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Alzheimer’s disease (AD) is the most common cause of dementia that involves a progressive and irrevocable decline in cognitive abilities and social behavior, thus annihilating the patient’s autonomy. The theoretical assumption that disease-modifying drugs are most effective in the early stages hopefully in the prodromal stage called mild cognitive impairment (MCI) urgently pushes toward the identification of robust and individualized markers of cognitive decline to establish an early pharmacological intervention. This requires the combination of well-established neural mechanisms and the development of increasingly sensitive methodologies. Among the neurophysiological markers of attention and cognition, one of the sub-components of the ‘cognitive brain wave’ P300 recordable in an odd-ball paradigm -namely the P3b- is extensively regarded as a sensitive indicator of cognitive performance. Several studies have reliably shown that changes in the amplitude and latency of the P3b are strongly related to cognitive decline and aging both healthy and pathological. Here, we used a P3b spatial filter to enhance the electroencephalographic (EEG) characteristics underlying 175 subjects divided into 135 MCI subjects, 20 elderly controls (EC), and 20 young volunteers (Y). The Y group served to extract the P3b spatial filter from EEG data, which was later applied to the other groups during resting conditions with eyes open and without being asked to perform any task. The group of 135 MCI subjects could be divided into two subgroups at the end of a month follow-up: 75 with stable MCI (MCI-S, not converted to AD), 60 converted to AD (MCI-C). The P3b spatial filter was built by means of a signal processing method called Functional Source Separation (FSS), which increases signal-to-noise ratio by using a weighted sum of all EEG recording channels rather than relying on a single, or a small sub-set, of channels.

A clear difference was observed for the P3b dynamics at rest between groups. Moreover, a machine learning approach showed that P3b at rest could correctly distinguish MCI from EC (80.6% accuracy) and MCI-S from MCI-C (74.1% accuracy), with an accuracy as high as 93.8% in discriminating between MCI-C and EC. Finally, a comparison of the Bayes factor revealed that the group differences among MCI-S and MCI-C were 138 times more likely to be detected using the P3b dynamics compared with the best performing single electrode (Pz) approach.

In conclusion, we propose that P3b as measured through spatial filters can be safely regarded as a simple and sensitive marker to predict the conversion from an MCI to AD status eventually combined with other non-neurophysiological biomarkers for a more precise definition of dementia having neuropathological Alzheimer characteristics.

Cubital tunnel syndrome is a common entrapment neuropathy of the upper limb. This condition can result in significant sensory disturbances and motor deficits in the distribution of the ulnar nerve. Surgical management of cubital tunnel syndrome is indicated when non-operative measures fail. However, in the elderly population, there may be a tendency to avoid surgery as nerve healing has been found to be poor. In our study, we reviewed the results of anterior transposition of ulnar nerve in patients 60 years of age and older. Our results were based on a self-reported outcome at a minimum of one year after surgery — 94.7% of our surgeries resulted in some improvement in symptoms experienced by the patients while there was an overall satisfaction rate of 83.3%. Based on our results, we recommend ulnar nerve transposition in the management of cubital tunnel syndrome in this group of patients if non-operative measures fail.

The study investigated the formal and informal old age protections in the major cities of Malaysia, Singapore and Philippines. The role of family support as important source of old-age protection in Asian countries was also investigated. Data were collected using a survey-interview method. A total of 250 young population and 250 of the elderly population in Kuala Lumpur were interviewed. Similar number of young and elderly population was interviewed in Manila. In Singapore, data was collected from 206 and 161 young and elderly population respectively. A Venn diagram was constructed to analyse the overlapping of availability of the various old age protections for the two generations and their relative sizes among the three cities were compared. Given the many agreement on the inadequacy of the formal old-age benefits, many reverted to informal protections such as insurance, savings and family support. With the exception of Manila, reliance on the family support as perceived by the younger generations has lost its importance.

Background: A new beta-tricalcium phosphate with unidirectional pore structure (UDPTCP), Affinos^® (Kurray, Okayama, Japan), has been in clinical use since 2015. To date, there have been only a few clinical studies using this material. We report here the first clinical study for distal radial fracture in the elderly population treated with UDPTCP.

Methods: Consecutive patients aged 65 years or older with dorsally displaced unstable fracture of the distal radius (n = 36) were treated operatively in our department. Following reduction of the fracture site, a 7 mm size cube of UDPTCP was placed in the gap of the bony defect and the fracture stabilized with mono-axial or poly-axial type locking plates and screws. Remodeling of the UDPTCP was evaluated by plain radiograph and clinical outcomes were also assessed.

Results: UDPTCP was significantly resorbed at 2 months after surgery, both at the center and periphery of the material. Complications were only observed in the post-operative period. Significant correction loss of radial alignment was seen in patients stabilized with poly-axial locking plate. The clinical outcome in all cases was excellent.

Conclusions: Block UDPTCP is a safe and convenient material for the treatment of distal radius fracture and is replaced within a suitable time period after grafting into the fracture site. UDPTCP and stable internal fixation is therefore a reliable strategy for restoring and preserving anatomical position, especially in the elderly population.