The testamentary capacity in acute stroke. A cross-sectional study

Succession law, which governs the creation and validity of wills, is closely tied to testamentary capacity (TC), the cognitive competence required for a valid will. This study explores TC in acute stroke patients and its connections to demographic and clinical characteristics. The research included first-time stroke patients admitted within 24 hours of symptom onset, meeting specific criteria. Data were collected, and assessment tools like the Addenbrooke's Cognitive Examination III (ACE-III) and Testamentary Capacity Assessment Tool (TCAT) were used. The study found that TCAT scores were not significantly affected by age or gender but positively correlated with education, the Barthel Index and ACE-III scores. They were negatively associated with National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (mRS) scores. Specific cognitive domains, particularly memory and attention, were independent determinants of TCAT scores. This research introduces TCAT as a valuable tool for evaluating testamentary capacity in stroke patients and highlights the multifaceted nature of TC, emphasizing the need for a nuanced approach. As the population ages and complex medical conditions become more prevalent, understanding the interplay between cognitive functioning and testamentary capacity becomes increasingly crucial for both legal and medical professionals.

A Questionnaire-Based Cross-Sectional Study of Insomnia among Middle-Aged Adults from Greece's Northeastern Fringe, Thrace

Background, aim: Insomnia constitutes a common and very debilitating disorder in modern societies. A better understanding of the etiologies and risk factors, modifiable or not, of insomnia is essential for a swifter diagnosis and a more appropriate treatment, mitigating its toll on individuals and society. To this purpose, the present study assessed the prevalence of insomnia in a randomly-selected adult population and its relation with a diverse range of socio-demographic characteristics and medical conditions. Methods:A sample of 771 participants aged 24 to 89 years (mean age 58±13 years; 42.7% women) was randomly selected from the general population of Thrace, a prefecture in Northeastern Greece with special cultural considerations, using a two-stage stratified sampling scheme. The Greek version of the Athens Insomnia Scale (AIS) was utilized to evaluate the presence of insomnia. Moreover, the Berlin Questionnaire for Obstructive Sleep Apnea and the Epworth Sleepiness Scale for Excessive Daytime Sleepiness were also utilized. Results:A total of 141 study participants (18.3%) were found to suffer from insomnia. Impaired sleep maintenance was reported as the most frequent symptom (62%). The following independent statistically significant risk factors emerged (p-value <0.05): BMI ≥35 (aOR=2.91), divorced or widowed individuals (aOR=2.23), female gender (aOR=1.76), age >70 years (aOR=1.61), snoring (aOR=1.61), midday sleep (aOR=1.58) and presence of chronic disease (aOR=1.55). Conclusion:The prevalence of isomnia in Thrace aligns with similar studies conducted in Greece and internationally. A multitude of socio-demographic characteristics and diseases, especially chronic, predispose to insomnia.

Association of Family Income with Health Indices and Healthcare Utilization in a Large Sample of Residents in Northern Greece

Objective:To describe the impact of subjects' family income, which was used as a proxy for socioeconomic status, with health characteristics and healthcare utilization of a large representative sample of population in Northern Greece, taking into account several socio-demographic characteristics and health behaviors of the participants. Material and method:Eight hundred and twelve participants (43.7% males) with a mean age of 49.±14.8 years (range 19-83 years), from the area of Thrace, Greece, were enrolled in this cross-sectional populational study. A two-stage stratified sampling scheme was used and subjects were classified, according to the net mean monthly household income, into three financial levels: low .1000 Euro; medium 1001-2000 Euro; and high >2000 Euro. Self-reported questionnaires for socio-demographic, lifestyle and health related characteristics were collected. Sleep characteristics, utilizing Epworth Sleepiness Scale, Athens Insomnia Scale, Pittsburgh Sleep Quality Index and Berlin Questionnaire, and mental health, using Zung Self-rating Anxiety Scale and Beck Depression Inventory have been also assessed. Results:The majority of participants belonged to the lower income level (476 subjects, 58.6%). Lower income level was associated with a higher prevalence of high alcohol consumption (p=0.030), low adherence to Mediterranean diet (p=0.016), low physical activity (p<0.001) and either short or long nocturnal sleep duration (p<0.001). After adjusting for all socio-demographic and lifestyle characteristics, subjects with low income had a higher risk for anxiety (aOR=1.97, p=0.017), depression (aOR=4.88, p<0.001), dyslipidemia (aOR=2.50, p=0.007), diabetes (aOR=3.58, p<0.001), obesity (aOR=1.97, p=0.038), cardiovascular disease (aOR=3.04, p=0.015) and sleep disorders, as well as for primary (aOR=3.56, p=0.017) and secondary (aOR=2.49, p=0.010) healthcare utilization compared to subjects with high income. Conclusion:Low income is an important factor, which adversely affects the health of individuals via different pathways such as adaptation of harmful everyday habits. Large-scale prospective cohort studies are necessary to verify these associations in a methodologically more robust way.