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Objective: To evaluate prescription drug use in the elderly and in particular, to determine the number and types of medications taken, whether and to what extent drugs that are contraindicated in this age group are being used, and what type of prescription check may be performed by primary care physicians., Design: A survey was performed in a sample of non-institutionalised elderly subjects (= 65 years). These were selected by cluster sampling in 11 of 20 Italian regions and were interviewed in the home by trained interviewers using a standardised questionnaire., Results: Eighty-seven percent of interviewed subjects reported that they had taken at least one medication in the previous year; higher frequencies were found in age groups= 75 years. The most common therapeutic classes of drugs used in all participating regions, in the previous week, were cardiovascular, gastrointestinal, metabolic (including drugs to treat diabetes) and nervous system. Among interviewed subjects, 45.3% reported using 4 or more different drugs, though wide regional differences were observed (Campania 60.5%, Bolzano 35.6%); 7.2 % were taking potentially inappropriate drugs while 2.3% were taking medications that may lead to potentially harmful interactions. In addition, 84.9% of subjects reported that their primary care physician regularly checked their drug prescriptions., Conclusions: The high frequency of prescription drug use observed in the elderly is a diffuse phenomenon, related to the worsening health conditions that inevitably accompany aging. Considering the extent of this phenomenon, care should be taken to improve qualitative (i.e. contraindications in the elderly, potential drug-interactions) and quantitative (high number of medications taken by the elderly) appropriateness in physician prescribing. In addition, special attention must be placed on regularly checking drug therapies in the elderly.

The Cronos Project is a post-marketing surveillance study implemented by the Italian Ministry of Health and the National Institute of Health whose main objectives are to characterise the population of Alzheimer's disease patients treated with acetylcholinesterase inhibitors and monitor effectiveness and drug safety in the field practice. In this project 503 Alzheimer's disease units were activated located throughout the country. The characteristics of these Alzheimer's disease units are presented for setting (territorial, university, hospital, extra-hospital), health personnel employed, examinations offered (CT and MRI scans and laboratory tests), counselling activities and relationship with caregiver associations in relation to neuropsychological tests.

Within the Cronos Project, 503 Alzheimer's disease units were activated throughout the country. In June/July 2002 a questionnaire was sent to all Alzheimer's disease units to collect data on neuropsychological tests utilised in the diagnostic process of dementias. Only 196 of Alzheimer's disease units that have responded to the questionnaire (196/392) declare to utilize neuropsychological test while 97.8% use the mini mental state examination. This paper aims to collect, for the first time in Italy, data on use of the neuropsychological tests in the specialist units on dementia and to propose a discussion on the reliability of neuropsychological instruments.