Background and Purpose-In a geographically defined population, we assessed incidence and determinants of aphasia attributable to first-ever ischemic stroke (FEIS). MethodsA 1-year prospective, population-based study among the permanent residents of the canton Basle City, Switzerland, was performed using multiple overlapping sources of information. Results-Among 188 015 inhabitants, 269 patients had FEIS, of whom 80 (30%; 95% CI, 24 to 36) had aphasia. The overall incidence rate of aphasia attributable to FEIS amounted to 43 per 100 000 inhabitants (95% CI, 33 to 52). Aphasic stroke patients were older than nonaphasic patients. The risk of aphasia attributable to FEIS increased by 4% (95% CI, 1% to 7%), and after controlling for atrial fibrillation, by 3% (95% CI, 1% to 7%) with each year of patients' age. Gender had no effect on incidence, severity, or fluency of aphasia. Cardioembolism was more frequent in aphasic stroke patients than in nonaphasic ones (odds ratio [OR], 1.85; 95% CI, 1.07 to 3.20). Aphasic patients sought medical help earlier than nonaphasic stroke patients. Still, after controlling for stroke onset-assessment interval, aphasic stroke patients were more likely to receive thrombolysis than nonaphasics (OR, 3.5; 95% CI, 1.12 to 10.96). Conclusion-Annually, 43 of 100 000 inhabitants had aphasia resulting from first ischemic stroke. Advancing age and cardioembolism were associated with an increased risk for aphasia. Severity and fluency of aphasia were not affected by demographic variables.

OBJECTIVE: To explore the relationship between hypercholesterolaemia, age and BMI among females and males. DESIGN: Population-based cross-sectional survey. SUBJECTS: The data came from the initial surveys of the WHO MONICA Project. In all, 27 populations with 48 283 subjects (24 017 males and 24 266 females) aged 25-64 y were used for the analysis. MEASUREMENTS: Total cholesterol, weight, height, BMI, prevalence of hypercholesterolaemia (PHC) defined as cholesterol Z6.5 mmol/l, and the prevalence of obesity (POB) defined as BMI Z30 kg/m 2 . RESULTS: PHC increased with age, with PHC in males being significantly higher than in females at age range 25-49 y and significantly lower than in females at age range 50-64 y. Age-related increase in hypercholesterolaemia was steeper in females than in males. There was a statistically significant positive association between hypercholesterolaemia and BMI. Multiple logistic regression analysis revealed a negative statistically significant (Po0.001) effect modification involving age and BMI on the risk of having hypercholesterolaemia both in females and males. The relation between PHC and BMI became weaker in higher age groups, with no statistically significant association in females aged 50-64 y. CONCLUSION: Public health measures should be directed at the prevention of obesity in young adults since the strongest effect of obesity on the risk of hypercholesterolaemia has been found in subjects aged 25-39 y.

Background: Recent research has corroborated the notion that seasonality in suicide is more heterogeneous and less consistent than postulated by former scholars. This work investigates the smoothing out of suicide seasonality in Switzerland between the late 19th and the end of the 20th century. It includes analyses by region and by suicide method. Methods: Monthly suicide frequencies in Switzerland are available for the period 1876-2000. Data on canton/region are available for the periods 1901-1920 and 1969-2000, and data on suicide method for the periods 1881-1920 and 1969-2000. Analyses focusing on the overall change rely on data aggregated by quinquennia. The Edwards' test and the peak-low ratio were used in univariate analyses of seasonality. Putative determinants of the peak-low ratio were examined using regression analysis with cantonal data. Results: The decrease of seasonal effects in suicide applies to a period of more than 100 years in Switzerland. Big differences of seasonal effects have existed all the time with regard to specific methods and to specific regions. No seasonality was apparent in poisoning, and in Geneva and Basle City, respectively. However, the seasonal effects have been most impressive in drowning and hanging suicides, and in rural Catholic regions. In regression analysis, the decline in suicide seasonality is associated with the decline in the agricultural work force. Conclusions: The smoothing out of suicide seasonality in Switzerland has been a continuous long term process, which probably started by the end of 19th century. Seasonal effects in suicide will probably fade away in most regions of Switzerland and in most suicide methods. This process is in parallel with the disappearance of the traditional rural society.