Geriatric Care <p><strong>Geriatric Care</strong> is the official journal of <a href="" target="_blank" rel="noopener">SIGOT</a> (<em>Società Italiana di Geriatria Ospedale e Territorio</em>), it is a recently-launched Open Access journal that seeks to publish high quality, peer-reviewed manuscripts dealing with the Geriatric Care in the different settings including the hospitals, residential services, nursing homes and home-care services for the elderly. The aim of the journal is to stimulate debate and dissemination of knowledge in the geriatric field in order to ameliorate efficacy, effectiveness and efficiency of interventions to improve health outcomes of the elderly people. <strong>Geriatric Care</strong> publishes contributions of epidemiology, pathophysiology and clinical assessment, management and treatments of the diseases of the older people, as well as health education and environmental health, hospital-residential-homecare management of the elderly including ethics, social and communication sciences, e-health and health technology assessment. Contributions on innovative topics of biological and genetics research, gender and disparity issues, as well as high-technology supports, i.e. domotics and robotics for the elderly, are welcome. <strong>Geriatric Care</strong> publishes <em>Original Articles</em>, <em>Review Articles</em>, <em>Brief Reports</em>, <em>Case Reports</em>, <em>Statement Reports</em> and <em>Editorials</em>.</p> <p>This journal does not apply charge for publication to Authors as it is supported by institutional funds.</p> PAGEPress Scientific Publications, Pavia, Italy en-US Geriatric Care 2465-1109 <p><strong>PAGEPress</strong> has chosen to apply the&nbsp;<a href="" target="_blank" rel="noopener"><strong>Creative Commons Attribution NonCommercial 4.0 International License</strong></a>&nbsp;(CC BY-NC 4.0) to all manuscripts to be published.<br><br> An Open Access Publication is one that meets the following two conditions:</p> <ol> <li>the author(s) and copyright holder(s) grant(s) to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship, as well as the right to make small numbers of printed copies for their personal use.</li> <li>a complete version of the work and all supplemental materials, including a copy of the permission as stated above, in a suitable standard electronic format is deposited immediately upon initial publication in at least one online repository that is supported by an academic institution, scholarly society, government agency, or other well-established organization that seeks to enable open access, unrestricted distribution, interoperability, and long-term archiving.</li> </ol> <p>Authors who publish with this journal agree to the following terms:</p> <ol> <li>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li> <li>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li> <li>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.</li> </ol> Development of a smart post-hospitalization facility for older people by using domotics, robotics, and automated tele-monitoring <p>Recent studies showed that about the 8% of beds are occupied by patients who experience a delayed hospital discharge (DHD). This is attributed to a delay in the arrangement of home-care assistance or in admission to long-term care facilities. Recently a lot of technologies have been developed to improve caring and monitoring of older people. The aim of this study is to design, implement and test a prototype of a technology based post-hospitalization facility for older people at risk of DHD by using domotics, robotics and wearable sensors for tele-monitoring. A sensorised posthospitalization facility has been built inside the hospital. Thirty-five healthy volunteers aged from 20 to 82 years were recruited. Clinical and functional assessment, <em>i.e.</em> motility index (MI), and human-robot interaction satisfaction were measured. A significant correlation was observed between automatic MI and the Gait Speed, the time sit-to-stand, and the Timed Up and Go test. Domotics, robotics and technology-based telemonitoring may represent a new way to assess patient’s autonomy and functional and clinical conditions in an ecological way, reproducing as much as possible a real life at home.</p> Carlotta Patrone Alberto Cella Chiara Martini Silvia Pericu Rosetta Femia Annalisa Barla Claudia Porfirione Matteo Puntoni Nicola Veronese Francesca Odone Niccolò Casiddu Gian Andrea Rollandi Alessandro Verri Alberto Pilotto ##submission.copyrightStatement## 2019-04-19 2019-04-19 5 1 10.4081/gc.2019.8122 Aging changes complexity of heart rate dynamics assessed by entropy and Lyapunov exponent analysis <p>In recent years, many research groups are trying to quantify the physiological signals of an individual, proposing new models to assess the complex dynamics of biological control systems. Indeed, life coincides with the good handling of the structures in the organism and of physiological control mechanisms, while disease and death coincide with the loss of structure and of coordinated functions. The homeodynamic systems which normally govern health are the same that cause pathological events when activated inadequately, or rather, when the balance between order and chaos of the elementary physiological processes is no longer effectively controlled in relation to any type of stress, both external and internal to the body. In a complex system, loss or alteration of communication between physiological signals means pathology. In this paper a signal analysis method based on Entropy (E), Lyapunov exponent (1), Median Absolute Deviation (MAD), Multiscale Entropy (MSE), is proposed to estimate the complexity of long-range temporal correlation heart rate (HR) time series for an elderly person and a young person both healthy. These new methods could improve overall understanding of the physiological system of the human organism, by adopting new models and experimental paradigms, such as those of fractality and entropy, who have the ability to direct from an <em>organ medicine</em> to a <em>modern systemic medicine.</em></p> Roberto Siciliano Giuseppe Agapito Sarah Siciliano Filippo Luca Fimognari ##submission.copyrightStatement## 2019-04-17 2019-04-17 5 1 10.4081/gc.2019.8038 The role of healthy nutrition and diet in the prevention of non-communicable diseases among the aged <p>Non-communicable diseases (NCDs) kill approximately 41 million individuals every year, proportional to 71% of all deaths universally. This paper discuses the role of healthy nutrition and diet in the prevention of non-communicable diseases among the aged. It is a theoretical research in which Non-communicable diseases and the aged was discussed, and researched backed nutritional recommendations for the prevention of common non-communicable diseases, and other geriatric illnesses was extensively discussed under; Increment in vegetable and fruit consumption, Lessening of saturated fat intake, Increment in dietary fiber, Lessening of dietary sodium intake, Increment in dietary potassium consumption and reduction in alcohol consumption. It was concluded that healthy nutrition can well help in the prevention of non-communicable and chronic diseases among aged, therefore, healthy nutrition should be a preferred strategy tool in the prevention of non-communicable and chronic diseases among this age group. It was however recommended that; keeping up of good weight, increasing of vegetable and natural fruits product consumption, reduction of saturated fat consumption, increasing of dietary fiber consumption, decrease in dietary sodium and increment of dietary potassium intake, and reducing the rate of alcohol use; all helps in the prevention of non-communicable disease and other geriatric illnesses affecting the aged.</p> <p>&nbsp;</p> Israel Ayenigbara ##submission.copyrightStatement## 2019-04-17 2019-04-17 5 1 10.4081/gc.2019.7961 Sarcopenia in the elderly: from clinical aspects to therapeutic options <p>Sarcopenia is a major contributor to the risk of physical frailty, functional decline, poor health-related quality of life and premature death in older people. Sarcopenia can be considered a geriatric syndrome. The term sarcopenia indicates the loss of muscle mass that accompanies aging. Muscle mass declines with aging process with differences between subjects in relation to the presence of chronic diseases, to lifestyles habits (mainly diet and physical activity), to cognitive status. Sarcopenia in the elderly is associated with poor health outcomes, such as falls, disability, loss of independence, and mortality; however, it is potentially treatable if recognized and intervened early. The prevalence of sarcopenia rates between 5% and 13% in community-dwelling older people aged 65 years and over, and is higher in those 80 years and older (20-25%). The cause of sarcopenia is generally thought to be multifactorial, with environmental causes, disease triggers, inflammatory pathway activation, and a large number of cellular and biochemical abnormalities. Resistance training and amino acid supplementation are a recommended practice for the prevention of sarcopenia. The essential elements for the management of the sarcopenic patient are the recognition of a condition of frailty, an accurate multidimensional geriatric assessment, with attention to cognitive problems, mood, functional problems, living conditions, using standardized instruments. Combining exercise with some pharmacological compounds such as β- Hydroxy-β-methylbutyrate (HMB) and dietary supplements (including proteins, aminoacids and vitamin D) may exert a beneficial effect on older adults thus influencing the progress to sarcopenia. The recommended daily amount of protein is greater for older people. Vitamin D and leucine enrichment seems mandatory in order to improve muscle mass and lowerextremity function among sarcopenic older adults. There are some evidences that collagen peptides in this setting might be even superior to whey protein in promoting muscle growth and increasing the mobility.</p> Angelo Bianchetti Andrea Novelli ##submission.copyrightStatement## 2019-04-24 2019-04-24 5 1 10.4081/gc.2019.8033 Toxic epidermic necrolysis by allopurinol: a case report <p>Toxic epidermal necrolysis (TEN) or Lyell’s syndrome is a rare but serious potentially fatal autoimmune dermatologic disease. It is characterized by cutaneous damage due to apoptosis of the keratinocytes with consequent dermo-epidermal separation for a &gt;30% extension of the body surface, associated with mucosal lesions. It is due to the activation of the immune system, often following the intake of potentially toxic drugs [antibiotics, antiepileptics, non-steroidal antinflammatory drugs (NSAIDs), allopurinol] or after infection with herpetic viruses or mycoplasma. We describe the case of an 82- year-old man starting therapy of Allopurinol for hyperuricemia. After four days the patient shows an extensive erythematous rash localized to the trunk and upper limbs. The following day the rash also involves the face, tending to the confluence and after another two days, the macules turn into de-epithelized areas because of dermo-epidermal separation and the lesions involve the oral and ocular mucosa, causing dysphagia and difficulty in speaking. He was treated with steroid and antihistamine therapy, suspending the previously undertaken therapy with antibiotic and Allopurinol.</p> Rosa Paola Cerra Alberto Castagna Laura Greco Rosaria Anna Galea Maria Lucia Citraro Carmen Ruberto Giuseppe Coppolino Giovanni Ruotolo ##submission.copyrightStatement## 2019-04-18 2019-04-18 5 1 10.4081/gc.2019.7958 Persistent bradycardia after hypoglycaemia: a case report and a brief literature review <p>Hypoglycaemia can cause cardiac arrhythmias such as QT interval prolongation and ventricular arrhythmias. Supraventricular arrhythmias and sinus bradycardia were rarely reported. We present the clinical case of an 84- year-old man who developed a persistent bradycardia after a hypoglycaemic episode. After restoration of normoglycaemia, bradycardia persisted for almost eighteen hours, without QT prolongation or any symptoms. Hypoglycaemia is an unusual cause of bradyarrhytmias mainly mediated by neurologic and endocrine systems. Our clinical case supports recent recommendations for more relaxed inpatient glycaemic targets in frail older adults who may be particularly vulnerable to hypoglycaemia and its consequences.</p> Beatrice Gasperini Pierpaolo Lamanna Rocco Serra Roberto Montanari Antonio Cherubini Emma Espinosa ##submission.copyrightStatement## 2019-04-18 2019-04-18 5 1 10.4081/gc.2019.7670