Luis Varela

Effect of multimorbidity on gait speed in well-functioning older people: A population-based study in Peru

To determine the association between multimorbidity and gait speed in a population‐based sample of older people without functional dependency.

Herpes zoster encephalitis: a rare complication in a nonagenarian

A 93-year-old bedbound woman with cognitive impairment was admitted with a 1-day history of herpes zoster (HZ) infection in the right S1/2 dermatomes, followed by fever and drowsiness. Physical examination revealed no neck stiffness, meningism or focal signs. Blood tests showed hypoalbuminaemia and lymphopenia. Conventional brain magnetic resonance imaging (MRI) revealed hippocampal atrophy and diffusion weighted imaging showed no acute infarctions. A polymerase chain reaction DNA microassay test of the cerebrospinal fluid (CSF) was positive for varicella zoster virus. The patient received acyclovir intravenously, with a favourable clinical course. HZ encephalitis is uncommon in elderly patients [1]. Clinical manifestations include rash, fever and altered mental status that can arise before, during or up to 6 months after the onset of skin lesions [2]. Patients with encephalitis should undergo CSF analysis and nucleic acid amplification tests to identify certain aetiologic agents. MRI is more sensitive and specific than computed tomography but may be normal. Electroencephalography helps to identify nonconvulsive seizure activity in confused, obtunded or comatose patients [3].