Leader: Antonella Zambon (UNIMIB); Other collaborator(s): UNIMIB, UNIBA, CNR
Analyzing large existing databases on community dwelling older adults, i.e. the English Longitudinal Study on Aging (ELSA), The Irish LongituDinal study on Ageing (TILDA), the Finnish Geriatric Intervention Study (FINGER), the Italian Longitudinal Study on Ageing (ILSA), the InCHIANTI study, the italian MULTIPLAT_AGE study, NeuroGate CMN-UniBa, SHARE database, INVECE.AB longitudinal study, etc. we will get information on multi-component interventions able to promote a successful aging and potentially prevent chronic diseases and cognitive decline in older community-dwelling subjects stratified according to their frailty and clinical risk factors for functional and cognitive decline and Non-Communicable Diseases (NCDs). Meta-analytic studies of the effectiveness of cognitive interventions to promote healthy aging will be also included. We will also analyze potential biomarkers that should allow the identification of those older individuals who are experiencing accelerated functional and/or cognitive decline and therefore are at high risk of developing multimorbidity and disability. Finally, a survey will be launched to evaluate the diffusion of multicomponent interventions in clinical practice and the physicains' attitude towards them.
Brief description of the activities and of the intermediate results
Three systematic reviews with meta-analysis (MA) were conducted to evaluate:
After meetings with experts from various disciplines (neurologists, geriatricians, etc.) a consensus was reached about the various search strings. For first MA 36 articles were eligible for inclusion in the analysis. Thirtytwo studies were in community-dwelling setting, 3 in hospital setting and only 1 in nursing home setting. Only the most frequently reported functional and cognitive outcomes were meta-analyzed: the short physical performance battery [SPPB], the timed up and go test [TUG], the Montreal Cognitive Assessment [MoCA]
scale, and the mini-mental state examination test [MMSE]. Improvements in functional and cognitive status in favor of the multi-component intervention compared to the control group were reported for all the outcomes analyzed. However, the only outcome who reached a statistically significant result was the TUG test.
For the second and third MA, we tried to classify biomarkers in different categories. The first category studied was "plasmatic biomarker". After initial screening, 266 articles were included: 84 articles for the second MA, and 107 articles for the third. The analysis of the articles regarding the association between biomarkers and functional and cognitive decline are currently ongoing.
Main policy, industrial and scientific implications
To address the expected impact of different type of multi-intervention approach of ouctome of interest.
These results will be useful in eventual ongoing modification of clinical trials
Activity completed.
Manuscript in preparation.