AME – Management of Elderly in hospital and primary care

The general population of western countries is aging. In Italy, we observe a constant increase of the population over 65 years old with multiple chronic conditions. Based on these socio-demographic changes, there is a strong need for disease prevention and management actions. The effectiveness of these actions, based on the best evidence available in the literature, will be assessed through randomized controlled studies that will determine the appropriateness of interventions in the Italian context related to the needs of the specific population. The whole project is harmonized, so the results of the WPs are complementary to each other to ensure greater coverage of the health problems of the elderly.

Workpackages and team

  • WP1: Models for managing frailty in the elderly at home
    Implementation and impact assessment of new roles of nurses (e.g. family health nurses) and development of a multifactorial intervention to improve people’s safety (e.g. to reduce falls), including RCTs
    Team: Alberto Dal Molin, Daniela Ferrante, Fabrizio Faggiano, Patrizia Zeppegno, Carmela Rinaldi, Erica Busca, Daiana Campani;
  • WP2: Development of acute care pattern for in-hospital elderly.
    Design and implementation of an interdisciplinary team model (e.g., Acute Care Elderly Unit) and innovative nursing care approaches.
    Team: Alberto Dal Molin, Mario Pirisi, Luigi Castello, Pier Paolo Sainaghi, Carlo Smirne, Erica Busca, Daiana Campani;
  • WP3: Impact of elective surgery and hospitalization on the frailty of the elderly
    Exploration of the effect of surgery and hospitalization on long-term outcomes through observational studies;
    Team: Rosanna Vaschetto, Alberto Dal Molin, Francesco Della Corte, Francesca Vigone;
  • WP4: Feasibility and acceptability of delivering Tertiary ALS Centre specialty care to home using technology: a model for geriatric care
    Exploration of the use of technology and telemedicine in ALS patients, obtaining a model to reproduce in the geriatric population.
    Team:  Fabiola De Marchi, Letizia Mazzini
  • WP5: Epidemiology and development of a new model for the management of Acute Kidney Injury (AKI) in elderly patients admitted to Novara Hospital: the NOV-AKI study
    Epidemiological analysis of acute renal injuries in Novara hospital with the development of a new integrated model between nephrologist and general practitioner in primary care. Identification of patients with acute renal injury (AKI) in the progression towards chronic renal disease through the evaluation of epigenetic changes in the urine.
    Team: Vincenzo Cantaluppi, Mario Giordano, Marco Quaglia



Research area: Burden of old age and disability, Prevention and treatment pathways

Principal Investigator (PI) and CO-PI:

Alberto Dal Molin (PI)- Researcher - Department of Translational Medicine – UPO
Mario Pirisi (Co-PI) – Full professor - Department of Translational Medicine - UPO