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A non-verbal problem solving task, viz. a simplified version of Shallice's London Towers Test, was given to 131 normal subjects to obtain normative data relating to age, education and sex. The test was built up in its easiest possible feature in order to be administrable also to demented patients, therefore possibly becoming part of the neuropsychological diagnostic procedures of the demential syndromes. Although this version of the test proved to be very easy and therefore likely to yield a statistically treatable wide distribution of scores in demented patients, the age-related decline of performance in normals was apparent. Education and sex showed no significant influence on the test-performance. With correction of the raw scores for age and with knowledge of the distribution of scores in the normal population, this test is now ready to assess the normality of the scores of a new subject according to his age, giving information on this otherwise still uncovered sector of cognitive abilities.

The internal consistency (Cronbach's alpha and item-total correlation) and construct validity (factor analysis, intercorrelations, and relationship with Hoehn and Yahr staging and Schwab and England's ADL scale) of the sections "motor examination" and "activities of daily living" of the Unified Parkinson's Disease Rating Scale (UPDRS) and of the Short Parkinson's Evaluation Scale (SPES) were analyzed in 59 subjects with Parkinson's disease (PD) with various degrees of disability. Our results indicate that the SPES is easier and quicker than UPDRS and that it maintains many psychometric properties similar to those of the UPDRS, but with the reduction of a number of items and ordinal levels of each item studied here (producing more homogenous sections than the original versions). The tremor items would be better represented as a separate section in both scales.

Background: The use of thrombolytic therapy for acute ischemic stroke is still controversial. A major problem is balancing the improvement in functional ability against the risk of early death from cerebral hemorrhage. Our aim was to assess whether patients who have had a stroke, and their proxies, would give consent to thrombolysis if this therapy were introduced into clinical practice for acute ischemic stroke in Italy. Methods: A 10-item questionnaire was administered by personnel not directly involved in the care of patients in 12 Italian hospitals. Interviews were carried out with at least 10 consecutive stroke inpatients per center in the postacute phase and to their proxies. Results: There were 685 responders (377 female), median age 58 years (range 18–98); 332 were patients and 353 proxies. Responders were representative of the Italian population as a whole as regards mean age and sex, education and marital status; 59% of responders (95% confidence interval 55–62%) would agree to thrombolysis in the case of stroke. There was more uncertainty among proxies than patients, especially when the decision had to be taken for a relative (41 vs. 17% could not decide, p < 0.001). The preference for thrombolysis was higher among more educated people (p = 0.001) and was not influenced by sex, age and marital status. Overall, 81% of responders would prefer to risk dying rather than remain severely disabled. Conclusion: Thrombolytic therapy is feasible in Italy as there is ample willingness to trade off a better functional outcome with a higher risk of death. Education is the main sociodemographic determinant of independent decision-making, as only those with an adequate cultural level are able to discriminate between one treatment option and another. The proxy’s uncertainty about how to interpret a patient’s preference regarding consent to thrombolytic therapy should be tackled, since proxies play a key role in making patients’ preferences known in case of incompetence after an acute stroke.