Background and Purpose-To evaluate the relationship between arterial stiffness and cognitive function in a population of elderly subjects reporting memory loss. Methods-We studied the association between cognitive function and arterial stiffness in 308 consecutive elderly subjects attending a geriatric outpatient clinic reporting memory impairment. Subjects were classified into 4 categories according to neuropsychological evaluation: normal cognitive function, mild cognitive impairment (MCI), Alzheimer disease (AD), or vascular dementia (VaD). Arterial stiffness was evaluated by carotid-femoral pulse wave velocity (PWV) measurement using Complior. Results-In this population, 78Ϯ8 years of age (women 64%), AD was present in 41%, VaD in 6%, MCI in 27%, and 26% of subjects had normal cognitive function. After adjustment for age, gender, systolic blood pressure, education level, cardiovascular diseases, and antihypertensive therapy, a significant association was observed between PWV and cognitive status (PϽ0.0001). PWV appears significantly higher in subjects with VaD (15.2Ϯ3.9 m/s) or AD (13.3Ϯ2.9 m/s) than in those without cognitive impairment (11.5Ϯ2.0 m/s; PϽ0.001). Moreover, PWV was higher in subjects with MCI (12.6Ϯ2.6 m/s) than in those without cognitive impairment (11.5Ϯ2.0 m/s; Pϭ0.01). For each 2 m/s increment in PWV, the adjusted odds ratio (95% CI) was 1.

Massive irreparable rotator cuff tears remain a challenging condition during daily clinical practice. Irreversible fatty infiltration of muscles and excessive chronic retraction of tendons predispose to high failure rates of their surgical treatment. Superior capsular reconstruction with either fascia lata autograft or a dermal allograft patch is a newly described solution that could prevent superior humeral head migration and restore the anteroposterior shoulder muscle force couples. The purpose of this article is to propose a technical modification of superior capsular reconstruction using long head of the biceps tendon autograft. The tendon's insertion into the glenoid is left intact, whereas laterally, it is tenotomized, transferred, and sutured with anchors onto the footprint of the supraspinatus tendon acting as a superior static stabilizer of the shoulder joint. Although this surgical modification has theoretical biological advantages, could be performed with the least technical demands, and simplifies the original demanding procedure, further prospective studies with large cohort populations and long-term follow-up are necessary to establish its effectiveness.

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