P Cicconetti

Sapienza University of Rome, Roma, Latium, Italy

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Publications (59)66.22 Total impact

  • Blood pressure monitoring 06/2014; 19(3):187-8. · 1.62 Impact Factor
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    ABSTRACT: The ME was described for the first time in 1993. Subsequently other studies with similar designs were performed. The present study, therefore, proposes: (i) to verify the existence of the benefits of exposure to music in elderly subjects with mild cognitive impairment (MCI), (ii) to explore whether it is possible to find any lasting improvement after training, conducted for a long period of time, with such musical pieces, in the measurable cognitive performances. The study we conducted showed that the ME is present in geriatric patients with MCI; the influence on spatial-temporal abilities remains constant in time if the stimulation is maintained. The continuation of our study will consist of increasing the number of individuals examined and in having them listen to music during the study of ECG rhythms and during the acquisition of cerebral functional magnetic resonance imaging (fMRI), and, at the same time, testing them by neuropsychometric methods.
    Archives of gerontology and geriatrics 02/2010; 51(3):e79-82. · 1.36 Impact Factor
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    ABSTRACT: Cardiovascular events (CE) occur most frequently in the morning hours in hypertensive subjects. We studied the association between the morning blood pressure (BP) surge and CE in prognosis of 10 normotensive and 32 well-controlled hypertensive elderly, in whom ambulatory BP monitoring was performed and who were followed prospectively for 5 years. The morning surge (MS) of BP was calculated as mean systolic BP during 2h after awakening--mean systolic BP during 1h that included the lowest sleep BP. During an average of 60 months, five CE occurred. When the patients were divided into two groups according to MS, those in the top terzile (MS group; MS> or =34 mmHg, n=14) had a higher prevalence of CE (5 versus 0, p=0.001) during the follow-up period, than the others (non-MS group; MS<34 mmHg, n=28). The logistic regression analysis showed the MS sleep-trough surge as predictive variable of CE (odds ratio, OR=0.794, p=0.022). In conclusion, in older normotensives and well-controlled hypertensives, a higher BP MS is associated with vascular risk independently of clinical and ambulatory BP. Reduction of the MS could thus be a therapeutic target for preventing vascular events also in non-hypertensive patients.
    Archives of gerontology and geriatrics 12/2008; 49(2):e105-9. · 1.36 Impact Factor
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    ABSTRACT: Everybody is subject to a physical clock, determining the calendar age, and also to a biological clock, the speed of which depends on the interaction between the genetic reserves and the environment. Stress is taken into account more and more as one of the main factors responsible for the acceleration of the biological clock and the dishomogeneity of the aging process. Despite the fact that centenarians are prone to chronic stress due to a progressive loss of self-sufficiency, more than a half of our centenarians were not depressed and had a low trait-anxiety: they showed an emotional tendency to react with a low anxiety-intensity to stressful conditions. Their good physical conditions may be explained by a positive character-disposition and by strong adaptability to the adversities of the life. Personality traits can be reduced to five basic phenomena, the so-called Big Five: extroversion, agreeableness, conscientiousness, openness to experience and emotional stability. In our sample 65.4% were classified as extroverted, 50% as open minded and 34.5% showed good emotional stability. In the centenarians aging of all apparatuses was slowed down by a healthy lifestyle and also by good adaptability that allowed for a positive and effective response to stress throughout their whole lives.
    Archives of gerontology and geriatrics 05/2008; 48(3):353-5. · 1.36 Impact Factor
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    ABSTRACT: The aim of our studies was to establish a standard method of assessment that allows an early identification of frailty in the elderly, i.e., to predict who are at risk of developing disabilities, in order to be able to intervene with preventive global and individualized measures. A new multidimensional scale called Marigliano-Cacciafesta polypathological scale (MCPS) was used on 180 elderly people, together with the Barthel index (BI), the global evaluation functional index (GEFI), the geriatric depression scale (GDS), the mini mental state examination (MMSE), the mini nutritional assessment (MNA), and the Tinetti test. A strongly significant statistical correlation was found between the MCPS and the nutritional state, mood level, motor functionality, level of disability and global functionality. As the fragile patients are at a risk to develop disabilities, we think that our scale can be a significant contribution to the multidimensional geriatric assessment (MGA), aimed at identifying and quantifying the parameter of fragility of each patient, an information which should be known, if we intend to introduce preventive measures.
    Archives of Gerontology and Geriatrics 01/2008; 46(3):327-34. · 1.70 Impact Factor
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    ABSTRACT: The purpose of the work was to verify whether our MCPS can be a tool for predicting the risk of developing disabilities. We considered 45 elderly subjects divided into three groups of 15 subjects each. Group 1 consisted of cases with a "moderate-severe" degree of polypathology, with no associated condition of disability evaluated by means of the activities of daily living (ADL). Group 2 contained cases with a "moderate" degree of polypathology (with no associated condition of ADL disability). The Group 3 was the control group with a "mild" degree of polypathology (with no disability associated with ADL). All subjects were re-evaluated after 6 and 12 months. Both Groups 1 and 2 of cases over time developed greater disabilities, compared to the control Group 3; in particular, the subjects with "moderate-severe" polypathology were more disabled after 12 months.
    Archives of Gerontology and Geriatrics 11/2007; 47(2):201-6. · 1.70 Impact Factor
  • High Blood Pressure & Cardiovascular Prevention 09/2007; 14(3).
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    ABSTRACT: Isolated Systolic Hypertension (ISH) is a known risk factor for cognitive impairment, but the time of onset of neurocognitive changes relative to the onset of ISH has yet to be established. The purpose of this study was to investigate the relationship between systolic BP values and neurocognitive function in the early stages of ISH. Twenty elderly patients with recently (< 2 years) diagnosed ISH and 10 elderly normotensive controls underwent Ambulatory Blood Pressure Monitoring (ABPM) and neurocognitive assessment, performed using the Mini Mental State Examination (MMSE), and the recording of ERPs with an odd ball acoustic paradigm. There were no significant differences in MMSE scores or in the P300 latency between ISH patients and controls. The N2 latency was significantly higher in ISH patients vs. controls (p<0.0001), and showed a significant association with both clinical and ambulatory systolic BP and pulse pressure values in the overall study population. These findings suggest the existence of early subclinical alterations in neurocognitive function in early ISH, detectable through ERPs. Our findings underscore the ISH may constitute a threat to neurocognitive health in the elderly.
    Clinical Neurophysiology 05/2007; 118(4):824-32. · 3.14 Impact Factor
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    ABSTRACT: Sleep is an active nervous process, which is structured in phases characterized by subsequent cycles of various psycho-physiological phenomena. It performs vital, yet mysterious functions and is in all likelihood involved in many processes, including cognitive processes. In old age the internal structure of sleep changes, but these physiological variations allow, in healthy subjects, a satisfactory quantity and quality of sleep. Until now there have been no literature reports of studies regarding sleep quality in extreme old age. Our work describes the investigation of the quality of sleep in a sample of 180 centenarians selected from the registered residents of Rome. We have studied sleep disorders, related pathologies and pharmacological treatments. The results of the study show good sleep quality for 57.4% of the sample group; 35.2% complain of medium intensity problems, significantly related to angina pectoris and to chronic obstructive bronchopneumopathy. Only 7.4% of the subjects showed severe problems, significantly related with cognitive deficiency and lower survival rate. The results of our study confirm, in centenarians as in the elderly, the existence of a positive correlation between sleep quality, survival and successful aging.
    Archives of Gerontology and Geriatrics 02/2007; 44 Suppl 1:385-9. · 1.70 Impact Factor
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    ABSTRACT: 24h ambulatory blood pressure monitoring (ABPM) can easily detect the circadian blood pressure (BP) pattern: usually, systolic and diastolic blood pressure (BP) show a nocturnal fall. Nocturnal BP values do not however always decline in essential hypertension: the subjects who show a nocturnal BP fall of at least 10% are called dippers; in other subjects, called non-dippers, BP behaviour is characterized by a lack of or very limited nocturnal BP fall. Several studies have investigated the relationship between the lack of or reduction of nocturnal BP fall (non-dipping pattern) and cardiovascular risk, showing not only an increase of target-organ damage (heart, brain, kidney), but a greater frequency of cardiovascular events (stroke, myocardial infarction, etc.) also and higher cardiovascular mortality in non-dippers subjects, both hypertensives and normotensives. Therefore, a non-dipping pattern may be an additional risk factor. Thus, ABPM could be a useful method to evaluate the initial global cardiovascular risk in patients with hypertension, and an adequate antihypertensive therapy should aim not only at lowering high BP values, but also at re-establishing the physiological nocturnal BP fall.
    Recenti progressi in medicina 01/2007; 98(7-8):401-6.
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    ABSTRACT: Several studies have shown a relationship between BISH and cerebrovascular events, but no studies have investigated a relationship with cognitive function. The aim was to assess the cognitive function in the elderly with recent BISH. According to WHO Guidelines (1999), we selected 10 elderly normotensives, 10 elderly with recently diagnosed (<2 years) BISH, and 10 elderly with recently diagnosed (<2 years) isolated systolic hypertension (ISH). They were submitted to 24-hr ambulatory blood pressure (BP) monitoring (ABPM) and to cognitive assessment by mini mental state examination (MMSE) and the recording of brain ERP, of type N2 and P300. The elderly with BISH, compared to normotensives, showed N2 wave latency values significantly higher, but similar P300 potential latency values and MMSE scores. The elderly with ISH showed N2 and P300 latency significantly higher than the normotensives. The gradual increase of the ERP latency values of the BISH and ISH elderly, in comparison to the normotensives, seems to indicate a gradual alteration of the cognitive processes related to the increase of BP.
    Archives of Gerontology and Geriatrics 01/2007; 44 Suppl 1:105-11. · 1.70 Impact Factor
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    ABSTRACT: The cardiovascular pathologies are the most common causes of death in the elderly patient. To single out the main risk factors in order to effectively prevent the onset of the disease, the authors experimented a special computerized tool, the neural network, that works out a mathematical relation that can obtain certain data (defined as output) as a function of other data (defined as input). Data were processed from a sample of 276 subjects of both sexes aged 26-69 years old. The output data were: high/low cholesterolemia, HDL cholesterol, triglyceridemia with respect to an established cut-off; the input data were: sex, age, build, weight, married/single, number of children, number of cigarettes smoked/day, amount of wine and number of cups of coffee. We conclude that: (i) a relationship exists, deduced from a neural network, between a set of input variables and a dichotomous output variable; (ii) this relationship can be expressed as a mathematical function; (iii) a neural network, having learned the data on a sufficiently large population, can provide valid predictive data for a single individual with a high probability (up to 93.33%) that the response it gives is correct. In this study, such a result is found for two of the three cardiovascular risk indicators considered (cholesterol and triglycerides); (iv) the repetition of the neural network analysis of the cases in question after a "pruning" operation provided a somewhat less good performance; (v) a statistical analysis conducted on those same cases has confirmed the existence of a strong relationship between the input and the output variables. Therefore the neural network is a valid instrument for providing predictive in a single subject on cardiovascular pathology risks.
    Archives of Gerontology and Geriatrics 01/2005; 40(2):157-72. · 1.70 Impact Factor
  • High Blood Pressure & Cardiovascular Prevention 01/2005; 12(3).
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    ABSTRACT: Human life expectancy is constantly increasing: the challenge for modern geriatric medicine is to identify the means to reach successfully extreme longevity. To determine which are the survival determinants in centenarians using a neural network. Sample of 110 centenarians living in Rome, mean age 101.6 years (SD=1.8) with a sex ratio males:females of 1:3. We administered an extensive health interview (lasting 1-2 h) to each subject. The questionnaire, carried out according to the Geriatric Multidimensional Assessment, is made up of 100 items including a comprehensive health and psychosocial assessment aimed at various topics of general health and well-being and some scales used in geriatric practice. We applied several three-layered feed-forward neural networks by mixing in different ways the most important of the 100 items. The most predicting powered net is the one constructed with 23 variables regarding comorbidity, cardiovascular risk factors, cognitive status, mood, functional status and social interactions, which therefore are strictly related to survival in centenarians. Survival in longevity is a complex biological phenomenon, which is an ideal field for using the neural network as a statistic method. The net shows us that the maintenance of social relationships even in presence of disability is of major importance for survival in the oldest old.
    Gerontology 01/2005; 51(3):199-205. · 2.68 Impact Factor
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    ABSTRACT: The cardiovascular pathologies are the most common causes of death in the elderly patient. To single out the main risk factors in order to effectively prevent the onset of the disease, the authors experimented a special computerized tool, the neural network, that works out a mathematical relation that can obtain certain data (defined as output) as a function of other data (defined as input). Data were processed from a sample of 276 subjects of both sexes aged 26–69 years old. The output data were: high/low cholesterolemia, HDL cholesterol, triglyceridemia with respect to an established cut-off; the input data were: sex, age, build, weight, married/single, number of children, number of cigarettes smoked/day, amount of wine and number of cups of coffee. We conclude that: (i) a relationship exists, deduced from a neural network, between a set of input variables and a dichotomous output variable; (ii) this relationship can be expressed as a mathematical function; (iii) a neural network, having learned the data on a sufficiently large population, can provide valid predictive data for a single individual with a high probability (up to 93.33%) that the response it gives is correct. In this study, such a result is found for two of the three cardiovascular risk indicators considered (cholesterol and triglycerides); (iv) the repetition of the neural network analysis of the cases in question after a “pruning” operation provided a somewhat less good performance; (v) a statistical analysis conducted on those same cases has confirmed the existence of a strong relationship between the input and the output variables. Therefore the neural network is a valid instrument for providing predictive in a single subject on cardiovascular pathology risks.
    Archives of Gerontology and Geriatrics - ARCH GERONTOL GERIATR. 01/2005; 40(2):157-172.
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    ABSTRACT: Cognitive impairment is an invalidating condition and its prevalence increases significantly with age. It is very important to identify the risk factors for cognitive impairment. Aside from age, sex, familiary history and educational level, the other major risk factors (hypertension, hypercolesterolemia, diabetes mellitus and tobacco), known to be associated frequently with different cerebrovascular diseases, might also contribute to degenerative forms of cognitive impairment because they might favour cerebral microvascular alterations with hypoperfusion, demyelinization and ischemic lesions of subcortical white matter. Longitudinal epidemiological studies detected that arterial hypertension, hypercolesterolemia and tobacco are frequently associated with degenerative forms of cognitive impairment. Some studies show there is no relationship between cognitive impairment and diabetes mellitus, while other underline its role; light alcohol drinking might protect against cognitive impairment. Other recently identified risk factors might be hyperhomocysteinemia and high C-reactive protein blood levels because they seem to be associated with cognitive impairment.
    Recenti progressi in medicina 12/2004; 95(11):535-45.
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    ABSTRACT: Several studies have shown a relationship between blood pressure (BP) and cognitive function. Yet very few studies have addressed circadian BP patterns in this context, perhaps due to poor availability of suitable methods to detect slight changes in the cognitive state. Today, brain event-related potentials (ERPs) allow us to detect subclinical changes in cognitive function. We enrolled 30 elderly patients with recently diagnosed hypertension (<2 years) that had never been treated: 18 dippers and 12 nondippers. Patients underwent 24-h ambulatory blood pressure monitoring (ABPM). Careful assessment of their cognitive state was carried out using the mini mental state examination (MMSE), and the recording of P300 and N2 ERPs. No significant differences between the two groups were found. MMSE scores in dippers and nondippers were similar (29.5+/-0.71 vs. 29.3+/-1.07, respectively; p =0.611), as were P300 latency values (377.78+/-33.28 vs. 364.67+/-35.12 in the central (Cz) position, p =0.310; 379.22+/-32.94 vs. 365.25+/-35.07 in the occipital (Pz) position, p =0.277) and N2 wave latency values (253.83+/-24.9 vs. 249.17+/-24.47 in the Cz position, p =0.617; 251.56+/-25.86 vs. 246.58+/-25.46 in the Pz position, p =0.608). These data show no association between the nondipping pattern and lower cognitive function in elderly subjects with recent hypertension.
    Hypertension Research 09/2004; 27(8):581-8. · 2.79 Impact Factor
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    ABSTRACT: Cigarette smoking has been clearly linked to the most common causes of death in the elderly and contributes to the higher death rate and disability rate associated with many chronic illnesses that are common in this age group. The combination of smoking along with other risk factors like hypertension and diabetes increase high frequency disease, and disability as well as adding to an increase in mortality rate. In order to verify if a healthy lifestyle really favours longevity and how much smoking is incompatible with extreme longevity, we investigated the prevalence of smokers and the total smoking exposure of a sample of centenarians as regards residual survival and health conditions. Our sample consists of 157 centenarians selected among the registered residents of Rome: 39 males and 118 females (ratio = 1:3), mean age being 101.59 years (sd = 1.8). 83.8% of the centenarians have never smoked, 13.5% are former smokers, and 2.7% are active smokers. The average starting age of smoking was 21.2 years while the average age of quitting in former smokers was 65.7 years with an average of 44.7 smoking years (sd = 17.1). The average number of smoked cigarettes per day is quite low, less than 10 cigarettes. There seemed to be a significant difference (p < 0.001) in gender results in smokers: male centenarians were 46%, while female reached only 8.1%. Statistically significant higher prevalence of diseases illnesses were noted among centenarian smokers over the age of 65 (p < 0.02). Moreover Cox's regression has shown in centenarians a lower survival rate (p < 0.05) in smokers than in non-smokers. In conclusion, our study is evidence that smoking is for all, but some exceptional subjects, incompatible with successful aging and compromises life expectancy even in extreme longevity.
    Recenti progressi in medicina 05/2004; 95(4):187-9.
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    ABSTRACT: Several studies have shown that cerebrovascular organ damage can related not only to average blood pressure (BP) levels, but also to BP variability. The aim of this study was to investigate the relationship between 24 hr BP variability and cognitive function in older hypertensives. Forty older, never treated hypertensives were submitted to 24 hr ambulatory BP monitoring (ABPM) and subdivided, according to the variability of the systolic BP (SBP), in two groups: 23 with higher (> PV) and 17 with lower (< PV) SBP variability, defined as the standard deviation (SD) of the mean 24 hr SBP values and as coefficient of variation (CV). They underwent a cognitive assessment by mini mental state examination (MMSE) and a recording of the brain event-related potentials (ERPs). ERPs record neuronal electric activity when the patients are submitted to frequent and rare acoustic stimuli and must recognize and count rare (target) stimuli. The two groups with statistically different 24 hr SBP variability, did not show significant differences in MMSE scores or in N2 and P300 ERP latencies, thus indicating a lack of difference in the cognitive ability between the two groups. Our results show that cognitive function is not related to 24 hr SBP variability in older hypertensives.
    Archives of gerontology and geriatrics. Supplement 01/2004;
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    ABSTRACT: In Western countries data from clinical and epidemiological studies have induced the public health offices to promote a great deal of advertising and informative campaigning for smoking reduction. Cigarette smoking has been clearly linked to the most common causes of death in the elderly and contributes to the higher death rate and disability rate associated with many chronic illnesses that are common in this age group. The combination of smoking along with other risk factors like hypertension and diabetes increase high frequency diseases, disability as well as adding to an increase in mortality rate. In order to verify if a healthy lifestyle really favors longevity and how much smoking is incompatible with extreme longevity we investigated the prevalence of smokers and the total smoking exposure of a sample of centenarians in relation with residual survival and health conditions. Our sample consists of 157 centenarians living in Rome, 39 males and 118 females (ratio m/f =1:3),mean age being 101.59 +/- 1.8 years (+/-SD), 83.8% of the centenarians have never smoked,13.5 % are former smokers, and 2.7% are active smokers. The average starting age of smoking is 21.2 years, while the average age of quitting is 65.7 years with an average of 44.7 +/- 17.1 smoking years. The average number of smoked cigarettes per day is quite low,less than 10 cigarettes, so that the total average number of smoked cigarettes is 158,045,well under 280,000 which is considered the cut-off point in many studies of when tumors are noticed. There seemed to be a significant difference (p < 0.001) in gender results in smokers: among male centenarians smokers reached 46%, while female smoker centenarians reached only 8.1%. Statistically significant chronic illnesses were noted among centenarian smokers over the age of 65 (p < 0.02). Moreover, Cox's regression has shown in centenarians a lower survival rate (p < 0.05) in smokers (20.7 +/- 11.2 months) than in non-smokers (27.0 +/- 19.0 months). In conclusion, our study evidences that smoking is for all but some exceptional subjects, incompatible with successful aging and compromises life expectancy even in extreme longevity.
    Archives of gerontology and geriatrics. Supplement 01/2004;