Rondanelli M, Sarra S, Antoniello N, et al. No effect of atypical antipsychotic drugs on weight gain and risk of developing type II diabetes or lipid abnormalities among nursing home elderly patients with Alzheimer's disease
University of Pavia, Ticinum, Lombardy, Italy Minerva medica
(Impact Factor: 0.91).
05/2006; 97(2):147-51. DOI: 10.1016/S0197-4580(04)80658-4
Weight gain and the risk of developing alterations in lipid and glucose metabolism are possible side effects of atypical antipsychotic therapy in young and adult patients. The objective of this study was to examine whether elderly patients with Alzheimer's disease (AD) gain weight or develop disturbances in lipid and glucose metabolism while being treated with atypical antipsychotic drugs.
This retrospective study identified 36 out of 99 patients (mean age: 75.4+/-7.1, 27 female, 9 males) who were taking risperidone (N=9, mean dosage: 1.42+/-0.49 mg/day), olanzapine (N=17: 4.42+/-1.10 mg/day), and quetiapine (N=10: 75+/-27 mg/day) over a 12 months period. Anthropometric parameters, mini nutritional assessment (MNA), total, HDL and LDL cholesterol, triglycerides, glycaemia were assessed at baseline (T0) and 12 (T1) months.
Body weight (BMI=23+/-5 vs 23+/-5), MNA score (21+/-4 vs 21+/-4), blood glucose (5.7+/-2 vs 4.9+/-0.9 mmol/L) or total cholesterol (4.9+/-1.1 vs 4.3+/-0.7 mmol/L), HDL cholesterol (1.3+/-0.3 vs 1.1+/-0.3 mmol/L), LDL cholesterol (3.3+/-0.7 vs 3 +/- 0.4 mmol/L), triglycerides (1.1+/-0 vs 1+/-0.3 mmol/L) did not reveal treatment-induced changes in the patients evaluated (T0 vs T1).
These results suggest that the treatment with low-dose of atypical antipsychotic drugs is not associated with weight gain or increase the risk of developing type II diabetes or abnormalities of lipid metabolism among elderly patients with AD, who were residing in long-term nursing home.
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ABSTRACT: In economically advanced countries, protein-energy malnutrition (PEM) occurs almost exclusively in the elderly. This condition, caused by organic disturbances or by psychological, social and cultural factors, can lead to a significant increase of morbidity and mortality. The correct and timely diagnosis of PEM, followed by adequate therapeutic and nutritional interventions, results in a significant improvement of the general condition of the patient. This paper reviews the principal multi-dimensional tools to assess nutritional status in the elderly, with particular reference to the Mini Nutritional Assessment (MNA). It also reviews the specific literature on applications of this method to Alzheimer's Disease (AD) and presents unpublished data concerning malnutrition in a sample of patients with mild-moderate AD. Nei Paesi economicamente avanzati, la malnutrizione proteico-energetica (PEM) si manifesta quasi esclusivamente nella popolazione senile. Tale condizione è determinata da cause organiche, o da fattori di natura psicologica, sociale e culturale, e può indurre un incremento significativo della morbilità e della mortalità. La diagnosi corretta e tempestiva della PEM, seguita da adeguati interventi terapeutici e nutrizionali, produce significativi miglioramenti sulle condizioni generali del paziente. Il presente lavoro offre una rassegna dei principali strumenti multi-dimensionali per la valutazione dello stato nutrizionale nell'anziano, con particolare riferimento al Mini Nutritional Assessment (MNA). Viene inoltre presentata una rassegna della letteratura specifica riguardante le applicazioni di tale metodica nella malattia di Alzheimer (AD), con la presentazione di dati inediti relativi alla condizione di malnutrizione in un campione di pazienti AD in stadio lieve-moderato.
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ABSTRACT: We present a numerical approach to evaluate the transfer function matrices of a periodic system corresponding to lifted state-space representations as constant systems. The proposed pole-zero method determines each entry of the transfer function matrix in a minimal zeros-poles-gain representation. A basic computation is the minimal realization of special single-input single-output periodic systems, for which both balancing-related as well as orthogonal periodic Kalman forms based algorithms can be employed. The main computational ingredient to compute poles is the extended periodic real Schur form of a periodic matrix. This form also underlies the solution of periodic Lyapunov equations when computing minimal realizations via balancing-related techniques. To compute zeros and gains, numerically stable fast algorithms are proposed, which are specially tailored to particular single-input single-output periodic systems. The new method relies exclusively on reliable numerical computations and is well suited for robust software implementations. Numerical examples computed with Matlab-based implementations show the applicability of the proposed method to high-order periodic systems.
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