Callosal changes are already present in patients with amnestic mild cognitive impairment (MCI) and mild Alzheimer disease (AD). The precocious involvement of the anterior callosal subregion in amnestic MCI extends to posterior regions in mild AD. Two different mechanisms might contribute to the white matter changes in mild AD: wallerian degeneration in posterior subregions of the corpus callosum (suggested by increased axial diffusivity without fractional anisotropy modifications) and a retrogenesis process in the anterior callosal subregions (suggested by increased radial diffusivity without axial diffusivity modifications).

Objectives-To estimate the prevalence of dementia in an elderly rural population and to determine the effects of age, sex, and education. Methods-To obtain prevalence estimates of both cognitive impairment and dementia a door to door two phase population survey was carried out in three rural villages in central Italy. Of 1147 inhabitants older than 64, 968 (84-4%) completed the protocol. Results-The prevalence rates (cases per 100 population over 64) were 8-0 for dementia and 27-3 for cognitive impairment. The prevalence rate for dementia did not differ between men and women (7.9 v 8-2), but increased with age (from 1*1 at age 65-69 to 34-8 at age 90-96). Subjects with less than three years of schooling had a significantly higher prevalence of dementia (14-6; 95% confidence interval (95% CI) 10.2-19.1) than subjects with three or more years of schooling (5.9; 95% CI 4.2-7.7). At the multivariate logistic analysis, the risk related with a low level of education was still present after adjustment for age and sex (OR = 2-0; 95% CI 1.2-3.3).Alzheimer's disease was diagnosed in 64% of the 78 demented patients, vascular dementia in 27%, and other dementing diseases in 9%. Conclusions-In both Alzheimer and vascular dementia subtypes, the prevalence rates did not differ between men and women, but increased with age and were higher in subjects with a low level of education. (7 Neurol Neurosurg Psychiatry 1996;60:628-633) Keywords: dementia; education; rural populationThe progressive aging of the population is associated with a steady increase in all age related diseases. Among these, dementing disorders cause great concern because of their peculiar disabling effects. Despite the interest in this condition, prevalence estimates show pronounced variations due to differences in case ascertainment procedures, diagnostic criteria, age distribution, and the rural or urban location of the populations studied.'8 Furthermore, education and occupation may influence the cognitive performance and increase the risk of dementia.9-'3The present study analyses baseline data obtained in a door to door prospective population survey on cognitive impairment and functional disability of people older than 64 (AQUILA study). Here we report the effects of age, gender, and education on the prevalence of dementia. MethodsWe selected three rural villages (Poggio Picenze, Scoppito, Tornimparte) near the town of L'Aquila (central Italy) because of their population size (a total of 1147 people over 64), population stability (only 0-2% of people over 59 had moved elsewhere in the five years preceding the prevalence day), and the active collaboration offered by family doctors.The study was conducted on all persons over 64 residing in the selected villages on the prevalence day (1 March 1992). The ascertainment of cases was made between March 1992 and February 1993 by means of a door to door two phase design. Four lay interviewers (MLB, MC, CG, and GM) and four doctors (ARC, CF, MTL, and PC) conducted the first (screening interview) and the s...

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Clinicians should consider the relevance of neuropsychiatric disorders and symptoms in patients with cognitive disturbances, and incorporate a thorough psychiatric examination in the evaluation of patients.

Background and Purpose Stress‐related catecholamines have a role in cancer and β‐adrenoceptors; specifically, β2‐adrenoceptors have been identified as new targets in treating melanoma. Recently, β3‐adrenoceptors have shown a pleiotropic effect on melanoma micro‐environment leading to cancer progression. However, the mechanisms by which β3‐adrenoceptors promote this progression remain poorly understood. Catecholamines affect the immune system by modulating several factors that can alter immune cell sub‐population homeostasis. Understanding the mechanisms of cancer immune‐tolerance is one of the most intriguing challenges in modern research. This study investigates the potential role of β3‐adrenoceptors in immune‐tolerance regulation. Experimental Approach A mouse model of melanoma in which syngeneic B16‐F10 cells were injected in C57BL‐6 mice was used to evaluate the effect of β‐adrenoceptor blockade on the number and activity of immune cell sub‐populations (Treg, NK, CD8, MDSC, macrophages, and neutrophils). Pharmacological and molecular approaches with β‐blockers (propranolol and SR59230A) and specific β‐adrenoceptor siRNAs targeting β2‐ or β3‐adrenoceptors were used. Key Results Only β3‐, but not β2‐adrenoceptors, were up‐regulated under hypoxia in peripheral blood mononuclear cells and selectively expressed in immune cell sub‐populations including Treg, MDSC, and NK. SR59230A and β3‐adrenoceptor siRNAs increased NK and CD8 number and cytotoxicity, while they attenuated Treg and MDSC sub‐populations in the tumour mass, blood, and spleen. SR59230A and β3‐adrenoceptor siRNAs increased the ratio of M1/M2 macrophages and N1 granulocytes. Conclusions and Implications Our data suggest that β3‐adrenoceptors are involved in immune‐tolerance, which opens the way for new strategic therapies to overcome melanoma growth. Linked Articles This article is part of a themed section on Adrenoceptors—New Roles for Old Players. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.14/issuetoc