Head Injury Tied to Long-Term Attention Issues in Kids

Study says brief lapses in attention can persist, even if brain injury is mild

Monday, August 3, 2015

MONDAY, Aug. 3, 2015 (HealthDay News) -- Children who suffer even mild brain injuries may experience momentary lapses in attention long after their accident, new research finds.

The study of 6- to 13-year-olds found these attention lapses led to lower behavior and intelligence ratings by their parents and teachers.

"Parents, teachers and doctors should be aware that attention impairment after traumatic brain injury can manifest as very short lapses in focus, causing children to be slower," said study researcher Marsh Konigs, a doctoral candidate at VU University Amsterdam in the Netherlands.

This loss of focus was apparent even when scans showed no obvious brain damage, the researchers said.

Traumatic brain injury can occur from a blow to the head caused by a fall, traffic accident, assault or sports injury. Concussion is one type of traumatic brain injury. In 2009, more than 248,000 teens and children were treated in U.S. emergency rooms for sports- and recreation-related traumatic brain injuries or concussions, according to the U.S. Centers for Disease Control and Prevention.

For the study, published online Aug. 3 in the journal Pediatrics, researchers compared 113 children who had been hospitalized with a traumatic brain injury with 53 children who had a trauma injury not involving the head. The injuries, which ranged from mild to severe, occurred more than 18 months earlier on average.

The researchers tested mental functioning and evaluated questionnaires completed by parents and teachers at least two months after the injuries.

The head-injured group had slower processing speed, the researchers found. And their attention lapses were longer than those noted in the other children. But unlike other research, no differences were reported in other types of attention, such as executive attention -- the ability to resolve conflict between competing responses.

The authors note, however, that although the findings suggest an association between head injury and lapses in attention, they do not prove a direct cause-and-effect relationship.

The study did not look at remedies, but Konigs said stimulant medications prescribed for attention deficit hyperactivity disorder (ADHD) may also benefit kids with head injuries who have these attention deficiencies.

The take-home message from this study is that even mild head injury can lead to problems, said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children's Medical Center of New York in New Hyde Park, N.Y. He was not involved with the research.

"This study provides further evidence of the importance of trying to minimize brain trauma, since even when there is no visible damage on CAT scans or MRIs, there can still be a significant adverse effect on attention span and behavior," Adesman said.

This research underscores the need to protect children from head injuries through proper supervision, consistent use of child car seats and seat belts, as well as headgear when bike riding and playing contact sports, he added.

A notable finding is that these effects on attention can be prolonged, said Dr. John Kuluz, a pediatric brain injury specialist at Nicklaus Children's Hospital in Miami, who was not involved in the study. While some kids recover sufficiently after head trauma, he said, others have attention lapses that can interfere with school work.

Parents and teachers can help by restricting "sensory overload," Kuluz said. "They can be overloaded with sensory input from video games, texting and other sources."

If you are limited in your ability to pay attention, he said, "use brain energy for the important things, such as your school work. Don't spend hours and hours on video games and texting."

SOURCES: Marsh Konigs, M.Sc., Ph.D. doctoral candidate, VU University, Amsterdam, the Netherlands; Andrew Adesman, M.D., chief, developmental and behavioral pediatrics, Cohen Children's Medical Center of New York, New Hyde Park, N.Y.; John Kuluz, M.D., pediatric brain injury specialist, and director, traumatic brain injury and neurorehabilitation, Nicklaus Children's Hospital, Miami, Fla.; August 2015, Pediatrics

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Exercise in Adolescence

Exercising during adolescence may reduce the risk of death from cancer and cardiovascular disease, according to a new study.

Nearly 75,000 women provided detailed information about their physical activity between the ages of 13 and 19. Current lifestyle and medical factors including diet, body mass index and chronic disease history were also collected.

The researchers then tracked mortality outcomes for an average of more than 12 years. Overall, women who participated in exercise as teenagers had lower odds of death from cancer and cardiovascular disease as adults. Women who participated in exercise both in their adolescent and adult lives had a 20 percent lower risk for death from all causes.

The lead author says these results, “support the importance of promoting exercise participation in adolescence to reduce mortality in later life and highlight the critical need for the initiation of disease prevention early in life.” I’m Dr. Cindy Haines of HealthDay TV… with news from today that can lead to healthy tomorrows.

Dementia Meds May Lead to Harmful Weight Loss: Study

Patients can lose 10 pounds or more, researchers find

By Robert Preidt

Monday, August 3, 2015

MONDAY, Aug. 3, 2015 (HealthDay News) -- A class of drugs widely used to treat dementia -- called cholinesterase inhibitors -- could cause harmful weight loss in some patients, a new study suggests.

These medications include Aricept (donepezil), Razadyne (galantamine) and Exelon (rivastigmine).
"Our study provides evidence in a large, real-world population that cholinesterase inhibitors may contribute to clinically significant weight loss in a substantial proportion of older adults with dementia," study lead author Dr. Meera Sheffrin, a geriatrics fellow in the School of Medicine, at the University of California, San Francisco, said in a university news release.

One expert said the findings point out a common problem for Alzheimer's patients.

"Weight loss is a concern, not only for patients but also for their overwhelmed caregivers, who keep struggling with multiple challenges, including providing their loved ones with appropriate foods to maintain weight, and deliver quality of care," said Dr. Giselle Wolf-Klein, director of geriatric education at North Shore-LIJ Health System in New Hyde Park, N.Y.

For the study, Sheffrin's team reviewed VA data from 2007 to 2010 on nearly 3,500 people diagnosed with dementia. The investigators assessed weight loss for people taking newly prescribed cholinesterase inhibitors versus weight loss experienced by those taking other types of newly prescribed medications.

Cholinesterase inhibitors are known to have side effects such as gastrointestinal symptoms, the study authors noted in the news release.

After one year of treatment, more than 29 percent of patients taking the dementia drugs had a significant weight loss. Meanwhile, 23 percent of those taking other medications had a significant weight loss in the same timeframe. Significant weight loss was defined as losing at least 10 pounds over 12 months, the researchers said.

The findings show that doctors need to consider the risk of harmful weight loss when prescribing these dementia drugs to older adults. Physicians also need to watch for weight loss in patients taking the drugs, the study authors said.

"This is very relevant to patient care because unintentional weight loss in older adults is associated with many adverse outcomes, including increased rates of institutionalization and mortality, a decline in functional status, and poorer quality of life," Sheffrin said.

But Wolf-Klein said it's tough to tease out the cause of weight loss in people with Alzheimer's disease.

"Weight loss in Alzheimer's disease is a well-known clinical problem, which was described many years before the advent of the new therapies," Wolf-Klein said. But, on the other hand, the drugs also "have all been associated with gastrointestinal complications, such as weight loss, nausea and vomiting," she added.

Wolf-Klein also explained that, for now, none of the drugs stops Alzheimer's disease, they merely slow illness progression. So, when weight loss becomes a concern, "timely discontinuation of cholinesterase inhibitors should be actively considered as demented patients progress in their disease," she said.

Another expert agreed.

"The results of this study suggest that the harms from these medications may outweigh their benefits, and that a decision to use them should be undertaken only after a detailed discussion between doctors, patients and caregivers," said Dr. R. Sean Morrison, professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai in New York City.

About one in six people over 80 are affected by Alzheimer's disease and other dementias, the researchers noted.

The study is published in the August issue of the Journal of the American Geriatrics Society.

SOURCES: Gisele Wolf-Klein, M.D., director, geriatric education, North Shore-LIJ Health System, New Hyde Park, N.Y.; R. Sean Morrison, M.D., co-director, Patty and Jay Baker National Palliative Care Center, and professor, geriatrics and palliative medicine, Icahn School of Medicine at Mount Sinai, New York City; University of California, San Francisco, news release, Aug. 3, 2015

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Combo Rx May Boost Ovarian Cancer Outcomes, But Too Few Get It: Study

Therapy involves dosing chemo directly into the abdomen, researchers explain

By Robert Preidt

Monday, August 3, 2015

MONDAY, Aug. 3, 2015 (HealthDay News) -- Chemotherapy delivered directly into the abdomen significantly improves survival among women with advanced ovarian cancer, a new study finds.
However, fewer than half of U.S. patients who could benefit from this treatment -- called intraperitoneal chemotherapy -- are receiving it, according to Dana-Farber/Brigham and Women's Cancer Center researchers.

The investigators studied whether a combination of intraperitoneal (IP) and intravenous (IV) chemotherapy was as effective in clinical practice as in a clinical trial involving women who'd had surgery for stage III ovarian cancer.

The researchers examined the medical records of more than 800 women who were treated for stage III ovarian cancer between 2003 and 2012, and were eligible for IP/IV combination therapy.
According to the study, 81 percent of women who received the dual therapy were alive three years after treatment, compared with 71 percent of those who received IV chemotherapy alone. However, only 41 percent of the patients who were deemed to be suitable candidates actually received the dual therapy, the team reported.

The investigators also found that the side effects of the dual therapy were less severe than those reported in the clinical trial.

"This is the first study to show that IP/IV chemotherapy improves survival in the real world, outside of a clinical trial," first author Dr. Alexi Wright, of Dana-Farber Cancer Institute in Boston, said in an institute news release.

"Unfortunately, fewer than half of women who qualify for IP/IV chemotherapy received the treatment. This suggests that increasing access to IP/IV chemotherapy may improve ovarian cancer patients' survival," she added.

Two experts not connected to the study agreed that the combo treatment may work better, but side effects are often an issue.

"The National Cancer Center Network guidelines do recommend this treatment option for patients with stage II or higher disease," said Dr. Eva Chalas, chief of gynecologic oncology at Winthrop-University Hospital in Mineola, N.Y.

"However, this treatment is more poorly tolerated by patients, and is associated with more side effects," she added, and the new study pointed that out, as well.

Still, "patients should be aware that this therapy represents a very effective option and should remain motivated to proceed, if it is recommended to them by their gynecologic oncologist," Chalas said.
Dr. Kit Cheng is a medical oncologist at North Shore-LIJ Cancer Institute in Lake Success, N.Y. She believes that future clinical trials "will shed more light to the best treatment to improve the survival of our [ovarian cancer] patients with the least amount of side effects."

The study was published in the Aug. 3 issue of the Journal of Clinical Oncology.

SOURCES: Kit Cheng, M.D., medical oncologist, North Shore-LIJ Cancer Institute, Lake Success, N.Y.; Eva Chalas, M.D., chief, gynecologic oncology and director, clinical cancer services, Winthrop-University Hospital, Mineola, N.Y.; Dana-Farber Cancer Institute, news release, Aug. 3, 2015

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Picky-eating Pre-schoolers

‘The picky eater’… up to 20 percent of parents say they’ve got a pre-schooler who is often or always selective with food, according to the authors of a new study.

So researchers wanted to know whether this phenomenon is developmentally normal or a sign that intervention is needed. They recruited more than 900 children 24 to 71 months old… Through questionnaires and in-home visits, their caregivers provided detailed information about eating habits, psychiatric symptoms and living environment.

The results… Both moderate and severe levels of selective eating were associated with symptoms of depression, social anxiety and generalized anxiety. Moderate levels were also associated with symptoms of separation anxiety and ADHD.

The authors say these findings show, “there is a need to develop interventions or provide further guidance to caregivers about the management of selective eating.” They say screening for this behavior may be a useful tool for identifying children vulnerable to anxiety issues.

I’m Dr. Cindy Haines of HealthDay TV…with the news that your doctors are reading – health news that matters to you.

Vitamin D and Bone Health

Will taking high doses of vitamin D help maintain bone health?

More than 200 post-menopausal women took part in a new study that looked at the benefits of high-dose vitamin D supplementation. At the start, none had osteoporosis, but all had vitamin D blood serum levels considered insufficient by some experts. The researchers divided participants into three groups. One group received placebo pills, another low-dose supplementation and the third, high-dose supplementation. Calcium absorption decreased in women taking placebo and low-dose vitamin D. And while it increased 1 percent in the high-dose group, that small change was not associated with any beneficial effects. The authors found no difference between the three groups when it came to bone mineral density, muscle function, muscle mass or falls. According to the study authors these results do not justify the practice of administering high-dose vitamin D to older adults to maintain high blood levels. I’m Dr. Cindy Haines of HealthDay TV your source for ideas to protect your health.

Bentley Continental V8S

Bentley is pitching the V8S as a car for V8 owners “who want more”. It’s priced at £139,000 – £9k more than the V8, roughly the same as the regular 567bhp W12 and below the range-topping 616bhp W12 Speed. Think of it as a more sporting, dynamic Conti GT.

Externally, the V8S has a more aggressive front splitter, side sills and rear diffuser. Our test car was fitted with the optional 21-inch alloys wrapped around the largest ceramic brake discs ever fitted to a production car (420mm front, 356mm rear – yours for £10,405...).

But the V8S is much more than a vanity pack. Engine output has been increased by 21bhp, taking the twin-turbo V8’s output to 521bhp and cutting the 0–60mph time by 0.4sec to 4.3secs, the same as the regular W12. With a 192mph vmax. Torque is up, too, from 487lb ft to 502lb ft, the whole lot on tap from 1,700rpm to 6,000rpm. This increased power reaches all four wheels through an 8spd ZF auto, recalibrated to hold onto the gears for longer.

Economy and emissions remain the same (26.7mpg, 246g/km CO2), thanks in part to the cylinder deactivation system, in which four cylinders are turned off when light-throttle ‘cruising’, the full eight coming on song when your inner Stig takes control.

Bentley has dropped the sports suspension by 10mm, increased the spring rates, revised the damping, stiffened the bushes and rear anti-roll bar and recalibrated the steering for “improved precision and feedback”.

Inside the V8S, it’s business as usual as you drop into one of the finest interiors in the car world. Take it easy in the S, and it’s lost none of the GT’s ability to devour huge distances with that dismissive poise that has earnt the Conti its reputation as such a fine GT car. But if you drop the ’box into S and gun the throttle, the V8S rides its torque, building speed in a way that no car weighing more than 2,200kg should, the optional sports exhaust serving up a very British baritone soundtrack.
Once you’ve adjusted to the fact that your GT has transformed into something altogether more menacing, you can dig into ?the staggering grip that the AWD GT can deliver. The revised steering is more precise, while the brakes remain face-bendingly effective.

True, the standard Conti W12 offers more power for about the same cash, but the V8S is cleverer than that. It’s a car concerned with the detail rather than merely the headline figures, and all the better for it.

Charlie Turner

3993cc, V8 twin-turbo, AWD, 521bhp, 502lb ft  26.7mpg, 246g/km CO2 ?0–60mph in 4.3secs, 192mph  2295kg  £139,000

Bentley Flying Spur V8

At first, the new V8 version of Bentley's four-door Flying Spur seems like a bit of a no-brainer versus the more expensive W12-engined variant. It looks virtually identical, has the same wonderful eight-speed gearbox, the same four-wheel-drive system, the same fragrantly opulent interior. It still has a pair of turbos, air suspension, a huge boot and enough space in the back to hold a bijou polo match. Albeit on tiny horses.

And yet it doesn't give much away in terms of performance: 62mph arrives only point-six of a second after the W12 (4.9 vs 4.3), and although the W12 musters membership of the 200mph club, a 183mph top speed isn't exactly going to leave you red-faced, even on the autobahn. It's 10 grand-plus cheaper, and, if you need a final nail in the coffin, manages nearly 26mpg rather than 19.2 for the W12, thanks to cylinder deactivation - it runs as a four-cylinder at small throttle openings.

And there's no ‘but' coming. Largely, the V8 Spur does everything the W12 does, and does it just as well. It's ever-so-slightly lighter than big brother - only by about 55kg - and with 500bhp and 488lb ft from the Audi-derived 4.0-litre bi-turbo, never feels slow. Plant the throttle in a straight line and the car has tremendous grunt, bellowing like a V8 heard through a pillow. The air suspension controls things well enough, and there's a choice of four different levels of stiffness - though, to be honest, the differences between the four strata aren't revelatory. You'll still roll into corners to set the Spur's stance before powering out, and this is not a car that shrinks: it always feels like two-and-a-half tonnes and 17.5ft of precious things.

But the basic message is that it's a fine Bentley. For waft, the W12 does hum more agreeably for this kind of car, and the V8 does make a bit more sense in the coupe, where this slightly more snarly, aggressive engine can be worked harder to better effect. The satnav/multimedia is dated, and the ride can be a little brittle over really bad surfaces. But we're being picky - and anyway, the optional Naim Audio stereo system makes you forget all that.

And yet, it's not quite as altruistic as it sounds. The Flying Spur is aimed at China - Bentley's biggest market after the US - and the reason for the smaller engine is a set of specific Chinese tax laws that attack cars with engines over four litres. Not that it matters - the V8 might not have the bar-room kudos of the ‘top' W12 model, but it's a cannier buy if you like a plush, imposing Bentley four-door with relatively reasonable running costs.

Tom Ford

The Numbers
3997cc V8 petrol, 4WD, 500bhp, 488lb ft, 25.9mpg, 254g/km CO2, 0-62mph in 4.9secs, 183mph, 2417kg, £136,000

The Verdict
A smaller-engined Spur that loses little in performance. The four-door Bentley of choice.

Bentley Continental GT3-R

Bentley's motorsport kudos has, until recently, relied on ancient history. Lord knows how the Bentley Boys even got out of London in their late Twenties Blower behemoths, never mind drive all the way to Le Mans, race the same vehicles for 24 hours, then roar back home for an evening's committed carousing.

Bentley won again at La Sarthe in 2003, of course, an internecine disruptor to Audi dominance. But the Continental GT3-R arrives as a road-going counterpart to a much newer competition car. The GT3 race version almost scored a podium finish on its debut in the Gulf 12 Hours at Yas Marina last December and picked up Bentley's first British race win for 84 years at Silverstone in the Blancpain this summer. A heaven-sent marketing opportunity, the result is arguably the lairiest Bentley since Birkin, Barnato and Co were waxing their moustaches.

That said, a few comparative facts are in order. The GT3 race car runs Bentley's 4.0-litre, twin-turbo V8, good for 600bhp unrestricted, fired to the rear wheels only via a carbon-fibre propshaft and harnessed by Xtrac's fabulous six-speed sequential 'box, fitted as a transaxle to optimise weight distribution. It also loses the front driveshaft, and its doors weigh a skinny 7kg compared to the road car's thumping 57kg. All in, it weighs 1,295kg.

The GT3-R is 100kg lighter than the regular road car but still troubles the scales at 2,195kg. That's pretty corpulent for a race-bred road car, even in this day and age, but the fact is the R has a wholly different job to do. "To be a true Bentley, the GT3-R had to be the most luxurious track-inspired GT ever, and this car pushes our trademark combination of luxury and performance to a new level," chairman and CEO Wolfgang Dürheimer says.

Just a bit. The engine is the familiar 4.0-litre V8, whose brace of turbos have been tweaked to run fatter boost, pumping the power output up to 572bhp, and shovelling out 516 torques from a sleepy 1,700rpm. It's a proper tarmac peeler.

More significantly, the Continental's ZF eight-speed transmission now runs shorter gearing, intensifying sensation as the GT3-R warps to 60mph in 3.6 seconds and beyond to its reduced - but surely academic - 170mph top speed. TG clearly loves the idea of a rear-drive Continental, but Bentley insists that all-wheel drive is a signature (re-engineering the car to that extent would have cost a fortune, too).

At least we get torque vectoring on the rear wheels for the first time, as well as recalibrated software for the car's drivetrain modes and a slightly less invasive stability system. There's also a new titanium exhaust system, which accounts for seven of the 100kg the R has lost, as well as thrusting the soundtrack deep into barrel-chested Barry White vocal territory. That, plus the Glacier White paint job, green go-faster stripes, wing decals (yuck), and carbon-fibre diffuser and wing, suggest that this particular Continental is disinclined to hide its light under a bushel.

I can't see too many of those anyway, as we head north into upstate New York. It takes monastic restraint not to bury the throttle the second we segue onto the interstate, but it's the R's composure over rubbishy, rumbly US tarmac and expansion joints that hits home first. This thing is wearing 275/35 rubber at all corners wrapped around 21-inch forged-alloy wheels but does an epic job of repelling real-world irritants like road and surface noise. It's extremely impressive. The Conti's air springs and dampers have been battle-hardened, but the calibration is well judged.

The cabin isn't for the faint-hearted, though. Haul those hefty doors shut, and you're admitted to a place of unparalleled build quality. Bentley sources its leather from Scandinavian cattle, whose hides are unblemished because there's no barbed wire to nick them. The bespoke carbon-fibre seats themselves are superb, there's diamond-quilted Alcantara facings on the doors, and handcrafted carbon-fibre inlaid on the dash. Even the paddle-shifters have been redesigned. But there's a lot of green in here. It's a divisive colour, green, and the accents are up the side of the centre console, on the seat bolsters and run round the rear compartment, now devoid of seats. It's greener than Kermit the Frog chairing  a Green Party meeting in Greenland.

In other news, the Continental is now supercar-fast. Acceleration and deceleration - thanks to 420mm carbon-ceramic front discs and 356mm rear ones, and eight-piston calipers - are now mighty enough to comprehensively rearrange your facial features. There's maybe a nanosecond of hesitation as the R prepares to throw 2.2 tonnes down the road, but too many other sensations get in the way before that one gets a look in. What it lacks in light and shade (the steering could use more feel, for example; the chassis, a little more interactivity), it makes up in sheer, unstoppable momentum. Except that it does stop, with immense conviction. To be reductive, it's almost a cut-price Bugatti Veyron.

On which basis, Bentley will have no trouble whatsoever selling the 300 GT3-Rs it's planning to build, even at the eye-watering price of £237,500 each.

Jason Barlow

The Numbers
3993cc twin-turbo V8, 572bhp, 516lb ft, 22.3 mpg, 295 g/km CO2, 0-60mph in 3.6secs, 170mph, 2195kg, £237,500

The Verdict
No hardcore uproar in this Bentley, but it's still brutally fast and beautifully made.

Bentley Continental GT 6.0 W12 Speed 2dr Auto

What’s this, then? A mid-life freshen-up for the Bentley Continental GT, a visual nip/tuck that starts at the front bumper and finishes at the rear spoiler and does, well, not that much in between. Really? Really. As facelifts go, this is one of the more minor. The front bumper has been chiselled, there are new B-for-Bentley vents on the front flanks, three new colours, more leather choices, and knurled gearlever paddles. Need more excitement? Well, wi-fi is now standard, there are new fonts for the dials and a reshaped steering wheel. What about more power? Oh yes, a bit of that too, but you’re not going to feel a gain of 15bhp when the W12 was already developing 567 of the suckers. That’s a 2.6 per cent power hike. Whoop. The other engines remain where they were - the entry-level V8 has 500bhp, the uprated V8 S 521bhp, and the flagship W12 Speed sticks on 626bhp. Oodles. No, the big news as far as engines go isn’t the power, but the economy. The W12 joins the V8 in having a cylinder shut-off system. No mean feat, you’d imagine, given that it has four banks of cylinders… Does that actually save any fuel? Apparently so. Due to the engine’s massive torque, Bentley claims the 6.0-litre W12 can actually run as a 3.0-litre V6 quite a bit of the time. The official economy figure for the standard 6.0 has risen from 19.5 to 20.1mpg, but privately Bentley believes the real world gains could be as much as 20 per cent. When I’ve driven Contis before they’ve always done about 15-16mpg, but this one was reading 18.4, so maybe there’s some truth in it. Hardly economical, though. No, but then if you can afford upwards of £140,300 (yep, that’s the base price now, the W12 Speed sits at 168,300, having gone up £11,600 from last year), you’ll be more concerned about how often you’re stopping for fuel rather than how much it’s costing you. The 20-gallon tank should mean you’ll get at least 350 miles between glugs. Does the Conti feel different as a result of these changes? Not really, although it does look a bit sharper. Personally, although the front end is now more defined, I think the extra scoops low down are too reminiscent of an Audi RS. Inside is good, too, with new straight fluting available for the seats (diamond pattern is still the way forward if you ask me), Alcantara headlining, LED illumination and updated brightwork. Detail changes, but this is probably all the Conti needs. How so? Because this is Bentley’s Porsche 911, the car that defines the brand to such an extent they can’t afford to tamper with it too much. Also, name me a car that truly, genuinely does what this one does - a real luxury GT. Not a Maserati GranTurismo, nor a Porsche 911 - too cramped and sporty. BMW 6-Series? Far too common. Rolls-Royce Wraith? Too stately and you’re into parts-of-a-million pricing. The only thing I came up with is the new Merc S-Class Coupe. That’s a lovely car, and really the only rival I’d drive if I was considering a Conti GT, but it doesn’t have the same sense of imperious progress and craftsmanship. Bentley knows its audience for this car so accurately that I’d swear each car is orientated to a specific buyer. What do you mean? If you’re young, have a V8, if you’re old, a W12 and if you like to gad about in the spirit of a Bentley Boy, have one with a suffix. Preferably ‘Speed’. In all seriousness, the V8 S is probably the pick of the range. It’s so strong and has a good dollop of charisma. The W12 is massively smooth, but a bit too hushed in standard trim. The Speed brings the noise and spirit back - it’s deeply, deeply fast. 0-60mph in 4.0secs doesn’t sound that fast these days, but then no Bentley has launch control - not really in the spirit of things, old chap. Give this thing the ability to depart the line with 4,000rpm on the dial and I bet you’d be looking at a sub-4 time. Once up and running, the W12 is mighty. And it’s mighty everywhere from about 1,200rpm on. There’s just so much torque. It’s loveliest in manual mode - stick it in a high gear and 607lb ft get to work on your lower spine. But the V8 S is the one to have? It is if you like driving. It manages its weight better than the W12, and does a passable impression of sportiness. The body control is exceptional for something weighing over 2.2 tonnes. Until something goes wrong. You hit a patch of standing water, a nasty mid-corner ridge, and you’re suddenly very aware of how much weight is being asked to behave itself. Good trick up to that point though. So no quantum shift for the Conti? As I said before, this car is already so well targeted at its audience, I don’t think there’s much Bentley can do that they’re not already doing. The only obvious ‘improvement’ would be to add hybrid technology to boost the smoothness/torque appeal yet further. Last year, then-CEO Wolfgang Schreiber said that by the end of this decade 90 per cent of Bentleys would be available with hybrid technology. Provided they’ve not changed their mind on that, I’m going to assume that the reason this facelift is so minor is that Bentley is busy preparing something much more dramatic for the next generation…