The association between obesity and mortality in the elderly remains controversial. To test the association between BMI and mortality, with the hypothesis of a mediation by low-grade inflammation (LGI), a prospective study design (median follow-up 7.8 years) was used on a sample of 4,970 elderly subjects (age ≥ 65 years) from the Moli-sani Study cohort. The association between BMI categories and overall or cause-specific mortality (hazard ratio, HR) was calculated by multivariable Cox regression. Dose-response relationship was tested using restricted cubic splines. Interaction between BMI and LGI, assessed through high-sensitivity C-reactive protein (hs-CRP) and INFLA-score, was also tested. In comparison with normal-weight, overweight was significantly associated with a 20% (adjusted HR = 0.80; 95%CI 0.67–0.95) reduced risk of total mortality, while severe obesity (BMI > 40) with an increased risk (HR = 1.81; 95%CI 1.13–2.93). Cubic spline curves showed a U-shaped relationship between BMI and total mortality (p value for nonlinear relationship = 0.001). Similar results were found for cardio-cerebrovascular and other causes mortality. Hs-CRP and INFLA-score were associated with an increased risk of total mortality in adjusted analyses. Mediation analysis did not show any effect of LGI on the association between BMI and mortality. However, after stratification for LGI under or below the population median, greater LGI increased the risk of mortality in obese elderly more than expected (p for interaction = 0.04). A U-shaped association between BMI and mortality was observed in Italian elderly subjects. While the association was independent of LGI levels, there was a significant interaction between BMI and LGI in increasing mortality risk in obese elderly individuals.

Objective: The role of antiseizure medications (ASMs) in patients with post‐stroke epilepsy (PSE) is still debated. Although a few studies have compared the efficacy of different ASMs on mortality in patients with PSE, overall evidence on the impact of ASM use on survival is limited. This study aimed to evaluate the association between ASM use and all‐cause mortality in patients with PSE. Methods: A cohort study was conducted using health care administrative database of Health Protection Agency of Bergamo (Italy). Individuals with a diagnosis of stroke followed by epilepsy onset between January 1, 2014 and December 31, 2017 were included. The date of epilepsy was considered as Index date (ID). Patients were followed from the ID until death, disenrollment, or end of follow‐up, whichever occurred first. Exposure to ASMs was defined as at least one dispensing within 30 days of the ID; patients without ASM dispensing during this period were considered non‐exposed. All‐cause mortality was analyzed using Cox proportional hazards models, with non‐exposure as the reference. Two analytical approaches were adopted: an intention‐to‐treat analysis and a time‐dependent analysis. Results: A total of 145 patients met the inclusion criteria: 107 ASM users and 38 non‐users. In the intention‐to‐treat analysis, ASM use was associated with a lower risk of all‐cause mortality (adjusted hazard ratio [HR]: 0.56; 95% confidence interval [CI]: 0.33–0.95). Consistent findings were observed in the time‐dependent analysis (adjusted HR: 0.39; 95% CI: 0.23–0.65). The sensitivity analyses confirmed the robustness of the results. Significance: In this population‐based cohort study, ASM use in patients with PSE was associated with a significantly reduced risk of all‐cause mortality compared to non‐use. These findings support the hypothesis that ASM treatment might be associated with positive effect in this high‐risk population.

Background/Objectives: Health Promotion Centres (HPCs) in Slovenia represent a European best practice for integrated prevention and health promotion. This study explores the feasibility of adapting the Slovenian HPC model to Bergamo Province, Lombardy, considering local population needs and health system characteristics. Methods: We conducted a qualitative feasibility and policy analysis based primarily on documentary review, complemented by a webinar, a study visit to Slovenia, and expert consultations (conducted in two group discussions) with professionals from ATS (Agenzia Tutela della Salute) Bergamo and local ASST (Azienda Socio-Sanitaria Territoriale) providers. Data were analysed using the PIET-T framework (Population–Intervention–Environment–Transfer). Results: Eight key elements define the Slovenian model: (1) governance and stewardship; (2) structural financing; (3) standardized service portfolio; (4) systematic preventive referrals; (5) integration with primary care and screening; (6) multidisciplinary teams with codified training; (7) community outreach and equity orientation; and (8) information systems and reporting. While Bergamo shares similar demographic and epidemiological profiles, differences in behavioral risk factors, project-based financing, fragmented initiatives, and limited digital integration necessitate adaptation. The comparative assessment highlighted key areas requiring contextual adaptation, including financing mechanisms, organisational coordination, workforce capacity, digital interoperability, and approaches to equity. Conclusions: The Slovenian HPC experience demonstrates the potential of integrated, community-based health promotion. Its adaptation to Lombardy appears feasible if core components are preserved and tailored to local governance, population, and health system conditions. These organisational features may be particularly relevant for time-dependent conditions, such as acute cardiovascular and cerebrovascular events, by potentially supporting more timely risk-factor management and coordination across diagnostic and emergency pathways. Rather than a blueprint for reform, this experience offers useful insights to reinforce prevention and health promotion within the ongoing territorial care reform in Lombardy.