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Background and aims: This study examined whether remembering location information relies on efficient inhibitory functions. Methods: In two experiments, younger and older adults performed an active visuo-spatial working memory (VSWM) span task. Participants were presented with a series of locations and asked to remember only final target locations, which were manipulated according to source (e.g., indicated by the experimenter or participant). Results: Data showed that, as the complexity of the VSWM task increased, older adults made more intrusion errors than younger adults, and that, older adults especially seemed to have difficulty in recalling correct locations when non-final locations were directly manipulated. Conclusions: This study highlights how older adults' performance in VSWM is influenced by inhibitory working memory functions, which become particularly crucial as attentional demands grow. [ABSTRACT FROM AUTHOR]

Chronic pain occurs in 45-85% of the geriatric population and the need to treat chronic pain is growing substantially. Unfortunately, treatment for chronic pain is not always correctly targeted, which leads to a reduced quality of life, with decreased socialization, depression, sleep disturbances, cognitive impairment, disability and malnutrition. Considering these consequences, healthcare professionals should aim at improving the diagnosis and treatment of chronic pain in older persons. One of the most important limitations in achieving successful pain management is that older people are not aware that pain management options exist or medications for pain, such as opioids, have associated benefits and adverse effects. Importantly, opioids do not induce any organ failure and if adequately used at the right dosage may only present some predictable and preventable adverse effects. Treating and controlling chronic pain is essential in elderly patients in order to maintain a good quality of life and an active role in both the family and society. To date there are only a few randomized clinical trials testing opioid therapy in elderly patients, and the aim of the present review is to highlight the efficacy and tolerability of opioid use through a literature search strategy in elderly people with chronic non-cancer pain.

Aims: Left ventricular (LV) mass increase is considered part of composite target organ damage in hypertension and an independent risk factor for cardiovascular (CV) events. This study was designed to explore whether left ventricular mass index (LVMI) is associated with cognitive decline and dementia in elderly subjects, independently of blood pressure (BP) levels., Methods and Results: Four hundred subjects (mean age 79 +/- 6 years) were studied. Left ventricular mass was measured echocardiographically in accordance with American Society of Echocardiography and normalized for body height to the 2.7 (LVMI). Global cognitive function was evaluated with the mini-mental state examination (MMSE) (maximum score 30). Dementia was defined as an MMSE score <21. Arterial stiffness was evaluated as carotid-femoral pulse wave velocity by Complior. Prevalence of hypertension was 70% and diabetes mellitus was diagnosed in 25%. No significant differences in traditional CV risk factors were observed across LVMI quartiles. Mini-mental state examination showed an inverse trend across LVMI quartiles (the higher the LVMI, the lower the MMSE, P for trend <0.05); systolic and diastolic BP levels were not different across LVMI quartiles. In multivariable logistic regression models, including age, sex, BP levels, and use of antihypertensive drugs as covariates, the highest LVMI was found to be independently associated with a two-fold higher likelihood of having dementia. The association persisted significant even after adjustment for arterial stiffness., Conclusion: In elderly subjects, LVMI is associated with a progressive cognitive decline. This association is independent of BP levels and/or large artery stiffness.

Background and Aims: Non-invasive measures of large artery structure and function--such as aorto-femoral pulse wave velocity (PWV), arterial compliance (AC) and common carotid intima-media thickness (CCA IMT)--can predict new CV events, independently of traditional CV risk factors. However, neither their relations with aorta properties nor the effects of aging and hypertension on those relations are yet clear., Methods and Results: 40 subjects (18 M, 22 F; mean age 60+/-16 yrs, range 21-83 yrs) free of any acute CV event, valve disease or atrial fibrillation, were studied. Aortic IMT, diastolic diameter (D) and distensibility (Dist) were measured by transesophageal echocardiography at three different levels: ascending aorta (AA), distal aortic arch (Aarc) and descending aorta (DA). PWV was measured by Complior. AC was measured as the ratio of stroke volume to pulse pressure. CCA IMT was measured by ultrasonography in diastole. The Dist, IMT, and D of each aortic segment were introduced alternatively into the regression models. After controlling for age, sex, traditional risk factors and prevalent CV disease, AC showed a significant positive association with the distensibility of proximal aortic segments, but no significant association with properties of distal aorta; PWV showed a significant positive association with proximal aorta wall thickness and a negative association with distal aorta distensibility; CCA IMT was positively associated with distal aorta wall thickness, but not with any explored property of the proximal aorta. None of these relationships differed between younger or older, normotensive or hypertensive subjects., Conclusions: Non-invasive measures of large artery structure and function are not equivalent with respect to their relations with aortic properties, so that AC seems to reflect proximal aorta function, PWV proximal aorta structure and distal aorta function, and CCA IMT distal aorta structure. Future studies are needed to confirm whether these relations identify a common pathogenetic mechanism, which may be the target for new therapeutic strategies.

Objective: The present study aimed at verifying Quinapril effects on both pressure and lipid profile in 15 patients (5 M, 10 F), aged 45 to 80 years (63 +/- 9), complaining for mild to moderate hypertension and dyslipidemia (total cholesterol > 200 mg/dl and triglycerides > 200 mg/dl). No relevant associated disease was present, including diabetes mellitus not any lipid lowering drugs were given., Method: After a wash-out period of one week, all patients, who had been hypertensive for 2 to 120 months (33 +/- 11), were given Quinapril 20 mg orally once a day for 6 months and kept on a low lipid diet from before treatment to the end of the study. Lipid profile we assessed at three-month intervals., Results: Blood pressure, monitored at two-week intervals, significantly decreased on the 1st month (p < 0.001), and kept lower thereafter. Mean total cholesterol, triglycerides and low density lipoprotein cholesterol levels, after 6 months of therapy, were reduced by 44 mg/dl (p < 0.001), 29 mg/dl (p < 0.001) and 39 mg/dl (p < 0.002) respectively., Conclusions: Our results seen indicate that Quinapril antihypertensive effects are accompanied by a significant improvement of the lipid profile.