bluuebunny/crossref_metadata_2025 huggingface dataset:
Cerebral blood flow changes in normal aging: Spect measurements
Authors: Swartz J. Randolph , Lesser Ira M. , Boone Kyle B. , Miller Bruce L. , Mena Ismael
Published: December 2004

Global and regional cerebral blood flow (CBF) were evaluated with single photon emission computerized tomography (SPECT) utilizing both 133Xenon (133Xe) (47 subjects, 47–82 years old) and 99Tc‐hexamethylpropyleneamine oxime (99Tc‐HMPAO) (27 subjects, 47–80 years old). The 133Xe results showed: among total subjects, no age‐related decline in global CBF, but a significant regional decline in the occipital lobe (p < 0.05); among men, significant age‐related declines in global, frontal, temporal, occipital and right hemisphere CBF (all p < 0.05); among women, no age‐related decline in global or regional CBF. The 99Tc‐HMPAO results showed no age‐related decline in either global or regional perfusion among total subjects, men or women. These results suggest that age‐related global and regional (including frontal lobe) CBF declines do not occur in healthy control subjects after the age of 45 years. However, gender differences in age‐related CBF changes warrant further study.
Hallucinations in Parkinson's disease: Characteristics and associated clinical features
Authors: Haeske‐Dewick Hilary C.
Published: December 2004

This study was undertaken to ascertain the prevalence of hallucinations in patients with Parkinson's disease, describe such hallucinations and determine factors that discriminate patients who experience hallucinations from those who do not. Initially, 10 out of 43 (23.3%) patients completing a self‐report screening questionnaire reported hallucinations. However, when 36 of these patients were interviewed, it was found that the self‐report questionnaire had extremely low sensitivity (56.3%) since 16 (44.4%) patients now described hallucinatory experiences. These experiences were reported in all sensory modalities except for that of taste. The reality qualities of visual hallucinations were investigated and were found not to resemble everyday visual experiences or documented LSD‐induced hallucinations or those of schizophrenia. Age, disability stage, self‐reported sensory loss and cognitive decline were significantly greater in those experiencing hallucinations. Premorbid intelligence, daily levodopa intake and the use of other anti‐Parkinsonian medications were not revealed as factors discriminating those with hallucinations from those without. Carer burden was related to severity of depression in the patient. After matching for age, depression did not differ significantly between groups.
Elderly criminals: A study of the first criminal offence in old age
Authors: Barak Yoram , Perry Tova , Elizur Avner
Published: December 2004

Although the majority of criminal offences are committed by young persons, about 1% of crimes have been reported in men over 65 years of age. Among prison populations association between old age and mental illness is often reported. We decided to evaluate all first‐time criminal offenders in the greater Tel Aviv area aged 65 years or older. Each person against whom the District Attorney brought forth an indictment in the period 1987–1992 was interviewed by a psychiatrist specializing in psychogeriatrics. Twenty‐six males and two females were thus evaluated. Their average age was 69.2 years (range 65–80). Forty‐three per cent of the offences were of a financial nature, and serious violence presented in 10.7% of the cases. Fifty per cent of the study's series suffered from a neuropsychiatric disorder, dementia and personality disorders accounting for half of those.
Temporal shifts in peak daily activity in Alzheimer's disease
Authors: Ghali Laura M. , Hopkins Robert W. , Rindlisbacher Peter
Published: December 2004

Clinicians caring for Alzheimer patients have observed that some individuals show increased agitation, restlessness and confusion in the late afternoon, evening or at night. This has popularly been named ‘sundowning’ or ‘the sundowning syndrome’. Despite its obvious clinical importance, little research has been conducted to investigate abnormal activity patterns in patients with Alzheimer's disease. In this study, rest–activity patterns were examined using and electronic monitor with a movement sensor. Eighteen patients diagnosed with Alzheimer's disease were monitored for 48 consecutive hours each. Analyses indicated that some subjects showed increased activity around the time of sunset, and that these individuals were most likely to be in the middle stages of the disease. Subjects in the early stages of the disease showed peak activity before sunset, while those in the late stage showed peak activity after sunset. This progressive phase shift with increasing years of illness is a previously unreported phenomenon which may offer an explanation for the ‘sundowning syndrome’.
Time for change—psychiatric morbidity in residential homes for the elderly
Authors: Neville Peter G. , Boyle Ann , Brooke Sara , Baillon Sarah , Scothern Gail , Broome Colin
Published: December 2004

Previous studies of psychiatric morbidity in Local Authority Social Services Part III homes have shown high rates of depression and dementia. Our study of Part III homes in Leicester city shows higher rates and greater severity of dementia than these studies. Eighty‐two per cent were diagnosed as suffering from dementia to some degree and 53% showed severe levels of cognitive impairment and dependency. A rate of depression (17%) was found, lower than in previously reported studies. These results seem to reflect the changing role of Part III homes in service provision for the elderly population.
Evaluation of an italian educational programme for dementia caregivers: Results of a small‐scale pilot study
Authors: Magni E. , Zanetti O. , Bianchetti A. , Binetti G. , Trabucchi M.
Published: December 2004

The study investigates the role of the characteristics of direct caregivers and of their demented relatives in the effectiveness of an educational programme for caregivers. Measures of stress, depression and knowledge of the disease were employed to monitor the effects of an eight‐session programme. Variables related to both the caregiver and the patient were significantly related to the degree of improvement during the course. Our conclusion is that the efficacy of educational programmes is related to caregiver‐patient interaction.
Presenile dementia: Sufferers, carers and services
Authors: Delany Norma , Rosenvinge Henry
Published: December 2004

An extensive search was made for people with presenile dementia (PSD) still under 65 years living in the Southampton Health District. Twenty‐seven sufferers were identified. People with PSD had a high degree of cognitive, behavioural and self‐care disabilities and carers showed considerable stress. Services were received from the old age psychiatry team, and to a lesser extent from social services and the Community Rehabilitation Unit. Community psychiatric nurses were the commonest form of support. The four sufferers in receipt of no services were less impaired. Identified needs included more counselling and advice and specific provision for the more physically active sufferer.
Cognitive assessment and diagnosis of dementia by camdex in elderly general hospital inpatients
Authors: Lázaro L. , Marcos T. , Pujol J. , Valdés M.
Published: December 2004

One hundred and eight patients aged 70 and older randomly chosen from those admitted to the departments of medicine and surgery in a university hospital were examined for dementia by the Cambridge Mental Disorders of the Elderly Examination (CAMDEX) and DSM‐III‐R criteria. Cognitive impairment was assessed by the cognitive section of the CAMDEX (CAMCOG) and the Mini‐Mental State Examination (MMSE). Fifty‐one per cent of the sample met DSM‐III‐R criteria for at least one psychiatric disorder, dementia being the most common (35%). The cut‐off point of CAMCOG (60/61) was more effective (100% sensitivity and 97% specificity) than the cut‐off point of MMSE (21/22) (95% sensitivity and 86% specificity) in detecting dementia, although the optimal cut‐off point of CAMCOG for our sample was lower than that suggested in previous studies.
Ethical issues in research with dementia patients
Authors: Berghmans Ron L. P. , Meulen Ruud H. J. Ter
Published: December 2004

The conduct of scientific research involving dementia patients is an ethically complex issue. Increased insight into the causes and aetiology of this condition can be of paramount importance for future patients and society as a whole. However, the rights and interests of vulnerable and incompetent persons as subjects in research make ethical boundaries imperative. A distinction should be made between research that may directly be of benefit to the subject (therapeutic research) and research in which no direct benefit for the patient can reasonably be expected (non‐therapeutic research). The majority of the research with dementia patients falls within the latter category. Several ethical issues are discussed, and special attention is paid to the ethical justification of non‐therapeutic research involving incompetent subjects suffering from dementia. Five conditions that should be met in order to make this kind of research ethically acceptable are formulated.
Personal history of depression and its appearance in Alzheimer's disease
Authors: Carpenter Brian D. , Strauss Milton E. , Kennedy John S.
Published: December 2004

This review of medical charts explored the prevalence of personal history of depression in two groups of geriatric inpatients with current major depression. One group had concurrent Alzheimer's disease (AD) along with major depression, while the other had major depression without dementia. Patients with major depression and no dementia were nearly three times as likely to have had a depressive syndrome in the past compared to patients with major depression and AD. Most depressed AD patients were experiencing their first episode of depression. This suggests that AD may be a risk factor for the first lifetime occurrence of depression. While the pattern of specific depressive symptoms was similar between groups, patients without AD more often reported symptoms with a substantial cognitive element (eg thoughts of death, worthlessness) and patients with AD demonstrated more non‐verbal manifestations of depression (eg tearfulness, sad face). A diathesis–stress model that takes into account the neuropathological and psychological concomitants of both depression and AD may be a useful framework for understanding how these two disorders influence one another.
Cognitive screening in a population‐based sample of community‐living elderly: Effects of age and education on the construct of cognitive status
Authors: Fisk John D. , Rockwood Kenneth , Hondas Bonnie , Tripp Dean A. , Stadnyk Karen , Doble Susan E.
Published: December 2004

This study examined the measurement properties of a cognitive screening test, the Halifax Mental Status Scale (HMSS), in a population‐based sample of community‐living elderly subjects (N = 361) and a clinic sample (N = 20) of patients with Alzheimer's disease. Receiver operating characteristic analyses yielded estimates of sensitivity and specificity of approximately 90% for this test. Factor analysis confirmed a three‐factor solution for the HMSS. Although both age and education were correlated with the HMSS total score, their relationship to the factor scores differed. Our study shows that comprehensive cognitive status tests do not measure a unitary construct and that adjustment of summary scores for education is unlikely to optimize sensitivity and specificity. In population‐based studies, only those components of a test that reflect education should be adjusted.
Non‐cognitive psychiatric symptoms in vascular and Alzheimer brain disease
Authors: Birkett D. Peter , Agdeppa Julita
Published: December 2004

Psychiatric symptoms, other than dementia, are compared in two groups of mental hospital patients who came to autopsy and had complete brain examination. One group had Alzheimer brain changes with no cerebral infarction. The other group had cerebral infarction with no Alzheimer brain changes. Onset with a non‐dementing paranoid illness after the age of 50 was commoner in the Alzheimer group. There was no predominance of affective symptoms in either group. Suddenness of onset of psychosis distinguished the infarct cases, even in cases where there was no neurologically evident stroke, and when there were long time intervals between onset and death. Those destined to suffer Alzheimer brain changes had a less sudden onset, fewer discharges and rehospitalizations and more frequent transition to dementia.§
Assessing response to tacrine using the factor analytic structure of the Alzheimer's disease assessment scale (Adas)—cognitive subscale
Authors: Olin Jason T. , Schneider Lon S.
Published: December 2004

A factor analysis of the Alzheimer's Disease Assessment Scale—Cognitive subscale (ADASc), the primary cognitive outcome measure in most clinical trials of drugs for Alzheimer's disease, was undertaken to test whether factor scores are differentially sensitive to change in a placebo‐controlled 30‐week trial of the cholinesterase inhibitor tacrine. The factor analysis identified three factors: language, memory and praxis, a factor structure similar to an earlier report. All three factors showed worsening for placebo patients and improvements for tacrine patients, with significant between‐group treatment effects. None of the factors was significantly more sensitive to change than another, suggesting that tacrine affects a range of cognitive function.
Determinants of the judgement of general practitioners on dementia
Authors: Wind Annet W. , Schellevis FrančOis G. , van Staveren Gerrit , Scholten Rob J. P. M. , Hooijer Chris , Jonker Cees , van Eijk Jacques T. H. M.
Published: December 2004

The aim of this study was to determine whether the judgement of general practitioners (GPs) on dementia conforms to the international concept of dementia. In this cross‐sectional study we related GPs' judgements on dementia to items of the DSM‐III‐R criteria for dementia. Thirty‐six GPs participated in the study, as well as 3731 community‐dwelling elderly subjects. Items of the criteria for dementia were measured independently of the GP judgement, using the Geriatric Mental State Schedule (GMS). The GPs' judgements were related to the three criteria: memory (odds ratio (OR) = 2.1 (95% CI: 1.8–2.4)), other cognitive functions (OR = 1.6 (95% CI: 1.3‐1.9)) and daily functioning (OR = 1.5 (95% CI: 1.3–1.9)). At item level, several relevant items of the criteria were related to the GPs' judgements recall, time orientation, concentration and muddled thinking. In addition, three items of daily functioning demanding cognitive skills (dependency in travelling, using medication and handling finances) were related. The items related to the severity categories of the GPs' judgements reflected the process of progression in dementia. We concluded that GPs conform to the international concept of dementia in their judgement on the presence of dementia, as well as in their categorization of severity.
Memory complaint in attenders at a self‐referral memory clinic: The role of cognitive factors, affective symptoms and personality
Authors: Barker Andrew , Prior Jacky , Jones Roy
Published: December 2004

Memory complaint has been shown to be poorly correlated with objective memory performance in non‐demented elderly people. A previous study indicated the possible importance of depression and personality in the presentation of memory complaint in people with mild memory impairment. The present study overcomes some previous methodological limitations and describes memory complaint, cognitive, affective and personality variables in subjects with mild cognitive impairment self‐referring to a memory clinic, with non‐presenting age‐ and sex‐matched community controls. Self‐referrers had a higher original IQ, but no evidence of greater decline in memory despite having more memory complaint. Personality factors were demonstrated to be important alongside affective symptoms in the presentation of memory complaint in these subjects.
Length of hospital stay and the timing of ECT
Authors: Ball C. J. , Fashola Y. , Herzberg J. L.
Published: December 2004

The lengths of stay of patients receiving ECT and medication or medication alone on an acute elderly admission ward were retrospectively compared. The lengths of stay for those who received ECT were significantly longer than for those not receiving ECT. If the ECT was given within 4 weeks of admission, the length of stay was similar to those receiving medication alone. In addition to symptom complexes, the decision to use ECT should take into account the length of the illness. Early ECT may reduce lengths of stay and decrease the likelihood of chronicity.
Family members'perception of the quality of nursing home care
Authors: Grau Lois , Teresi Jeanne , Burton Brenda , Chandler Barbara
Published: December 2004

This study investigated the extent to which factors not directly related to the caregiving situation predicted family members' perceptions of the quality of nursing home care their elderly relative received. A conceptual model based on consumer satisfaction theory was used to test the extent to which factors associated with family members' expectations for care and their emotional response to the nursing home placement predicted perceptions of quality among 452 relatives representing the residents of two skilled care facilities. The entire model accounted for 27% of the variation in quality assessments. Attitudes towards nursing homes in general, length of resident stay and emotional responses to the placement (concern about the race/ethnicity of caregivers, caregiver burden and caregiver emotional distress) were found to be significant predictors of perceptions of quality.
Behavioural complications of dementia—can they be treated?
Authors: Hinchliffe A. C. , Hyman I. L. , Blizard B. , Livingston G.
Published: December 2004

Subjects over 65 with DSM‐III‐R dementia and living in the community (with carers) who were General Health Questionnaire (GHQ) cases were recruited. Subjects were assessed using the Mini Mental State Examination and the Geriatric Mental State (GMS). Carers were interviewed using the GMS or the CIS (Clinical Interview Scale). Information was collected on behavioural disturbance in their relatives using the Present Behavioural Examination; the most distressing behaviours were noted. A multidisciplinary team generated an individualized plan aiming to reduce the most distressing behaviours. Couples were then randomized into groups 1 and 2. For group 1, plans were implemented over 16 weeks and they were then reassessed using the same rating scales as before (phase 1). They were followed up a further 16 weeks later to see if the benefits of intervention were sustained (phase 2). Group 2 were assessed after a period as waiting list controls (phase 1). Their plans were then implemented and they were reassessed (phase 2). There was an improvement in carer mental health and in the behavioural difficulties of the person with dementia for group 1; the two measures of outcome were associated. For group 2, there was no improvement in either outcome measure. The findings are discussed in relation to their relevance for clinical practice.
Psychiatric diagnoses, outcomes and lengths of stay of patients admitted to an acute psychogeriatric unit
Authors: Moss Francine , Wilson Brett , Harrigan Susan , Ames David
Published: December 2004

One hundred and ten consecutive patients admitted to an acute psychogeriatric unit were assessed with the Geriatric Mental State Schedule, Assigned a DSM‐III‐R diagnosis and their length of stay in hospital and discharge destination noted. Forty‐two per cent of patients had organic disorders (mainly dementia), 32% had affective disorders (mainly depression) 23% had schizophrenia or a related disorder. The median length of stay was 29 days and bore little relation to diagnosis, age, sex or cognitive function. Patients with an organic mental disorder were more likely to enter long‐term institutional care, but 78% of patients were able to return to the same level of accommodation (own home, hostel or nursing home) that they had occupied prior to admission. On a four‐point non‐blind outcome scale, 86% of patients were rated as improved at discharge.
Postprandial blood pressure changes in geropsychiatric patients
Authors: Vieweg Victor , McRae Barbara , Eldridge Estena , Lewis Robert
Published: December 2004

Postprandial hypotension is more common among the elderly than among the young. Complications of postprandial hypotension potentially include falls, fractures and death. We studies 21 ambulatory patients in a university‐affiliated, state‐operated geropsychiatric hospital. Subjects had major psychiatric diagnoses and received vasoactive drugs for those diagnoses. After baseline measurements, study subjects ate lunch within 15 minutes. The next day, we repeated the procedure except that study subjects did not eat lunch until after they completed the protocol. Mean blood pressure progressively dropped during the 45‐minute period following eating with the greatest difference between eating and not eating values occurring at 45 minutes. Our study results more closely approximated the findings in the literature for community‐dwelling elderly than geropsychiatric patients in residential settings. Age alone may explain study differences. Based on our preliminary findings, it may be that major psychiatric illness and/or its treatment do not alter age‐related cardiovascular hemodynamics in geropsychiatric patients compared with their non‐psychiatric counterparts.
Dementia and driving: Results of a semi‐realistic simulator study
Authors: Harvey Richard , Fraser David , Bonner Dierdre , Warnes Anthony , Warrington Elizabeth , Rossor Martin
Published: December 2004

The objective was to assess the performance of patients with dementia on the DRIVAGE semi‐realistic driving simulator task. A study of patients with dementia who were continuing to drive a car at the time of assessment, was undertaken in a specialist Pre‐Senile Dementia Clinic at The National Hospital for Neurology and Neurosurgery and a driving simulator laboratory at King's College, London. It comprised thirteen patients diagnosed with dementia (10 Alzheimer's disease, three focal dementia syndrome), mean age 63 (range 57–71) years. Measured performance was judged by an independent rater, blind to diagnosis and neuropsychological test results, as either normal or poor by comparison with data previously collected on 125 normal older drivers. Secondary performance was assessed from objective performance data generated by the simulator. The performance of seven patients was rated as normal and that of six as poor. The majority with poor performance could only complete two of four driving tasks. The normal group scored higher on the Mini Mental State Examination (24 (21–27) vs 17 (13–22)), were less impaired on neuropsychological testing, particularly tasks assessing performance IQ, and had intact perceptual abilities. The results of the study demonstrate that patients with dementia can retain their ability to perform a driving task. Loss of this ability is broadly associated with progression of the dementia, impaired perception and impairment of non‐verbal intelligence tests. Studies on larger groups of patients in a more comprehensive driving task would be required to demonstrate specific markers of loss of driving ability.
Driving, Alzheimer's disease and ageing: A potential cognitive screening device for all elderly drivers
Authors: Mitchel Rebecca K. , Castleden C. Mark , Fanthome Yvette C.
Published: December 2004

To compare detriments to driving ability related to Alzheimer's disease (AD) and normal ageing, 19 patients with AD and 48 apparently normal elderly subjects were assessed on measures of cognitive ability to drive (Stroke Drivers Screening Assessment—SDSA). The presence of AD could have a large detrimental effect on driving ability, as measured by a battery of cognitive tests known to be related to on‐road driving performance. All of the AD group failed, whereas 48% of the control group failed (mean = 5.09, 95% confidence interval 3.75–6.43; t = 7.59, dƒ = 65, p<0.001). Normal ageing may also have a detrimental effect on driving ability, as a significant negative correlation was found between apparently normal ageing and performance on the battery (r = –0.72, 95% confidence interval –0.6 to –0.8; dƒ = 56, p<0.001). These data suggest that cognitive decline related to AD and normal ageing may render some unsafe to drive, provided that the correlation between the SDSA and on‐road driving skills holds for normal and demented elderly. Further validation of the SDSA is needed but cognitive screening may well be an important tool in deciding about an individual's safety on the road.
Teaching old age psychiatry to medical students in england
Authors: Gregory Carol A. , Dening Tom
Published: December 2004

A questionnaire regarding the teaching of old age psychiatry was sent to psychiatrists at teaching hospitals in England. A 53% response was received. Old age psychiatry is usually taught within general psychiatry, though there is frequent collaboration with geriatric medicine. Large numbers of students provide a challenge to this small speciality. More resources including time for teaching appear to be needed. Old age psychiatrists were keen to convey their enthusiasm and highlight the positive aspects of working with the elderly.
Delusional misidentification in association with cortical lewy body disease—a case report and overview of possible mechanisms
Authors: Baldwin Robert C. , Snowden Julie S. , Mann David M. A.
Published: December 2004

A patient presented with a Capgras delusion and reduplication of place. At postmortem there were numerous cortical Lewy bodies. This is believed to be the first such case in which these phenomena have been observed in proven cortical Lewy body disease. The clinical and diagnostic features are described and a brief overview of possible explanations for the phenomena discussed.
Morale in old age: Refining the model
Authors: Wenger G. Clare , Davies Richard , Shahtahmasebi Said
Published: December 2004

The literature on morale has identified many variables as correlates. In most instances, relationships have been sought with specific variables without taking into account the possible effects of other factors which may be responsible for the correlation. This article identifies correlating variables identified in a review of the literature and matches most of them with similar variables from a study conducted in North Wales. Bivariate and multivariate analyses are presented in an attempt to create a refinement of the model of morale. In so doing, the authors reduce the number of variables of interest by half and present a refined model which, when all other variables are controlled for, includes: health limited activities; potential carer when ill; support network type; meeting as many people as desired; self‐assessed loneliness; self‐assessed health.
Characteristics of violent elderly in the emergency department
Authors: Ganzini Linda , Edwards Pam , Surkan Pamela J. , Drummond David J.
Published: December 2004

The objective of the study was to determine (1) the incidence of violent acts committed by elderly patients in an emergency department and (2) the characteristics of these violent elderly patients compared to non‐elderly violent patients. A 5‐year retrospective review was undertaken of all dangerous behaviour incident reports (DBRs) in an urban Veterans Affairs Medical Center. Information abstracted from DBRs included descriptions of verbal or physical aggression, use of a weapon, injury to others and outcome of the incident. Demographic information, psychiatric and medical diagnoses and frequency of medical center use were obtained by medical record review. Twenty‐one violent elderly persons (age 60 years and over) were compared to 190 non‐elderly violent persons (under age 60). Eighty‐one per cent of the aged patients had a psychiatric diagnosis, most commonly alcohol dependence or a psychotic disorder. Old patients had more medical illness than young patients, but both groups were frequent users of medical services (mean 4.4 emergency department visits or hospitalizations for elderly vs 3.7 for non‐elderly in the year before incident). There were no differences between the two age groups in characteristics of the perpetrators, nature of the violent episodes or outcomes. Violent elderly persons in the emergency department are likely to have both medical and psychiatric illness and use medical services frequently. They are not distinctly different from younger violent patients.
Psychiatric morbidity in elderly attenders at an accident and emergency department
Authors: Walker Zuzana , Leek Catherine A. , D'ath Penny J. , Katona Cornelius L. E.
Published: December 2004

The point prevalence of depression and dementia, their effect on length of admission and outcome and the extent to which they were detected by the attending doctor were assessed in 109 elderly patients presenting with physical illness at an accident and emergency department. Depression and dementia were assessed using the Brief Assessment Schedule (BAS). Twenty‐seven percent were found to be depressed and 16% demented. The only feature associated with depression was female gender. Depressed patients stayed in hospital significantly longer and had a worse outcome at 14 days than patients not depressed. This was independent of the severity of their physical illness. Only 10% of the psychiatric morbidity was detected by the attending doctor.
Decline in quality of life for patients with severe dementia following a ward merger
Authors: Bredin Kathleen , Kitwood Tom , Wattis John
Published: December 2004

The effect of a ward merger on the quality of life of patients with severe dementia in a mental hospital was investigated by means of the observational method of dementia care mapping (DCM). Nineteen patients in two long‐stay wards were included in the study prior to the merger. Fourteen of these were observed in the merged ward, together with five newly admitted patients. Key DCM indicators showed that the quality of life of patients included in both phases of the study had declined significantly. This may be explained, in part at least, in terms of a cycle of demoralization and depersonalization' in the interaction of staff and patients. Further research is required into the dynamics of this cycle.
Delusional depression in elderly patients: Characteristics and relationship to age at onset
Authors: Baldwin Robert C.
Published: December 2004

In a prospective study, 34 patients with delusional depression were compared with 100 non‐psychotically depressed patients and a subgroup of 30 age‐ and sex‐matched control patients. Depressed patients with delusions were more likely to be single, especially single men. The most common delusions were those of persecution and hypochondriasis. There were no striking differences in other depression symptoms and no evidence for the hypothesis that delusional depression is associated with a later age of depression onset.
To what extent is dementia underreported on british death certificates?
Authors: Morgan Kevin , Clarke David
Published: December 2004

Of 1042 elderly people randomly sampled from the community in a longitudinal study of ageing, 512 had died in the period 1985–1994, with 44 of these deaths occurring among respondents who, at clinical interview, met DSM‐III‐R criteria for dementia. The presence of dementia, however, was recorded on only 15 (34%) of the 44 death certificates from this group. This low level of recording was not significantly related to the patient's gender, age or place of death. The likelihood of dementia being recorded was also unrelated to date of death, with earlier (1985–1990) and later (1990–1994) certificates showing similar levels of non‐recording. Analyses of all 512 certificates showed that cases of dementia were 2.5 times more likely than the non‐demented to have bronchopneumonia recorded as a principal cause of death. These results confirm earlier links between dementia and death from respiratory disease but suggest that, when assessed in random community samples, the extent to which dementia is under reported on British death certificates is greater than previously estimated.
Factors determining interrater agreement with rating global change in dementia: The cibic‐plus
Authors: Boothby H. , Mann A. H. , Barker A.
Published: December 2004

Global ratings of change were obtained from 17 clinicians on eight patients, as though participating in an antidementia drug trial. Simultaneous rating was made possible by the use of videotaped semi‐standardized interviews, and clinical change was simulated by providing raters with adjusted initial assessment documentation representing the situation 6 months earlier. In a second study, seven more ratings were obtained on the two patients who had commanded best and worst agreement in order to clarify important variables for levels of agreement. The main finding was that levels of interrater agreement on a global rating of change (which included carer information) varied widely from patient to patient. An important contributor to this variation was carer information. The order in which information for rating had been presented was found to be of overriding importance; if carer information was presented before patient information, considerably higher levels of agreement were achieved on the global rating than if the reverse order was used.
Personality traits and frontal lobe dementia
Authors: Lebert Florence , Pasquier Florence , Petit Henri
Published: December 2004

The diagnosis of frontal lobe dementia (FLD) involves the assessment of affect. Three affective states predominate in FLD: apathy, elation and emotionalism. Nineteen FLD patients were investigated for a relationship between affective changes and premorbid personality traits. The negative results support the hypothesis that mood changes in FLD have a neurological basis and are important in early diagnosis.
Patterns of two psychogeriatric hospitalization services in israel: A one‐year survey
Authors: Heinik Jeremia , Barak Yoram , Salgenik Igor , Elizur Avner
Published: December 2004

We compare two different approaches to inpatient psychiatric hospitalizations in the elderly (age 65+) in Israel. In one, 79 patients were hospitalized during the year 1993 in specialized psychogeriatric wards, at Sha'ar Menashe (ShM) psychiatric hospital. In the other, 133 patients were hospitalized during the same period in general psychiatric wards, at Abarbanel (Ab) psychiatric hospital. This study retrospectively evaluates: demographic data, sources of referral, characteristics of emergency admissions, psychiatric history, psychiatric diagnoses, use of medical services, and outcome measures (length of hospitalization, death rates, nursing status at discharge, placement at discharge). Rate of admission (per 100 000 population) is 2.2‐fold higher at ShM than at Ab. The two centres differ significantly in sources of referral (closer links with geriatric services at ShM) and the use of medical services (prevailing use of medical ambulatory services and the hospital's internal medicine wards at ShM, while at Ab more patients were referred for general hospital evaluations). All other variables studied (demographics, characteristics of emergency admissions, psychiatric history, psychiatric diagnoses, outcome measures) were similar between the two centres. The discussion emphasizes the 'audit' orientation of the study. It also stresses the surprising lack of differences between centres in some major variables, and frames research questions for future use.
Scopolamine‐induced cognitive impairment as a predictor of cognitive decline in healthy elderly volunteers
Authors: Barker Andrew , Jones Roy , Simpson Pauline , Wesnes Keith
Published: December 2004

There are theoretical grounds for believing that scopolamine‐induced cognitive deficit may be predictive of future cognitive decline. In the present study, 22 healthy elderly volunteers were reassessed 3 years after a scopolamine challenge. Although there was little overall change in mean cognitive test scores over time, in two out of 10 tests scopolamine‐induced decrement was related to subsequent decline.
Delusions of pregnancy and delivery in elderly women
Authors: Curran Julie S. M. , Pugh Rhiannon E.
Published: December 2004

The occurrence of delusional pregnancy in three elderly women is reported. Although two of the three patients had dementia, psychodynamic factors were nevertheless thought to contribute to the formation of the beliefs. The cases draw attention to the occurrence of this delusional belief in elderly female patients and illustrate the importance of considering psychodynamic factors in understanding psychopathology in organic disorder.
Suicide in the elderly in antiquity
Authors: Seidel Geoffrey
Published: December 2004

Self‐killing in the elderly of the Greco‐Roman world is explored through the study of 89 case descriptions and an investigation of ancient philosophical and medical writings. Social, political and ethical dimensions are prominent as well as medical and psychiatric ones, and the related issue of euthanasia cannot be avoided. Physical illness and to a lesser extent mental illness were significant causes of suicide in the elderly. Historical data can contribute towards an informed debate on these issues in today's world.
Analysis of functional MRI time‐series
Authors: Friston K. J. , Jezzard P. , Turner R.
Published: December 2004

A method for detecting significant and regionally specific correlations between sensory input and the brain's physiological response, as measured with functional magnetic resonance imaging (MRI), is presented in this paper. The method involves testing for correlations between sensory input and the hemodynamic response after convolving the sensory input with an estimate of the hemodynamic response function. This estimate is obtained without reference to any assumed input. To lend the approach statistical validity, it is brought into the framework of statistical parametric mapping by using a measure of cross‐correlations between sensory input and hemodynamic response that is valid in the presence of intrinsic autocorrelations. These autocorrelations are necessarily present, due to the hemodynamic response function or temporal point spread function. © 1994 Wiley‐Liss, Inc.
Selective auditory attention effects in tonotopically organized cortical areas: A topographic ERP study
Authors: Alcaini Marie , Giard Marie‐HéLène , Echallier Jean‐Fraņois , Pernier Jacques
Published: December 2004

This study reinvestigates some aspects of the neurophysiological mechanisms of auditory selective attention, by testing the hypothesis that auditory attention can exert a selective control over the sensory processing of acoustic stimuli in tonotopic auditory cortex. Event‐related potentials (ERPs) were recorded from human subjects while they listened selectively to a tone sequence in one ear and ignored a concurrent sequence of a different frequency in the opposite ear. The tone frequencies were 500, 1,000, 2,000, or 4,000 Hz in separate sequences, and were delivered at a constant rate of one every 800 ms. The effects of attention were analyzed in the difference waves obtained by subtracting ERPs to ignore tones from those of the same tones when attended. The earliest effect of attention (70–80 ms post‐stimulus) was found to present the same spatio‐temporal organization as the obligatory, sensory‐evoked N1 wave, with similar tonotopic changes in scalp distribution with the tone frequencies. At longer latencies, two other attentional effects were observed, of probable endogenous origin: one around 175 ms post‐stimulus, possibly originating from non‐tonotropic auditory cortex, and the latest one (after 300 ms) from non‐specific areas. The results support the hypothesis of a genuine sensory gating mechanism for auditory attention, taking place in tonotopic auditory cortex at an early stage of sensory processing, even in low attentional load conditions. © 1995 Wiley‐Liss, Inc.
Contribution à la connaissance de la réaction d'extension de cycles selon Demjanow
Authors: Naves Y. R. , Bachmann P.
Published: December 2004

La fraction d'hydrocarbures qui accompagne le cyclocitronellol et les triméthyl‐cyeloheptanols lorsqu'on applique la réction d'extension cyelique de Demjanow à la dihydro‐cyclogéranylamine, contient, à côté de triméthyl‐1,1,4‐cycloheptènes, du méthylène‐2‐triméthyl‐1,1,3‐cyclohexane.
Recherches sur les chromatophores IV. Sur la structure des chromatophores de la carotte
Authors: Straus Werner
Published: December 2004

1) La structure microscopique des chromoplastes de la carotte consiste en «petits anneaux» (granules, grana) qui sont disposés en ligne droite ou en forme de cercle les uns à côté des autres. L'association linéaire des petits anneaux a un caractère fibrillaire. La disposition parallèle de plusieurs fibrilles forme une texture réticulaire dont les mailles peuvent e'tre de grandeur différente selon la grandeur des anneaux. Le chromoplaste peut contenir plusieurs couches superposées de systèmes annulaires. Tous les anneaux sont d'aspect granuleux. De plus grands anneaux permettent de distinguer qu'ils sont eux‐mêmes composés de très petits anneaux. La structure plus détaillée des petits anneaux n'a pas pu être perçue au microscope.
Die Frage nach der Aufrollung von Fadenmolekeln in strömenden Lösungen
Authors: Kuhn Werner , Kuhn Hans
Published: December 2004

Fadenmolekeln hochpolymerer Stoffe, welche in ruhender Lösung eine statistisch wahrscheinlichste Gestalt (loses Knäuel) haben, erfahren in strömender Lösung nicht nur Richtungsänderungen der Fadenachse; vielmehr werden durch die von der strömenden Flüssigkeit ausgeübten Kräfte auch Änderungen der Gestalt, insbesondere Änderungen des Abstandes h zwischen Molekelanfangs und ‐endpunkt erzwungen.
Zur Chemie und Morphologie der basischen Salze zweiwertiger Metalle X. Das hochbasische Zinkhydroxychlorid III
Authors: Feitknecht W. , Weidmann H.
Published: December 2004

Die Zusammensetzung wurde bei zwei etwas verschieden hergestellten Präparaten durch Analyse ermittelt. Bei Präparat I wurden 100 cm3 0,1‐m. ZnCl2‐Lösung mit 60% der äquivalenten Laugenmenge versetzt, bei Präparat II mit 80%. Beide Fällungen wurden 5 Monate in Jenaerglaskolben unter der Mutterlauge altern gelassen. Nach dem Isolieren wurden sie mit Wasser und Aceton Ausgewaschen und im Vakuum bis zur Gewichtskonstanz getrocknet.
Metal Complexes with Macrocyclic Ligands. XI. Ring size effect on the complexation rates with transition metal ions
Authors: Leugger Alex P. , Hertli Liselotte , Kaden Thomas A.
Published: December 2004

The 12‐16 membered tetraazamacrocycles 1‐6 were synthesized, their protonation constants and complexation kinetics measured at 25° and I = 0.50. The results of Table 1 Show that pK is strongly influenced by the ring size whereas pK and pK are relatively insensitive to it. This can be understood in terms of electrostatic interactions of the positive charges when located on adjacent amino groups.

The kinetics of complex formation between the macrocyclic ligands and several transition metal ions have been studied by pH‐stat and stopped‐flow techniques and the results have been analyzed as bimolecular reactions between the metal ion and the different protonated species of the ligands. The rate constants, given in Table 2, show that the macrocycles react less rapidly than analogous open chain amines. However, for a given protonated species of the ligand the rate of complexation follows the order Cu2+ > Zn2+ > Co2+ > Ni2+ which parallels the sequence of their water exchange rates. For the diprotonated tetraamines LH reacting with Cu2+ the slower rates seem to be mainly a consequence of electrostatic interactions, since a correlation between logk and pK exists. For LH+, however, the complexation rates of a metal ion with the different macrocycles are all in one order of magnitude and do not depend in a regular way on the ring size or the basicity of the ligand. It is therefore suggested that in this case other factors such as unfavourable preequilibria must be considered as important.
The Dianions of Pyrene and Pyrene Isomers as (4n)π‐Perimeters
Authors: Müllen Klaus
Published: December 2004

Metal reduction of pyrene and of pyrene isomers under carefully controlled conditions yields the corresponding dianions. The properties of the neutral compounds and of the dianions are studied via 1H‐NMR. spectroscopy. Whereas the former exhibit similar behaviour, the charge distribution within the dianionic species proves to be very different. As a consequence, some of the polycyclic dianions can be regarded essentially as (4n)π‐perimeters, an approach which is satisfactorily rationalized by simple MO‐models. Further evidence in favour of this bonding scheme comes from the ESR. spectroscopic measurement of the spin density distribution within the corresponding radical anions.
Identification of Twenty‐one Novel Constituents of Oriental Tobacco Flavour (Nicotiana tabacumL.) including (E)‐3‐methyl‐non‐2‐en‐4‐one, pentadecan‐15‐olide, 8α, 13:9α, 13‐diepoxy‐15, 16‐dinorlabdane, (Z)‐octadec‐9‐en‐18‐olide, and (E)‐2‐ethylidene‐6, 10, 14‐trimethyl‐pentadecanal
Authors: Demole Edouard , Enggist Paul
Published: December 2004

Investigation by gas liquid chromatography of a small but organoleptically typical subfraction of Oriental tobacco condensate led to the identification of 47 compounds. Of these 21 have hitherto not been reported as Oriental tobacco constituents, and 14 appear to be novel to all tobacco types. The latter are (E)‐3‐methyl‐non‐2‐en‐4‐one (1), (E)‐1‐(2, 3, 6‐trimethylphenyl)‐but‐2‐en‐1‐one (3), pentadecan‐15‐olide (12), 8α, 13:9α, 13‐diepoxy‐15, 16‐dinorlabdane (17), (Z)‐octadec‐9‐en‐18‐olide (18), (E)‐2‐ethylidene‐6, 10, 14‐trimethylpentadecanal (21), the norlabdanoids 9, 10, 11, 14, 15, 16, tridecan‐2‐one, and 2‐phenylethyl isovalerate. The macrolides 12 and 18 represent the first musk compounds detected in tobacco. Identification were made by direct comparison (MS. and/or 1 H‐NMR./IR.) with the authentic chemicals synthesized whenever necessary.
Chemical Synthesis and Biological Activity of the Dogfish (Squalus acanthias) α‐melanotropins I and II, and of related peptides
Authors: Eberle Alex , Chang Yao‐Shih , Schwyzer Robert
Published: December 2004

The purpose of this investigation is to provide synthetic proof for the structure of dogfish (Squalus acanthias) α‐MSH and to investigate the consequences of the presence of methionine in position 13 and the lack of the N‐terminal acetyl group in this hormone. Because of the facile oxidation of methionine (13) during handling or storage, a number of specifically oxidized hormones (Met4 and Met13) as well as tripeptides belonging to the C‐terminal second message sequence were investigated. All the products were prepared by classical methods in homogeneous solution; intermediate and end products were extensively purified and characterized (Tables 3 and 4). The assays for melanotropic activity were performed in vitro with the modified reflectometric assay using the skin of Rana pipiens. It is concluded that the structures assigned to dogfish α‐MSH I and II are correct and that the isolated samples contain slight quantities of [13‐methionine (S‐oxide)]dogfish α‐MSH and [4, 13‐bis‐methionine (S‐oxide)]dogfish α‐MSH. The peptides with methionine in position 13 are as active in this assay as those containing valine. This also holds for the NH2/OH interchange distinguishing dogfish α‐MSH I from dogfish α‐MSH II. However, the lack of the N‐terminal acetyl group strongly reduces the biological activity. Its introduction into dogfish α‐MSH I results in a product that is equipotent with mammalian α‐MSH. These and other conclusions are discussed in detail.