MARLON JULIANO ROMERO ALIBERTI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/66, Hospital das Clínicas, Faculdade de Medicina
LIM/66, Hospital das Clínicas, Faculdade de Medicina
2 resultados
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- Prospective GERiatric Observational (ProGERO) study: cohort design and preliminary results(2020) SARAIVA, Marcos Daniel; RANGEL, Luis Fernando; CUNHA, Julia Lusis Lassance; ROTTA, Thereza Cristina Ariza; DOURADINHO, Christian; KHAZAAL, Eugenia Jatene Bou; ALIBERTI, Marlon Juliano Romero; AVELINO-SILVA, Thiago Junqueira; APOLINARIO, Daniel; SUEMOTO, Claudia Kimie; JACOB-FILHO, WilsonBackgroundThe demographic changes in Brazil as a result of population aging is one of the fastest in the world. The far-reaching new challenges that come with a large older population are particularly disquieting in low- and middle-income countries (LMICs). Longitudinal studies must be completed in LMICs to investigate the social and biological determinants of aging and the consequences of such demographic changes in their context. Therefore, we designed the Prospective GERiatric Observational (ProGERO) study, a longitudinal study of outpatient older adults in SAo Paulo, Brazil, to collect data both on aging and chronic diseases, and investigate characteristics associated with adverse outcomes in this population.MethodsThe ProGERO study takes place in a geriatric outpatient clinic in the largest academic medical center in Latin America. We performed baseline health examinations in 2017 and will complete subsequent in-person visits every 3 years when new participants will also be recruited. We will use periodic telephone interviews to collect information on the outcomes of interest between in-person visits. The baseline evaluation included data on demographics, medical history, physical examination, and comprehensive geriatric assessment (CGA; including multimorbidity, medications, social support, functional status, cognition, depressive symptoms, nutritional status, pain assessment, frailty, gait speed, handgrip strength, and chair-stands test). We used a previously validated CGA-based model to rank participants according to mortality risk (low, medium, high). Our selected outcomes were falls, disability, health services utilization (emergency room visits and hospital admissions), institutionalization, and death. We will follow participants for at least 10 years.ResultsWe included 1336 participants with a mean age of 828years old. Overall, 70% were women, 31% were frail, and 43% had a Charlson comorbidity index score >= 3. According to our CGA-based model, the incidence of death in 1 year varied significantly across categories (low-risk=0.6%; medium-risk=7.4%; high-risk=17.5%; P<0.001).Conclusion The ProGERO study will provide detailed clinical data and explore the late-life trajectories of outpatient older patients during a follow-up period of at least 10years. Moreover, the study will substantially contribute to new information on the predictors of aging, senescence, and senility, particularly in frail and pre-frail outpatients from an LMIC city.
- Clinical characteristics and outcomes of COVID-19 patients with preexisting dementia: a large multicenter propensity-matched Brazilian cohort study(2024) BICALHO, Maria Aparecida Camargos; ALIBERTI, Marlon Juliano Romero; DELFINO-PEREIRA, Polianna; CHAGAS, Victor Schulthais; ROSA, Patryk Marques da Silva; PIRES, Magda Carvalho; RAMOS, Lucas Emanuel Ferreira; BEZERRA, Adriana Falangola Benjamin; FERES, Ana Beatriz de Castro; GOMES, Angelica Gomides dos Reis; BHERING, Angelinda Rezende; PESSOA, Bruno Porto; SILVA, Carla Thais Candida Alves da; CIMINI, Christiane Correa Rodrigues; SUEMOTO, Claudia Kimie; DIAS, Cristiana Andrade Coelho; CARAZAI, Daniela dos Reis; PONCE, Daniela; RIOS, Danyelle Romana Alves; MANENTI, Euler; ANSCHAU, Fernando; BATISTA, Joanna d'Arc Lyra; ALVARENGA, Joice Coutinho de; VIGUINI, Julia Avancini; ZANELLATO, Julia Mariot; RUGOLO, Juliana Machado; RUSCHEL, Karen Brasil; NASCIMENTO, Leticia do; MENEZES, Luanna Silva Monteiro; OLIVEIRA, Lucas Moyses Carvalho de; CASTRO, Luis Cesar de; NASI, Luiz Antonio; CARNEIRO, Marcelo; FERREIRA, Maria Angelica Pires; GODOY, Mariana Frizzo de; GUIMARAES-JUNIOR, Milton Henriques; OLIVEIRA, Neimy Ramos de; ZIEGELMANN, Patricia Klarmann; PORTO, Paula Fonseca; MENDES, Paulo Mascarenhas; PARAISO, Pedro Gibson; REIS, Priscilla Pereira dos; FRANCISCO, Saionara Cristina; ARAUJO, Silvia Ferreira; AVELINO-SILVA, Thiago Junqueira; MARCOLINO, Milena SorianoBackground Although dementia has emerged as an important risk factor for severe SARS-CoV-2 infection, results on COVID-19-related complications and mortality are not consistent. We examined the clinical presentations and outcomes of COVID-19 in a multicentre cohort of in-hospital patients, comparing those with and without dementia.Methods This retrospective observational study comprises COVID-19 laboratory-confirmed patients aged >= 60 years admitted to 38 hospitals from 19 cities in Brazil. Data were obtained from electronic hospital records. A propensity score analysis was used to match patients with and without dementia (up to 3:1) according to age, sex, comorbidities, year, and hospital of admission. Our primary outcome was in-hospital mortality. We also assessed admission to the intensive care unit (ICU), invasive mechanical ventilation (IMV), kidney replacement therapy (KRT), sepsis, nosocomial infection, and thromboembolic events.Results Among 1,556 patients included in the study, 405 (4.5%) had a diagnosis of dementia and 1,151 were matched controls. When compared to matched controls, patients with dementia had a lower frequency of dyspnoea, cough, myalgia, headache, ageusia, and anosmia; and higher frequency of fever and delirium. They also had a lower frequency of ICU admission (32.7% vs. 47.1%, p < 0.001) and shorter ICU length of stay (7 vs. 9 days, p < 0.026), and a lower frequency of sepsis (17% vs. 24%, p = 0.005), KRT (6.4% vs. 13%, p < 0.001), and IVM (4.6% vs. 9.8%, p = 0.002). There were no differences in hospital mortality between groups.Conclusion Clinical manifestations of COVID-19 differ between older inpatients with and without dementia. We observed that dementia alone could not explain the higher short-term mortality following severe COVID-19. Therefore, clinicians should consider other risk factors such as acute morbidity severity and baseline frailty when evaluating the prognosis of older adults with dementia hospitalised with COVID-19.