The ROVIGO study (risk of vascular complications: impact of genetics in old people): protocol, study design, and preliminary results of the initial survey : cardiovascular epidemiology in the elderly.

BACKGROUND: The epidemiology of cardiovascular risk (CV) in the elderly is far from being defined, and the reasons why some subjects retain a healthy body while growing old while others are affected by different diseases or die prematurely are still unknown. AIMS: To compare the CV risk pattern in two elderly cohorts living in North-East Italy. MATERIALS AND METHODS: The Risk Of Vascular complications: Impact of Genetics in Old people (ROVIGO) study is a population-based study including 580 unrelated elderly subjects representative of general population living in Rovigo in the Veneto region. They were compared to a cohort of 580 age-gender-matched unrelated subjects from the CArdiovascular STudy in the Elderly (CASTEL) living in the same region in Castelfranco Veneto and Chioggia. RESULTS: Blood pressure (BP), heart rate (HR), low-density-lipoprotein cholesterol, and prevalence of coronary heart disease, heart failure and chronic pulmonary disease were lower in the ROVIGO than in the CASTEL cohort, while high-density-lipoprotein cholesterol and the prevalence of diabetes were higher in the former than in the latter. In the ROVIGO cohort, diabetes, left ventricular hypertrophy, coronary and cerebrovascular diseases were more represented in men. In the CASTEL cohort, systolic BP was higher in women. In both cohorts, the lipid pattern was less favourable and HR higher in women, chronic pulmonary disease more represented in men. CONCLUSIONS: People living in Rovigo were at lower CV risk than those in Castelfranco Veneto and Chioggia, mainly due to lower BP values, better lipid pattern and lower prevalence of CV and pulmonary disease.

Differences in the intellectual profile of children with intellectual vs. learning disability.

The WISC-IV was used to compare the intellectual profile of two groups of children, one with specific learning disorders (SLDs), the other with intellectual disabilities (ID), with a view to identifying which of the four main factor indexes and two additional indexes can distinguish between the groups. We collected information on WISC-IV scores for 267 children (Mage=10.61 [SD=2.51], range 6-16 years, females=99) with a diagnosis of either SLD or ID. Children with SLD performed better than those with ID in all measures. Only the SLD children, not the ID children, revealed significant differences in the four main factor indexes, and their scores for the additional General Ability Index (GAI) were higher than for the Cognitive Proficiency Index (CPI). Children with a diagnosis of SLD whose Full-Scale Intelligence Quotient (FSIQ) was <85 showed a similar pattern. Our findings confirm the hypothesis that children with SLD generally obtain high GAI scores, but have specific deficiencies relating to working memory and processing speed, whereas children with ID have a general intellectual impairment. These findings have important diagnostic and clinical implications and should be considered when making diagnostic decisions in borderline cognitive cases.

Construction and validation of an ecological version of the Wisconsin Card Sorting Test applied to an elderly population.

The goal of this project was to construct and validate an ecological version of the Wisconsin Card Sorting Test (WCST) aimed at the elderly. This was accomplished by replacing the geometric stimuli of the traditional version with stimuli belonging to the semantic category of transport vehicles, and by elimination of the color yellow. The results showed the ecological WCST version was preferred over the traditional version and older people felt less tired during test performance. In the two independent normal elderly groups, all pairs of scores that can be derived from the WCST correlated significantly with each other. Six of 11 outcome measures of the traditional WCST-128 (long) version were significantly influenced by age. By contrast, in the WCST-64 (short) version and in the ecological WCST-54 version only one measure was affected by the age variable. No significant effect of education level or gender emerged from the results in any WCST version. Again, the subjects with cognitive deterioration had lower performance in the ecological WCST-54 version than in the two traditional WCST versions. It seems reasonable to assume that the ecological version of WCST is more discriminating and has more advantages than the traditional versions. Further research on individual differences in the performance on this task will increase understanding of the components of the test, and of the variety of factors and possible deficits that could lead to an impaired performance of the test.

Difference in mortality after hip fracture is associated with postdischarge prescription of antithrombotic prophylaxis: a case-control study.

This study was undertaken to determine whether a prolongation of pharmaceutical antithrombotic prophylaxis beyond hospitalization for hip fracture is associated with a reduced mortality rate. One hundred seventy-nine cases with hip fracture (patients older than 50 years of age) admitted to local general hospitals in 1999 who received postdischarge prescription of any antithrombotic agent (heparin, oral anticoagulants, antiplatelet drugs) and 179 age- and sex-matched patients with hip fracture who did not were included. Postdischarge mortality was assessed at 90 days. Compared with patients who did not receive postdischarge prescription of antithrombotic agents, those who did had an odds ratio of 0.22 (95% confidence interval 0.08-0.59) for all causes of mortality. This result did not change after excluding nonvascular mortality (odds ratio, 0.17; confidence interval, 0.03-0.73; p=0.011). Patients admitted to the hospital for hip fracture are at high risk of death after discharge if they are not given antithrombotic treatment. To substantiate these data, ad hoc prospective randomized trials are needed.