Silvio Berlusconi's legal challenge to a conviction of paying for sex with an under-age prostitute has opened as the former premier spent his seventh morning working with Alzheimer's patients as part of a tax-fraud sentence.

Berlusconi is appealing against a conviction, seven-year prison sentence and lifetime ban from politics.

He denies having sex with the Moroccan teenager at the centre of the scandal that revealed sex-fuelled "bunga bunga" parties at the then-premier's villa near Milan.

The appeals trial is expected to continue for months.

Berlusconi is performing community service four hours a week as part of his sentence for tax fraud. The four-year sentence was reduced to one year under a general amnesty which can apply only to a first conviction.

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