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Ambrosini E, Cid M, de Isla CG, Salamanca P, Borghese NA, Ferrante S, Caielli M, Milis M, Loizou C, Azzolino D, Damanti S, Bertagnoli L, Cesari M, Moccia S. Automatic speech analysis to early detect functional cognitive decline in elderly population. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:212-216. [PMID: 31945880 DOI: 10.1109/embc.2019.8856768] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This study aimed at evaluating whether people with a normal cognitive function can be discriminated from subjects with a mild impairment of cognitive function based on a set of acoustic features derived from spontaneous speech. Voice recordings from 90 Italian subjects (age >65 years; group 1: 47 subjects with MMSE>26; group 2: 43 subjects with 20≤ MMSE ≤26) were collected. Voice samples were processed using a MATLAB-based custom software to derive a broad set of known acoustic features. Linear mixed model analyses were performed to select the features able to significantly distinguish between groups. The selected features (% of unvoiced segments, duration of unvoiced segments, % of voice breaks, speech rate, and duration of syllables), alone or in addition to age and years of education, were used to build a learning-based classifier. The leave-one-out cross validation was used for testing and the classifier accuracy was computed. When the voice features were used alone, an overall classification accuracy of 0.73 was achieved. When age and years of education were additionally used, the overall accuracy increased up to 0.80. These performances were lower than the accuracy of 0.86 found in a recent study. However, in that study the classification was based on several tasks, including more cognitive demanding tasks. Our results are encouraging because acoustic features, derived for the first time only from an ecologic continuous speech task, were able to discriminate people with a normal cognitive function from people with a mild cognitive decline. This study poses the basis for the development of a mobile application performing automatic voice analysis on-the-fly during phone calls, which might potentially support the detection of early signs of functional cognitive decline.
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Abstract
Hyponatremia is the most common electrolyte disorder. It may have serious consequences in asyntomatic patients with a mild disease. Therefore, an evaluation of unsual causes is of paramount importance. Polypharmacy is highly prevalent in older people and many drugs can cause hyponatremia as a collateral effect. In our retrospective analysis of geriatric medical records dated 2015 we found that 39 out of the 273 hospitalized patients had hyponatremia. Polipharmacy was highly prevalent, especially in hyponatremic patients. Non-steroidal anti-inflammatory drugs, which are seldom considered as a cause of hyponatremia were instead found to be associated to an increased risk of the disorder (adjustedOR 3.61, 95% CI 1 - 12.99, p = 0.05). In-hospital mortality was higher in patients with moderate or severe hyponatremia at hospital admission. Our study underlines the importance of considering rare but potentially reversible causes of hyponatremia, which can lead to serious consequences.
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Affiliation(s)
- S Damanti
- Dr. Sarah Damanti, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Geriatric Unit, Via Francesco Sforza 35, 20100 Milano, Italy; Phone: +390255035239, Fax Number: +390250320734,
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Damanti S, Azzolino D, Riva S, Cano A, Marcucci M. PoliFIT-INFOcus: A pilot study exploring how to promote physical activity in older people. Eur J Intern Med 2018; 57:e41-e42. [PMID: 30268575 DOI: 10.1016/j.ejim.2018.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 09/04/2018] [Indexed: 11/27/2022]
Affiliation(s)
- S Damanti
- Department of Clinical and Community Sciences, University of Milan, Italy; Geriatric Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - D Azzolino
- Geriatric Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - S Riva
- University of Wolverhampton, West Midlands, UK
| | - A Cano
- Department of Paediatrics, Obstetrics and Gynaecology, Universitat de Valência, Spain
| | - M Marcucci
- Geriatric Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
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Damanti S, Abbate C, Chiodini I, Cesari M, Nestola T, Belloni G, Mandelli C, Mari D, Lucchi T. Behaviour disorder caused by Cushing's syndrome in an older person. Age Ageing 2018; 47:905-906. [PMID: 30007289 DOI: 10.1093/ageing/afy102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 06/18/2018] [Indexed: 11/12/2022] Open
Abstract
An 81-year-old woman was hospitalised for behavioural disorders that had been progressively emerging over a period of few weeks. The symptoms appeared to worsen over time. A diagnosis of vascular dementia, complicated by psychosis, was initially hypothesised. The inefficacy of the antipsychotic/benzodiazepine medications used, along with the presence of hypertension, hypokalaemia and metabolic alkalosis (resistant to pharmacological attempts of correction), as well as the hirsutism and the development of several infections, led us to consider Cushing's syndrome. Endocrinological analysis suggested ectopic adrenocorticotropic hormone (ACTH) secretion. Although endogenous Cushing's syndrome is rare in older people, it should always be considered among the differential diagnosis of behavioural disorders.
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Affiliation(s)
- S Damanti
- Geriatric Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan.,Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - C Abbate
- Geriatric Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
| | - I Chiodini
- Department of Clinical and Community Sciences, University of Milan, Milan, Italy.,Unit for Bone Metabolism Diseases and Diabetes, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - M Cesari
- Geriatric Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan.,Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - T Nestola
- Fellowship in Geriatrics and Gerontology, University of Milan, Milan, Italy
| | - G Belloni
- Fellowship in Geriatrics and Gerontology, University of Milan, Milan, Italy
| | - C Mandelli
- Geriatric Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
| | - D Mari
- Geriatric Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
| | - T Lucchi
- Geriatric Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
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Azzolino D, Damanti S, Cesari M. Nutritional Status in Frail Cirrhotic Patients Undergoing Liver Transplantation. J Frailty Aging 2018; 7:196-197. [PMID: 30095152 DOI: 10.14283/jfa.2018.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The liver is the largest and most important metabolic organ, playing a pivotal role in the integration of biochemical pathways of carbohydrates, fats, proteins, and vitamins (1). End-stage liver disease (ESLD) has an important negative effect on nutritional status (2) and malnutrition is a common problem in patients waiting for liver transplantation (LT). The mean weight loss during ESLD is about 9 Kg and this contributes to further morbidities and mortality (3).
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Affiliation(s)
- D Azzolino
- Dr. Domenico Azzolino, Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Pace 9, 20122 Milan – Italy,
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Damanti S, Cortesi L, Pasina L, Mari D, Marcucci M. Does rhythm or rate control strategy influence anticoagulant treatment in older patients with atrial fibrillation? Data from REPOSI. Eur J Intern Med 2017; 44:e18-e19. [PMID: 28679484 DOI: 10.1016/j.ejim.2017.06.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 06/26/2017] [Accepted: 06/28/2017] [Indexed: 10/19/2022]
Affiliation(s)
- S Damanti
- Nutritional Sciences PhD, Università degli studi di Milano, Italy; Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - L Cortesi
- IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
| | - L Pasina
- IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
| | - D Mari
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M Marcucci
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
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Antoniazzi S, Chiarelli M, Venturini F, Nobili A, Pasina L, Casiraghi C, Damanti S, Periti G, Rossio R, Mannucci P. PS-060 Agreement between potential drug interactions identified by an electronic tool and clinical judgment: intercheck versus physicians. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Seravalle G, Carzaniga C, Attanasio R, Grassi G, Lonati L, Facchini C, Cozzi R, Fatti LM, Montini M, Vitale G, Sciortino G, Damanti S, Brambilla G, Cavagnini F, Mancia G, Scacchi M. Decreased adrenergic tone in acromegaly: evidence from direct recording of muscle sympathetic nerve activity. Clin Endocrinol (Oxf) 2012; 77:262-7. [PMID: 22233452 DOI: 10.1111/j.1365-2265.2012.04335.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Sympathovagal imbalance has been shown in acromegaly by indirect measurements of adrenergic tone. Data regarding direct measurement of sympathetic activity are lacking as yet. Aim of this study was to assess the adrenergic tone through direct recording of muscle sympathetic nerve activity (MSNA) in acromegalic patients. DESIGN Fifteen patients (age 26-66 years, eight women) with newly diagnosed active acromegaly without hyperprolactinaemia, pituitary hormone deficiencies, obstructive sleep apnoea and cardiac hypertrophy, and 15 healthy subjects matched for age, sex and body mass index were recruited. After evaluating anthropometric and echocardiographic parameters, anterior pituitary function, glucose and lipid metabolism, and measuring plasma leptin, direct recording of sympathetic outflow via the microneurographic technique was performed. RESULTS For similar anthropometric and metabolic parameters in patients and controls, HOMA index was significantly increased in the former (4·2 ± 2·39 vs 1·6 ± 0·19, P < 0·001). Surprisingly, this finding of insulin resistance was accompanied by a marked sympathetic inhibition (MSNA 18·3 ± 8·10 vs 37·3 ± 6·48 bursts/min, P < 0·0001, respectively in patients and controls). A reduction in plasma leptin (1·6 ± 1·04 vs 6·5 ± 2·01 μg/l, P < 0·0001) was also recorded in the patients. MSNA was positively correlated with leptin (P < 0·0001). CONCLUSIONS Newly diagnosed acromegalic patients without cardiac hypertrophy display a decreased sympathetic outflow in spite of insulin resistance. This finding might be related to hypoleptinaemia.
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Affiliation(s)
- G Seravalle
- Department of Cardiology, Ospedale San Luca IRCCS, Istituto Auxologico Italiano, Milan, Italy
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