Chapters authored
Non-Pharmacological Approaches in the Treatment of Dementia By Grazia D’Onofrio, Daniele Sancarlo, Davide Seripa, Francesco
Ricciardi, Francesco Giuliani, Francesco Panza and Antonio Greco
Currently, a pharmacological disease-modifying treatment for dementia is not available, but different non-pharmacological approaches appear to be useful. In this chapter, we describe traditional treatments such as cognitive and emotion-oriented interventions, sensory and multi-sensory stimulation interventions and also potentially alternative interesting options such as behavioural therapy, animal-assisted therapy, home-adaptation therapy and assistive technologies to support patient with dementia. Many non-pharmacological treatments have reported benefits in multiple research studies, but there is a need for further Randomized controlled trials (RCTs) with an adequate sample size to improve the strength of evidence in order to apply these approaches.
Part of the book: Update on Dementia
From Sarcopenia to Frailty: The Pathophysiological Basis and Potential Target Molecules of Intervention By Zhuowei Yu, Qingwei Ruan, Grazia D’Onofrio and Antonio Greco
Skeletal muscle is not only an endocrine organ but also one of core components of muscloskeletal system. Sarcopenia refers to a decline in the skeletal muscle mass and function. The former involves the size and number of changes in two types of myofibers, lower satellite cell density, and regeneration ability. The latter shows a loss of muscle strength. Frailty is a geriatric syndrome with multisystem impairment associated with increased vulnerability to stressors. Sarcopenia increases the risk of frailty and may be one of the major causes of physical frailty phenotype. Sarcopenia is also potentially associated with cognitive frailty phenotype. Aging might be the common underlying pathophysiology of sarcopenia and frailty. Therefore, there are some potential target molecules in aging-related signaling pathways that might be associated with sarcopenia and frailty. Nevertheless, sarcopenia can mediate metabolism and promote accelerate systemic aging, frailty, and age-related diseases by myokines in an endocrine manner. Lifestyle interventions (resistance exercise and dietary restriction) of gerontoscience are effective in the prevention of sarcopenia. Some pharmacological agents are registered in different phases of clinical trials for sarcopenia intervention. Phytochemicals, mTOR inhibitors, metformin and acarbose, NAD precursors, and sirtuin activators demonstrated that multiple target antiaging effects might also have preventive and therapeutic perspectives on sarcopenia and frailty.
Part of the book: Frailty and Sarcopenia
Old Age and Women’s Identity By Greco Francesca Romana, D’Onofrio Grazia, Seripa Davide, Ciccone Filomena, Sancarlo Daniele, Mangiacotti Antonio and Greco Monica
Female identity is a dynamic concept, and it has been a very discussed issue by contemporary cultural critic. How does old age affect identity construction and perception in elderly woman? Has feminine gender an impact in subjective well-being? Psychological changes of midlife women have been as conflicting as the idea that society has about them. Personality changes after young adulthood in women is a controversial matter. Erikson proposed that women might not develop identities in early adulthood as men do. In fact, he argued that women develop them later, in the context of an intimate relationship. Moreover, identity development appears to have important consequences for midlife well-being. For example, Vandewater et al. found that women’s midlife well-being was facilitated by earlier attainment of a well-articulated identity. In these situations accomplishment of developmentally earlier tasks (identity formation) sets the stage for later psychological health. Our work sheds additional light on how women live this period of life in terms of happiness and purpose of life.
Part of the book: Geriatric Medicine and Gerontology
The Complexity of Frailty: Psychological Mechanism and Therapeutic Interventions in Old People - A Narrative Review By Francesca Romana Greco and Grazia D’Onofrio
Aging is a complex and dynamic process. Senses become less sophisticated and negative life events increase. These factors combined with medical conditions contribute to develop a degenerative functional autonomy of the elderly. This clinical condition is known as frailty. However, there is a difference in the way people live their silver years in terms of happiness and their sense of autonomy. Both being and feeling frail represent two different drives of cognitive representations concerning how the elderly live their lives. In addition, other factors such as cognitive stimulation, assistive technology and physical activity can support frail people to achieve independence. This chapter aims to provide an overview on how the psychological environment may affect frailty, suggesting a possible role of new technology’s solutions and physical activity as therapeutic interventions.
Part of the book: Frailty in the Elderly
Sarcopenia: Technological Advances in Measurement and Rehabilitation By Letizia Lorusso, Luigi Esposito, Daniele Sancarlo and Grazia D’Onofrio
Sarcopenia is an important recently defined disease affecting people aged ≥65 years all over the world. Improving the assessment of loss of muscle mass is becoming mandatory. In this regard, various new technologies have been advanced. Although the gold standard is represented by magnetic resonance imaging (MRI) or magnetic resonance spectroscopy (MRS), computed tomography (CT) or dual-energy X-ray absorptiometry (DXA), followed by biological impedance analysis (BIA) compared with DXA, there are numerous correlations between sarcopenia and health domain of everyday life that must be investigated and addressed, trying to obtain the best possible outcome in the older population. In this review, we focused on all types of new technologies assessing loss of muscle mass, frailty, independence, walking, capacity to get dressed, and loss of balance or sleepiness in older people and that could improve the diagnosis of sarcopenia or the rehabilitation of sarcopenic patients to prevent possible accidents. Different technologies have been proposed to investigate the factors promoting the loss of muscle mass and weakness. Despite the standard EWGSOP 2019 guidelines defining a specific methodology for the diagnosis of sarcopenia, not all domains and devices were included, and new frontiers of prevention have been explored.
Part of the book: Frailty and Sarcopenia
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