Graziano Onder

Graziano Onder
Catholic University of the Sacred Heart | UNICATT · Department of Geriatrics

About

612
Publications
104,434
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30,320
Citations
Citations since 2016
264 Research Items
18046 Citations
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Introduction
Skills and Expertise

Publications

Publications (612)
Article
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Objectives To assess in the Italian general adult population the trends of blood pressure (BP) and prevalence of raised BP (RBP), hypertension and its control in order to evaluate population health and care, and the achievement of an RBP 25% relative reduction as recommended by the WHO at population level. Design Results comparison of health exami...
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Purpose: To provide an overview of the current deprescribing attitudes, practices, and approaches of geriatricians and geriatricians-in-training across Europe. Methods: An online survey was disseminated among European geriatricians and geriatricians-in-training. The survey comprised Likert scale and multiple-choice questions on deprescribing appro...
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Introduction In hospitalized patients with COVID-19, bloodstream infections (BSI) are associated with high mortality and high antibiotic resistance rates. The aim of this study was to describe BSI etiology, antimicrobial resistance profile and risk factors in a sample of patients deceased with COVID-19 from the Italian National COVID-19 surveillanc...
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Background The COVID-19 pandemic caused an overabundance of valid and invalid information rapidly spread via traditional media, by internet and digital communication. Health Literacy (HL), as the ability to access, understand, appraise, apply health information, is fundamental for finding, interpreting, correctly using COVID-19 information. Method...
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Background In monitoring population health and the effectiveness of public health strategies, the body mass index (BMI) is often assessed within national surveys from self-reported height and weight rather than measured values. Using data collected within a recent health examination survey (HES), the discrepancies between self-reported and measured...
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Background Little is known on how frailty influences clinical outcomes in persons with specific multimorbidity patterns. Aims To investigate the interplay between multimorbidity and frailty in the association with mortality in older individuals living in nursing homes (NH). Methods We considered 4,131 NH residents aged 60 years and over, assessed...
Article
Objective: Type 2 diabetes may affect the humoral immune response after vaccination, but data concerning coronavirus disease 19 (COVID-19) vaccines are scarce. We evaluated the impact of diabetes on antibody response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in older residents of long-term care facilities (LTC...
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Background Nursing home (NH) residents suffered the greatest impact of the COVID-19 pandemic. Limited data are available on vaccine-induced immunity and on the protection ensured by a prior infection in this population. Aims The present study aims to monitor antibody levels and their persistence over a 6-month period in NH residents according to t...
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Background and objective: Prescribing cascades occur when a drug is prescribed to manage side effects of another drug, typically when a side effect is misinterpreted as a new condition. A consensus list of clinically important prescribing cascades that adversely affect older persons' health (i.e., where risks of the prescribing cascade usually exc...
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Background: Italy has witnessed high levels of COVID-19 deaths, mainly at the elderly age. We assessed the comorbidity and the biochemical profiles of consecutive patients ≤65 years of age to identify a potential risk profile for death. Methods: We retrospectively analyzed clinical data from consecutive hospitalized-for-COVID-19 patients ≤65 yea...
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Background Dysphagia is a frequent condition in older nursing home residents (NHRs) which may cause malnutrition and death. Nevertheless, its prevalence is still underestimated and there is still debate about the appropriateness and efficacy of artificial nutrition (AN) in subjects with severe dysphagia. The aim is to assess the prevalence of dysph...
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Background Despite the growing clinical relevance of Long-COVID, there is minimal information available on the organizational response of health services to this condition. Methods A national online survey of centers providing assistance for Long-COVID was implemented. Information collected included date of start of activity, target population, mo...
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Introduction: Data on frailty frequency are heterogeneous and mostly based on cross-sectional studies. Little is known about frailty development and progression over time. Our aim was to conduct a systematic analysis of frailty prevalence and incidence in a large cohort of older adults and to evaluate the association with incident disability, in o...
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Background Chronic cough (CC) is a burdensome health problem in adult and older people, with a major impact on quality of life. Its management is often troublesome, and many guidelines have been released. Notwithstanding, a proportion of cases still do not reach a definite diagnosis and resolutive treatment. A coordinated approach between different...
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Down syndrome (DS) is a neurodevelopmental disorder that is characterized by an accelerated aging process, frequently associated with the development of Alzheimer’s disease (AD). Previous studies evidenced that DS patients have various metabolic anomalies, easily measurable in their serum samples, although values that were found in DS patients were...
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Introduction: Dementia is common in nursing homes (NH) residents. Defining dementia comorbidities is instrumental to identify groups of persons with dementia that differ in terms of health trajectories and resources consumption. We performed a cross-sectional study to identify comorbidity patterns and their associated clinical, behavioral, and fun...
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Background Patients hospitalised for COVID-19 may present with or acquire bacterial or fungal infections that can affect the course of the disease. The aim of this study was to describe the microbiological characteristics of laboratory-confirmed infections in hospitalised patients with severe COVID-19. Methods We reviewed the hospital charts of a...
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Multimorbidity and polypharmacy are emerging health priorities and the care of persons with these conditions is complex and challenging. The aim of the present guidelines is to develop recommendations for the clinical management of persons with multimorbidity and/or polypharmacy and to provide evidence-based guidance to improve their quality of car...
Article
A third dose of mRNA COVID-19 vaccine dose restores high levels of anti-Spike IgG in nursing home residents. A longer interval between first and third dose does not impair immunogenicity.
Preprint
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Background Dysphagia is a frequent condition in older nursing home residents (NHRs) which may cause malnutrition and death. Nevertheless, its prevalence is still underestimated and there is still debate about the appropriateness and efficacy of artificial nutrition in subjects with severe dysphagia. The objective assesses the prevalence of dysphagi...
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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...
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Objective: To systematically review the evidence from randomized controlled trials comparing the effects of goal-oriented care against standard care for multimorbid adults. Data sources/study setting: The literature presenting the results of randomized trials assessing the outcomes of goal-oriented care compared with usual care for adults with m...
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Purpose Up to 26% of residents in nursing homes (NHs) are affected by cancer. Their care represents a challenge, because NHs are not usually considered a setting focused on oncologic management and care. The aim of this paper is to describe socio-demographic and clinical features of patients with cancer residing in European NHs. Methods Cross-sect...
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Background/Objectives Obesity is associated with an increased risk of noncommunicable diseases, such as diabetes, coronary heart disease, stroke, cancers, and conditions, including obstructive sleep apnea and osteoarthritis. Obesity is largely preventable, and halting its rise is one of the World Health Organization Global Action Plan for the Preve...
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Older adults are often affected by multiple chronic conditions and experience geriatric syndromes that may affect the risk/benefit profile of medications. Little is known about the use of such medications in the older population. This article describes medication use and costs in Italian adults aged ≥90 years. Data from the 2019 Pharmaceutical Pres...
Article
Aims: The present study sought to examine the effect of COVID-19 pandemic and lockdown measures on the prescription of sacubitril/valsartan in patients with Heart Failure (HF) in Italy. Methods and results: Data from AIFA monitoring registries were analysed. The sacubitril/valsartan monitoring registry is based on 6-month prescriptions. A monthl...
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The COVID-19 pandemic has changed routine care practice for older persons, especially in those with frailty living in long term care (LTC) facilities. Due to the high mortality rates of Nursing home (NH) residents during the first wave of the COVID-19 pandemic, priority for COVID-19 vaccinations was given to this vulnerable population. However, the...
Article
Objectives The aim was to characterize multimorbidity patterns in a large sample of older individuals living in nursing homes (NHs) and to investigate their association with mortality, also considering the effect of functional status. Design Observational and retrospective study. Setting and Participants We analyzed data on 4131 NH residents in I...
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Background: Pacemaker (PM) and implantable cardioverter defibrillators (ICD) are equipped with a magnetic sensor activated by external application of magnets to easily manage some functions of these devices. If activated inadvertently or outside a controlled environment and without the supervision of clinical personnel, this magnetic mode introduc...
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Italy was a country severely hit by the first coronavirus disease 2019 (COVID-19) pandemic wave in early 2020. Mortality studies have focused on the overall excess mortality observed during the pandemic. This paper investigates the cause-specific mortality in Italy from March 2020 to April 2020 and the variation in mortality rates compared with tho...
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Background We evaluated whether frailty and multimorbidity predict in-hospital mortality in patients with COVID-19 beyond chronological age. Methods 165 patients admitted from March 8th to April 17th, 2020, with COVID-19 in an acute geriatric ward in Italy were included. Pre-disease frailty was assessed with the Clinical Frailty Scale (CFS). Multi...
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Recognizing frailty in primary care is important to implement personalized care pathways and for prognostication. The aim of this study was to build and validate a frailty index based on routinely collected primary care data in Italy. We used clinical data from 308,280 Italian primary care patients 60+ with at least 5 years of follow-up, part of th...
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Background: Hospitalized older patients are particularly exposed to adverse health outcomes. Objective: In this study, we aimed at investigating the prognostic interactions between disability in basic activities of daily living (BADL), cognitive impairment, low handgrip strength, anticholinergic cognitive burden (ACB), and depression on 1-year mort...
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Background Accurate identification of older persons at risk of unplanned hospital visits can facilitate preventive interventions. Several risk scores have been developed to identify older adults at risk of unplanned hospital visits. It is unclear whether risk scores developed in one country, perform as well in another. This study validates seven ri...
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Background 1.5–8% of older adults live in nursing homes (NHs), presenting a high prevalence of frailty and polypharmacy. Aims To investigate the association of frailty with polypharmacy and drug prescription patterns in a sample of European Nursing Home (NH) residents. Methods Cross-sectional study based on the data from the Services and Health f...
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Background Policies to combat the COVID-19 pandemic have disrupted the screening, diagnosis, treatment, and monitoring of noncommunicable (NCD) patients while affecting NCD prevention and risk factor control. Aims To discuss how the first wave of the COVID-19 pandemic affected the health management of NCD patients, identify which aspects should be...
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The article was originally published electronically on the publisher’s internet portal on 07 August 2020 without open access. With the author(s)’ decision to opt for Open Choice the copyright of the article changed on 14 May 2021 to © The Author(s) 2021 and the article is forthwith distributed under a Creative Commons Attribution 4.0 International...
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Background Health outcomes of older subjects with hip fracture (HF) may be negatively influenced by multiple comorbidities and frailty. An integrated multidisciplinary approach (i.e. the orthogeriatric model) is, therefore, highly recommended, but its implementation in clinical practice suffers from the lack of shared management protocols and poor...
Chapter
Sarcopenia is the age-related decline in muscle mass and strength and is associated with increased risk of adverse health outcomes including falls, morbidity, loss of independence, disability and mortality. Despite important efforts to find effective pharmacological treatment, to this date there are no official approved drugs for the treatment of s...
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Background: the aim of this study was to examine the cross-sectional and longitudinal associations of different multimorbidity patterns with physical frailty in older adults. Methods: we used data from the Swedish National study on Aging and Care in Kungsholmen to generate a physical frailty measure, and clusters of participants with similar mul...
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COVID-19 dramatically influenced mortality worldwide, in Italy as well, the first European country to experience the Sars-Cov2 epidemic. Many countries reported a two-wave pattern of COVID-19 deaths; however, studies comparing the two waves are limited. The objective of the study was to compare all-cause excess mortality between the two waves that...
Article
Background Health instability, measured with the Changes in Health and End-stage disease Signs and Symptoms (CHESS) scale, predicts hospitalizations and mortality in home care clients. Heart failure (HF) is also common among home care clients. We seek to understand how HF contributes to the odds of death, hospitalization or worsening health among n...
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Background Most COVID-19-related deaths have occurred in older persons with comorbidities. Specific patterns of comorbidities related to COVID-19 deaths have not been investigated. Methods A random sample of 6085 individuals in Italy who died in-hospital with confirmed COVID-19 between February and December 2020 were included. Observed to expected...
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Background Frailty is increasingly reported among older adults with cardiovascular diseases and it has been demonstrated to increase negative health outcomes and mortality. To date, no systematic review of the evidence is available regarding the association between frailty and ischemic heart disease (IHD). We performed a systematic review of litera...
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This study aims to benchmark mean societal costs per client in different home care models and to describe characteristics of home care models with the lowest societal costs. In this prospective longitudinal study in 6 European countries, 6-month societal costs of resource utilization of 2060 older home care clients were estimated. Three care models...
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Objectives: Drugs with anticholinergic properties are associated with an increased prevalence of delirium, especially in older persons. The aim of this study was to evaluate the association between the use of this class of drugs in nursing home (NH) patients and prevalence of delirium, particularly in people with dementia. Design: Cross-sectiona...
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Polypharmacy is very common in older adults and increases the risk of inappropriate and unsafe prescribing for older adults. Older adults, particularly women (who make up the majority of this age group), are at the greatest risk for drug-related harm. Therefore, optimising drug prescribing for older people is very important. Identifying potentially...
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Background: People with Down syndrome (DS) are at high risk to develop Alzheimer's disease dementia (AD). Behavioral and psychological symptoms of dementia (BPSD) are common and may also serve as early signals for dementia. However, comprehensive evaluation scales for BPSD, adapted to DS, are lacking. Therefore, we previously developed the BPSD-DS...
Article
Objective Behavioral and psychological symptoms of dementia (BPSD) place a heavy burden on patients as well as caregivers. Recently, pain was identified as an important determinant of BPSD. However, it is not yet known what influence sex has on BPSD and pain. Thus, the present study aimed to identify possible associations between BPSD, pain, and se...
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...
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Background Benzodiazepines (BZDs) and Z-drugs have high potential for developing frequent adverse drug events in older adults (e.g., psychomotor sedation, drug-related dementia, deliria, drug dependence, etc.). Knowledge of the prevalence and patterns of the use of BZDs/Z-drugs in vulnerable older patients is important in order to prevent and reduc...
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Background There is concern about the increased risk for SARS-CoV-2 infection, COVID-19 severe outcomes and disparity of care among patients with a psychiatric disorder (PD). Based on the Italian COVID-19 death surveillance, which collects data from all the hospitals throughout the country, we aimed to describe clinical features and care pathway of...
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Objective Explicit screening tools and implicit evaluation methods have been developed to assist healthcare professionals in the management of pharmacotherapy in older adults. As prescribing habits and locally available medications vary considerably between countries, guides tailored to the needs of specific regions may be required. We aimed to rep...
Article
PurposeTo describe the objectives, methods and expected impact of an international consortium (iKASCADE) whose purpose is to improve drug safety for older adults by addressing prescribing cascades through a sex and gender lens.Methods To create a comprehensive, internationally relevant inventory of prescribing cascades affecting older adults, the c...
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Objectives To investigate caregivers and patients characteristics related to different dimensions of burden in Parkinson’s disease (PD).Methods55 pairs of PD patients and caregivers were recruited. The burden was evaluated with the Caregiver Burden Inventory (CBI). Multivariate analysis was applied to evaluate the impact of caregivers’ and patients...
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Residents of long-term care (LTC) homes have suffered disproportionately during the Covid-19 pandemic, from the virus itself and often from the imposition of lockdown measures. Provincial Geriatrics Leadership Ontario, in collaboration with interRAI and the International Federation on Aging, hosted a virtual Town Hall on September 25 2020. The purp...
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Background: In Italy, during the first epidemic wave of 2020, the peak of coronavirus disease 2019 (COVID-19) mortality was reached at the end of March. Afterward, a progressive reduction was observed until much lower figures were reached during the summer, resulting from the contained circulation of SARS-CoV-2. This study aimed to determine if and...