From an international comparison of arm anthropometric reference norms for the elderly a new diagnostic criterion for severe wasting malnutrition was derived: corrected arm muscle area at or below 16.0 cm2 for men or 16.9 cm2 for women. Of 201 consecutive hospital admissions aged 65 years and over, 10 subjects were malnourished according to this criterion. For each sex the malnourished group had lower weight, arm circumference and arm muscle area than the nonmalnourished group. Progressive decline of arm muscle mass during the study period was common in the malnourished groups. The diagnosis of severe wasting malnutrition had prognostic implications. Malnourished subjects had a much higher 90-day mortality than the 191 nonmalnourished subjects (50% versus 16.2%).

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During one year 151 patients with 154 strokes were studied prospectively to determine the occurrence and outcome of urinary incontinence after a stroke. Seventeen per cent had pre-existing urinary incontinence. At 1, 4 and 12 weeks, 60%, 42% and 29% of the survivors, respectively, were not continent. Cystometry was performed in those with moderate or severe urinary incontinence persisting 4 weeks after the stroke. Detrusor instability was present in 85% of those who had been continent prior to their stroke. Factors associated with urinary incontinence at 4 weeks were moderate or severe motor deficit, impaired mobility and mental impairment (P less than 0.001). Two-thirds of patients with mild urinary incontinence at 4 weeks regained continence by 12 weeks.

Spinal cord injury (SCI) is a catastrophic and costly result of both intentional and unintentional injury. We present data from the Health Statistics Services files of New Zealand for the year 1988 on the epidemiology of SCI resulting in morbidity. New Zealand has one of the highest rates of SCI in the western world and since 1979 this has been increasing. It occurs most often to young, Caucasian men and is typically the result of motor transport crashes. The ethnicity adjusted rates show high rates for Maori males. Children in New Zealand have greater than 4 times the risk of an SCI than American children. The rehabilitation and hospital costs for SCI are among the highest for all injuries. There were a higher number of high cervical injuries than reported in previous series and 92% of SCI were incomplete indicating the high rehabilitation potential of the sample. Some measures are suggested to reduce the incidence of SCI.

The prevalence of idiopathic Parkinson's Disease (IPD) in Dunedin, New Zealand on 31st July 1990 was 110.4/100,000. When corrected to a standard population based on the 1960 U.S. census, the prevalence fell to 76.0/100,000 due to changes in the age structure of the population. The corrected prevalence in Wellington (another New Zealand city), in 1962 was 99.6 (before the introduction of levodopa), and in Aberdeen, Scotland in 1984 was 102.7. The principal difference was fewer people under 65 years of age in our study. Case finding methods and diagnostic criteria were similar in all three studies, and case ascertainment was adequate. Under representation of younger people could be due to either a lower incidence rate or poorer survival due to treatment with high doses of levodopa compounds. Prospective research is required to explain our findings.