This study examined the association between spontaneous finger tapping and cognitive function, with a detailed analysis of the two main phases of finger tapping, the touch-phase and the off-phase. 170 elderly patients (83 men, 87 women; M age = 82.1 yr., SD = 6.2) underwent cognitive assessment including the Mini-Mental State Examination, a forward digit span test, and 15 sec. of finger tapping. Results indicated a significant increase in the length and variability of the finger-touch phase among participants with mild cognitive impairment or dementia compared to participants with no cognitive impairment, suggesting a relationship between finger tapping and attention, short-term memory, and cognitive diagnosis. Pattern classification analyses on the finger tapping parameters indicated a specificity of 0.91 and sensitivity of 0.52 for ruling out cognitive impairment.

Studies of calcium oxalate crystals in urine suggest similarities to crystal growth in calcium oxalate renal calculi. Previous reports indicate that urinary crystals in patients in whom stones form are larger than those in normal subjects. We report herein a study on crystal size by structure and habit (shape) based on direct microscopic measurement of crystals in urine of 27 normal subjects and in 6 of 22 patients in whom stones form. The mean size of all crystals in normal subjects is 12.0 plus or minus 7.8 micrometers. Calcium oxalate monohydrate crystals are significantly smaller than calcium oxalate dihydrate (p less than 0.01). In 22 patients with stones there was no correlation between crystalluria and severity or duration of disease. The mean crystal size in 6 patients did not support the conclusion that patients in whom stones form excrete larger crystals than normal subjects.

mean excess rating increased from 89% (SD 52) in 1990 to 158% (SD 40) in 2002 (difference 69%, 95% confidence interval 41 to 97; P < 0.000, paired t test), but fell to 56% (SD 43) on treatment (102%, 79 to 126; P < 0.000), which was 33% lower (5 to 61; P = 0.022) than the original rating in 1990. CommentThe increase in mortality rating in the second survey, together with the substantial reduction in the excess applied to patients taking statins show that underwriters now assess risk more realistically and recognise that the prognosis for familial hypercholesterolaemia has improved with more effective treatment.2 Nevertheless variability in the rating applied was considerable, and patients could usefully be advised to shop around for the most competitive premium. The results of the survey, however, are reassuring and should encourage relatives of probands to be tested rather than being deterred by concerns about life assurance.We thank the life assurance companies for participating in the study.

Background: Cognitive decline and dementia are highly prevalent amongst the elderly. Medication management problems are also prevalent in this population. Although both problems coexist, the quantitative association between them has not been comprehensively analyzed. Method: A prospective cross-sectional study of a successive cohort of 425 patients was performed in a community-based geriatric assessment unit. Personal information, results of cognitive function tests, a diagnosis of dementia and an examination of basic knowledge of the medication regimen were recorded and entered into a patient register at the end of each patient’s assessment. Results: Performance in cognitive function tests was significantly poorer in patients demonstrating lack of basic knowledge of the medication regimen. Mean Mini-Mental State Examination score: 19.1 versus 25.5 (p < 0.001); mean number of words recalled on a 3-word recall test: 1.0 versus 1.84 (p < 0.001); abnormal clock drawing test: 82 versus 57.7%, respectively (p < 0.001). The number of patients diagnosed with dementia was greater among patients who demonstrated lack of basic knowledge of the medication regimen (46.8 vs. 6.9%, respectively; p < 0.001). Conclusion: A strong association between lack of basic knowledge of the medication regimen and cognitive dysfunction was demonstrated in elderly patients referred to a geriatric assessment unit, suggesting that lack of basic knowledge of the medication regimen is indicative of cognitive dysfunction and vice versa.