Correlation between the bone mass, psychometric performances, and the levels of autonomy and autosufficiency in an elderly Italian population above 80 years of age

This study was aimed at evaluating the correlation between bone mineral den sity (BMD) and the psychophysical health status in an elderly study populat ion (62 subjects, mean age 84 +/- 5 years, 21 males and 41 females), instit utionalized (Group A) in various structures of Pozzallo, a marine locality of the Ragusa Province in Sicily. BMD was measured by using ultrasonography of the calcanear area (T-score, Z-score, stiffness). The alterations of th e cognitive and affective spheres as well as the levels of autonomy and aut osufficiency were estimated by means of psychometric scales like mini-menta l state examination (MMSE), geriatric depression scale (GDS), activities of daily living (ADL) and instrumental activities of daily living (IADL). Oth er biological, social and health-related factors, such as age, sex, body we ight and height, nutritional and drug-taking habits, physical activity and previous pathologies, were also considered. These variables were compared t o those obtained in a similar, but non-institutionalized controls (Group B) of 63 subjects (mean age 85 +/- 2 years, 27 males and 36 females), being s imilar in number and age distribution, frequenting the Geriatric Day Center of the same locality. Statistical analysis revealed significant difference s between Groups A and B: the BMD was considerably lower, but also the cogn itive and affective performances were strongly reduced in Group A. These fi ndings can be attributed to decreased psychosensorial stimuli and lost inte rest of the patients in Group A, resulting in a lower physical activity, ac companying the depressive state, and may represent the first signs of a dec reased intellectual performance, which can later be transformed into dement ia. The functional abilities and the levels of autonomy are also reduced, r isking the loss of autosufficiency. Also, the drug usage was different in G roup A: more sedative-hypnotics and anticoagulants were consumed. As regard s the polymorbidities, arterial hypertension and consequent chronic renal f ailure, hepatopathies and thyreopathies were most frequent, these latter tw o being more frequent in the Group A. (C) 2001 Elsevier Science Ireland Ltd . All rights reserved.