Francesco Landi

Francesco Landi
Catholic University of the Sacred Heart | UNICATT · Department of Geriatrics, Neuroscience and Orthopedics

MD, PhD

About

579
Publications
168,480
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51,293
Citations
Citations since 2016
276 Research Items
37532 Citations
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Publications

Publications (579)
Article
Frailty is a clinically measurable state of vulnerability to developing increased dependency and/or mortality when exposed to a stressor. Chronic diseases, aggressive treatments, antibiotic overuse, microbiota changes, immune senescence, and increased use of medical devices and implants (i.e., central lines and catheters) expose modern patients to...
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Methods The aim of this paper is to define terms commonly related to sarcopenia to enable standardization of these terms in research and clinical settings. The Global Leadership Initiative in Sarcopenia (GLIS) aims to bring together leading investigators in sarcopenia research to develop a single definition that can be utilized worldwide; work on a...
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Long COVID, a condition characterized by symptom and/or sign persistence following an acute COVID-19 episode, is associated with reduced physical performance and endothelial dysfunction. Supplementation of l-arginine may improve endothelial and muscle function by stimulating nitric oxide synthesis. A single-blind randomized, placebo-controlled tria...
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We recently conducted a systematic review and meta-analysis to assess the association between protein consumption and frailty in older adults [...]
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Multisystem derangements encompassing musculoskeletal, stress, and metabolic response have been described in older adults with physical frailty and sarcopenia (PF&S). Whether PF&S is also associated with markers of cellular senescence has yet to be explored. To address this research question, we quantified the serum levels of selected inflammatory,...
Article
Definition and epidemiology OH is defined as a reduction in systolic BP of at least 20 mmHg or in diastolic BP of at least 10 mmHg within three minutes of standing. It is a common condition in older adults, with prevalence ranging from 5% in individuals <50 years old to 30% in patients >70 of age. It is responsible for adverse events (i.e., falls,...
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The present study examined the association between lower-limb muscle power and protein-related parameters in older adults. This study followed a cross-sectional design. Participants were community-dwelling older adults. Candidates were considered eligible if they were 60 years or older, lived independently, and possessed sufficient physical and cog...
Article
In febrile patients with known systemic autoimmune disease, early discrimination between infection and disease flare often represents a clinical challenge. This study aimed at evaluating the efficacy of procalcitonin (PCT) and other common inflammatory biomarkers in discriminating disease flare from bacterial infections in the Emergency Department...
Poster
Background and Aims: The aim of this prospective observational study conducted on 1782 consecutive patients with previous COVID- 19 infection was to assess whether cardiovascular risk correlates with the incidence of symptoms and changes in respiratory function parameters in the post-COVID syndrome. The association between estimated cardiovascular...
Poster
contributing to systemic inflammatory syndrome, acute respiratory distress syndrome and vascular events of the acute phase of disease. Evidence regarding COVID-19 middle- and long-term consequences on endothelial function, however, is still lacking. Our study aimed to evaluate if COVID- 19 severity could significantly affect the endothelial functio...
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Objectives: This study aimed to assess the effects of frailty and the perceived quality of life (QOL) on the long-term survival (at least 1 year) of patients ≥ 80 years hospitalized for COVID-19 and the predictors of frailty and QOL deterioration in survivors. Design: This is a single-center, prospective observational cohort study. Setting and Part...
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Clostridioides difficile infection (CDI) represents a significant cause of morbidity and mortality, mainly in older and frail subjects. Early identification of outcome predictors, starting from emergency department (ED) admission, could help to improve their management. In a retrospective single-center study on patients accessing the ED for diarrhe...
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Nonconventional clinical presentations of diseases are common in older adults. Even dramatic events, such as foreign body (FB) inhalation, can occur in a subtle and non-specific manner. Pill aspiration is a rare yet overlooked cause of airway injury. It accounts for approximately 7% of all FB aspirations. In contrast, oral dysphagia and polypharmac...
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Background. Wernicke–Korsakoff syndrome (WKS) is a serious neurological disorder caused by thiamine (vitamin B1) deficiency. The term refers to two different conditions. Wernicke encephalopathy (WE) is an acute syndrome related to the deficiency. It requires early diagnosis and emergent treatment to prevent long term consequences and even death. Ko...
Article
Background The present study explored cross-sectional and longitudinal associations between protein intake and physical function in older adults. Methods We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated the association between protein intake and measures of physical function in older...
Article
Aim: Older adults are frequently stigmatized for improper emergency department (ED) visits and hospitalizations. In this study, we aimed to investigate the relationship between age and appropriateness of ED visits, and the mismatching between ED clinical severity and hospitalizations. Methods: We carried out a nationwide assessment of Italian In...
Article
Objective Low muscle mass is one of the mediators of numerous complications accompanying malnutrition status and sarcopenia and at the same time may have a greater effect on survival than other clinical characteristics. In this study, we evaluated the impact of low appendicular skeletal muscle (ASM) on all-cause mortality risk over 10 years in olde...
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Low muscle mass and malnutrition are prevalent conditions among adults of all ages, with any body weight or body mass index, and with acute or chronic conditions, including COVID-19. This article synthesizes the latest research advancements in muscle health and malnutrition, and their impact on immune function, and clinical outcomes. We provide a t...
Article
Background Fatigue with reduced tolerance to exercise is a common persistent long-lasting feature amongst COVID-19 survivors. The assessment of muscle function in this category of patients is often neglected. Aim To evaluate the potential impact of a daily supplementation based on amino acids, minerals, vitamins, and plant extracts (Apportal®) on...
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Background: The present systematic review and meta-analysis investigated the cross-sectional and longitudinal associations between protein intake and sarcopenia in older adults. Methods: Observational studies that investigated the association between protein intake and sarcopenia as the primary or secondary outcome in people aged 60 years and ol...
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Background: The present systematic review and meta-analysis investigated the cross-sectional and longitudinal associations between protein intake and frailty in older adults. Methods: We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated the association between protein intake and frailty...
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Background Demographic changes in the western world entail new clinical approaches and challenges in older persons. Low skeletal muscle mass and low physical performance in older persons are both predisposing conditions for disability and obtaining knowledge in this cohort is essential. Aim The primary aim of the study was to analyze a broader spe...
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Background: Sarcopenia is associated with adverse outcomes in older people. Several tools are recommended to assess muscle mass, muscle strength and physical performance, but are not always available in daily practice. Objective: The aim of the present study is to evaluate if there is a correlation between the personal perception of physical per...
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Background: Severe clinical pictures and sequelae of COVID-19 disease are immune mediated and characterized by a 'cytokine storm'. Skeletal muscle has emerged as a potent regulator of immune system function. The aim of the present study is to define the prevalence of sarcopenia among COVID-19 survivors and the negative impact of sarcopenia on the...
Article
Long COVID affects a large share of persons of all age groups but may be especially burdensome for vulnerable older adults. Long COVID has a complex pathophysiology encompassing inflammatory and autoimmune processes, perturbations in metabolic pathways, and alterations in endothelial function and redox homeostasis. The management of long COVID requ...
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Objective: The purpose of the present study was to assess the effect of a specific oral nutritional supplement among patients recovered from COVID-19 but suffering symptoms of fatigue. Methods: This is an observational case-control study involving a sample of 66 COVID-19 survivors divided in two groups, 33 subjects in the intervention group who...
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Background: Endothelial cells damage and thromboinflammation are considered key elements in the generation of organ impairment in patients with COVID-19 disease. The endothelial function is evaluated by measuring flow-mediated dilation (FMD). We aimed to analyze the association between FMD impairment and retinal vascular parameters in early post-C...
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Objective: To determine whether a multicomponent intervention based on physical activity with technological support and nutritional counselling prevents mobility disability in older adults with physical frailty and sarcopenia. Design: Evaluator blinded, randomised controlled trial. Setting: 16 clinical sites across 11 European countries, Janua...
Article
COVID-19 pandemic forced countries to adopt strategies aimed at responding to the health emergency by containing contagion. Lockdowns have ensured the achievement of this goal, but imposed substantial restrictions to the freedom of movement and resulted in social isolation for a large share of vulnerable people. The aim of the present study was to...
Article
Coronavirus disease 2019 is known to impact older people more severely and to cause persistent symptoms during the recovery phase, including cognitive and neurologic ones. We investigated the cognitive and neurologic features of 100 elderly patients with confirmed diagnosis of coronavirus disease 2019 evaluated in the postacute phase through a dire...
Article
Aim To determine the prevalence and associated factors of vitamin D deficiency in COVID-19 survivors and the relationship between vitamin D status and physical performance. Methods Vitamin D status was assessed in a sample of patients who had recovered from COVID-19 and were admitted to a post-acute outpatient service at Fondazione Policlinico Uni...
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Background: To compare the performance of eight frailty instruments to identify relevant adverse outcomes for older people across different settings over a 12 month follow-up. Methods: Observational longitudinal prospective study of people aged 75 + years enrolled in different settings (acute geriatric wards, geriatric clinic, primary care clini...
Article
Objective People with Down syndrome (DS) are particularly vulnerable to Covid-19 and show altered immune response to vaccination. We aimed to evaluate the immune response of a group of adults with DS treated with standard regimens of SARS-CoV-2 vaccine as compared with an aged- and sex-matched group of persons without DS. Methods We compared antib...
Article
Aging has been identified as one of the most relevant risk factors for poor outcomes in COVID-19 infection. Since now, different mechanisms responsible for worse outcomes in the elderly have been proposed, which include the remodeling of immune system, the higher prevalence of malnutrition and sarcopenia, the increased burden of multimorbidity, and...
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Background: Endothelial dysfunction has a role in acute COVID-19, contributing to systemic inflammatory syndrome, acute respiratory distress syndrome, and vascular events. Evidence regarding COVID-19 middle- and long-term consequences on endothelium are still lacking. Our study aimed to evaluate if COVID-19 severity could significantly affect the...
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Muscle loss alone, or in the context of sarcopenia or cachexia, is a prevalent condition and a predictor of negative outcomes in aging and disease. As adequate nutrition is essential for muscle maintenance, a growing number of studies has been conducted to explore the role of specific nutrients on muscle mass or function. Nonetheless, more research...
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Background: Neurological manifestations of Sars-CoV-2 infection have been described since March 2020 and include both central and peripheral nervous system manifestations. Neurological symptoms, such as headache or persistent loss of smell and taste, have also been documented in COVID-19 long-haulers. Moreover, long lasting fatigue, mild cognitive...
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COVID-19 negatively impacts several organs and systems weeks or months after initial diagnosis. Skeletal muscle can be affected, leading to fatigue, lower mobility, weakness, and poor physical performance. Older adults are at increased risk of developing musculoskeletal symptoms during long COVID. Systemic inflammation, physical inactivity, and poo...
Article
Objectives To evaluate, in a cohort of adults ≥80 years old, the frailty status at the emergency department (ED) admission, for the in-hospital death risk stratification of patients needing major surgical procedures. Design Single-center prospective observational cohort study. Setting and Participants The study was conducted in the ED of a teachi...
Article
Objective To compare one-year mortality risk associated with syncope and unexplained fall in older adults with dementia. Methods 522 patients (aged >65 years) with dementia and history of transient loss of consciousness and/or unexplained falls were evaluated. The diagnosis of syncope was based on European Society of Cardiology guidelines. A “Sync...
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Introduction The SARS CoV-2 pandemic still generates a very high number of affected patients and a significant mortality rate. It is essential to establish objective criteria to stratify COVID-19 death risk. Frailty has been identified as a potential determinant of increased vulnerability in older adults affected by COVID-19, because it may suggest...
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Background: Cardiovascular disease still represents the leading cause of death worldwide. Management of risk factors remains crucial; despite this, hypercholesterolemia, which is one of the most important modifiable cardiovascular risk factor, is still high prevalent in general population. The aim of this study is to determine the prevalence of dy...
Article
PurposeFall-Risk Increasing Drugs (FRIDs) are an important and modifiable fall-risk factor. A Clinical Decision Support System (CDSS) could support doctors in optimal FRIDs deprescribing. Understanding barriers and facilitators is important for a successful implementation of any CDSS. We conducted a European survey to assess barriers and facilitato...
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Background Although the prevalence of sarcopenic obesity is increasing, nowadays a universally accepted definition still does not exist. Because, this clinical entity is defined as the combination of obesity and sarcopenia, the diagnosis appears to be strictly linked to criteria used for sarcopenia and the available prevalence data are not uniform....
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Introduction The novel coronavirus SARS-Cov-2 can infect the respiratory tract causing a spectrum of disease varying from mild to fatal pneumonia, and known as COVID-19. Ongoing clinical research is assessing the potential for long-term respiratory sequelae in these patients. We assessed the respiratory function in a cohort of patients after recove...
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Purpose To describe a guidance on the management of post-acute COVID 19 patients in geriatric rehabilitation. Methods The guidance is based on guidelines for post-acute COVID-19 geriatric rehabilitation developed in the Netherlands, updated with recent insights from literature, related guidance from other countries and disciplines, and combined wi...
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The COVID-19 pandemic is impressively challenging the healthcare system. Several prognostic models have been validated but few of them are implemented in daily practice. The objective of the study was to validate a machine-learning risk prediction model using easy-to-obtain parameters to help to identify patients with COVID-19 who are at higher ris...
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Introduction: Although pulmonary embolism (PE) is a frequent complication of the clinical course of COVID-19, there is a lack of explicit indications regarding the best algorithm for diagnosing PE in these patients. In particular, it is not clear how to identify subjects who should undergo computed tomography pulmonary angiography (CTPA), rather th...
Article
Introduction Hospitalization is associated with acute changes in sarcopenia status in older people, but the influencing factors are not fully understood. Pre-admission care dependency level as a risk factor has not yet been investigated. Objective Evaluate if pre-admission care dependency level is an independent predictor of sarcopenia changes fol...
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Background Systemic vascular involvement in COVID-19 has been identified in several patients: not only endothelial derangement and increased permeability are reported to be early hallmarks of organ damage in patients with COVID-19 but are also the most important cause of worsening of clinical conditions in severe cases of SARS-CoV-2 infection. Ther...
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Frailty is a reversible state of reduced resilience to stressful events resulting from a multisystem impairment of the human body. As frailty progresses, people become more vulnerable to numerous adverse events, including falls and fractures, cognitive decline, disability, hospitalization, nursing home placement, and death. As such, substantial hea...
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The human ageing process is universal, ubiquitous and inevitable. Every physiological function is being continuously diminished. There is a range between two distinct phenotypes of ageing, shaped by patterns of living - experiences and behaviours, and in particular by the presence or absence of physical activity (PA) and structured exercise (i.e.,...
Article
Background Interactions between chronic kidney disease (CKD) and several comorbidities may potentially affect prognosis of older hospitalized patients. This study aims at evaluating the prognostic interactions between estimated glomerular filtration rate (eGFR), anemia, sarcopenia, functional and cognitive dysfunction, and 3-year mortality among ol...
Article
Objectives Symptom persistence weeks after laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) clearance is a relatively common long-term complication of Coronavirus disease 2019 (COVID-19). Little is known about this phenomenon in older adults. The present study aimed at determining the prevalence of persistent sympto...
Article
Objectives To evaluate, in a cohort of adults aged ≥80 years, the overlapping effect of clinical severity, comorbidities, cognitive impairment, and frailty, for the in-hospital death risk stratification of COVID-19 older patients since emergency department (ED) admission. Design Single-center prospective observational cohort study. Setting and Pa...
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We explored the potential link between chronic inflammatory arthritis and COVID-19 pathogenic and resolving macrophage pathways and their role in COVID-19 pathogenesis. We found that bronchoalveolar lavage fluid (BALF) macrophage clusters FCN1+ and FCN1+SPP1+ predominant in severe COVID-19 were transcriptionally related to synovial tissue macrophag...
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Introduction The present study investigated the association between protein intake and cognitive function in older adults. Methods We performed a literature search with no restriction on publication year in MEDLINE, SCOPUS, CINAHL, AgeLine from inception up to October 2020. Observational studies that investigated as a primary or secondary outcome...
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Objective: Since December 2019, new pneumonia of unknown aetiology broke out in Wuhan, Hubei province, China. Subsequently, a virus, later named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as the causative agent of the disease. Currently, the epidemic has spread all over the world. The most common manifestations...
Chapter
This chapter reviews the effect of three classes of drugs (cardiovascular, hormone, and metabolic agents) on sarcopenia and muscular outcomes in older adults. For each class of medications, it describes the evidence from clinical studies and the biological plausibility. The effects of angiotensin II converting enzyme (ACE) inhibitors on muscle func...
Chapter
Beta-hydroxy-beta-methylbutyrate (HMB) is synthesized from leucine in two separate steps occurring in liver and muscle cell. The HMB supplementation has been generally used as ergogenic supplement usually combined with exercise training. The HMB use in older subjects has gained in interest to reduce sarcopenia and increase muscle function. HMB has...
Article
Background: Cardiac structure and function change with age. The higher prevalence of left ventricular hypertrophy (LVH) with concentric remodeling is indicative of a typical geometric pattern of aging associated with a higher cardiovascular (CV) risk and diseases. The recent associations found between low left ventricular and skeletal mass in olde...
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Background and aims: To assess experts' preference for sarcopenia outcomes. Methods: A discrete-choice experiment was conducted among 37 experts (medical doctors and researchers) from different countries around the world. In the survey, they were repetitively asked to choose which one of two hypothetical patients suffering from sarcopenia deserv...
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The genetic basis of Lewy body dementia (LBD) is not well understood. Here, we performed whole-genome sequencing in large cohorts of LBD cases and neurologically healthy controls to study the genetic architecture of this understudied form of dementia, and to generate a resource for the scientific community. Genome-wide association analysis identifi...
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The genetic basis of Lewy body dementia (LBD) is not well understood. Here, we performed whole-genome sequencing in large cohorts of LBD cases and neurologically healthy controls to study the genetic architecture of this understudied form of dementia, and to generate a resource for the scientific community. Genome-wide association analysis identifi...
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Background The “Sarcopenia and Physical Frailty in Older People: Multicomponent Treatment Strategies” (SPRINTT) project sponsored a multi-center randomized controlled trial (RCT) with the objective to determine the effect of physical activity and nutrition intervention for prevention of mobility disability in community-dwelling frail older European...
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Weather and the susceptibility of children to SARS‐CoV‐2 infection is still a debated question and currently a hot topic, particularly in view of important decisions regarding opening schools. Therefore, we performed this prospective analysis of anti‐SARS‐CoV‐2 IgG antibodies in children with known household exposure to SARS‐CoV‐2 and compared thei...
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Aim The present study investigated if hypertension, blood pressure, and antihypertensive therapy were significantly associated with frailty status in community-dwelling older adults. In addition, we tested if such associations were consistent across different frailty instruments. Material and methods Two-hundred older adults were enrolled in the s...