the metabolic syndrome is increasingly recognized due to its increasing prevalence and to its role as cardiovascular risk factor. The preva- lence of this syndrome is directly related to age. The age related increase of the metabolic syndrome is due to the age related increase in insulin resistance, obe- sity, diabetes, hypertension, and dyslipidaemia. Also in the elderly the metabol- ic syndrome is associated to an increased frequency of cardiovascular diseases. Several treatments aimed to treat the specific alterations present in the meta- bolic syndrome are useful to reduce the cardiovascular disease incidence in these patients. La sindrome metabolica è un'entità clinica sostanzialmente eterogenea, rappre- sentata dalla co-esistenza di alterazioni multiple, che riguardano l'obesità, in mo- do particolare l'obesità addominale, l'alterata tolleranza glucidica, la dislipidemia (alti livelli di trigliceridi e bassi livelli di HDL) e l'ipertensione arteriosa. La prevalenza di queste alterazioni è differente tra i sessi, nelle diverse età e in dif- ferenti gruppi etnici. Esistono tuttora alcuni problemi relativi alla definizione e al- la diagnosi di sindrome metabolica: le componenti proposte sono variabili conti- nue e per quanto sia necessario stabilire un valore di cut-off, non esiste tuttavia un consenso sugli specifici valori per stabilire la diagnosi di ciascuna componente; queste variabili sono sicuramente interrelate, ma la fisiopatologia delle loro rela- zioni non è ancora chiaramente compresa; è ancora dibattuto se includere o me- no insulinoresistenza e diabete tra le componenti diagnostiche e se includere altre variabili (tipo quelle concernenti l'infiammazione o la coagulazione). Una delle questioni attualmente molto dibattuta è se la sindrome metabolica insorga a causa dell'insulinoresistenza oppure a causa dell'obesità. Anche la difficoltà di trovare un consenso riguardo ad un nome ricorda quanto an- cora si sia lontani da un accordo unanime riguardo a tale sindrome. È stata chia- mata sindrome plurimetabolica 1, sindrome metabolica 2, sindrome X 3, quartetto mortale 4, sindrome da insulinoresistenza 5, sindrome dismetabolica 6. La descrizione della sindrome metabolica ed il tentativo di standardizzarne i crite- ri diagnostici hanno una storia che risale ai primi del '600 ma che tuttora tiene vi- vace il dibattito. Fu Nicolaes Tulp (1593-1674) per primo, ad Amsterdam, a de- scrivere un caso di sindrome da ipertrigliceridemia 7. Tulp stabilì il nesso tra iper- trigliceridemia ed ingestione di acidi grassi saturi ("latte puro nel sangue"), obesità e tendenza al sanguinamento (da ipertensione?). Non solo, egli suggerì un ap- proccio terapeutico corretto indicando una riduzione nell'apporto di acidi grassi
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ABSTRACT: Dietary habits play an important role in healthy ageing. We have investigated the role of dietary patterns on overall mortality in a large series of Italian elderly, recruited in five EPIC cohorts in Northern (Varese and Turin), Central (Florence) and Southern Italy (Naples and Ragusa).A total of 5611 subjects (72.6 % women) aged 60 years or older, enrolled in 1993-1998, were prospectively followed (median 6.2 years), with 152 deaths (98 women). Four major dietary patterns were identified by using an exploratory factor analysis based on dietary information collected at enrollment. The associations between these dietary patterns and overall mortality were evaluated by Cox models adjusted for potential confounders. The 'Olive Oil & Salad' pattern, characterised by a high consumption of olive oil, raw vegetables, soups and poultry, emerged as being inversely associated with overall mortality in both crude and adjusted models. After adjustment for gender, age and caloric intake, overall mortality was reduced by approximately 50 % in the highest quartile and a significant trend emerged (P = 0.008). This association persisted after adjusting for several additional confounders (hazard ratio (HR) 0.50; 95 % CI 0.29, 0.86; P for trend = 0.02). An association of the 'Pasta & Meat' pattern (characterised by pasta, tomato sauce, red meat, processed meat, added animal fat, white bread and wine) with increased overall mortality was also suggested, but only for the highest quartile in a multivariate model. Dietary recommendations aimed at the Italian elderly population should support a dietary pattern characterised by a high consumption of olive oil, raw vegetables and poultry.British Journal Of Nutrition 08/2007; 98(2):406-15. · 3.34 Impact Factor