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Alzheimer''s disease (AD) is a progressive neurodegenerative illness and the most frequent cause of dementia in the elderly. The identification of activated microglia within neuritic plaques, coupled with the presence of numerous inflammatory proteins, suggests that inflammation is an integral part of the pathogenetic process in AD. In the present paper we have investigated the levels of circulating inflammatory mediators as potential AD biomarkers concentrating essentially on (a) soluble CD40 (sCD40), a member of the tumor necrosis factor receptor superfamily lacking the membrane-associated endodomain by alternative splicing, and (b) transforming growth factor (TGF)-β1, a cytokine deeply involved in AD and playing a protective role on CNS. Decrease of TGF-β1 in AD patients could enhance the effects of pro-inflammatory cytokines produced by activated microglia as well as the expression of factors, such as the CD40/CD40 ligand complex, by microglia and astrocytes.Total venous blood samples were obtained from 33 patients with clinical diagnosis of possible late-onset AD, 40 healthy age-matched and 11 healthy young individuals. A significant increase of sCD40 levels plasma of AD patients versus healthy controls was measured, concomitantly with a decrease in TGF-β1 concentration. These variations, however, showed no correlation with the expression of ApoE ε4 allele, which was determined in order to assess the different frequency of this risk factor between AD and control groups.Since no comparable modifications were detected in patients affected by Parkinson''s disease or non-AD-based dementia, we propose that sCD40 and TGF-β1 plasma levels might represent possible differential biomarkers of AD, and be useful pre-mortem to support the clinical diagnosis of late-onset AD. [Copyright &y& Elsevier]

Comprehensive geriatric assessment has become synonymous with geriatric practice. This includes evaluation of the older person’s physical and mental health, and the functional and social status. We propose a new way of representing a person’s condition, called the “polar diagram”. This shows the subject’s scores on the evaluation scales that are arranged in radial positions inside a circle. The outer part of the circle corresponds to the best condition. Gaps between the best condition and the actual scores are easily identified. The diagram can be employed to monitor the subject’s condition and to assess any changes in outcomes. [Copyright &y& Elsevier]