Dr. Cristina PolidoriProfessor of Ageing Medicine and Geriatrics
Dr. Polidori is the head of the Ageing Clinical Research Unit of the Dpt II of Internal Medicine at the University Hospital of Cologne
M. Cristina Polidori is MD, Geriatrician and Gerontologist. She is the head of the Ageing Clinical Research Unit at the Dpt. II of Internal Medicine and Center for Molecular Medicine of the University Hospital of Cologne, Germany. Dr. Polidori's fields of expertise are 1) comprehensive geriatric assessment (CGA)-based prognosis and geriatric resource evaluation for personalized multidomain interventions in advanced age; 2) nutritional cognitive neuroscience; 3) translational challenges of bridging the gap between Geroscience and Geriatrics for healthy aging and 4) role of geriatric education for medical students and HealthCare professionals to improve the management of older adults. M. C. Polidori is Professor of Geriatrics, Professor of Physiological Chemistry and PI-Associate member of the Cluster of Excellence CECAD of the University of Cologne. She is author of over 130 peer-reviewed publications and co-editor of the first EuGMS textbook of Geriatrics Learning Geriatric Medicine. Dr. Polidori received numerous prestigious awards in the field of aging Research, is Honorary Fellow of the Royal College of Physicians and President of the German Association for Cognitive Training e.V.
Using the Multidimensional Prognostic Index (MPI) to improve cost-effectiveness of interventions in multimorbid frail older persons: results and final recommendations from the MPI_AGE European ProjectAging Clinical and Experimental Research
MPI_AGE is a European Union co-funded research project aimed to use the Multidimensional Prognostic Index (MPI), a validated Comprehensive Geriatric Assessment (CGA)-based prognostic tool, to develop predictive rules that guide clinical and management decisions in older people in different European countries. A series of international studies performed in different settings have shown that the MPI is useful to predict mortality and risk of hospitalization in community-dwelling older subjects at population level. Furthermore, studies performed in older people who underwent a CGA before admission to a nursing home or receiving homecare services showed that the MPI successfully identified groups of persons who could benefit, in terms of reduced mortality, of specific therapies such as statins in diabetes mellitus and coronary artery disease, anticoagulants in atrial fibrillation and antidementia drugs in cognitive decline. A prospective trial carried out in nine hospitals in Europe and Australia demonstrated that the MPI was able to predict not only in-hospital and long-term mortality, but also institutionalization, re-hospitalization and receiving homecare services during the one-year follow-up after hospital discharge. The project also explored the association between MPI and mortality in hospitalized older patients in need of complex procedures such as transcatheter aortic valve implantation or enteral tube feeding. Evidence from these studies has prompted the MPI_AGE Investigators to formulate recommendations for healthcare providers, policy makers and the general population which may help to improve the cost-effectiveness of appropriate health care interventions for older patients.
Frailty is an important factor determining a higher risk of adverse health outcomes in older adults. Although scientific community in the last two decades put a lot of effort for its definition, to date no consensus was reached on its assessment. The mainstream thinking describes frailty as a loss of physical functions or as accumulation of multiple deficits. Recently, a novel conceptual model of frailty has emerged based on the loss of harmonic interaction between multiple domains (also referred as dimensions) including genetic, biological, functional, cognitive, psychological and socio-economic domain that ultimately lead to homeostatic instability. Therefore, the multidimensional aspects of frailty condition could be captured by the comprehensive geriatric assessment (CGA) and its derived Multidimensional Prognostic Index (MPI). This instrument has been applied in different clinical settings and in several cohorts of older adults with specific acute and chronic diseases, showing always excellent accuracy in stratifying population according the mortality risk and other negative health outcomes, i.e. hospitalization, institutionalization or admission to homecare services. This MPI “plasticity” provides a single numerical prognostic index which could be helpful in clinical decision making for the management of frail older adults.
The increasing aging demographics never seen before is associated with the enormous challenge of dementia epidemics which urgently needs a paradigm shift in the approach to cognitive functions in health and disease. If on one hand the achievement or maintenance of a healthy lifestyle should be a medical priority, the early recognition of cognitive disturbances is mandatory. Cognitive impairment is not only associated with disability and lack of compliance and adherence, but also with dangerous geriatric syndromes such as instability, falls, and delirium.
Significance: Inflammation increases during the aging process. It is linked to mitochondrial dysfunction and increased reactive oxygen species (ROS) production. Mitochondrial macromolecules are critical targets of oxidative damage; they contribute to respiratory uncoupling with increased ROS production, redox stress, and a cycle of senescence, cytokine production, and impaired oxidative phosphorylation. Targeting the formation or accumulation of oxidized biomolecules, particularly oxidized lipids, in immune cells and mitochondria could be beneficial for age-related inflammation and comorbidities.
Older women are frailer, but less often die than men: a prospective study of older hospitalized peopleMaturitas
The association between frailty, mortality and sex is complex, but a limited literature is available on this topic, particularly for older hospitalized patients. Therefore, the objective of our study was to prospectively evaluate sex differences in frailty, assessed by the Multidimensional Prognostic Index (MPI) and mortality, institutionalization, and re-hospitalization in an international cohort of older people admitted to hospital.
Area of Expertise
Cluster of Excellence CECAD of the University of Cologne : PI-Associate member
Royal College of Physicians : Honorary Fellow
German Association for Cognitive Training e.V. : President
Medical Faculty of the University of Perugia, Italy :
Harvard Medical School and Whitaker Cardiovascular Institute : Neurology
University of Perugia, Italy : Philosophy