The hospital policy on breastfeeding project to promote breastfeeding in Italy: not so ambitious, still effective.

Hallucinations are common and frequent non-motor symptoms of Parkinson's disease (PD), affecting 30–60% of patients. Hallucinations in PD can manifest across different sensory modalities and vary in their phenomenological complexity. Typically, structured or well-formed hallucinations, which are primarily visual in PD (e.g., seeing people, animals, objects), emerge in the mid to advanced stages of the disease. However, many PD patients also experience so called “minor hallucinations” (MH) that occur frequently and earlier in the course of the illness, and precede structured visual hallucinations by many years and later co-occur with them. MH comprise presence hallucinations (PH) (sensation that someone is nearby despite no one being there), passage hallucinations (feeling of an indefinite figure passing in peripheral vision) and illusions (misperception of actual stimuli). Both structured hallucinations and MH can cause significant distress, negatively affecting patients’ quality of life, leading to increased caregiver burden, and complicating disease management with poor functional outcome. Moreover, several clinical and research findings highlighted that hallucinations represent a risk factor for accelerated cognitive decline and dementia in PD, suggesting a more severe or rapidly progressing form of the disease. Cognitive deficits in PD can be viewed as a spectrum ranging from subtle cognitive changes and fluctuations to mild cognitive impairment and ultimately, dementia. Generally, PD patients can show deficits across multiple cognitive domains, including attention, visual and verbal memory, visuospatial abilities, and executive functions. Neuropsychological studies have consistently linked cognitive impairment and dementia to structured visual hallucinations, typical of advanced PD. Non-demented patients with structured visual hallucinations often show mild cognitive impairment with deficits in frontal subcortical cognitive functions which comprise executive-attentional processes (attentional control, inhibition, initiation, cognitive flexibility, working memory). Research also indicated a sharp decline in posterior cortical functions (visual and spatial processing, language) during the transition to dementia in patients with structured visual hallucinations. While MH are considered precursors to structured visual hallucinations and therefore a potential early marker of dementia, MH have not been linked to global cognitive decline nor dysfunction in specific cognitive domains using neuropsychological tests, despite evidence of structural and functional brain changes in PD patients with MH. Though a few studies suggested impairments of attentional control and visuospatial abilities in PD patients with MH compared to patients without hallucination, the large majority of studies did not find any significant differences in global or specific cognitive functions between PD patients with MH compared to patients without hallucination, with both groups having similar neuropsychological performance.